Thursday, November 28, 2013

Does Increased Chewing Reduce Food Intake?

ChewOnThisLogoLast night, at my virtually “sold out” public show in Thunder Bay, Ontario, I emphasized the importance of eating slowly and chewing every bite.

But does this really help reduce overeating?

This question is addressed in a randomised controlled cross-over study by Yong Zhu and James Hollis from the University of Iowa published in the Journal of the Academy of Nutrition and Dietetics.

The study was conducted in fourty-five 18- to 45-year-old normal-weight, overweight, and obese participants, who were asked to attend three test sessions to eat pizza for lunch until comfortably full by chewing each portion of food either 100%, 150%, or 200% of their baseline number of chews before swallowing.

Food intake in the sessions with 150% and 200% of their baseline number of chews was reduced significantly, by 9.5% and 14.8%, respectively, compared with the 100% session.

As one might expect, increasing the number of chews also prolonged meal duration and reduced eating rate while subjective appetite at meal termination or during the immediate postprandial period did not differ.

These data are certainly compatible with the hypothesis that increasing the number of chews per bite might reduce food intake and may thus assist in body-weight management.

Obviously, whether not increased chewing of each bite will actually assist in sustainable weight loss is another question – in fact, one that still needs to be answered.

Nevertheless, eating slowly while chewing and savouring every bite certainly seems a promising strategy to reduce overeating and feel full with less.

If you have experimented with chewing more to better manage your weight, I’d like to hear about it.

@DrSharma
Thunder Bay, ON

ResearchBlogging.orgZhu Y, & Hollis JH (2013). Increasing the Number of Chews before Swallowing Reduces Meal Size in Normal-Weight, Overweight, and Obese Adults. Journal of the Academy of Nutrition and Dietetics PMID: 24215801

 

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8 Responses to “Does Increased Chewing Reduce Food Intake?”

  1. Christina RD says:

    Slowing down and focusing on the meal has a variety of benefits vs a mindless, quick meal while in front of a screen or multitasking. Tasting and enjoying the food helps you feel satisfied, as does actually watching the food disappear (in North America we tend to feel full once our plate is empty).

    Slower eating allows more time for the satiety hormones to be released (sometimes referred to as stomach to brain communication). It is often recommended to eat a bit less than you think you want, wait 10-20 minutes and then if still hungry have additional food then. Slowing down and enjoying your meal is also more relaxing than multitasking while you eat (although this is becoming more common).

  2. Rob says:

    Dr. Sharma…I have been following your blog posts for the past 6 weeks or so and recently watched you being interviewed on CTV News, I believe from Thunder Bay, and I am frankly a little confused, please clarify something for me.

    In the interview and in past blog posts, you simplify the root cause of obesity as being poor emotional health, and you classify obesity as a disease (yes, I am paraphrasing so I invite you to correct me on this.)

    Conversely, could I say the following and know it to be true? Formerly overweight or obese individuals who are currently at a normal weight, and have incorporated the good health and weight management habits of physical activity and good nutrition over a long period of time, let’s say 5 or more years, have no emotional health issues?”

    Furthermore, in today’s article, you are asking emotionally unhealthy people to consider changing what is basically a habit, an eating habit.

    However, you seem to repeatedly diminish the overall long term approach of changing lifestyle habits, specifically, daily physical activity and good nutrition (see World Health Organization guidelines) to help these same individuals with their obesity, why?

    Please clarify.

    Thanks in advance.

    Robert S Bazzo

  3. D Connors says:

    …sigh…while the trial results are no doubt valid, I see little chance that this is practical or sustainable advice in the real world. Life (and eating, and weight…) are much too complex for such a solution to be viable. The bigger context is the importance of mindful eating and being able to enjoy and savour good quality food in a relaxed atmosphere vs our all-too-common cheap, fast food eaten on the run.

  4. Nancy says:

    I haven’t tried the chewing angle, but tend to be a slow eater anyway. In the 70s I was part of a study in Hamilton, Ont. to see if the number of bites taken, then reduced over time, would help. We kept a food diary and had a counter. The first week we established a baseline, then over the weeks reduced the number of bites eaten. We were told to eat whatever we wanted to, so even if we gained initially, we would see results later on. The theory was that even if we ate 100 bites of chocolate cake a day to start with, if over time we reduced it down to 70 bites, we’d lose weight. I did lose some weight, but gave up before the study ended, and regained. Of my subgroup of about a dozen, we did have one “shining star” and some that lost, but I never heard anything further about the study so assumed it wasn’t all that successful.

  5. Arya M. Sharma, MD says:

    Thanks for the question – firstly, by no means do all people with excess weight have emotional issues. Emotional eating is only one of many reasons that someone can gain weight. Secondly, whether you call it “lifestyle change” or “treatment” the bottom line is that it take ongoing effort to lose weight and keep it off – when you abandon the “lifestyle change” or “treatment”, the weight comes back. Thirdly, although many guidelines advise an “eat less – move more” approach to weight management, evidence shows that this approach alone is rarely successful in the long-term (if it works for you, congratulations, but you are now one of those rare exceptions). If it were that simple, no one would have a weight problem. It is not that I do not see the importance of changing “habits” – it is just that I recognize how difficult this is to do and that there are many real barriers to doing so (which is why so many people do not “succeed” – no diet or exercise plan I have ever heard of addresses emotional eating, depression, anxiety disorder, ADD, chronic pain, insomnia or any of the other countless reasons why someone may be gaining weight in the first place). This is why it is time to look at the “real causes” or obesity and move beyond simple “lifestyle change” – there is, in fact, nothing “simple” about changing your life!

  6. Elina Josephson says:

    Part of my maintenance is doing exactly this only with mindful intent and deep appreciation for the food that I am eating. I choose everything about my usual daily eating experience with great care; from beautifully crafted Japanese small plates, to local, seasonal foods, to a carefully decorated and crafted presentation. I take the time to remember the people involved in bringing this food to my home and my plate and eat each tiny bite by first tasting it with different parts of my tongue and seeing how many different flavors I can detect. I then focus on the texture and take time to enjoy the uniqueness of each bite of food. Only then do I chew it slowly as I continue to extract every possible moment of pleasure from each morsel. This practice has been an integral part of maintaining my weight loss these past four and a half years. I am not sure that I have every appreciated and enjoyed my food as much when I was heavy and simply gulped my food down in a need to satisfy the hunger. Mindful eating has been my secret (or not so secret weapon) against regain.

  7. Lorna says:

    I’m approaching the 5 year mark of maintaining an 85 lb loss. I do take more time with each bite of food – firstly because the foods I choose to eat require more chewing than my previous hyper-processed diet did but, second, because I want to enjoy and savour and slow down. Works for me.

    I enjoyed the secondary line of chat as well – re: emotional eating. One part of Rob’s question was whether long time maintainers like me ever have emotional health issues. I was a lifelong emotional eater and yo yo dieter. I finally realized that I wasn’t unhappy because I was fat, I was fat because I was unhappy. Even the Globe and Mail used this as a title when they featured my husband and me in their “How they lost it” feature. Figuring out how to manage my emotional health without diving into a bag of potato chips was more important to me than the lifestyle changes. I absolutely needed to deal with my inability to cope with stress, anxiety, depression and fear in order to successfully employ the lifestyle changes required for healthy weight loss/maintenance.

    Rob, of COURSE I still have emotional health issues! I wouldn’t be human otherwise! But, with therapy and coaching and self help, I’ve developed strategies to manage those issues without food. This makes the dietary and lifestyle choices easier to swallow (ugh, bad pun) – I don’t need to self medicate with food any longer. My weight is stable and my mental health waxes and wanes with the various crises of the day.

    I believe that many sufferers from obesity eat for emotional reasons and that true health means your spirit-body-mind have to be in balance. Focussing just on the physical (eat less/exercise more) while the other 2 remain out of whack will not lead to long term success. I agree wholeheartedly with Dr. Sharma on this one.

  8. Rob says:

    First of all, thank you Dr. Sharma and Lorna for your thoughtful replies and comments. Congratulations to you Lorna for your successful approach to maintaining your weight loss.

    I believe I should apologize for not clearly defining what I mean by “good health and weight management habits of physical activity and good nutrition.” I am not really talking about the “eat less/exercise more” model that most are referring to when talking about overweight and obesity, please let me explain.

    I too do not believe in caloric deficits that promote rapid weight loss often found in what I call “mainstream diet books” where you combine significant calorie reduction with increased physical activity. Yes, you will lose weight; the body in combination with the brain will use body fat, and sometimes lean muscle, as a primary source of energy under such conditions leading to the individual experiencing weight loss. The challenge, as you both elude to, is to now maintain the new lower weight going forward, that is, for the rest of one’s life. So, I think we are on the same page here.

    Furthermore, I do agree that part of attaining and maintaining a healthy weight involves other factors around what I would call “the patterns of life.” I would suggest reading “Wellbeing, The Five Essential Elements’ written by Tom Rath and Jim Harter, Gallup Press, here is an excerpt:

    “Wellbeing is about the combination of our love for what we do each day, the quality of our relationships, the security of our finances, the vibrancy of our physical health, and the pride we take in what we have contributed to our communities. Most importantly, it’s about how these five elements interact.”

    During stressful moments in our lives, when our wellbeing is being challenged for an extended period of time, our body and brain naturally look for relief from the constant production of cortisol and search for foods with high amounts of sugar, fat and salt.
    What I find interesting is the message around diminishing the importance of physical wellbeing, specifically physical activity and good nutrition, two of the four lifestyle habits to follow for good overall health and wellbeing (the other two being abstinence or moderate alcohol consumption and abstinence of smoking) that both the Center for Disease Control and Prevention and the World Health Organization promote as keys to preventing 80% of chronic disease and more than 40% of cancer cases. There is also good evidence to include good quality sleep as a fifth lifestyle habit.

    I am reading the tea leaves correctly?

    Curious.

    Do obese people not benefit from healthy lifestyle habits like so-called “normal weight” people do?

    How do normal weight and healthy people maintain their weight and health for the rest of their lives? Genetics? And, is it easier for them to make and maintain change? If so, why?

    Is obesity, the disease, a condition that has nothing to do with this notion of wellbeing?

    Thank you again for the opportunity to share my thoughts.

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