Already at diagnosis, head and neck cancer patients are atrisk for malnutrition. Local symptoms such as swallowingproblems are a major cause of malnutrition in thesepatients.1 Additionally, malnutrition may result fromchanges in smell and taste/aversion and loss of appetite.Presence of these systemic symptoms at diagnosis may beindicative for the cachexia syndrome. Therefore, we testedthe hypothesis that head and neck cancer patients to betreated with primary or postoperative (chemo)radiationsuffer from cachexia.
Enhancing sweetness of vegetables by addition of sucrose or sweeteners can increase acceptance but is not necessarily desirable. An alternative strategy could be to combine vegetables with other vegetables. By offering combinations of vegetables it might be possible to suppress bitterness, enhance sweetness and provide texture variety leading to increased acceptance. The aim of this study was to determine the influence of combining vegetables with other vegetables on sensory properties and acceptance. Carrot (sweet), cucumber (neutral), green bell pepper (bitter) and red bell pepper (sour) were assessed individually and in combination with the other three vegetables in two mixing ratios (1:2 and 2:1). Additionally, four combinations of three vegetables (mixing ratio 1:1:1) were assessed. A trained panel (n = 24) evaluated taste, flavour and texture and a consumer panel (n = 83) evaluated acceptance of all vegetables and combinations. Combining green bell pepper with carrot (1:2 and 2:1) increased sweetness and decreased bitterness. Combining cucumber, carrot or red bell pepper with green bell pepper (1:2) increased bitterness. Mainly sweetness and bitterness were associated with acceptance whereas texture (crunchiness, firmness and juiciness) did not strongly influence acceptance. Cucumber was the most accepted vegetable followed by carrot, red bell pepper and green bell pepper. Acceptance of vegetable combinations can differ from acceptance of individual vegetables depending on vegetable type and mixing ratio. Only 3 of 16 vegetable combinations had higher acceptance compared to the least accepted vegetable in the combination and similar acceptance as the more accepted vegetable in the combination. For 13 of 16 vegetable combinations acceptance did not increase compared to acceptance of individual vegetables. These findings suggest that strategies aimed at increasing vegetable consumption can be devised using specific combinations of vegetables.
Vegetables have low taste intensities, which might contribute to low acceptance. The aim of this study was to investigate the effect of taste (sweetness, sourness, bitterness, umami, and saltiness) and fattiness enhancement on consumer acceptance of cucumber and green capsicum purees. Three concentrations of sugar, citric acid, caffeine, mono-sodium glutamate, NaCl, and sunflower oil were added to pureed cucumber and green capsicum. Subjects (n = 66,35.6 ± 17.7 y) rated taste and fattiness intensity. Different subjects (n = 100, 33.2 ± 16.5 years) evaluated acceptance of all pureed vegetables. Taste intensities of vegetable purees were significantly different (P < 0.05) between the three tastant concentrations except for umami in both vegetable purees, sourness in green capsicum puree, and fattiness in cucumber puree. Only enhancement of sweetness significantly (P < 0.05) increased acceptance of both vegetable purees compared to unmodified purees. In cucumber purees, relatively small amounts of added sucrose (2%) increased acceptance already significantly, whereas in green capsicum acceptance increased significantly only with addition of 5% sucrose. Enhancement of other taste modalities did not significantly increase acceptance of both vegetable purees. Enhancing saltiness and bitterness significantly decreased acceptance of both vegetable purees. We conclude that the effect of taste enhancement on acceptance of vegetable purees differs between tastants and depends on tastant concentration and vegetable type. With the exception of sweetness, taste enhancement of taste modalities such as sourness, bitterness, umami, and saltiness was insufficient to increase acceptance of vegetable purees. We suggest that more complex taste, flavor, or texture modifications are required to enhance acceptance of vegetables.
While the creation of an energy deficit (ED) is required for weight loss, it is well documented that actual weight loss is generally lower than what expected based on the initially imposed ED, a result of adaptive mechanisms that are oppose to initial ED to result in energy balance at a lower set-point. In addition to leading to plateauing weight loss, these adaptive responses have also been implicated in weight regain and weight cycling (add consequences). Adaptions occur both on the intake side, leading to a hyperphagic state in which food intake is favored (elevated levels of hunger, appetite, cravings etc.), as well as on the expenditure side, as adaptive thermogenesis reduces energy expenditure through compensatory reductions in resting metabolic rate (RMR), non-exercise activity expenditure (NEAT) and the thermic effect of food (TEF). Two strategies that have been utilized to improve weight loss outcomes include increasing dietary protein content and increasing energy flux during weight loss. Preliminary data from our group and others demonstrate that both approaches - especially when combined - have the capacity to reduce the hyperphagic response and attenuate reductions in energy expenditure, thereby minimizing the adaptive mechanisms implicated in plateauing weight loss, weight regain and weight cycling. Past research has largely focused on one specific component of energy balance (e.g. hunger or RMR) rather than assessing the impact of these strategies on all components of energy balance. Given that all components of energy balance are strongly connected with each other and therefore can potentially negate beneficial impacts on one specific component, the primary objective of this application is to use a comprehensive approach that integrates all components of energy balance to quantify the changes in response to a high protein and high energy flux, alone and in combination, during weight loss (Fig 1). Our central hypothesis is that a combination of high protein intake and high energy flux will be most effective at minimizing both metabolic and behavioral adaptations in several components of energy balance such that the hyperphagic state and adaptive thermogenesis are attenuated to lead to superior weight loss results and long-term weight maintenance.
![Advancing the evidence base for sustainable city-region food systems [Meeting the growing appetite of cities - delivering an evidence base for urban food policy]](https://publinova-harvester-content-prod.s3.amazonaws.com/thumbnails/files/previews/pdf/20240419021006037873.manuscript-thumbnail-400x300.png)
