Factors that determine energy compensation: a systematic review of preload studies

Abstract

Insufficient energy compensation after a preload (meal, snack, or beverage) has been associated with excess energy intake, but experimental studies have used heterogeneous methodologies, making energy compensation difficult to predict. The aim of this systematic review was to analyze the relative contributions of two key variables, preload physical form and intermeal interval (IMI), to differences in energy compensation. Forty-eight publications were included, from which percent energy compensation (%EC) data were extracted for 253 interventions (121 liquid, 69 semisolid, 20 solid, and 43 composite preloads). Energy compensation ranged from -370% (overconsumption, mostly of liquids) to 450% (overcompensation). A meta-regression analysis of studies reporting positive energy compensation showed that IMI (as the predominant factor) together with preload physical form and energy contributed significantly to %EC differences, accounting for 50% of the variance, independently from gender and BMI. Energy compensation was maximized when the preload was in semisolid/solid form and the IMI was 30-120 min. These results may assist in the interpretation of studies assessing the relative efficacy of interventions to enhance satiety, including functional foods and weight management products.

Keywords: intermeal interval; physical form; satiety; weight management.

© 2013 International Life Sciences Institute.

Figures

Figure 1

Flow diagram of literature search strategy.

Figure 2. Distribution of %EC values in preload studies (n = 253) employing liquid, semisolid, solid, and composite (a solid or semisolid plus a beverage) meal preloads, for intermeal intervals between 5 and 240 min

The Spearman's rho coefficient is indicated. Y-axis values of 100% indicate perfect compensation (dotted line). Values <100% indicate undercompensation, with values <0% indicating consumption of additional energy beyond the preload energy content (i.e., “overeating”). Values above 100% indicate the preload suppressed subsequent intake to an extent greater than the energy content of the preload (i.e., “overcompensation”). Percent energy compensation is graphed against the Log(Time) on the first graph to improve the fit of the linear regression line. Log(Time) is not used in the other examples to facilitate interpretation of the IMI. * Significant correlation at the p < 0.01 level; ** p < 0.001.

Figure 3. Mean (SEM) energy compensation index in studies using IMIs of up to 30 min (n = 50), 30–120 min (n = 145), and >120 min (n = 39) by preload physical form category

Only studies reporting positive energy compensation (EC) are included. An ECI value of 10 corresponds to 100% (precise) energy compensation. ECI values >10 indicate overcompensation. * Liquid preloads differ from semisolid preloads with p < 0.05; ** liquid preloads differ from semisolid preloads with p < 0.001 and from solid preloads with p < 0.01; # trend for semisolid preloads to differ from composite meals with p = 0.077.

Figure 4. Distribution of %EC values in preload studies (n = 253) according to preload weight, preload energy content, and preload energy density

The Spearman's rho coefficient is indicated. Y-axis values are to be interpreted as for Figure 2, in reference to the 100%EC line (dotted line). * Significant correlation at the p < 0.05 level; ** p < 0.01.