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Meta-Analysis
. 2021 Jul 30;12(4):1177-1195.
doi: 10.1093/advances/nmaa178.

Effects of Whole Grain Intake, Compared with Refined Grain, on Appetite and Energy Intake: A Systematic Review and Meta-Analysis

Lisa M Sanders  1 , Yong Zhu  2 , Meredith L Wilcox  1 , Katie Koecher  2 , Kevin C Maki  1   3
Affiliations
Meta-Analysis

Effects of Whole Grain Intake, Compared with Refined Grain, on Appetite and Energy Intake: A Systematic Review and Meta-Analysis

Lisa M Sanders et al. Adv Nutr. .

Abstract

Results from observational studies indicate that whole grain (WG) intake is inversely associated with BMI and risk of weight gain. WG intake may influence energy balance and body composition through effects on appetite and energy intake. To evaluate the impact of WG food consumption on appetite and energy intake, a systematic review and meta-analysis was performed of results from randomized controlled trials (RCTs) assessing WG food consumption, appetite, and energy intake in adults. A search of PubMed, Scopus, and Food Science and Technology Abstracts yielded 36 RCTs measuring subjective appetite ratings after consuming WG foods compared with refined grain (RG) controls. Thirty-two of these studies reported AUCs for subjective appetite (hunger, fullness, satiety, desire to eat, or prospective consumption) and/or energy intake and were included in the meta-analysis. Pooled estimates from meta-analyses are expressed as standardized mean differences (SMDs). Compared with RG foods, intake of WG foods resulted in significant differences in AUCs for subjective hunger (SMD: -0.34; 95% CI: -0.46, -0.22; P < 0.001), fullness (SMD: 0.49; 95% CI: 0.31, 0.66; P < 0.001), satiety (SMD: 0.33; 95% CI: 0.18, 0.47; P < 0.001), and desire to eat (SMD: -0.33; 95% CI: -0.46, -0.20; P < 0.001). There were small, nonsignificant reductions in prospective consumption ratings (P = 0.08) and energy intake (P = 0.07) with WG intake compared with RG. These results support the view that consumption of WG foods, compared with RG foods, significantly impacts subjective appetite, and might partly explain the inverse associations between WG food intake and risk of overweight, obesity, and weight gain over time. PROSPERO registration: CRD42020148217.

Keywords: appetite; desire to eat; energy intake; fullness; hunger; meta-analysis; prospective food consumption; randomized controlled trials; satiety; whole grain.

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Figures

FIGURE 1
FIGURE 1
Flow diagram of literature search process for the effect of WGs on subjective appetite and energy intake in adults. FSTA, Food Science & Technology Abstracts; WG, whole grain.
FIGURE 2
FIGURE 2
Forest plot of the meta-analysis on the effect of WG intake on hunger in adults. Values are the standardized mean differences (SMDs) for hunger AUC between WG intake and RG intake (21, 22, 28–43). Comm., commercial; Ctrl., control; RG, refined grain; var., variety; WG, whole grain.
FIGURE 3
FIGURE 3
Forest plot of the meta-analysis on the effect of WG intake on fullness in adults. Values are the standardized mean differences (SMDs) for fullness AUC between WG intake and RG intake (28, 30, 32, 33, 35, 36, 38–43). Comm., commercial; Ctrl., control; RG, refined grain; var., variety; WG, whole grain.
FIGURE 4
FIGURE 4
Forest plot of the meta-analysis on the effect of WG intake on satiety in adults. Values are the standardized mean differences (SMDs) for satiety AUC between WG intake and RG intake (21, 29, 31–34, 36, 38, 39, 43–46). Ctrl., control; HAWG, high-amylose whole grain; RG, refined grain; var., variety; WG, whole grain.
FIGURE 5
FIGURE 5
Forest plot of the meta-analysis on the effect of WG intake on desire to eat in adults. Values are the standardized mean differences (SMDs) for desire to eat AUC between WG intake and RG intake (21, 28–31, 34, 37, 39–42). Comm., commercial; Ctrl., control; RG, refined grain; var., variety; WG, whole grain.
FIGURE 6
FIGURE 6
Forest plot of the meta-analysis on the effect of WG intake on prospective consumption in adults. Values are the standardized mean differences (SMDs) for prospective consumption AUC between WG intake and RG intake (32, 33, 36, 38, 43, 47, 61). Ctrl., control; RG, refined grain; var. variety; WG, whole grain.
FIGURE 7
FIGURE 7
Forest plot of the meta-analysis on the effect of WG intake on energy intake in adults. Values are the standardized mean differences (SMDs) for caloric intake between WG intake and RG intake (13, 29, 31, 32, 36, 38–40, 43, 48–56). Ctrl., control; RG, refined grain; WG, whole grain.
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