Nutritional Pearls: Snack Better, Eat Less Later

Question: Ronald is a 37-year-old overweight man with prediabetes and hypertension. At his last visit, he was advised to begin replacing his go-to between-meal snacks of candy and chips with the healthier alternatives of fruit and nuts.

He returns for a follow-up visit and is frustrated that despite making this change, he has not yet lost any weight.
 

How do you advise your patient?
(Answer and discussion on next page)

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Answer: Improving the quality of the food that you eat can have a big impact on your long-term health even if you don't lose a pound.

While the goal of making healthy food decisions is to improve one’s overall health, often making those improvements can result in losing weight—most likely because of calorie density. Calorie density measures the number of calories by weight of a particular food. Fudge has a high-calorie density (roughly 0.5 oz of chocolate fudge = 70 calories) while popcorn has a low-calorie density (0.5 cup of plain popcorn = 70 calories). Choosing the popcorn instead of the fudge is likely to leave you fuller and more satisfied, not to mention that it's a whole grain and full of fiber. I regularly recommend swapping your snacks for healthier alternatives, whether it is switching pretzels and chips to nuts for savory cravings and from candy to fruit to satisfy the sweet.

The Research

A team in Leicestershire, England noted that making those improved choices might be more satisfying for the short term, but would that higher satisfaction affect how much people ate at the next meal?

In the study, researchers monitored the feedings of 12 college-age women. All the participants had maintained a healthy weight for the previous 6 months, were not trying to lose weight, and were screened to make sure none exhibited signs of disordered eating. In a randomly-assigned order, each participant were asked to visit the lab for 2 late afternoon visits and each time were given 1 of 2 snacks. At the first visit, the snack was about 5.5 oz of mixed berries (strawberries, raspberries, blackberries, and blueberries), totaling 272 calories. On the second visit, the snack was the same number of calories but in the form of berry-flavored jellybeans.

One hour after eating the snack at each visit, the participants were given a standard dinner meal of pasta with tomato sauce and instructed to eat until they "were comfortably full and satisfied." If the participant consumed the entire plate of pasta, they were given another—and this was repeated until they indicated they were full. At regular intervals, both before and after the snack and before and after the dinner meal, the participants were asked to rate how hungry they felt along with other indications of appetite and satisfaction.

The Results

The participants ate 20% fewer calories at the subsequent dinner meal when snacking on berries versus the jellybeans. It was also noted that the women took longer to eat the berries than the candy, and after the candy snack, the women ate the dinner meal more quickly. Furthermore, when the participants ate the berries as their snack, they reported feeling less hungry, more full, and having less of a desire to eat 2 hours after the dinner than they did when they snacked on the candy.

What's the "Take Home"?

This study does reinforce the idea of switching to quality snacks over junk. The quality of food is better for the body and leads individuals to consume fewer calories at their next meal. However, this is a very small study of all university-aged women, so a much larger study in a more diverse group of people is warranted.

Reference:

1. James LJ, Funnel MP, Milner S. An afternoon snack of berries reduces subsequent energy intake compared to an isoenergetic confectionary snack. Appetite. 2015;95:132-137.