Appetite 56 (2011) 6570

Contents lists available at ScienceDirect

Appetite
journal homepage: www.elsevier.com/locate/appet

Research report

Dietary bres in the regulation of appetite and food intake. Importance of viscosity
Mette Kristensen *, Morten Georg Jensen
Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Rolighedsvej 30, DK-1958 Frederiksberg C, Denmark

A R T I C L E I N F O

A B S T R A C T

Article history:
Received 22 July 2010
Accepted 19 November 2010
Available online 27 November 2010

Dietary bres have many functions in the diet, one of which may be to promote control of energy intake
and reduce the risk of developing obesity. This is linked to the unique physico-chemical properties of
dietary bres which aid early signalling of satiation and prolonged or enhanced sensation of satiety.
Particularly the ability of some dietary bres to increase viscosity of intestinal contents offers numerous
opportunities to affect appetite regulation. Few papers on the satiating effect of dietary bres include
information on the physico-chemical characteristics of the dietary bres being tested, including
molecular weight and viscosity. For viscosity to serve as a proxy for soluble dietary bres it is essential to
have an understanding of individual dietary bre viscosity characteristics. The goal of this paper is to
provide a brief overview on the role of dietary bres in appetite regulation highlighting the importance
of viscosity.
2010 Elsevier Ltd. All rights reserved.

Keywords:
Dietary bres
Viscosity
Appetite regulation
Obesity
Energy intake

Introduction
The role of dietary bres in health and disease has become
clearer in some cases, but still generates controversy in others.
Many observational studies link high intakes of dietary bre with
reduced risk of cardiovascular disease (Jacobs, Meyer, Kushi, &
Fulsom, 1998; Liu et al., 1999; McKeown, Meigs, Liu, Wilson, &
Jacques, 2002; Sahyoun, Jacques, Zhang, Juan, & McKeown, 2006),
incidence of type 2 diabetes (Esmaillzadeh, Mirmiran, & Azizi,
2005; McKeown et al., 2002; Montonen, Knekt, Jarvinen, Aromaa, &
Reunanen, 2003; Schulze et al., 2007) and mortality (Jacobs,
Andersen, & Blomhoff, 2007; Sahyoun, Jacques, Zhang, Juan, &
McKeown, 2006), whereas the link to risk for developing different
types of cancers is less consistent (Position of the American
Dietetic Association, 2008). In recent years, dietary bres have
received increased attention for their potential role in weight
regulation, and high intakes have been associated with a smaller
weight gain in prospective observational studies (Bazzano et al.,
2005; Koh-Banerjee et al., 2004; Liu et al., 2003).
Trowell (1972) dened dietary bres as the remnants of edible
plant cell polysaccharides, lignin and associated substances which
escape hydrolytic enzymatic digestion in the upper gastrointestinal tract. However, no universally accepted denition exists to date
although a Codex denition of dietary bres was agreed upon in
2009 which denes dietary bres as carbohydrate polymers with

* Corresponding author.
E-mail address: mekr@life.ku.dk (M. Kristensen).
0195-6663/$ see front matter 2010 Elsevier Ltd. All rights reserved.
doi:10.1016/j.appet.2010.11.147

10 or more monomeric units which are not hydrolysed by the

endogenous enzymes in the small intestine of humans (Codex
Alimentarius Commision, 2009). This, along with many other
dietary bre denitions, is linked to analytical criteria which are
good for labelling purposes (particularly solubility in water) but
not as informative as for example viscosity and fermentability, as
these are physicochemical properties which may affect gastrointestinal function.
Research has been conducted to address the effects of viscous
dietary bres on physiological responses, but little data is provided
on physico-chemical characteristics of individual dietary bres
used in the different intervention studies. Also, some limitations in
the use of these characteristics when trying to predict the
physiological response of dietary bres may be the lack of
established correlations between standardised in vitro and in vivo
measurements. For viscosity to serve as a proxy for soluble dietary
bres it is essential to have an understanding of individual dietary
bre viscosity characteristics. The purpose of this paper is to
discuss the importance of viscosity when considering the satiating
effect of dietary bres.
Viscosity of solutions and gastrointestinal digesta
Viscous dietary bres induce thickening when mixed with
liquids, and include many soluble dietary bres such as gums,
pectins, sea weed alginates and b-glucans. The degree of
thickening depends on a number of factors such as structure,
chemical composition, concentration and molecular weight (MW)
(Dikeman & Fahey, 2006; Dikeman, Murphy, & Fahey, 2006).

M. Kristensen, M.G. Jensen / Appetite 56 (2011) 6570

66

Viscosity of dietary bres in solution also depends on their rate

of hydration. Vuksan et al. (2009) found that viscosity of three
preload drinks with glucomannan, cellulose or a new viscous
polysaccharide (NVP) were similarly low immediately after mixing
(<2 Pa s), but increased over a period of 75 min, reaching a
maximum of 41 and 70 Pa s for glucomannan and NVP, respectively. Studies on the hydration rates of different preparations of
guar gum showed marked differences in hydration rate and
maximum viscosity. Some preparations hydrated so slowly that
even after 5 h they only attained viscosity levels of 60% of their
maximum viscosity (Ellis & Morris, 1991). This is not a feature
unique to guar gum and may explain why some dietary bre
preparations appear to be clinically ineffective.
Another issue is to which degree the viscosity of the
gastrointestinal content induced by dietary bres is affected by
pH as they are subjected to extreme variations in pH upon transit
through the gastrointestinal tract. This highly depends on dietary
bre source and the proportion of neutral to acidic residues. For
example, viscosity of guar gum preparations is generally unaffected upon acidication as they are mainly comprised of neutral
polysaccharides, whereas the opposite occurs with xanthan gum
and some alginates (Brownlee et al., 2005; Draget, Skjak-Braek, &
Smidsrod, 1997). Acidication results rst in the release of nonstarch polysaccharides (NSP) followed by break down of NSP, thus
an optimal pH for functionality of the individual dietary bres may
exist (Dikeman & Fahey, 2006).
Twelve different dietary bres were compared with respect to
solution viscosity and digesta viscosity after gastric and small
intestine in vitro digestion (Dikeman et al., 2006), of which some
are shown in Table 1. The viscosity of 2% solutions of cellulose, guar
gum, oat bran, psyllium and wheat was measured immediately
upon mixing and ranged from 508 to 141,606 Pa s  rpm, where
guar gum and psyllium obtained the highest viscosities. Viscosity
increased during simulation of gastric digestion which may have
been a response to hydration of the brous substrates, and perhaps
interaction with the acidic environment, releasing bound NSP. As
digestion proceeds, polysaccharide structural interactions may
have been modied resulting in decreased viscosity. However, the
disadvantage of in vitro digestion models is the inability to account
for interaction with nutrients present in the digesta as well as the
presence and absorption of water which affects dietary bre
concentration and hence viscosity.
Similarly, Sosulski and Cadden (1982) compared the water
hydration and fat absorption capacities of different dietary bre
sources (Table 2). Here, it appears that the mucilage content of the
samples were proportional to the water hydration capacity (WHC),
in that psyllium seeds, linseed hulls and mustard hulls, all rich in
mucilage (50, 21 and 12% mucilage, respectively, which was partly
analysed as hemicellulose) exhibited the greatest WHC. In this
study, lignin which is concentrated in sunower hulls, accounted
for increased fat absorption capacity, thus viscosity may be less
important for the fat absorption capacity of dietary bres.

Table 1
Examples of viscosity measures after 18 h hydration in 1% solutions and after
simulation of gastric and small intestine in vitro digestion (from Dikeman et al.,
2006).
Dietary bre
source

Dietary
bre (%)

Viscosity of
2% solution
(Pa s  rpm)

Gastric
viscosity
AUC 4 h
(Pa s  rpm)

Intestine
viscosity
AUC 12 h
(Pa s  rpm)

Cellulose
Guar gum
Oat bran
Psyllium
Wheat bran

99.1
82.3
19.5
90.0
49.7

1112
141,606
1358
48,800
508

313
870,266
739
16,150
642

113
35,916
693
8655
202

Table 2
Examples of particle size, water hydration and fat absorption capacity of different
dietary bre sources (from Sosulski & Cadden, 1982).
Dietary bre
source

Dietary
bre (%)

MLPS
(mm)a

Water hydration
capacity (g/g)

Fat absorption
capacity (g/g)

Sunower heads
Psyllium seeds
Linseed hulls
Mustard hulls
Wheat bran
Sunower hulls
Pea hulls
Cellulose

19.5
7.9
13.0
24.4
9.8
57.4
34.6
63.5

90
240
190
340
320
302
410
<63

4.15
10.05
8.05
5.75
3.15
3.65
2.55
1.95

4.4
0.8
1.8
1.1
2.0
3.2
0.8
2.0

a
MPLS is the aperture through which 50% of the sample will pass indicating
mean particle size.

Viscous dietary bres in appetite regulation mechanisms of

action
Hunger and food intake are regulated by multi-factorial
physiological and psycological factors, of which viscous dietary
bres seem to be a rst-class candidate addressing many of these.
Firstly, dietary bres lower the energy density of foods, as it is
not absorbed in the small intestine. Mastication of foods rich in
dietary bres often requires more time and effort, which allows
more signals mediating satiety sensations to the brain (Blundell &
Halford, 1994). Because viscous dietary bres absorb large
quantities of water, they also increase stomach distension which
may trigger afferent vagal signals of fullness (de Graaf, Blom,
Smeets, Staeu, & Hendriks, 2004) making viscous dietary bres
act through mechanical factors. Most studies link ingestion of
viscous dietary bres to delayed gastric emptying (Benini et al.,
1995; Bergmann et al., 1992; Marciani et al., 2000), but not all
(Shimoyama et al., 2007).
While gastric satiety is of mechanical origin, intestinal satiety is
typically nutrient-dependent, where satiety signals are released
upon close interaction between the intestinal wall and nutrients.
Exposure of the intestinal mucosa to nutrients induces release of
appetite regulating peptides which either function as hormones or
activate neural pathways. Viscous dietary bres increase the
viscosity of the digesta in the small intestine and therefore prolong
small intestine transit time and absorption rate of nutrients. The
modied absorption rate of nutrients and thus prolonged presence
of nutrients in the small intestine affects the release of peptide
which in turn affects gastric emptying and signalling to the central
nervous system. Proximally in the small intestine, the presence of
fat and protein will result in the release of cholecystokinin (CCK),
whereas glucoagon-like peptide 1 and peptide YY (PYY) result from
more distal responses (Blundell & Halford, 1994; Chaudhri, Small,
& Bloom, 2006). Ghrelin is a hunger signal which is secreted
primarily by the stomach and duodenum (Overduin, Frayo, Grill,
Kaplan, & Cummings, 2005), and its levels rise during fasting, and
decrease upon eating, which has led to the suggestion that ghrelin
may be involved in meal initiation (Cummings, 2006). Also,
increased digesta viscosity results in a thickening of the unstirred
water layer which presents a greater barrier to absorption (Gray,
2006; Leeds, 1987) and perhaps to interaction between nutrients
and peptide-releasing cells in the mucosa. Further, an enhancement of the ileal brake may also be observed with dietary bre
consumption. Exposure of the intestinal mucosa in the ileum to
nutrients will activate the ileal brake resulting in decreased gastric
emptying rate as well as small intestine transit along with reduced
acid secretion, pancreatic enzyme secretion and bile acid secretion
(Maljaars, Peters, & Masclee, 2007).
Finally, fermentation has been proposed to affect satiety. It has
been hypothesised that colonic fermentation resulting in increased

M. Kristensen, M.G. Jensen / Appetite 56 (2011) 6570

production of short-chain fatty acids could stimulate colonic Lcells to produce several appetite-regulating hormones such as PYY
and GLP-1 (Peters, Boers, Haddeman, Melnikov, & Qvyjt, 2009).
However, a cause and effect relationship between fermentation
and satiety responses has not been fully established. This is
difcult to do as fermentable bres also contribute to a lower
energy density and/or increased viscosity.
Viscosity and appetite regulation evidence from clinical
human interventions
The satiating effects of dietary bres have been tested in many
short-term studies, using a variety of dietary bres, doses and food
matrices. However, most papers do not provide data on the dietary
bres used in terms of their physico-chemical characteristics such
as MW, WHC, fermentability and viscosity. These are vital
information, as a description of a dietary bre as being b-glucans
or pectin is insufcient to characterise a dietary bre, because
source, extraction procedure and food processing among other
things determine physico-chemical characteristics. A few recently
published studies do include these characteristics (see Table 3 for
overview), and the role of viscosity in relation to satiating potential
of dietary bres will be discussed based on these.
In a study by Marciani et al. (2001), the effect of viscosity on
gastric emptying and satiety was compared to that of the presence
of nutrients. Twelve healthy participants ingested high or lowviscosity locust bean gum beverages either containing nutrients or
being a non-nutrient control. Interestingly, increased viscosity
increased AUC for satiety more so than did addition of nutrients to
the beverage. Others observed similar ndings when administering alginate and whey protein based beverages to 33 healthy young
adults (Solah et al., 2010). In this crossover study hunger was
decreased when the subjects ingested the high viscosity/low
protein compared to the high protein low viscosity drink. Although
the presence of nutrients is known to induce satiety, these results
indicate that viscosity may be an independent contributor as
suggested by others (Mattes & Rothacker, 2001; Zijlstra, Mars, de
Wijk, Westerterp-Plantenga, & de, 2008).
The effect on food intake in adolescents from consumption of
three different dietary bre preload beverages has been studied
(Vuksan et al., 2009). The beverages were identical in volume,
caloric content and taste, but differed with regard to dietary bre
source and viscosity. Cellulose served as a control had a viscosity of
1 Pa s. Glucomannan and a NVP mixture (PGX1: xanthan, sodium
alginate and glucomannan) were intermediate (41 Pa s) and high
viscosity (70 Pa s) beverages. Food intake at the next meal was
shown to be lower after NVP compared to both glucomannan and
cellulose beverages, but no difference in appetite sensation or 24 h
energy intake was seen. Thus, only a short term effect on satiety
appeared to result from intake of highly viscous NVP. In a different
study, Hoad et al. (2004) also investigated the effects of alginate
using two different beverages with 1% of weak and strong gelling
alginates and comparing their effects on satiety and gastric
emptying with that of 1% guar gum and a low-bre control
beverages. Alginate is unique due to its ability to form gels when
acidied and in the presence of multicovalent cations such as Ca2+,
and the richer in guluronic acids the stronger the gel. Using
magnetic imaging techniques, they found that the alginate formed
rigid lumps in the stomach, but gastric emptying rate was
unaffected. The strong gelling alginate and guar resulted in
increased sensation of fullness and decreased hunger, but no effect
of the weak gelling alginate was observed. The effects on fullness
and hunger correlated with viscosity induced by the dietary bres
rather than upon gel formation in the stomach. We recently
investigated the effect of alginate containing beverages on appetite
sensation, food intake and gastric emptying rate assessed with the

67

paracetamol marker method (Jensen, Kristensen, Belza, Knudsen, &

Astrup, 2010). In 19 healthy individuals, the effect of two different
volumes (330 and 500 ml) with the same dietary bre concentration was compared to iso-caloric and iso-volumetric non-bre
controls. Apparent viscosity was 4-fold higher in alginate
beverages compared to control. We found that the 330 ml alginate
beverage resulted in decreased food intake at the next meal with
no signicant effect on appetite sensation or gastric emptying rate,
whereas the opposite was observed for the 500 ml beverages.
When considering short term effects on satiety, gastric distension
is one of the means by which viscous beverages may exert their
effects; however, no studies have addressed whether gastric
distension following consumption of viscous dietary bres may be
a transient phenomenon.
The satiating potential of wheat bran, oat bran and guar gum
beverages were compared to both a control beverage and an isocaloric wheat bread in 19 healthy adults (Lyly et al., 2009). Only
the guar gum beverage, which also had a 50- to 700-fold higher
viscosity at time of ingestion compared to wheat and oat bran
beverages, increased satiety compared to the control beverage.
However, an iso-caloric wheat bread increased satiety more,
stressing the difference between liquid and solid meals. bGlucans was also the topic of research in a different study, where
the combined effect of fructooligosaccharides (FOS) and barley
rich in b-glucans was investigated based on a hypothesis that a
combination of increased digesta viscosity and increased colonic
fermentation would induce satiety more so than the individual
component (Peters et al., 2009). However, the addition of bglucan, FOS or a combination thereof did not affect appetite or
food intake, although addition of b-glucans to the nutrient bar
doubled in vitro digesta viscosity compared to a control bar.
Compared to the other studies, this increase in viscosity is
relatively modest, which can be due to the use of a solid meal
rather than a beverage as seen in the other studies. Also, a viscous
beverage gives a different mouthfeel which may induce
sensation of fullness and satiety by itself as suggested by others
(Lyly et al., 2009; Mattes & Rothacker, 2001).
The effects of two different oat bran containing beverages on
subjective satiety and circulating concentrations of appetite
regulating peptides was studied in a crossover study in 20 healthy
participants (Juvonen et al., 2009). Both beverages contained 10.2 g
of dietary bres but MW distribution differed with more than 50%
having a MW > 1,000,000 in the high viscosity beverage and 85%
<100,000 in the low viscosity beverage. As a result viscosity
differed more than 12-fold. Contrary to what was expected, the low
viscosity beverages induced a greater postprandial increase in
satiety ratings, CCK, GLP-1 and PYY than the high viscosity
beverage over a 180 min period. Also, gastric emptying measured
by paracetamol absorption was faster with the low viscosity
beverage. The authors propose that the increase in chyme viscosity
may have prevented the close interaction between nutrients and
gastrointestinal mucosa required for efcient stimulation of
enteroendocrine cells and peptide release. However, if true, it
should apply to other studies, particularly taken into consideration
that viscosity was only increased 12-fold here by addition of oat
bran, whereas the others observe 70- to 20,000-fold differences in
beverage viscosities (Bennett et al., 2009; Hoad et al., 2004;
Juvonen et al., 2009; Lyly et al., 2009).
Gastric function is altered after gastric surgery, and in another
study, the effect of a 200 ml 3% locust bean gum (LBG) solution on
hunger and gastric emptying was compared to 1000 ml of water in
normal weight individuals and post-Swedish Adjustable Gastric
Banding (SAGB) patients (Bennett et al., 2009). The LBG solution
had an apparent viscosity of 170 mPa s compared to water, which
has an apparent viscosity of 1 mPa s. Here a signicant suppression
of the LBG solution on hunger and gastric emptying rate in both

68

Table 3
Overview of intervention studies investigating the relation between food or digesta viscosity and effect on appetite regulation or food intake.
Study design

Meal/product characteristics

Viscosity

Findings

Crossover RCT in 19 healthy individuals

of 270 min duration

Iso-caloric avoured non-DF and DF beverages

with 3 g alginate DF/100 ml at two different
volumes (330 ml and 500 ml)

Viscosity of the non-DF and DF beverages

was 100 mPa s and 480 mPa s at time
of ingestion

Reduced ad libitum energy intake at the next

meal with 330 ml DF beverage. Satiety was
increased and prospective food intake and
gastric emptying rate was decreased with
the 500 ml DF beverage

Juvonen et al. (2009)

Crossover RCT in 20 healthy adults of

180 min duration

Two beverages with high or low viscosity oat

bran beverages with 10.2 g DF

At 20 min: <250 or >3000 mPa s

Satiety, CCK, PYY and GLP-1 and ad libitum

energy intake increased and ghrelin
decreased with the low viscosity beverage

Bennett et al. (2009)

Crossover RCT in 5 healthy and 5

post-SAGB of 90 min duration

100 ml of water (low viscosity) and 200 ml of 3%

locust bean gum (high viscosity) beverages

At t = 0 min: 171 mPa s vs. 10 mPa s

for water

Hunger sensation and gastric emptying rate

were lower after high viscosity beverage
for both healthy and post-SAGB patients

Lyly et al. (2009)

Crossover RCT in 10 healthy adults of

120 min duration

Control and three beverages with wheat bran

(10.5 g DF), oat b-glucan (10.5 g DF) or guar gum
(7.8 g DF) and iso-caloric wheat bread

At time of ingestion: 1.7, 2.6, 33.5 and

1740 mPa s for control, guar, wheat
and oat beverages

Only the guar gum beverage increased

satiety and reduced willingness to eat
compared to control. Wheat bread
increased satiety more than beverages

Peters et al. (2009)

Crossover RCT in 21 healthy volunteers

of 240 min duration on two consecutive
days

Four iso-caloric nutrient bars with 2.5 g DF control,

4.1 g DF barley bar, 8.1 g DF FOS bar, or 10.2 g
DF FOS + barley bar

Gastric viscosity measured after

30 min: control: 0.35 Pa s;
barley: 0.84 Pa s; others not given

No effect on appetite ratings or food

intake on day 1 or 2

Vuksan et al. (2009)

Crossover RCT in 31 healthy adolescents

of 90 min duration

DF preloads with 5.1 g DF from CE, GM or NVP

Measured for 90 min. Peak

viscosity: 1, 41 and 70 Pa s for CE,
GM and NVP

Food intake was lower after NVP

compared to GM and CE. No effect
on appetite sensation

Hoad et al. (2004)

Crossover RCT in 12 healthy adults of

240 min duration

Four beverages with no DF, a 1% of weak gelling

alginate, a strong gelling alginate or guar
gum (3.25 g DF)

At time of ingestion: 0.0016, 17, 50

and 39.1 Pa s for control, weak and
strong alginate and guar gum

Fullness was increased and hunger

decreased with strong gelling alginate
and guar gum, but not weak gelling
alginate

Marciani et al. (2001)

Crossover RCT in 12 healthy adults of

90 min duration

High or low-viscosity locust bean gum beverages

with or with nutrients, DF content not provided

Viscosity of the low and high viscosity

beverages was 0.06 Pa s and 29.5 Pa s

Fullness increased more with viscosity

than with the presence of nutrients.
Satiety increased logarithmically
with gastric volumes

Solah et al. (2010)

Single-blinded cross-over RCT in 32

healthy young subjects of 240 min
duration

Four nutrient beverages with alginate and whey

protein. High viscosity and low protein
(<2 g), low viscosity and
high protein (30 g)

Beverage with low viscosity was

28.5  7 and high viscosity was 86  7 cP

Hunger decreased more with increasing

viscosity than with the protein content

CCK, cholecystokinin; CE, cellulose; DF, dietary bre; FOS, fructooligosaccharides; GLP-1, glucagon-like peptide-1; GM, glucomannan; NVP, novel viscous polysaccharide (NVP) mixture (PGX1: xanthan, sodium alginate and
glucomannan); PYY, peptide YY; RCT, randomised clinical trial; SAGB, Swedish adjustable gastric banding.

M. Kristensen, M.G. Jensen / Appetite 56 (2011) 6570

Author
Jensen et al. (2010)

M. Kristensen, M.G. Jensen / Appetite 56 (2011) 6570

normal controls and post-SAGB patients was seen, despite the

relatively low apparent viscosity and the large difference in
volume which in itself may have affected hunger ratings. It should
however be noted, that with the LBG solution calories were added
which also may have affected hunger ratings. Interestingly, postSAGB patients had lower hunger ratings compared to controls
independent of treatment.
In some studies, the dietary bre beverages were consumed
immediately upon mixing, although maximum hydration of the
dietary bres and thus maximum viscosity occurs at a later stage.
This may be both advantageous and disadvantageous as an
increased viscosity in the mouth may in itself induce a sensation of
fullness, but there is a limit as to how viscous a beverage can be
without affecting palatability negatively. Also, gastric and small
intestinal effects may be diminished when maximum viscosity is
reached several hours after consumption.
Only the effect on short term appetite and food intake has been
addressed in the cited studies, and as of yet it is unclear whether
the effects induced by increased viscosity is a transient phenomenon. Also, most studies used beverages as a vehicle, although most
dietary bres are consumed as solid foods in real life. The food
matrix may be of importance for the hydration of dietary bres just
as processing of foods affect physico-chemical properties of dietary
bres. Thus the evidence presented is difcult to interpret with
regard to the effect of dietary bres as such. However, if weight loss
is the goal, a low-calorie high viscosity preload beverage consumed
prior to all main meals may reduce food intake. It has been
estimated, that the gradual weight gain of 0.51 kg/year in
American adults can be explained in most people by a positive
energy balance of <200 kJ/d (Hill, 2006). However, studies
generally report more consistent benecial effects of dietary bres
in acute studies compared to longer term weight loss studies,
indicating that adaptation to a higher intake of dietary bres may
occur or that other factors come into play in the long term.
Concluding remarks
Clinical evidence for a role of viscosity in mediating a
physiological response in relation to appetite regulation is not
rmly established, although the majority of the cited studies do nd
increased sensation of satiety or fullness with viscous dietary bre
enriched beverages. However, the studies which nd no or negative
effects also report the smallest differences in viscosity between
control and active treatment, which indicates that a major increase
in viscosity is necessary for a clinically relevant physiological
response. The effect on digesta viscosity induced by solid vs. liquid
meals needs to be addressed in the future, just as the possibility that
the satiating effect observed with viscous dietary bres is a transient
phenomenon and that adaption to both viscosity and gastric
distension may occur. These aspects need to be investigated further
to fully explain the contribution of viscous dietary bres to appetite
regulation in both the short and long term.
References
Bazzano, L. A., Song, Y., Bubes, V., Good, C. K., Manson, J. E., & Liu, S. (2005). Dietary
intake of whole and rened grain breakfast cereals and weight gain in men. Obesity
Research, 13, 19521960.
Benini, L., Castellani, G., Brighenti, F., Heaton, K. W., Brentegani, M. T., Casiraghi, M. C.,
et al. (1995). Gastric emptying of a solid meal is accelerated by the removal of
dietary bre naturally present in food. Gut, 36, 825830.
Bennett, J., Rhodes, M., Malcolm, P., Dainty, J., Simpson, B., Johnson, I., et al. (2009).
Assessment of the relationship between post-meal satiety, gastric volume and
gastric emptying after Swedish adjustable gastric banding. A Pilot Study using
magnetic resonance imaging to assess postsurgery gastric function. Obesity Surgery, 19, 757763.
Bergmann, J. F., Chassany, O., Petit, A., Triki, R., Caulin, C., & Segrestaa, J. M. (1992).
Correlation between echographic gastric emptying and appetite. Inuence of
psyllium. Gut, 33, 10421043.

69

Blundell, J. E., & Halford, J. C. (1994). Regulation of nutrient supply. The brain and
appetite control. Proceedings of the Nutrition Society, 53, 407418.
Brownlee, I. A., Allen, A., Pearson, J. P., Dettmar, P. W., Havler, M. E., Atherton, M. R.,
et al. (2005). Alginate as a source of dietary ber. Critical Reviews in Food Science and
Nutrition, 45, 497510.
Chaudhri, O., Small, C., & Bloom, S. (2006). Gastrointestinal hormones regulating
appetite. Philosophical Transactions of the Royal Society B: Biological Sciences, 361,
11871209.
Codex Alimentarius Commision (2009). Report of the 30th Session of the Codex Committee on Nutrition and Foods for Special Dietary Uses. ALINORM 09/32/26 November
2008: para 2754 and Appendix II.
Cummings, D. E. (2006). Ghrelin and the short- and long-term regulation of appetite
and body weight. Physiology and Behavior, 89, 7184.
de Graaf, C., Blom, W. A., Smeets, P. A., Staeu, A., & Hendriks, H. F. (2004). Biomarkers of
satiation and satiety. American Journal of Clinical Nutrition, 79, 946961.
Dikeman, C. L., & Fahey, G. C. (2006). Viscosity as related to dietary ber. A review.
Crititcal Reviews in Food Science and Nutrition, 46, 649663.
Dikeman, C. L., Murphy, M. R., & Fahey, G. C., Jr. (2006). Dietary bers affect viscosity of
solutions and simulated human gastric and small intestinal digesta. Journal of
Nutrition, 136, 913919.
Draget, K. I., Skjak-Braek, G., & Smidsrod, O. (1997). Alginate based new materials.
International Journal of Biological Macromolecules, 21, 4755.
Ellis, P. R., & Morris, E. R. (1991). Importance of the rate of hydration of pharmaceutical
preparations of guar gum; a new in vitro monitoring method. Diabetic Medicine, 8,
378381.
Esmaillzadeh, A., Mirmiran, P., & Azizi, F. (2005). Whole-grain consumption and the
metabolic syndrome. A favorable association in Tehranian adults. European Journal
of Clinical Nutrition, 59, 353362.
Gray, J. I. (2006). Dietary bre. Denition, analysis, physiology & health. International
Life Sciences Institute. ILSI Europe Concise Monograph Series. Champ, Martine.
Hill, J. O. (2006). Understanding and addressing the epidemic of obesity. An energy
balance perspective. Endocrine Reviews, 27, 750761.
Hoad, C. L., Rayment, P., Spiller, R. C., Marciani, L., Alonso, B. d. C., Traynor, C., et al.
(2004). In vivo imaging of intragastric gelation and its effect on satiety in humans.
Journal of Nutrition, 134, 22932300.
Jacobs, D. R., Jr., Andersen, L. F., & Blomhoff, R. (2007). Whole-grain consumption is
associated with a reduced risk of noncardiovascular, noncancer death attributed to
inammatory diseases in the Iowa Womens Health Study. American Journal of
Clinical Nutrition, 85, 16061614.
Jacobs, D. R., Jr., Meyer, K. A., Kushi, L. H., & Folsom, A. R. (1998). Whole-grain intake
may reduce the risk of ischemic heart disease death in postmenopausal women.
The Iowa Womens Health Study. American Journal of Clinical Nutrition, 68, 248
257.
Jensen, M. G., Kristensen, M., Belza, A., Knudsen, J., & Astrup, A. (2010). Acute effect of
alginate-based preload beverage on postprandial appetite sensation, energy intake
and gastric emptying in healthy subjects. Unpublished Work.
Juvonen, K. R., Purhonen, A. K., Salmenkallio-Marttila, M., Lahteenmaki, L., Laaksonen,
D. E., Herzig, K. H., et al. (2009). Viscosity of oat bran-enriched beverages
inuences gastrointestinal hormonal responses in healthy humans. Journal of
Nutrition, 139, 461466.
Koh-Banerjee, P., Franz, M., Sampson, L., Liu, S., Jacobs, D. R., Jr., Spiegelman, D., et al.
(2004). Changes in whole-grain, bran, and cereal ber consumption in relation to
8-y weight gain among men. American Journal of Clinical Nutrition, 80, 12371245.
Leeds, A. R. (1987). Dietary bre. mechanisms of action. International Journal of Obesity,
11(Suppl. 1), 37.
Liu, S., Stampfer, M. J., Hu, F. B., Giovannucci, E., Rimm, E., Manson, J. E., et al. (1999).
Whole-grain consumption and risk of coronary heart disease. Results from the
Nurses Health Study. American Journal of Clinical Nutrition, 70, 412419.
Liu, S., Willett, W. C., Manson, J. E., Hu, F. B., Rosner, B., & Colditz, G. (2003). Relation
between changes in intakes of dietary ber and grain products and changes in
weight and development of obesity among middle-aged women. American Journal
of Clinical Nutrition, 78, 920927.
Lyly, M., Liukkonen, K. H., Salmenkallio-Marttila, M., Karhunen, L., Poutanen, K., &
Lahteenmaki, L. (2009). Fibre in beverages can enhance perceived satiety. European
Journal of Nutrition, 48, 251258.
Maljaars, J., Peters, H. P., & Masclee, A. M. (2007). Review article. The gastrointestinal
tract. Neuroendocrine regulation of satiety and food intake. Alimentary, Pharmacology and Therapeutics, 26(Suppl. 2), 241250.
Marciani, L., Gowland, P. A., Spiller, R. C., Manoj, P., Moore, R. J., Young, P., et al. (2000).
Gastric response to increased meal viscosity assessed by echo-planar magnetic
resonance imaging in humans. Journal of Nutrition, 130, 122127.
Marciani, L., Gowland, P. A., Spiller, R. C., Manoj, P., Moore, R. J., Young, P., et al. (2001).
Effect of meal viscosity and nutrients on satiety, intragastric dilution, and emptying assessed by MRI. AJP Gastrointestinal and Liver Physiology, 280, G1227G1233.
Mattes, R. D., & Rothacker, D. (2001). Beverage viscosity is inversely related to
postprandial hunger in humans. Physiology and Behavior, 74, 551557.
McKeown, N. M., Meigs, J. B., Liu, S., Wilson, P. W., & Jacques, P. F. (2002). Whole-grain
intake is favorably associated with metabolic risk factors for type 2 diabetes and
cardiovascular disease in the Framingham Offspring Study. American Journal of
Clinical Nutrition, 76, 390398.
Montonen, J., Knekt, P., Jarvinen, R., Aromaa, A., & Reunanen, A. (2003). Whole-grain
and ber intake and the incidence of type 2 diabetes. American Journal of Clinical
Nutrition, 77, 622629.
Overduin, J., Frayo, R. S., Grill, H. J., Kaplan, J. M., & Cummings, D. E. (2005). Role of the
duodenum and macronutrient type in ghrelin regulation. Endocrinology, 146,
845850.

70

M. Kristensen, M.G. Jensen / Appetite 56 (2011) 6570

Peters, H. P., Boers, H. M., Haddeman, E., Melnikov, S. M., & Qvyjt, F. (2009). No effect of
added b-glucan or of fructooligosaccharide on appetite or energy intake. American
Journal of Clinical Nutrition, 89, 5863.
Position of the American Dietetic Association: Health Implications of Dietary Fiber.
(2008). Journal of the American Dietetic Association, 108, 17161731.
Sahyoun, N. R., Jacques, P. F., Zhang, X. L., Juan, W., & McKeown, N. M. (2006). Wholegrain intake is inversely associated with the metabolic syndrome and mortality in
older adults. American Journal of Clinical Nutrition, 83, 124131.
Schulze, M. B., Schulz, M., Heidemann, C., Schienkiewitz, A., Hoffmann, K., & Boeing, H.
(2007). Fiber and magnesium intake and incidence of type 2 diabetes. A prospective study and meta-analysis. Archives of Internal Medicine, 167, 956965.
Shimoyama, Y., Kusano, M., Kawamura, O., Zai, H., Kuribayashi, S., Higuchi, T., et al.
(2007). High-viscosity liquid meal accelerates gastric emptying. Neurogastroenterology and Motility, 19, 879886.

Solah, V. A., Kerr, D. A., Adikara, C. D., Meng, X., Binns, C. W., Zhu, K., et al. (2010).
Differences in satiety effects of alginate- and whey protein-based foods. Appetite,
54, 485491.
Sosulski, F., & Cadden, A. (1982). Composition and physiological properties of several
sources of dietary ber. Journal of Food Science, 47, 14721477.
Trowell, H. (1972). Dietary bre and coronary heart disease. Review in European Etudes
in Clinical Biology, 17, 345349.
Vuksan, V., Panahi, S., Lyon, M., Rogovik, A. L., Jenkins, A. L., & Leiter, L. A. (2009).
Viscosity of ber preloads affects food intake in adolescents. Nutrition, Metabolism
and Cardiovascular Diseases, 19, 498503.
Zijlstra, N., Mars, M., de Wijk, R. A., Westerterp-Plantenga, M. S., & de, G. C. (2008). The
effect of viscosity on ad libitum food intake. International Journal of Obesity
(London), 32, 676683.