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BY MARY ELLEN CAMIRE & MEGAN BLACKMORE
Breakfast fo ods and satiety
Oatmeal provides a higher level of satiety than many
other breakfast foods.
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25
S
atiety is related to a sense of
fullness and loss of hunger.
Measurement of satiety is a
subjective process. Linear visual
analog scales are used by many psy-
chology and nutrition researchers
to measure both feelings. A satiety
index has also been developed,
showing that foods provide difer-
ent levels of satiety (see chart).
Delayed satiety contributes
to overeating. On a physiological
level, satiety inhibits ghrelin, a
stomach hormone that increases
hunger, and stimulates leptin,
a hormone produced in adipose
tissue believed to decrease appetite
and increase energy expenditure.
Other biochemical regulators
of food intake that decrease
appetite/hunger are enterostatin
and insulin in the pancreas and
cholecystokinin, glucagon-like
peptide 1, and peptide YY in the
small intestine.
Satiety manipulation holds
promise as a means to control
obesity, despite numerous pitfalls.
For example, people may continue
to eat when full, particularly when
engaged in another activity such
as driving or watching television.
Satiety efects may be short-
lived, with no impact on daily
energy consumption. Long-term
compliance with satiating diet
changes may falter, or the ability of
the diet to produce satiation may
decrease over time.
Finally, measurement
techniques are very subjective, and
numerous factors complicate the
design of studies. For example,
making experimental meals equal
in calorie content may result in
one meal being much smaller than
another, adding a volume variable
to the experiment.
targeting Breakfast
Breakfast is an easy meal to miss
in busy households. While cutting
out one meal may appear to be a
simple means to cut daily caloric
intake, research indicates that
this meal is the one not to be
missed. Numerous studies have
reported a link between breakfast
skipping and obesity in children
and adolescents. The National
Weight Control Registry follows
adults who have lost signifcant
amounts of weight; 78% of
successful dieters in the Registry
reported eating breakfast every
day (Wyatt et al., 2002). Even
those individuals who eat breakfast
may fnd that they feel hungry
before lunchtime, thus breakfasts
that delay stomach emptying may
increase satiety and eventually
allow consumers to control their
energy consumption.
Can a stomach be fooled
into feeling full? Expanding
food volume with non-caloric
ingredients, such as air and water,
ofers a means to limit energy
intake. Before lunch, 28 lean men
were given strawberry-favored
yogurt shakes whose volumes were
Building a better breakfast to promote healthy weight requires
an understanding of the effects of food volume, proteins, lipids,
carbohydrates, and dietary fber on appetite.
Breakfast fo ods and satiety
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altered by whipping in additional air (Rolls
et al., 2000). The men were then allowed
to consume foods the rest of the day ad
libitum. Fullness was greater, and caloric
consumption was 12% less, after the 600-
mL shake was consumed, as compared
with the 300-mL version.
Barbara Rolls, Professor of Nutritional
Sciences at Pennsylvania State University,
is the creator of the Volumetrics Eating
Plan, and she has reported several other
studies where increased volume led to
increased feelings of fullness. Extruded
breakfast cereals could be processed
for greater expansion and lower bulk
density; bakery products could likewise
be processed to increase the size of
the serving without increasing energy
value. However, processing efects on
digestibility should be evaluated before
adopting such an approach.
When four types of white bread
that were altered to have difering loaf
volumes (1,1003,000 mL) were fed to
volunteers, the bread with the second
lowest loaf volume had the highest satiety
index (Burton and Lightowler, 2006). The
densest bread provided the lowest glycemic
index, but was disliked by volunteers.
Simply adding more water to a food can
reduce calories while increasing volume.
Several studies have compared non-
breakfast foods with and without added
water. In general, added water increased
satiety, but did not necessarily reduce
subsequent caloric intakes. While many
breakfast foods do not lend themselves to
dilution, cooked breakfast cereals such
as oatmeal and grits could be suitably
formulated to contain more water without
viscosity loss.
Stomach responses to food are
diferent in obese persons, who tend to
have larger empty stomach volumes than
do normal-weight people. A meal that
may be satisfying to a person who is not
overweight simply does not fll up a person
with higher body mass index. Gastric
emptying is faster in obese persons as well,
contributing to feelings of hunger.
Proteins
Popular diet plans tout high protein intakes
to control weight. Protein afects insulin
activity and contributes to thermogenesis.
However, both the amount and type of
protein in a meal infuence satiety. High-
protein meals delay stomach emptying and
thus create a longer-lasting feeling of fullness.
After completion of a very-low-calorie
diet for four weeks, overweight adults who
consumed a 30-g protein supplement during
weight maintenance tended to gain only
fat-free mass and reported higher satiety
compared to peers who did not receive the
supplement (Lejeune et al., 2005). A high-
protein breakfast was more efective than a
high-carbohydrate breakfast in decreasing
serum ghrelin levels after the meal (Blom et
al., 2006).
Croissant doughnut White bread eggs High-bran Whole-grain oatmeal
cereal bread
250
200
150
100
50
0
S
A
T
I
E
T
Y

I
N
D
E
X
Satiety index for various foods, compared to white bread = 100.
From Holt et al. (1995).
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Many breakfast foods are
suitable for protein fortifcation.
The Quaker Oats Co. markets
three favors of Quaker Weight
Control instant oatmeal that
contain 7 g of protein vs 4 g in
its conventional instant oatmeal
products, and 6 g vs 3 g of dietary
fber. Whey protein isolate
provides the extra protein; oat
four and guar gum contribute
soluble fber. Dannon also markets
a yogurt, Light & Fit Crave Control,
with higher protein and dietary
fber content to curb appetite.
Breakfast is prime time for
eggs. However, some consumers
may not perceive eggs as a tool for
weight control. To address this
concern, a small study was funded
by the Egg Nutrition Center.
Thirty overweight women were
given isocaloric, equal-weight
breakfasts: 2 scrambled eggs, 2
slices of toast, and fruit spread
were fed on one occasion, while
a 3.5-inch bagel, 2 tablespoons of
cream cheese, and 3 oz of nonfat
yogurt were tested on a diferent
day (Vander Wal et al., 2005).
Protein, fat, and calories were
slightly higher in the egg breakfast.
Signifcantly more energy and
macronutrients were consumed
at lunch after the bagel breakfast.
Perhaps the most intriguing fnding
was reduced energy intake for
the 36 hr after the egg breakfast.
Increased availability of frozen egg
breakfast entrees, including some
based on egg whites, may spur
consumer acceptance of eggs for
breakfast on busy mornings.
Lipids
Although lipids are the most
energy-dense macronutrients,
they are not necessarily the most
satiating. Fats provide pleasant
texture and favor in the mouth
that may retard satiety signals.
Fat can delay stomach emptying,
contributing to sustained feelings
of fullness. Quantity, not fat
source or degree of saturation,
seems to play a more important
role. When high-fat (6% of
energy) test breakfasts difering
only in ratios of polyunsaturated,
monounsaturated, and trans fats
were fed to young overweight
men, no diferences in postprandial
appetite, amount of food consumed
following the breakfast, or energy
expended were observed (Flint et
al., 2003).
A theory referred to as the
ileal brake proposes that digestion
of lipids in the ileum portion of
the small intestine, rather than
the duodenum (portion closer to
the stomach), leads to a variety of
changes that increase satiety and
inhibit appetite. Thus, techniques
to delay fat digestion could lead to
satiety control. Such modifcations
have been explored in liquid-meal
replacements that are popular on-
the-go breakfast options.
Novel lipid emulsions added to
these beverages were more slowly
digested in vitro and subsequent
feeding studies revealed that the
modifed drinks produced greater
isocaloric satiety than did the
original formula (Mela, 2006).
Slim-Fast Optima shakes utilize
this technology and contain an
extra 1 g of lipid/serving. The
company claims these products
help control hunger for up to 4 hr.
Critical to the development of ileal
brakestimulating foods will be
the avoidance of steatorrhea that
limits acceptance of orlistat and
similar lipase inhibitors. Enteric-
coated lipid supplements consumed
with breakfast may ofer another
alternative.
Choosing a fat-free breakfast
option may backfre because
satiety may be reduced. Normal-
weight young adults fed mufns
containing comparable amounts
of either peanut oil, canola oil,
or butter, or a fat-free mufn
reported greater hunger as little
as 30 min after eating the fat-free
mufn breakfast (Alfenas and
Mattes, 2003). More calories were
consumed at subsequent meals on
the days that the volunteers ate the
fat-free mufns as well.
Carbohydrates & dietary fiber
Now that the low-carb craze has
passed, researchers are focusing on
fnding optimal types and amounts of
carbohydrates for appetite control.
Addition of novel lipid emulsions to meal
replacement drinks increases isocaloric satiety.
Slim-Fast Optima shakes, which contain an
extra 1 g of lipid/serving, are said to help control
hunger for up to 4 hr.
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Simple sugars are rapidly digested
and are targeted for reduction
in some products. Although the
application of glycemic index for
food labeling is controversial,
carbohydrate digestibility does
appear to play a role in health.
British schoolchildren consumed
an average of 145 fewer calories at
lunch after eating a low-glycemic-
index breakfast (which included
breakfast cereals), compared to
high-glycemic-index breakfasts
(Warren et al., 2003). This
diference could not be attributed
to simple sugars alone since the
children consumed a mean intake
of 119 calories more after eating the
high-glycemic breakfast than they
did after eating the low-glycemic
breakfast with added sucrose.
What type of breakfast will
be most satisfying? An Australian
study (Holt et al., 1999) fed four
types of experimental breakfasts
to a small group of healthy young
adults. The four meals were similar
in energy content, although higher
in calories than the volunteers
typical breakfasts. A croissant
breakfast represented a high-fat,
high-carbohydrate meal; the egg
and bacon breakfast was high in
both fat and protein; a cornfakes
option was high carbohydrate but
low in dietary fber; the high-bran
cereal breakfast was high in both
carbohydrates and dietary fber.
Volunteers felt the serving sizes
of the high-fat options were too
small. Perceived hunger was least
and fullness highest after the high-
bran breakfast but the cornfakes
meal was more satisfying than the
croissant breakfast. Alertness was
higher after the high-bran breakfast,
which took the longest to consume
but was considered least appealing
by volunteers unaccustomed to a
high-fber cereal.
Dietary fber encompasses
many polymers whose physiological
efects vary. Dietary fber is not
digestible, and despite partial
fermentation of soluble fber in the
gut, these compounds can help
dilute the energy density of foods.
Soluble fber increases the viscosity
of intestinal contents that slows
digestion and may decrease hunger.
Insoluble fber adds bulk and can
speed a foods transit time in the
gastrointestinal tract. However,
dietary fbers efect on satiety is
not clear. Most foods contain a
mixture of soluble and insoluble
fber that further complicates
evaluation of satiation.
Dietary fber helps maintain
higher levels of cholecystokinin
after eating. Since fat in foods
spurs release of this hormone,
California researchers compared
breakfasts that varied in their fber
and fat content to assess efects of
meal composition on satiety and
related biochemical changes. The
high-fber, low-fat and low-fber,
high-fat breakfasts increased satiety
in women, but not in men, who
felt fuller after consuming either
of the low-fat meals (Burton-
Freeman et al., 2002). Plasma
cholecystokinin concentrations
were signifcantly associated with
all subjective measures of satiety.
The researchers concluded that
for every 1% increase in plasma
cholecystokinin, fullness ratings
increased by 0.50 and hunger and
desire to eat declined by 0.45.
Two options exist for using
Breakfast foods containing extra protein and fber help
provide a feeling of fullness. Examples are Quaker
Oats Co.s Quaker Weight Control instant oatmeal and
Dannons Light & Fit Crave Control yogurt.
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30 30 02.07 www.ift.org
fbers to modulate satiety: direct
addition to foods or use as a
dietary supplement. Dairy-based
beverages were fortifed with 1%
(by weight) of guar gum or two
types of alginate, and their in
vivo efects on gelation within
volunteers stomachs were assessed
by magnetic resonance imaging,
MRI (Hoad et al., 2004). Alginates
reacted with stomach acid to form
lumps. Although gastric emptying
was not signifcantly diferent
among treatments, beverages
containing guar and the 70%
guluronic acid residue, high-gelling
alginate increased fullness, despite
being least palatable.
Bread fortifed with wheat
fber afected serum levels of
ghrelin and peptide YY after
test meals compared to white
bread or bread fortifed with oat
fber, but all three bread types
produced similar hunger ratings
from volunteers (Weickert et al.,
2006). Daily supplements of 8 g
of oligofructose before breakfast
and dinner for two weeks
increased satiety after breakfast
and led to a 10% reduction in
calories consumed at lunch when
compared to a maltodextrin
placebo (Cani et al., 2006).
While whole grains are typically
a good source of dietary fber,
they also contain germ lipids
and bioactive components whose
satiating efects have yet to be
explored. The Physicians Health
Study found an inverse relationship
between body mass index and
breakfast cereal consumption,
but whole-grain cereals were not
necessarily more protective, perhaps
due to the limited availability of
whole grain ready-to-eat cereals in
the 1980s when the study began.
The chewier, denser texture of
whole grain products could be
exploited to increase satiety.
increasing satiety
Many Americans begin their day
with cofee or tea. These beverages
may be the only foods consumed
for breakfast. Cafeine and related
methylxanthines do exert some
infuence over appetite, but
mechanisms for this efect have not
yet been documented. Stimulants
afect metabolism as well and thus
may contribute to weight control.
These beverages are clear and
have negligible energy content
until modifed by the addition of
sweeteners and dairy products.
Opportunities exist to modify
cofee and tea to increase their
satiating ability while controlling
caloric content per serving.
Lighteners could be formulated
to make these beverages more
satiating. The roles of fatigue and
lack of alertness in satiety should
be explored further. Foods and
beverages that maintain alertness
may allow some consumers to avoid
snacking for a little extra energy.
As indicated above,
composition and physical
properties of breakfast foods could
be modifed to increase satiety.
Sensory quality of satiating foods
requires careful balancingnot
high enough and consumers will
not use the product; too good and
they may be tempted to consume
larger portions than is desirable.
Products to control appetite should
be convenient for consumers,
and shelf-stable, portable items
may reach a greater share of our
expanding population. FT
Mary Ellen Camire, Ph.D. (mary.camire@umit.
maine.edu), a Professional Member of IFT, is
Professor, and Megan Blackmore (megan.black-
more@umit.maine.edu) is Graduate Assistant and
Dietetic Intern, Dept. of Food Science and Human
Nutrition, University of Maine, 5735 Hitchner Hall,
Orono, ME 04469-5735. Send reprint requests to
author Camire.
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Schaafsma, G., and Hendriks H.F.J. 2006. Efect of
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