Eating in the Absence of Hunger

Hat tip to Jane Plain and her ongoing series on “The physiology of body fat regulation” for citing this study as it provides a rather interesting insight into the psychoendoneuropathophysiology of the obese condition.  Eating in the Absence of Hunger.  

Caloric compensation and eating in the absence of hunger in 5- to 12-y-old weight-discordant siblings (Kral et al., 2012)

They were all full or half, weight-discordant, same-sex siblings and each sibling pair had the same mother; same mitochondrial DNA, shared a womb, etc.

Study design:study design

On Visit 1, they were all fed a 1000-1400 kcal dinner*, and then given 2873 kcal of snacks* [hint: all asterisks share the same meaning] to eat as much as they wanted.  After dinner, they are said to have been “in the Absence of Hunger,” so all subsequent snacking was considered: “Eating in the Absence of Hunger.”  Bigger/older kids got a little more to eat for dinner to try and make them all similarly satiated prior to snacking.  This is the gravitas.  The next part was tinkering: they gave a little (57-80 kcal) or a lot (97-136) of pudding* for an appetizer and measured food intake at dinner – did the kids who ate more pudding compensate by eating less dinner?   These pudding ‘preloads’ were isovolemic, 100 grams each, and only varied in energy density (more calories didn’t mean more physical filling of the stomach).

Theoretically, those who exhibited higher Eating in the Absence of Hunger would eat more food at dinner, after the pudding appetizer.

*The dinner/snacks/pudding they selected may have stacked the deck:snacks

*Tangent: in a sense, it’s like the authors wanted to ensure a positive result by doing this.  Metabolic Syndrome can be defined by responding positively to a low carb diet, and the opposite is probably close to true – obese are more susceptible to carb-induced metabolic deterioration and what not.  There are many more factors at play of course; I’m just saying maybe these scientists didn’t select these particular sugary carb-rich foods at random.  Perhaps they selected foods which they knew would differentially impact lean vs. obese kids, thus ensuring a positive result and a cool paper that would be lauded by the good editors at AJCN.  Or maybe I’m giving them too much credit… serendipity?  Ha!

Divide and conquer

Here’s what the lean kids ate:lean FI

Those fed the low cal preload (78 kcal) ended up eating 26 more kcals overall, meaning they compensated for 52 kcals of the appetizer.  Those fed the high cal appetizer (135 kcal) ended up eating 22 more kcals overall, meaning they compensated for 113 kcals.  WELL DONE, LEAN METABOLISMS!

Obese:obese FI

Those fed the low cal preload actually fully compensated by eating less food at dinner, whereas those fed the high cal preload overshot by almost 3-fold relative to their lean siblings (22 vs. 58 kcal).

*The difference between the low & high cal pudding appetizer preloads was small:preload

just sayin’

After a few bouts of statistical sorcery, looking at the two extremes (lean older siblings vs. obese younger siblings) they ended up saying the lean ones overcompensated by 175% and the obese overate by 126%.  I prefer straight talk, and so am taking those data with a grain of salt even though they agree with the subtext of this narrative (ie, the deck was stacked, unwittingly or otherwise).

Further, when the amount of snacking they did in the first test condition was taken into account, they calculated that lean kids compensated nearly perfectly whereas obese undercompensated by 50%.

“Eating in the Absence of Hunger” …  the bigger kids were fed more to compensate for their size and metabolic demands, so theoretically hunger was normalized across the board.  *If Metabolic Syndrome can be defined by a positive response to a low carb diet, then where is the inverse threshold?  conspiracy theorizing makes my brain hurt.  The easier conclusion is that for whatever reason, these obese kids failed to properly regulate food intake. acutely. of a high carb diet after a high carb snack.  Proposition for future study: keto.


calories proper

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  • George Henderson

    An interesting correlation I saw in a similar study that varied the preloading meals; the bigger the lunch, the more food was eaten at dinner. Which is consistent with CIHO, if you ask me.

    • William Lagakos

      Anything on meal composition? I’ve been trolling Pubmed & Scholar for a while in search of any interactions, positive or negative, relative to composition of the preload.

      • thisisbetty

        This is just a laypeeps article from a few months ago but it’s kind of related and interesting.

        I’ve always known people who claim that eating breakfast just makes them hungry all day. Growing up I was always starving at school before lunch and after eating my cheerios and milk with OJ for breakfast.

        It seems clear that not everyone responds that way of course. Seems for me it was a sign of things to come as I didn’t have any weight issues at all until early adulthood.

        • William Lagakos

          Hi Betty,
          Thanks for the link. The literature in this area is really in its infancy – intermittent fasting, nutrient timing, etc. – cool stuff.

          Come to think of it, “adult onset” may have nothing to do with age, but maybe some other lifestyle change that has nothing to do with it…eg, new job that has a fun lunch break, so you no longer fast from breakfast until dinner. or maybe just lunch break at a different time. probably also interacts with diet composition. Sorry for the rant!

          • thisisbetty

            It is cool!

            I don’t have a medical background at all … but I first discovered Good Cals Bad Cals at the library when it was just released.

            For awhile there wasn’t much I could find out there about its subject matter online (maybe didn’t know where to look), and of course the average person thinks your mental if you try to discuss any of it or the other heresies.

            For example I think a person could get a less negative reaction for saying they snort crack for breakfast rather then skipping it entirely .. gotta jump start that metabolism or all is lost dontchaknow?

            Ok maybe that’s a bit extreme. : > .. anyway .. it’s great to find all these people online trying to advance things beyond the nutritional dark ages. The pushback to straight CICO never ceases to amaze.

          • William Lagakos

            Yes, that is a bit extreme, but I’ve heard worse 😉

  • George Henderson

    That only applied to obese subjects. I think this may have been it:
    “The satiation mechanism of obese subjects was also different from lean subjects. For example, obese subjects overate after preloads while lean subjects underate compared to their baselines.”

    • William Lagakos

      In lean women, a protein-enriched appetizer did the trick (better than carbs, alcohol, and fat). But this study was designed completely differently – 90 minute intermeal interval.
      …my quest to find keto meals tested in obese continues…

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  • Jane Plain (Woo)

    Fabulous post 😉
    See what full text reveals! Trickery! 100% of the “high cal” preload was carb increase. Surprise to no one except most obesity researchers, the fat children failed to compensate for these calories; obesity resistant lean children ate almost exactly the same total calories. Leanness suggests limited susceptibility to goldfish cracker induced hyperinsulinemic mediated fat gain.

    It would be amazing to compare, perhaps, a very low GI, lower carb diet and similar design… like, instead of snacking on “high cal” food of white flour starches, see how well the fat children compensate for snack calories of almonds and macadamia nuts, relative to thin children. I believe not only will children spontaneously start losing weight (as insulin mediated fat storage is attenuated) but they will exhibit normal accounting for calories eaten before dinner.

    In fact, I know this n=1 experience because I was once a chubby child placed on low carb diet. Everyone praised me for my kindergarten willpower for losing so much weight. All I knew was that fatty roast beef and chicken = yummy, so I was a happy little brat eating to gluttony with no cal restriction.

    • William Lagakos

      Trickery! thanks, and for the improved definition of leanness = “limited susceptibility to goldfish cracker induced hyperinsulinemic mediated fat gain” :)

      wait – you really had that experience in kindergarten!? always surprised when I hear about stuff like that IRL (or in Internet Real Life).

  • William Lagakos

    Short-term overeating results in incomplete energy intake compensation regardless of energy density or macronutrient composition