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. Author manuscript; available in PMC: 2019 May 31.
Published in final edited form as: Curr Top Nutraceutical Res. 2018 May 31;16:113–120.

Effect of Two Oat-based Cereals on Subjective Ratings of Appetite

Candida J Rebello 1, William D Johnson 1, Corby Martin 1, Jodee Johnson 2, Marianne O’Shea 2, YiFang Chu 2, Frank L Greenway 1
PMCID: PMC6141034  NIHMSID: NIHMS949861  PMID: 30237755

Abstract

Viscosity generated by oat β-glucan induces gastrointestinal mechanisms that influence appetite. Two oat-based ready-to-eat cereals (RTEC) with similar amounts of β-glucan but differing in their protein and sugar content were compared for their effects on appetite. Forty-seven healthy individuals, ≥18 years old, enrolled in a crossover trial consumed RTEC1 or RTEC2 in random order at least a week apart. Breakfasts contained 250kcals cereal and 105kcals fat-free milk. Subjective ratings of appetite were completed at baseline, and at 30, 60, 120, 180 and 240 minutes after consumption of the breakfast meals. Responses were analyzed as area under the curve (AUC) and per time-point. Significance was set at α=0.05. Fullness (p=0.01) and stomach fullness (p=0.02) were greater with RTEC 1 compared to RTEC 2 at 240 minutes. Stomach fullness (p=0.01) was greater at 30 minutes, and desire to eat (p=0.04) was reduced at 120 minutes with RTEC2 compared to RTEC1. There was no difference in the AUC for hunger, fullness, stomach fullness, desire to eat, or prospective intake. Ready-to-eat cereals containing similar amounts of oat β-glucan differed in the timing of significant differences in fullness or desire to eat, but appetite ratings over a four hour period did not differ.

Keywords: Appetite, Beta-glucan, Cereal, Fiber, Oats

INTRODUCTION

Obesity is the result of chronic energy imbalance that involves both dietary intake and physical activity levels. The changes needed to reverse obesity require sustained intervention at several levels (Gortmaker et al., 2011). Foods that increase perceptions of fullness provide advantages to a consumer in the short-term, as these foods should help individuals comply with energy restriction or specific diet plans. Moreover, by making the weight loss experience more pleasant and presumably less arduous, these foods can contribute to success in meeting behavioral goals such as managing weight or instilling eating habits that promote health.

The means by which dietary fiber influences appetite is related to its intrinsic physical and chemical properties, particularly its bulking effects and viscosity. Consumption of highly viscous soluble dietary fiber delays gastric emptying and increases stomach distension (Prove and Ehrlein, 1982) thereby stimulating afferent vagal signals of fullness (de Graaf et al., 2004). Satiety signals are released following interaction between the gut wall and nutrients (Powley and Phillips, 2004). In the small intestine, the increased viscosity of intestinal contents prolongs transit time and the absorption rate of nutrients (Maljaars et al., 2008). A thickening of the unstirred water layer poses an additional barrier to absorption (Johnson and Gee, 1981). Thus, viscous dietary fibers trigger an interaction of neural and hormonal signals that modulate appetite by enhancing the interaction between nutrients and the cells that release these hormones (Kristensen and Jensen, 2011).

β-glucan, a soluble fiber found in significant amounts in oat kernels, exhibits high viscosity at relatively low concentrations (Sadiq Butt et al., 2008). There appears to be overwhelming evidence that the effects of β-glucan on satiety relate to its viscosity (Rebello, 2016); however, β-glucans of similar structure, molecular weight, solution conformation and thereby rheological properties, exhibit vastly differing physiologic activity. The degree of polymerization, the molecular interactions within the structure, and the physicochemical properties of the fiber can be affected by food processing operations depending up on the processing methods employed (Tiwari et al., 2011). Further, food structure and matrix may have a role to play in appetite regulation. Variations in the processing of the oats, the concentration of soluble fiber, and the manufacturing process affect the amount, solubility, molecular weight, and structure of the β-glucan in the products (Anttila et al., 2004; Sadiq Butt et al., 2008). Thus, the functionality of β-glucan differs from one product to another. Two seemingly similar ready-to-eat cereals may therefore differ in their effects on appetite.

In a previous study, an oat-based ready-to-eat cereal containing 1.7 g of oat β-glucan (RTEC 2) was compared with an isocaloric 250 kilocalorie (kcal) serving of oatmeal. Oatmeal which contained 2.6 g of beta glucan and was served hot increased satiety measured subjectively compared to RTEC 2 (served cold) (Rebello et al., 2013). The present study compared 250 kcal servings of oat-based ready-to-eat cereals containing 1.5 g (RTEC 2) and 1.7 g (RTEC 1) of oat β-glucan, both served cold.

While the foods were matched for weight and liquid content, RTEC 1 had lower sugar content and higher protein content than RTEC 2. The small difference in the protein content of the two cereals was not expected to influence satiety, and the evidence for the effects of blood glucose concentrations on appetite are mixed (Anderson et al., 2002; Holt et al., 1995) (Anderson and Woodend, 2003; Liu et al., 2012).

The purpose of this study was to compare the effect of the two cereals on appetite ratings over a four hour period following consumption. The hypothesis was that the cereals would differ in their effects on subjective measures of satiety since the functionality of β-glucan may be different in the two products, having similar amounts of β-glucan.

SUBJECTS AND METHODS

Subjects

Forty-eight healthy subjects were enrolled (age: ≥ 18years) in a randomized, crossover trial. All subjects participated in an initial screening that involved measurement of body weight, height, waist and hip circumferences, vital signs (blood pressure, pulse rate), chemistry-15 panel (glucose, creatinine, potassium, uric acid, albumin, calcium, magnesium, creatine phosphokinase, alanine-leucine transaminase, alkaline phosphatase, iron, total cholesterol, triglycerides, high density lipoprotein [HDL] cholesterol, and low density lipoprotein [LDL] cholesterol), complete blood count with differential (hemoglobin, hematocrit, mean cell volume, platelet count, white blood cell count), and β-HCG urine pregnancy test (in females of child-bearing potential). Questionnaires related to dietary restraint (Eating Inventory)(Stunkard and Messick, 1985) to exclude restrained eaters, and menstrual cycle so that breakfast test days would fall within the luteal phase of the menstrual cycle, were completed. A medical screening questionnaire was administered to confirm health. Exclusion criteria included (1) women who were pregnant or nursing, (2) weight gain or loss of ≥ 4kg in the last 3 months, (3) fasting glucose >126 mg/dL, (4) dietary restraint score ≥ 14, and (5) allergy to any of the foods used for the test breakfast meals (oats or milk).

The study was approved by the Institutional Review Board of the Pennington Biomedical Research Center and participants provided written informed consent. The trial was registered on ClinicaTrials.gov with registration number NCT01372683.

Study Design

Each participant was tested on two days. On one occasion the breakfast meal consisted of the RTEC 1 (Quaker Oatmeal Squares™, PepsiCo Inc., Barrington, IL) and on the other occasion the breakfast meal served was RTEC 2 (Honey Nut Cheerios™, General Mills Inc., Minneapolis, MN). The order of the two breakfast meals was balanced and randomly assigned. The randomization was done in blocks of two. Treatments were assigned to females from the top of the randomization list and males from the bottom so that equal numbers of males and females enrolled in the study were assigned to each group. The breakfasts contained 355 kcal, consisting of 250 kcal cereal, 105 kcal of lactose-free fat-free milk and 1.5 cups of water (Table 1). RTEC 1 (66g) and RTEC 2 (70g) were prepared by adding 1.25 cups of milk and served with 1.5 cups of water.

Table 1.

Energy and nutrient content of isocaloric oat based breakfast cereals

RTEC1 RTEC22 Lactose-Free Skim Milk
Calories (kcal) 250 250 105
Fat (g) 3 3.4 0.3
Protein (g) 7.2 4.5 10.3
Carbohydrates (g) 52.8 49.9 15.6
Fiber (g) 6 4.5 0
Soluble Fiber (g) 2.4 1.8 0
β-Glucan (g) 1.5 1.7 0
Sugar (g) 12 20.4 0
Serving Size (g) 66 64.6 306.3
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1

Quaker Oat Squares; (Pepsico Inc.Barrington IL);

2

Honey Nut Cheerios; (General Mills Inc. Minneapolis MN

At the first test visit, participants arrived at the center in a fasted state and having avoided strenuous exercise for 24 hours prior to the test meal. Women with reproductive capacity completed the menstrual cycle questionnaire. Participants also completed a questionnaire about colds or allergies that might affect taste, and were asked to return on another day if such a condition was present. Electronic visual analog scales (VAS) were administered prior to serving the test meal. Participants rated their degree of each subjective state by placing the cursor over a line on a computer screen and clicking at a point, which was anchored using the descriptors “Not at all” to “Extremely.” Visual analog scales were scored by the computer on a 0 to 100 scale and the score was sent directly to the database. Based on the validated questionnaire, hunger, fullness, desire to eat, satisfaction, and prospective intake, were assessed,.(Flint et al., 2000) Stomach fullness was included as an exploratory measure.

The subjects were presented with their first breakfast meal, given 20 minutes to complete the entire breakfast meal including the cereal, water, and lactose-free fat-free milk. Visual analog scales were then administered at 30, 60, 120, 180 and 240 minutes following the start of the breakfast meal. Subjects were asked an open ended question (How do you feel?) at each of the time-points that the VAS were completed to elicit any adverse events. Subjects returned on another day separated by at least a week and repeated the test with the other breakfast meal.

Statistical Analysis

A mixed model analysis of variance for a doubly repeated measures crossover trial was performed. The model included the following sources of variability: residual carryover (sequence) effects, random subject effects within sequence groups, period effects, and treatment effects (sequence by period interaction). The changes from time 0 were summarized as least squares means plotted for each cereal type across the assessment times. Treatment effects were compared per time point and also for area the under the curve (AUC) using SAS (version 9.2, PROC MIXED; SAS Institute, Cary, NC). AUC was estimated using the linear trapezoidal rule. During the planning phase of the study, sample size was estimated using G*Power, Version 3.1.2 (F. Faul, Universitat Kiel, Germany) with the following assumptions: (i) power ≥ 0.80 was considered acceptable, (ii) the significance level under the null hypothesis was set at α=0.05, (iii) the primary outcome was VAS AUC with a priori standard deviation assumed to be 3047 based on previous research (Pasman et al., 2008) and (iv) the null hypothesis was to be tested against a two-directional alternative. The study was well powered with 47 participants for detecting a minimum difference of 1258 between cereal types, which is similar to observed differences in AUC (1213) for desire to eat from a similar food intake study (Pasman et al., 2008).

RESULTS

Forty eight subjects were enrolled in the study. One subject decided against participating in the study. Data relating to 47 subjects were analyzed. There were no adverse events. Descriptive characteristics of the subjects at baseline are summarized in Table 2. There was no difference in the AUC for the VAS ratings of hunger, fullness, stomach fullness, desire to eat, or prospective intake. Satisfaction introduces a hedonic component into the subjective measurement of satiety and was included to determine if subjects rated their appetite perceptions from a comparable baseline (Cardello et al., 2005). As expected, there was no statistically significant difference in the AUC for satisfaction between the two cereals over the four hour period. Although RTEC 2 produced greater satisfaction than RTEC 1 at the 30 minute time-point (p=0.04), it was not considered of clinical relevance. In an analysis of the VAS scores at the various time points, fullness (p=0.01) and stomach fullness (p=0.02) were greater with RTEC 1 as compared with RTEC 2 at 240 minutes. However, stomach fullness (p=0.01) was greater at 30 minutes, and desire to eat (p=0.04) was reduced at 120 minutes with RTEC 2 as compared with RTEC 1 (Figures 1–5).

Table 2.

Subject characteristics at baseline including demographics

n = 47
Mean ± SD
Age 33.9 ± 14.7
BMI (kg/m2) 25.8 ± 6.2
Waist Circumference (cm) 83.9 ± 16.1
n (%)
Gender
 Female 28 (59.6)
 Male 19 (40.4)
Race
 Asian  6 (12.8)
 Black 12 (25.5)
 White 28 (59.6)
 Other   1 (2.1)
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Figure 1.

Figure 1

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Subjective appetite ratings (least-square means; n = 47) after consumption of oat-based ready-to-eat cereals.

Figure 5.

Figure 5

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Subjective appetite ratings (least-square means; n = 47) after consumption of oat-based ready-to-eat cereals.

DISCUSSION

In the present study there was no significant difference in the appetite ratings over the four hour period, for the two cereals each served cold and containing similar amounts of β-glucan, but each cereal differed from the other in the time period (early or late postprandial) during which subjects reported increased perceptions of satiety.

Foods that have the potential to slow blood glucose levels have been shown to produce a later increase in postprandial feelings of fullness as compared with foods with a greater potential to raise blood glucose levels which may explain why RTEC 1 increased fullness at the 240 minute time point (Krog-Mikkelsen et al., 2011); but, how appetite is affected by blood glucose levels is not clear (Anderson et al., 2002; Holt et al., 1995) (Anderson and Woodend, 2003; Liu et al., 2012). Protein increases perceptions of satiety but there is a band-width in protein amount and concentration where relatively more protein promotes satiety (Westerterp-Plantenga et al., 2012). In the present study, the difference in the protein content of the two cereals was 3% of the energy content of the meals. Thus, the difference in the protein content was not expected to have an influence on appetite.

A study that investigated the effects of oat β-glucan on subjective measures of appetite showed that consumption of 4 g oat β-glucan served with yogurt had no effect on appetite despite a reduction in the post prandial blood glucose response (Hlebowicz et al., 2008). In another study investigating the effects of oat-based cereals, it was concluded that the optimal dose of β-glucan affecting satiety and other markers of appetite regulation were between 4 g and 6 g and that the hormonal effects (peptide YY) were mediated through increased viscosity observed with increasing the concentration of β-glucan (Beck EJ, 2009). However, as previously reviewed, an increase in satiety has been demonstrated at doses ranging from 1.6 g to 8 g (Rebello, 2016). Thus, both the content and the physicochemical properties of β-glucan may have a role to play in the appetite response.

A few studies have demonstrated that eating oatmeal served as a hot meal increases satiety measured either subjectively or by measuring energy intake compared to ready-to-eat cereals served cold (Geliebter et al., 2014; Geliebter et al., 2015; Rebello et al., 2014; Rebello et al., 2016; Rebello et al., 2013). However, in each of these studies oatmeal also had a higher content of β-glucan than the ready-to-eat cereal. Other studies have compared β-glucan in cereals served cold (Beck et al., 2009), or in a bread (Hartvigsen et al., 2014), or in cold beverages (Lyly et al., 2010; Pentikainen et al., 2014) and shown an increase in satiety measured subjectively compared to products without β-glucan. Together with these studies (Beck et al., 2009; Geliebter et al., 2014; Geliebter et al., 2015; Hartvigsen et al., 2014; Lyly et al., 2010; Pentikainen et al., 2014; Rebello et al., 2014; Rebello et al., 2016; Rebello et al., 2013), the present study comparing two cereals with similar amounts of β-glucan served cold, demonstrates the temperature may not have a significant role in the satiety response.

The study is limited by a lack of data on the physicochemical properties and viscosity of the β-glucan in the two cereals. Comparisons of the effects of soluble fiber on appetite require an elucidation of the structure, molecular size, and molecular weight of the β-glucan in the products tested, which were unavailable in this study. Nevertheless, cereals high in fiber including small amounts of β-glucan, consumed on a daily basis can make a contribution towards helping consumers adhere to dietary goals whether by influencing the early or late postprandial appetite response. Although the results of the study did not completely agree with the hypothesis, it is important that they find a place in the public domain for anyone who may be interested.

CONCLUSIONS

RTEC 2 with a lower fiber and higher sugar content than RTEC 1 produced an early postprandial increase in self-reported markers of appetite, whereas RTEC 1 prolonged the sensation of fullness at selected postprandial time points. However, the oat-based ready-to-eat cereals demonstrated no differences in self-reported markers of appetite and hunger over the four hour assessment period. Future studies investigating the effect of oat-based cereals on appetite should focus on the role of β-glucan, with emphasis on characterization of its physicochemical and rheological properties.

Figure 2.

Figure 2

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Subjective appetite ratings (least-square means; n = 47) after consumption of oat-based ready-to-eat cereals. Fullness at 240 minutes: p=0.01

Figure 3.

Figure 3

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Subjective appetite ratings (least-square means; n = 47) after consumption of oat-based ready-to-eat cereals. Stomach fullness at 30 minutes: p=0.01, 240 minutes: p=0.02.

Figure 4.

Figure 4

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Subjective appetite ratings (least-square means; n = 47) after consumption of oat-based ready-to-eat cereals. Desire to eat at 120 minutes: p=0.04.

Acknowledgments

F. L. Greenway designed the study, William Johnson was the study statistician, C.J. Rebello wrote the article and all authors edited the manuscript. The study was funded by PepsiCo Inc. The views expressed in this article are those of the authors and do not necessarily reflect the opinion or policies of PepsiCo, Inc. This publication was supported in part by the National Institutes of Health under Award Number T32 A T004094 and in part by 1 U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health which funds the Louisiana Clinical and Translational Science Center.

Footnotes

Conflicts of Interest

J. Johnson, M. O’Shea, and Y. Chu are employees of PepsiCo. Inc.

Study Site:

Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA

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