Chewing a greater number of chews per bite has been shown to increase fullness, lower hunger levels and lead to a lower energy intake, when compared to chewing each bite fewer times. Increased levels of fullness and decreased levels of hunger have also been observed after consuming harder textured foods which require more chewing activity and have a longer oro-sensory exposure time. The aim of this study was to investigate whether consumption of foods differing in texture, classified as ‘fast’ or ‘slow’ foods, combined with differences in oral processing behaviours (chewing normally or more slowly), has an impact on self-reported hunger, fullness and satiety outcomes.

This is an interim analysis of a randomised crossover experiment designed to test the impact of both oral processing behaviours and food texture on self-reported hunger, fullness and satiety. Participants consumed two breakfasts of different texture (a ‘fast’ yoghurt and fruit compote option, and a ‘slow’ granola option) twice; once at their normal rate of eating and once after being instructed to eat slowly. Measures of self-reported appetite (hunger, fullness, satiety, desire to eat and prospective food consumption) were assessed using a visual analogue scale at three time points; baseline (minimum 20 minutes before consumption), immediately pre-consumption and post-consumption. Statistical analysis was conducted in SPSS; paired sample t tests and one-way analysis of variance was conducted to measure whether change in appetite ratings between the time points differed between the four breakfast options.

Data were collected from 16 healthy volunteers (study aiming to recruit n = 21; mean age 32.1 y, female n = 13, 81.3%). For all four breakfast options, levels of hunger, desire to eat and prospective food consumption significantly decreased, and levels of fullness and satiety significantly increased between both baseline and post-consumption, (p < 0.05) and between pre-consumption and post-consumption (p < 0.05). However, amongst the four breakfast options, no significant differences were observed in change in these appetite measures between baseline and post-consumption and pre- and post-consumption (p > 0.05).

This interim analysis demonstrates no differences in mean change in appetite measures for breakfast options of different texture chewed normally or more slowly. Analysis of the full study will determine the effect of oral processing behaviours and food texture on self-reported hunger, fullness and satiety outcomes.

Replacing missing teeth alone is not enough to engender dietary behaviour change amongst older adults. Whilst there is a body of evidence to support oral rehabilitation in conjunction with dietary advice, this is currently limited to edentate patients even though the majority of older adults are now partially dentate. One approach proven to change long-term food behaviours but is novel in this population is habit-formation. Consequently, this study developed and tested a habit-based tailored dietary intervention, in conjunction with oral rehabilitation amongst partially dentate older adults.

A pilot randomised control trial was conducted on 57 partially dentate older patients. Participants were randomised to an intervention group (habits-based dietary intervention) or a control group and followed up for 8 months. The intervention group attended four meetings with a trained researcher to target habit-formation around 3 dietary domains (fruit/vegetables, wholegrains, healthy proteins). The primary outcome measure was self-reported automaticity for developing healthy habits and habit formation was assessed using the Self-Report Behavioural Automaticity Index (SRBAI). Preliminary analysis was conducted on n = 36 participants between baseline and 8 month follow up.

Preliminary results showed that SRBAI scores and self-reported frequency of days doing habits in the intervention group for all tailored dietary habits was significant between baseline and follow up visits (p < 0.001). There were moderate positive correlations between automaticity and habit adherence (Fruit/vegetables rho = 0.43, p = 0.09: Wholegrains rho = 0.44, p = 0.08: Healthy Proteins rho = 0.52, p = 0.03) for the intervention group. Automaticity trends were increased in the intervention group for all 3 dietary habits compared to the control group but, other than wholegrain (p = 0.005), between group differences were non-significant (p > 0.05). BMI decreased in the intervention group (29.6 to 28.7 kg/m2) compared to a non-significant increase in the control group (27.7 to 27.8 kg/m2) (p = 0.08). There were slight increases in Mini Nutritional Assessment mean change scores (0.19 intervention: 0.32 control) for both groups, however between-group differences were not statistically significant (p = 0.9). Greater improvements in food intake around dietary habits were observed in the intervention group (Fruit/vegetables:108 g Fibre 4g: Protein 11g) compared to the control group (Fruit/vegetables -17g: Fibre 2g: Protein -4g).

Preliminary results demonstrate the success of a habit-based dietary intervention coupled with oral rehabilitation in positively influencing dietary behaviours and other nutritional outcomes in partially dentate older adults.