It is widely believed that exposure to sweetened foods and beverages stimulates the liking and desire for sweetness. Here we provide an updated review of the empirical evidence from human research examining whether exposure to sweet foods or beverages influences subsequent general liking for sweetness (‘sweet tooth’), based on the conclusions of existing systematic reviews and more recent research identified from a structured search of literature. Prior reviews have concluded that the evidence for a relationship between sweet taste exposure and measures of sweet taste liking is equivocal, and more recent primary research generally does not support the view that exposure drives increased liking for sweetness, in adults or children. In intervention trials using a range of designs, acute exposure to sweetness usually has the opposite effect (reducing subsequent liking and desire for sweet taste), while sustained exposures have no significant effects or inconsistent effects. Recent longitudinal observational studies in infants and children also report no significant associations between exposures to sweet foods and beverages with measures of sweet taste preferences. Overall, while it is widely assumed that exposure to sweetness stimulates a greater liking and desire for sweetness, this is not borne out by the balance of empirical evidence. While new research may provide a more robust evidence base, there are also a number of methodological, biological and behavioural considerations that may underpin the apparent absence of a positive relationship between sweetness exposure and liking.

We previously reported that the addition of a specified mulberry fruit extract (MFE) to rice consistently reduces post-prandial glycaemic (PPG) and post-prandial insulinemic (PPI) responses. This research tested whether this effect generalises to a broad range of rice types, reflecting the wide variation in rice characteristics known to influence glycaemic responses. In a randomised, balanced, partial factorial crossover design, Sona Masoori (SM), Bora Saul (BS), Gobindobogh (Gb) and Banskati (Bn) rices were tested with and without 0·37 g MFE. Healthy, normal-weight Indian adults (N 120) each consumed four of the eight possible boiled rice meals, all containing about 50 g available carbohydrate. The primary outcome was the effect of MFE on PPG, expressed as the percentage change in the positive, incremental AUC over 2 h. The mean effect of MFE on PPG for all rice types combined was −11·4 % (P < 0·003). The reduction in PPG was in a qualitatively similar range for all rice types (–9·8 to −15·1 %), and this was statistically significant for Bn. MFE also reduced the corresponding PPI response to all rice types combined by a mean of 10·1 % (P < 0·001; range −6·1 to −13·4 %), and the reduction in PPI was statistically significant for SM, Gb and BS. In conclusion, addition of 0·37 g MFE modestly reduced PPG and PPI responses to rices in general, and the effects were statistically significant for specific rice types.

Extracts of mulberry have been shown to reduce post-prandial glucose (PPG) and insulin (PPI) responses, but reliability of these effects and required doses and specifications are unclear. We previously found that 1·5 g of a specified mulberry fruit extract (MFE) significantly reduced PPG and PPI responses to 50 g carbohydrate as rice porridge, with no indications of intolerance. The trials reported here aimed to replicate that work and assess the efficacy of lower MFE doses, using boiled rice as the carbohydrate source. Two separate randomised controlled intervention studies were carried out with healthy Indian males and females aged 20–50 years (n 84 per trial), with PPG area under the curve over 2 h as the primary outcome. Trial 1 used doses of 0, 0·37, 0·75, 1·12 and 1·5 g MFE in boiled rice and 0 or 1·5 g MFE in rice porridge. Trial 2 used doses of 0, 0·04, 0·12, 0·37 g MFE in boiled rice. In trial 1, relative to control, all MFE doses significantly decreased PPG (–27·2 to −22·9 %; all P ≤ 0·02) and PPI (–34·6 to −14·0 %, all P < 0·01). Breath hydrogen was significantly increased only at 1·5 g MFE (in rice porridge), and self-reported gastrointestinal symptoms were uniformly low. In trial 2, only 0·37 g MFE significantly affected PPG (–20·4 %, P = 0·002) and PPI (–17·0 %, P < 0·001). Together, these trials show that MFE in doses as low as 0·37 g can reliably reduce PPG and PPI responses to a carbohydrate-rich meal, with no apparent adverse effects.

We previously found that guar gum (GG) and chickpea flour (CPF) added to flatbread wheat flour lowered postprandial blood glucose (PPG) and insulin responses dose dependently. However, rates of glucose influx cannot be determined from PPG, which integrates rates of influx, tissue disposal and hepatic glucose production. The objective was to quantify rates of glucose influx and related fluxes as contributors to changes in PPG with GG and CPF additions to wheat-based flatbreads. In a randomised cross-over design, twelve healthy males consumed each of three different 13C-enriched meals: control flatbreads (C), or C incorporating 15 % CPF with either 2 % (GG2) or 4 % (GG4) GG. A dual isotope technique was used to determine the time to reach 50 % absorption of exogenous glucose (T50 %abs, primary objective), rate of appearance of exogenous glucose (RaE), rate of appearance of total glucose (RaT), endogenous glucose production (EGP) and rate of disappearance of total glucose (RdT). Additional exploratory outcomes included PPG, insulin, glucose-dependent insulinotropic peptide and glucagon-like peptide 1, which were additionally measured over 4 h. Compared with C, GG2 and GG4 had no significant effect on T50 %abs. However, GG4 significantly reduced 4-h AUC values for RaE, RaT, RdT and EGP, by 11, 14, 14 and 64 %, respectively, whereas GG2 showed minor effects. Effect sizes over 2 and 4 h were similar except for significantly greater reduction in EGP for GG4 at 2 h. In conclusion, a soluble fibre mix added to flatbreads only slightly reduced rates of glucose influx, but more substantially affected rates of postprandial disposal and hepatic glucose production.

Currently it is estimated that about 1 billion people globally have non-alcoholic fatty liver disease (NAFLD), a condition in which liver fat exceeds 5 % of liver weight in the absence of significant alcohol intake. Due to the central role of the liver in metabolism, the prevalence of NAFLD is increasing in parallel with the prevalence of obesity, insulin resistance and other risk factors of metabolic diseases. However, the contribution of liver fat to the risk of type 2 diabetes mellitus and CVD, relative to other ectopic fat depots and to other risk markers, is unclear. Various studies have suggested that the accumulation of liver fat can be reduced or prevented via dietary changes. However, the amount of liver fat reduction that would be physiologically relevant, and the timeframes and dose–effect relationships for achieving this through different diet-based approaches, are unclear. Also, it is still uncertain whether the changes in liver fat per se or the associated metabolic changes are relevant. Furthermore, the methods available to measure liver fat, or even individual fatty acids, differ in sensitivity and reliability. The present report summarises key messages of presentations from different experts and related discussions from a workshop intended to capture current views and research gaps relating to the points above.

The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, including in developing countries, particularly in South Asia. Intakes of foods generating a high postprandial glucose (PPG) response have been positively associated with T2DM. As part of efforts to identify effective and feasible strategies to reduce the glycaemic impact of carbohydrate-rich staples, we previously found that addition of guar gum (GG) and chickpea flour (CPF) to wheat flour could significantly reduce the PPG response to flatbread products. On the basis of the results of an exploratory study with Caucasian subjects, we have now tested the effect of additions of specific combinations of CPF with low doses of GG to a flatbread flour mix for their impacts on PPG and postprandial insulin (PPI) responses in a South-Asian population. In a randomised, placebo-controlled full-cross-over design, fifty-six healthy Indian adults consumed flatbreads made with a commercial flatbread mix (100 % wheat flour) with no further additions (control) or incorporating 15 % CPF in combination with 2, 3 or 4 % GG. The flatbreads with CPF and 3 or 4 % GG significantly reduced PPG (both ≥15 % reduction in positive incremental AUC, P<0·01) and PPI (both ≥28 % reduction in total AUC, P<0·0001) compared with flatbreads made from control flour. These results confirm the efficacy and feasibility of the addition of CPF with GG to flatbread flour mixes to achieve significant reductions in both PPG and PPI in Indian subjects.

Rice is an important staple food for more than half of the world's population. Especially in Asian countries, rice is a major contributor to dietary glycaemic load (GL). Sustained consumption of higher-GL diets has been implicated in the development of chronic diseases such as type 2 diabetes mellitus. Given that a reduction in postprandial glycaemic and insulinaemic responses is generally seen as a beneficial dietary change, it is useful to determine the variation in the range of postprandial glucose (PPG) and insulin (PPI) responses to rice and the primary intrinsic and processing factors known to affect such responses. Therefore, we identified relevant original research articles on glycaemic response to rice through a systematic search of the literature in Scopus, Medline and SciFinder databases up to July 2014. Based on a glucose reference value of 100, the observed glycaemic index values for rice varieties ranged from 48 to 93, while the insulinaemic index ranged from 39 to 95. There are three main factors that appear to explain most of the variation in glycaemic and insulinaemic responses to rice: (1) inherent starch characteristics (amylose:amylopectin ratio and rice cultivar); (2) post-harvest processing (particularly parboiling); (3) consumer processing (cooking, storage and reheating). The milling process shows a clear effect when compared at identical cooking times, with brown rice always producing a lower PPG and PPI response than white rice. However, at longer cooking times normally used for the preparation of brown rice, smaller and inconsistent differences are observed between brown and white rice.

Consumption of carbohydrate-containing foods leads to transient postprandial rises in blood glucose concentrations that vary between food types. Higher postprandial glycaemic exposures have particularly been implicated in the development of chronic cardiometabolic diseases. Reducing such diet-related exposures may be beneficial not only for diabetic patients but also for the general population. A variety of markers have been used to track different aspects of glycaemic exposures, with most of the relevant knowledge derived from diabetic patients. The assessment of glycaemic exposures among the non-diabetic population may require other, more sensitive markers. The present report summarises key messages of presentations and related discussions from a workshop organised by Unilever intended to consider currently applied markers of glycaemic exposure. The particular focus of the meeting was to identify the potential applicability of glycaemic exposure markers for studying dietary effects in the non-diabetic population. Workshop participants concluded that markers of glycaemic exposures are sparsely used in intervention studies among non-diabetic populations. Continuous glucose monitoring remains the optimal approach to directly assess glycaemic exposure. Markers of glycaemic exposure such as glycated Hb, fructosamine, glycated albumin, 1,5-anhydroglucitol and advanced glycation end products can be preferred dependent on the aspect of interest (period of exposure and glucose variability). For all the markers of glycaemia, the responsiveness to interventions will probably be smaller among the non-diabetic than among the diabetic population. Further validation and acceptance of existing glycaemic exposure markers applied among the non-diabetic population would aid food innovation and better design of dietary interventions targeting glycaemic exposure.

Green tea may stimulate energy metabolism; however, it is unclear if acute effects are caused by specific catechins, caffeine or their combination. The objective of the present study was to examine the separate and combined effects of different catechins and caffeine on energy expenditure (EE) and fat oxidation over a single day. Fifteen healthy, normal-weight males received capsules containing placebo, caffeine alone (150 mg), or caffeine plus a catechin mixture (600 mg) enriched in either epigallocatechin-3-gallate (EGCG), epigallocatechin or a mix of catechins, in a randomised cross-over double-blinded design. On each test day EE, respiratory quotient (RQ) and substrate oxidation were measured under sedentary conditions in a respiratory chamber for 13·5 h. We found no significant treatment effect on EE (P = 0·20) or RQ (P = 0·68). EGCG with caffeine insignificantly raised EE and fat oxidation v. caffeine-only and placebo (EE 5·71 (se 0·12) v. 5·68 (se 0·14) v. 5·59 (se 0·13) MJ/12·5 h, respectively; fat oxidation 84·8 (se 5·2) v. 80·7 (se 4·7) v. 76·8 (se 4·0) g/12·5 h). Catechin/caffeine combinations at these dosages and mode of application had non-significant acute effects on EE and fat oxidation. The maximum observed effect on EE of about 2 % could still be meaningful for energy balance over much longer period of exposure. However, higher short-term effects reported in the literature may reflect variations in green tea extracts, added caffeine, or synergies with physical activity. The specific mechanisms and conditions that may underpin observed longer-term benefits of catechin-enriched green tea consumption on body composition remain to be confirmed.

Human perceptions and selection of food are derived from the prevailing and momentary food, agro-economic and cultural environment, cognitive and biological characteristics of individuals, and the real and perceived intrinsic and extrinsic attributes of foods themselves. The range of items typically chosen and consumed within a given population is largely determined by interaction of the external environmental context with guiding sets of implicit and explicit social and psychobiological ‘rules’. Within the rather broad limits of biology, individual food choices and intake behaviours relate to and reflect aspects of food availability, existing habitual behaviours, learning mechanisms, and individual beliefs and expectations. Many of the relevant features of these variables are uniquely human, together determining what is ‘food’, when, how, by and with whom it is chosen and eaten, and in what quantities. They also provide the opportunities for individuals to establish and maintain a relatively stable set of culturally and biologically determined affective responses (‘likes’) and intake behaviours. Understanding of the potential contribution of these influences under different conditions can serve to explain many of the observed characteristics of human eating, and highlight potential avenues for intervention.

To gain an understanding of UK consumer attitudes and beliefs regarding starchy foods and their dietary role, a questionnaire based on the theory of planned behaviour was developed and sent out to a UK consumer sample (n 800). The content focused on attitudes and beliefs towards starchy foods, perceived barriers towards increasing their intake (e.g. cost, habit, social influences), perceptions of personal and recommended starchy food intake, intention to increase starchy food intakes in the future and socio-demographic information. Responses (n 414) indicated that consumers have highly divergent attitudes and beliefs regarding starchy foods. These foods are seen as nutritious and good for one's health, but also as high in energy and not helping to control weight, and the overall intention to increase starchy food intake was extremely low. Possible barriers towards increasing starchy food intake were the perceptions that personal starchy food intakes were already high, beliefs that starchy food intakes should be reduced to achieve a healthier diet, and the view that personal starchy food intakes did not need to be changed any further, because (depending on attitude) individual's intakes had already been increased or reduced. The model including attitude and subjective norm had the best fit for predicting reported intention to increase starchy food consumption, with attitude being the strongest contributor. Addition of the factor ‘family's liking of starchy foods’ significantly improved the model. For reported starch intake, the model including attitude had the best fit, and addition of other factors did not improve the model. These findings indicate that health promotion strategies aimed at increasing complex carbohydrate intakes should take these perceptions into consideration; however, further work is required to examine how these potential barriers can best be addressed in practice.

This study reports results from a randomized controlled intervention trial, focusing on: (1) the identification of successful consumer strategies for increasing fruit and vegetable intakes to the recommended levels of more than five (80 g) portions per day and (2) impact on overall diet and nutrient intakes. Adult men and women (n 170) fulfilling the main recruitment criterion of eating less than five fruit and vegetable portions per day but contemplating increasing intakes were recruited. Complete valid dietary data was provided by 101 intervention (fifty-nine estimated fruit and vegetable intakes, and forty-two simultaneous weighed total dietary and estimated fruit and vegetable intakes) and twenty-four control subjects (weighed total dietary intakes). Intervention advice included the specific association of high fruit and vegetable intake with reduced risk of disease, practicalities, and portion definition with a target intake of greater than five 80 g fruit and vegetable portions per day for 8 weeks. There were significant effects (P < 0·001) on weighed intakes of fruit and vegetables in the intervention group, rising from 324 (se 25) to 557 (se 31) g/d and reflected by validated portion measures at 8 weeks intervention. Successful strategies chosen by ‘achievers’ of the target intake (65% of subjects) were conventional (fruit as a snack, vegetables with main meals etc.) and favoured fruit. There were significant increases in percentage energy from carbohydrate (from sugars not starch), vitamin C, carotenes and NSP and there was a significant decrease in percentage energy from fat for subjects who had high fat intakes (> 35% energy) at baseline. Follow-up self-reported measures at 6 and 12 months indicated mean intakes of 4·5 and 4·6 defined portions/d respectively, suggesting some sustainable effect. In conclusion, the intervention led to significant increases in fruit and vegetable intakes largely via conventional eating habits, with some desirable effects on macro- and micronutrient intakes.

To assess the response of low consumers of fruit and vegetables to a nutrition education intervention programme, data were collected from 104 adults on attitudinal variables related to ‘eating more fruit, vegetables and vegetable dishes’. Questionnaires (based on the theory of planned behaviour) assessing perceived barriers to increasing fruit and vegetable consumption were administered before an action-orientated intervention programme and at the end of the intervention period (8 weeks). Questionnaire scores for belief-evaluations in the intervention groups pre- and post-study indicated that support of family and friends, food costs, time constraints and shopping practicalities (in order to increase intake of fruit, vegetable and vegetable dishes) were barriers to greater consumption of these foodstuffs. Perceived situational barriers to increasing intakes of fruits and vegetables were: limited availability of vegetables, salads and fruit at work canteens, take-aways, friends' houses and at work generally. Following the intervention the number of visits to the shops was perceived as a greater barrier for increasing intakes of fruit and vegetables. Perceived practical opportunities for increasing intakes highlighted drinking fruit juice, taking fruit as a dessert, having fruit as a between-meal snack and eating two portions of vegetables with a meal. About two-thirds of intervention subjects achieved the recommended fruit and vegetable target, but it is concluded that practical issues and situational barriers need to be addressed for the success of future public health campaigns.