Effects of Oral and Gastric Stimulation on Appetite and Energy Intake

Appetite is regulated by many factors, including oro-sensory and gastric signals. There are many studies on contributions of and possible interaction between sensory and gastric stimulation, but there are few studies in humans using simultaneous oral and gastric stimulation. We investigated the effect of simultaneous, but independently manipulated, oral and gastric stimulation on appetite ratings and energy intake. We hypothesized that compared with no stimulation, oral and gastric stimulation would equally and additively decrease appetite ratings and energy intake. Healthy men (n = 26,21 +/- 2 years, BMI 22 +/- 3 kg/m(2)) participated in a randomized crossover trial with four experimental conditions and a control condition. Experimental conditions consisted of oral stimulation, with either 1 or 8min modified sham feeding (MSF), and gastric stimulation, with either 100 or 800 ml intragastrically infused liquid (isocaloric, 99 kcal, 100 ml/min). The control condition consisted of no oral or gastric stimulation. Outcome measures were energy intake 30min after the treatment and appetite ratings. Compared with the control condition, energy intake decreased significantly after the 8 min/100 ml (19% lower, P = 0.001) and 8min/800 ml conditions (15% lower, P = 0.02), but not after the 1 min/100 ml (14% lower, P = 0.06) and 1 min/800 ml conditions (10% lower, P = 0.39). There was no interaction of oral and gastric stimulation on energy intake. Hunger and fullness differed across all conditions (P <= 0.01). In conclusion, duration of oral exposure was at least as important in decreasing energy intake as gastric filling volume. Oral and gastric stimulation did not additively decrease energy intake. Longer oro-sensory stimulation, therefore, may be an important contributor to a lower energy intake.