ࡱ> =>  !"#$%&'()*+,-./0123456789:;<@?JIABCDEFGH`LKNMOPQRSTUVWXYZ[\]^_abcdefghijklmnopqrsRoot Entry Fd&N@CompObjnWordDocument5ObjectPool @JN@JN  !"#$&+-./0138:;<=>@EGHIJKMRTUVWXZ^_`abcdefgh FMicrosoft Word 6.0 Document MSWordDocWord.Document.69qࡱࡱ> Lࡱ> B  .1  &`` & MathType "-(e(Oܥe- e}"   Dfffff~(@fZh(Ԩ֨֨֨ȩThS BH ԨPh ԨDprof. dr. sc. Milena L. Mandi Faculty of Food Technology Kuhaeva 18 pp 709 HR-31107 Osijek CROATIA Tel: ++385 31 551 615 Fax: ++385 31 121 291 E-mail: Milena.Mandic(ptfos.hr Dr Barry J Everitt Editor-in-Chief, Physiology and Behavior Department of Experimental Psychology University of Cambridge Dear Dr Everitt, We have revised the manuscript BE 96/367 as requested by the referee. Enclosed are two copies of the manuscript and a matching diskette. We have accepted the suggestion by referee 1 about the cut-off point for obesity. Due to a lack of European or Croatian standards the first cut-off we used was a mean for a sample of local 7th grade pupils found in a 1985 survey. Since there were actually 234 13-yr-old children that participated in our present study (not all of them were chosen for the food preference survey) we have calculated new cut-off points as 85th percentiles of the original group for boys and girls respectively. We also accept the changes to the title. We have included a more comprehensive discussion of the results in light of earlier findings on food preference as requested by referee 1. According to this referee's suggestions we have decided to use only one table to present differences in hedonic ratings between boys and girls as well as between obese and normal-weight children. We also thank referee 1 for the help with the language of the paper. We apologize for the delay in revising the manuscript. Season's greetings! Sincerely Adolescent Acceptance of Different Foods by Obesity Status and by Sex MARIJA ADAM PERL,1 MILENA L. MANDI,2 LJILJANA PRIMORAC,2 TOMISLAV KLAPEC2 and ANTONIJA PERL2 1Clinical Hospital Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia, 2University J. J. Strossmayer, Faculty of Food Technology, F. Kuhaa 18, HR-31107 Osijek, Croatia Prof. dr. sc. Milena L. Mandi Faculty of Food Technology F. Kuhaa 18 pp 709 HR-31107 Osijek C R O A T I A Tel: +385 31 551 615; Fax: +385 31 121 291; E-mail: Milena.Mandic(ptfos.hr ABSTRACT MARIJA ADAM PERL, MILENA L. MANDI, LJILJANA PRIMORAC, TOMISLAV KLAPEC AND ANTONIJA PERL. Adolescent Acceptance of Different Foods by Obesity Status and by Sex This work investigated possible differences in food preference between obese and normal-weight adolescents, as well as between female and male 7th grade pupils (average age = 13.1 years). Survey of affinities for nine food groups was determined with a facial hedonic scale. The children were divided according to their BMI into normal-weight and obese group, respectively. In this sample of adolescents we could not find any proof for the theory of increased preference for fattening foods by obese compared to normal-weight people. In fact, our normal-weight group showed greater liking of sweets, meat and cereals than the obese group. Normal-weight boys also preferred meat and sweets more than normal-weight girls. We consider psychological and social factors (e.g. perception of ideal body shape or social stigmatism of obesity) as the most logical explanations for the observed differences. Further research should clarify whether food preference plays a significant role in the etiology of adolescent obesity. Adolescents; Food preference; Hedonic scale; Obesity status; Body mass index; Sex INTRODUCTION Obesity is one of the most common disorders in developed countries. Aside from its possible psychological and social implications, it is associated with a number of health problems like hyperlipidemia, carbohydrate intolerance, pulmonary and renal problems, pregnancy complications, hypertension and diabetes (3(. Obesity increases both overall mortality and the risk of death from CVD with newest studies showing that these risks decline with age (34; 38; 50(. Prevalence of obesity is increasing both in adults and children over the last decades (30; 36; 51(. Essentially, scientists agree on genetic, as well as nutritional background of the disorder. The unfavorable ratio between energy intake and level of physical activity is often blamed as the main cause for the rise in childhood obesity. Obesity in childhood usually tracks into adulthood (6(. The difficulties associated with the necessary multiple approach in the treatment of obesity warrant the need for effective preventive measures applicable in early childhood (24(. Food preference could have a role in the etiology of obesity. It has been shown that highly palatable foods can bring about obesity in experimental animals (2; 45(. In humans it is a much more complex issue. It has been found that dieting status has a greater influence than weight on food preference of adolescents (7(. Deviations of food preference in psychologically-based eating disorders like anorexia and bulimia nervosa have also been detected (9; 10; 47(. Similarly, lower preference for high-sucrose and high-fat stimuli have also been reported for female athletes (8(. An association between food preference and sensory ratings of olfactory stimuli has been found, which could be pointing to a physiological basis of food preference (23(. Obese people are generally regarded as over-responsive to sweet foods. However, as pointed out by some authors, some of the incriminated, highly palatable foods like chocolate and cookies, are rich in fat as well as in carbohydrates and sucrose. (12(. The same group of authors also reported an increased preference for sweetened high-fat foods in obese subjects (11(. It appears that opioid peptides control food intake, regulating the pleasure response to foods (37(. Higher plasma levels of opioid peptides have been found in obese women, as compared to normal-weight women (29(. The same has been found in obese rats (40(. It has been suggested that abnormalities in the secretion of endogenous peptides could account for elevated sensory preference and overeating of sweet high-fat foods (14(. It has also been shown, both in experimental animals and humans, that consumption of such foods increases release of opioid peptides (19; 28(. Therefore, it is possible that opioid effects form the basis for the development of food preferences. There is new evidence for genetic influence on food preference (21(. The authors also emphasized the importance of accessibility of preferred foods, for preference to have an effect on the use of such foods. The importance of parental influence for the development of food preferences in children has also been emphasized (35(. This work investigates possible differences in food preference between obese and normal-weight adolescents, as well as between female and male adolescents. In our survey we tested the hypothesis of obese people's greater acceptance of certain foods, which could be an important factor in the etiology of the disorder because of the strong effect food preference has on food choice and consumption. METHODS This investigation was carried out among seventh grade pupils of two elementary schools in Osijek, Croatia. 40 girls and 61 boys of an average age of 13.1 years participated. Height was measured to the nearest 0.5 cm with subjects standing without shoes, heels together and head in horizontal Frankfurter plane. Body weight was measured to the nearest 0.1 kg, using a SECA scale, with subjects only lightly dressed. Body mass index (BMI), an indicator of the state of nourishment, was calculated on the basis of the anthropometric data on body height and weight The marginal values for obesity were the BMIs of 24.83 for 13-yr-old girls, and 24.00 for 13-yr-old boys. The values represent the 85th percentiles of the mean BMIs for 116 boys and 118 girls from two elementary schools in the area, since there exist no appropriate European or Croatian standards. According to this, there were 13.7% obese children (12.9% of boys and 14.4% of girls) in the schools under study, but since one of the aims of the study was to test food acceptance of obese and normal-weight children, the children were intentionally chosen according to their BMI in order to increase the number of obese ones. The obese group consisted of 26 (14 girls and 12 boys) and the normal-weight group of 75 participants (26 girls and 49 boys). Normal-weight girls had the mean BMI of 20.94 ( 1.93 compared to the value of 19.57 ( 2.07 by normal-weight boys. The mean BMIs of obese girls and boys were 28.71 ( 1.55 and 28.85 ( 3.64, respectively. The children's affinity for the main food groups was determined with an acceptance test using a seven-point facial hedonic scale (41(. Each "face" presented one of the following attitudes: like extremely, like very much, like moderately, neither like or dislike, dislike moderately, dislike very much, and dislike extremely. The attitudes were allocated appropriate scores from 7 to 1. Foods were divided among the nine following groups with representative examples of each group given in parentheses for clarification purposes: 1-cereal products (breads, rice, pasta) 2-milk and products (milk, cocoa drink, plain yogurt, fruit yogurt, fresh cheese, ripened cheese) 3-meat (pork, beef, chicken, sausage, salami, hot dog, lunch meat) 4-fish 5-eggs (boiled eggs, fried eggs) 6-fats and products (butter, margarine, mayonnaise, bacon) 7-vegetables (lettuce, coleslaw, green pepper, tomato, pickled gherkins, boiled potato, pommes frittes, swiss chard stew, kale stew, cabbage stew, spinach stew) 8-fruits (apple, banana, orange) 9-confectionery (chocolate, honey, cookies, marmelade, "kinder lada", ice cream) Children filled out the food acceptance test form at home under parental supervision, with the exception of a few cases when we assisted the children at school due to parental unreliability. Results of hedonic rating for the childrens attitude towards foodstuffs were examined in relation to obesity status and sex. Paired t-test was used to evaluate differences between means. Differences were considered statistically significant for values of p<0.05. RESULTS Mean hedonic scores ( ( SD) for different food groups as given by normal-weight and obese 13-yr-old adolescents, are given in Table 1. Significantly higher mean scores by the normal-weight group were found for confectionery (p=0.028), meat (p=0.018) and cereal products (p=0.005). Comparing hedonic scores between obese and normal-weight girls we could not find any significant difference (Table 1). However, normal-weight boys had a higher mean score than obese boys for confectionery (p=0.012) (Table 1). The mean hedonic scores for meat and confectionery, respectively, given by normal-weight boys are significantly higher than the value by normal-weight girls (p=0.005 and p=0.0004, respectively) (Table 1). There was no significant difference whatsoever between the obese boys' and obese girls' mean hedonic scores for different foodgroups (Table 1). DISCUSSION In the investigated group of 13-yr-old adolescents we found significant difference between normal-weight and obese children in preference for confectionery, meat and products, and cereal products. On the basis of earlier findings by several authors (27; 54( we expected to see obese children's better acceptance of sweets, but the results of hedonic scoring showed the opposite. Previous research on taste preference for sweet solutions gave inconclusive results (4; 31; 39; 44; 53(. Therefore, Drewnowski et al. based their investigations of food preferences on mixtures of milk, cream and sugar in order to obtain "complex sensory stimuli that are more representative of foods commonly encountered in the diet (11; 12(. The results suggested that there was an increased preference for sweet, high fat foods by obese people, which is in agreement with earlier findings of obese people's cravings for sweets like chocolate, cookies and ice cream (54(. However, in later publications, Drewnowski et al. divided obese subjects into subgroups according to age at onset of obesity and past fluctuations in body weight (16; 17(. The results led them to conclude that not all obese people are equally or at all overresponsive to sweets. The unexpected results in our group of adolescents could be a reflection of that, as well as the fact that a relatively small number of obese children participated. A psychological background of the results is also possible. This could be attributed to the self-consciousness of the obese children, enhanced by the social stigmatism of obesity, which is especially pronounced during adolescence (33; 48; 52(. The resulting sense of guilt could have affected their open declaration of liking. The normal-weight children, however, free from inhibitions, openly expressed their positive acceptance of confectionery. It has been observed before that obese subjects do not react spontaneously to stimuli related to their problem (5(. Drewnowski et al. also concluded that self-reported food preference is biased in the obese (15; 18(. We did not find any difference between normal-weight and obese girls for any of the food groups (Table 1). However, normal-weight boys had a higher mean score for confectionery compared to obese boys. The higher score for fruits by normal-weight boys is marginally insignificant (p=0.054, respectively). Both normal-weight girls and boys rated cereal products better than their obese counterparts, but not statistically significantly so (p=0.094 and p=0.054, respectively). This explains the higher mean hedonic score for the food group by the combined normal-weight group (Table 1). The combined normal-weight group showed a significantly higher score for meat and meat products. This is primarily based on the rating by the normal-weight boys since both normal-weight and obese boys rated meat better than respective female groups (NW boys vs. NW girls, p=0.005; OB boys vs. OB girls, p=0.079). Normal-weight boys also rated sweets significantly higher than normal-weight girls (Table 1). It is obvious hereby that better liking for sweets by the combined normal-weight group can almost exclusively be ascribed to normal-weight males. Similarly, Monneuse et al. reported that palatability of dairy products grew along with sucrose concentration in young boys (42(. Older groups of both men and women showed inverted U-shaped preference functions with optimal sucrose level at 10% in females and 20% in males. Frye et al. also found elevated preference for sugar / fat mixtures in men compared to women (25(. Men preferred both the mixtures with 10% and 20% sucrose. Normal-weight boys also showed better acceptance of fats in comparison to their female peers, but this did not reach statistical significance (p=0.059). The decreased preference for sweets, meat and fats in normal-weight girls might have reflected the often found negative attitude toward sweet and fatty foods which is much more profound in females (1; 22; 49(. As early as elementary education children obtain their first knowledge on the importance of nutrition, as well as of the foods predominantly associated with obesity, such as sweets and fats. Adolescent girls already tend to use popular women from media and show-business as role models, which glorify the "ideal" image of thin female stature. It has been found that about two-thirds of adolescent girls at any age are dissatisfied with their weight (43(. More than half of all girls in the study were dissatisfied with the shape of their bodies. At the same time, only underweight boys were dissatisfied with their weight, while normal-weight boys wanted to weigh more. One third of boys were dissatisfied with their body shape, wishing a more masculine stature. Similarly, other workers showed that greater personal dissatisfaction, a thinner ideal body shape and a more negative attitude towards obesity were associated with female children (32; 46; 52(. Extreme aversion to high-fat foods exists in anorexia nervosa which predominantly develops in females (13; 47(. Frye and Demolar found a significant difference between sexes in preference for salty (26(. Further research is needed to determine whether this is in any connection to our finding of lower preference for meat by normal-weight girls as compared to boys. The mean scores obtained by all investigated children were in the positive range of the hedonic scale for all food groups, with a slightly more positive means for fruits ( EMBED Equation.2 =6.36), and more negative for fats and products ( EMBED Equation.2 =4.65). Boys rated higher the following food groups: cereal products, milk and dairy products, meat and meat products, eggs, fats and products, vegetables and confectionery (Table 1). The average score for milk and dairy products, including all children, was 5.53, which is between the categories "like moderately" and "like very much". Only five children (three boys and two girls) associated their liking of the food group with the "like extremely" category. Milk and dairy products are rich sources of dietary calcium, phosphorus and protein, and are also significant contributors of some micronutrients (vitamins A, D, B2, B12) to the diet. It has been observed that people are usually small in countries where there is little consumption of milk during childhood (20(. Although it is impossible to predict the actual consumption of milk and dairy products on the basis of acceptance expressed by this group of adolescents, we would be much more pleased with a greater degree of liking toward this food group of special significance in adolescent development. None of the children, used the highest category to express their acceptance of vegetables, which along with fats ( EMBED Equation.2 =4.65) and fish ( EMBED Equation.2 =4.83), had the lowest mean score ( EMBED Equation.2 =4.99) in this group of children (Table 1). This is another concerning fact because of the indispensable role this food group has in supplying the necessary dietary fiber and micronutrients to human nutrition. Fruits had the highest mean hedonic score ( EMBED Equation.2 =6.36). Their refreshing aroma probably accounts for the advantage this food group has gained over vegetables, which have similar value considering their contributions in the form of micronutrients and dietary fiber. According to the presented results, we found no increased preference for fattening foods as reported by the obese as compared to the normal-weight children. This might suggest that factors other than preference are important for the etiology of obesity. However, the social stigmatization of obesity may have suppressed the declaration of a preference by this group of obese adolescents. Physiological and psycho-social factors are the most logical explanations for the observed differences in food preference between normal-weight boys and girls. REFERENCES 1. Bellisle, F.; Monneuse, M. O.; Steptoe, A.; Wardle, J. Weight concerns and eating patterns: A survey of university students in Europe. Int. J. Obes. 19:723-730; 1995. 2. Bray, G. A. Obesity, a disorder of nutrient partitioning: The MONA LISA hypothesis. J. Nutr. 121:1146-1162; 1991. 3. Brownell, K. D. Obesity: Understanding and treating a serious, prevalent and refractory disorder. J. Consult. Clin. Psychol. 50:820-823; 1982. 4. Cabanac, M.; Duclaux, R. Obesity: Absence of satiety aversion to sucrose. Science 168:496-497; 1970. 5. Cairella, M.; D'Ippolito, A.; Godi, R.; Modestini, M. P.; Oliva, D.; Ruggieri, V. L'obeso e lo spot pubblicitario: Un'ipotesi di ricerca. Clinica Dietologica 21:73-75; 1994. 6. Clarke, W. R.; Lauer, R. M. Does childhood obesity track into adulthood? CRC Crit. Rev. Food Sci. Nutr. 33:423-430; 1993. 7. Contento, I. R.; Michela, J. L.; Williams, S. S. Adolescent food choice criteria: role of weight and dieting status. Appetite 25:51-76; 1995. 8. Crystal, S.; Frye, C. A.; Kanarek, R. B. Taste preferences and sensory perceptions in female varsity swimmers. Appetite 24:25-36; 1995. 9. Drewnowski, A. Changes in mood following carbohydrate consumption. Am. J. Clin. Nutr. 46:703; 1987. 10. Drewnowski, A.; Bellisle, F.; Aimez, P.; Remy, B. Taste and bulimia. Physiol. Behav. 41:621-626; 1987. 11. Drewnowski, A.; Brunzell, J. D.; Sande, K.; Iverius, P. H.; Greenwood, M. R. C. Sweet tooth reconsidered: Taste responsiveness in human obesity. Physiol. Behav. 35:617-622; 1985. 12. Drewnowski, A.; Greenwood, M. R. C. Cream and sugar: Human preferences for high-fat foods. Physiol. Behav. 30:629-633; 1983. 13. Drewnowski, A.; Halmi, K. A.; Pierce, B.; Gibbs, J.; Smith, G. P. Taste and eating disorders. Am. J. Clin. Nutr. 46:442-450; 1987. 14. Drewnowski, A.; Krahn, D. D.; Demitrack, M. A.; Nair, K.; Gosnell, B. A. Taste responses and preferences for sweet high-fat foods: Evidence for opioid involvement. Physiol. Behav. 51:371-379; 1992. 15. Drewnowski, A.; Kurth, C.; Holden-Wiltse, J.; Saari, J. Food preferences in human obesity: Carbohydrates versus fats. Appetite 18:207-221; 1992. 16. Drewnowski, A.; Kurth, C. L.; Rahaim, J. E. Taste preferences in human obesity: Environmental and familial factors. Am. J. Clin. Nutr. 54:635-641; 1991. 17. Drewnowski, A.; Holden-Wiltse, J. Taste responses and food preferences in obese women: Effects of weight cycling. Int. J. Obes. 16:639-648; 1992. 18. Drewnowski, A.; Rock, C. L. The influence of genetic taste markers on food acceptance. Am. J. Clin. Nutr. 62:506-511; 1995. 19. Dum, J.; Gramsch, C.; Herz, A. Activation of hypothalamic beta-endorphin pools by reward induced by highly palatable food. Pharmacol. Biochem. Behav. 18:443-447; 1983. 20. FAO. Handbook on human nutritional requirements. Rome; 1974. 21. Faciglia, G. A.; Norton, P. A. Evidence for a genetic influence on preference for some foods. J. Am. Diet. Assoc. 94:154-158; 1994. 22. Fiddes, N. Social aspects of meat eating. Proc. Nutr. Soc. 53:271-280; 1994. 23. Frank, R. A.; van der Klaauw, N. J. The contribution of chemosensory factors to individual differences in reported food preferences. Appetite 22:101-123; 1994. 24. Frelut, M. L.; Isnard, P. Pr(vention et prise en charge de l' ob(sit( de l'enfant. M(decine et Nutrition 30:146-151; 1994. 25. Frye, C. A.; Crystal, S.; Ward, K. D.; Kanarek, R. B. Menstrual cycle and dietary restraint influence taste preferences in young women. Physiol. Behav. 55:561-567; 1994. 26. Frye, C. A.; Demolar, G. L. Menstrual cycle and sex differences influence salt preferences. Physiol. Behav. 55:193-197; 1994. 27. Geiselman, P. J.; Novin, D. The role of carbohydrates in appetite, hunger and obesity. Appetite 3:203-223; 1982. 28. Getto, C. J.; Fullerton, D. T.; Carlson, I. H. Plasma immunoreactive beta-endorphin response to glucose ingestion in human obesity. Appetite 5:329-335; 1984. 29. Givens, J. R.; Wiedemann, E.; Andersen, R. N.; Kitabchi, A. E. B-Endorphin and B-lipotropin plasma levels in hirsute women: Correlation with body weight. J. Clin. Endocrinol. Metab. 50:975-976; 1980. 30. Gortmaker, S. L.; Dietz, W. H.; Sobol, A. M.; Wehler, C. A. Increasing pediatric obesity in the United States. Am. J. Dis. Child. 141:535-540; 1987. 31. Grinker, J. Obesity and sweet taste. Am. J. Clin. Nutr. 31:1078-1087; 1978. 32. Hill, A. J.; Draper, E.; Stack, J. A weight on children's minds: Body shape dissatisfactions at 9-years old. Int. J. Obes. 18:383-389; 1994. 33. Hoerr, S. L.; Kallen, D.; Kwantes, M. Peer acceptance of obese youth: A way to improve weight control efforts? Ecol. Food Nutr. 33:203-213; 1995. 34. Hubert, H. B.; Feinleib, M.; McNamara, P. M.; Castelli, W. P. Obesity as an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in the Framingham heart study. Circulation 67:968-977; 1983. 35. Koivisto, U. K.; Fellenius, J.; Sj(d(n, P. O. Relations between parental mealtime practices and children's food intake. Appetite 22:245-257; 1994. 36. Kuczmarski, J.; Flegal, K. M.; Campbell, S. M.; Johnson, C. L. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA 272:205-211; 1994. 37. LeMagnen, J. A role for opiates in food reward and food addiction. In: Capaldi, E. D.; Powley, T. L., eds. Taste, experience and feeding. Washington, DC: APA Press; 1990:241-252. 38. Lindsted, K. D.; Singh, P. N. Body mass and 26-year risk of mortality among women who never smoked: Findings from the Adventist Mortality Study. Am. J. Epidemiol. 146:1-11; 1997. 39. Malcolm, R.; O'Neil, P. M.; Hirsch, A. A.; Currey, H. S.; Moskowitz, G. Taste hedonics and thresholds in obesity. Int. J. Obes. 4:203-212; 1980. 40. Margules, D. L.; Moisset, B.; Lewis, M. J.; Shibuya, H.; Pert, C. B. Beta-endorphin is associated with overeating in genetically obese mice (ob/ob) and rats (fa/fa). Science 202:988-991; 1978. 41. Meilgaard, M.; Civille, B. S.; Carr, B. T. Sensory evaluation techniques. Boca Raton, Ann Arbor, Boston, London: CRC Press, Inc; 1991:213-216. 42. Monneuse, M. O.; Bellisle, F.; Louis-Sylvestre, J. Impact of sex and age on sensory evaluation of sugar and fat in dairy products. Physiol. Behav. 50:1111-1117; 1991. 43. Moore, D. C. Body image and eating behavior in adolescents. J. Am. Coll. Nutr. 12:505-510; 1993. 44. Rodin, J.; Moskowitz, H. R.; Bray, G. A. Relationship between obesity, weight loss and taste responsiveness. Physiol. Behav. 17:591-597; 1976. 45. Rothwell, N. J.; Stock, M. J. A paradox in the control of energy intake in the rat. Nature (London) 273:146-147, 1978. 46. Sasson, A.; Lewin, C.; Roth, D. Dieting behavior and eating attitudes in Israeli children. Int. J. Eat. Dis. 17:67-72; 1995. 47. Simon, Y.; Bellisle, F.; Monneuse, M. O.; Samuel-Lajeunesse, B.; Drewnowski, A. Taste responsiveness in anorexia nervosa. Brit. J. Psych. 162:244-_951126691F$N ONOle PIC LMETA hTimes New Romant- 2 `@X & "System-"System-ࡱ FMicrosoft Equation 2.0 DS Equation Equation.29qࡱ>ࡱ> C EHFF 2X.#dqࡱ> CompObj fObjInfo Equation Native <_951126690 F8NgN246; 1993. 48. Sobal, J.; Nicolopoulos, V.; Lee, J. Attitudes about overweight and dating among secondary school students. Int. J. Obes. 19:376-381; 1995. 49. Stafleu, A.; de Graaf, C.; van Staveren, W. A. Attitudes towards high-fat foods and their low-fat alternatives: Reliability and relationship with fat intake. Appetite 22:183-196; 1994. 50. Stevens, J.; Cai, J.; Pamuk, E. R.; Williamson, D. F.; Thun, M. J.; Wood, J. L. The effect of age on the association between body-mass index and mortality. N. Engl. J. Med. 338:1-7; 1998. 51. Sunnegardh, J.; Bratteby, L. E.; Hagman, U.; Samuelson, G.; Sjolin, S. Physical activity in relation to energy intake and body fat in 8 and 13-year-old children in Sweden. Acta Paediatr. Scan. 75:955-963; 1986. 52. Wardle, J.; Volz, C.; Golding, C. Social variation in attitudes to obesity in children. Int. J. Obes. 19:562-569; 1995. 53. Wooley, O. W.; Wooley, S. C.; Dunham, R. B. Calories and sweet tastes: Effects on sucrose preference in the obese and non-obese. Physiol. Behav. 9:765-768; 1972. 54. Wurtman, J. J. The involvement of brain serotonin in excessive carbohydrate snacking by obese carbohydrate cravers. J. Am. Diet. Assoc. 9:1004-1007; 1984. Table 1, Hedonic ratings of different foodstuffs by 13-yr-old adolescents divided into subgroups according to sex and obesity status (NW -normal-weight; OB -obese) FOOD GROUPADOLESCENTSEMBED Equation.2( SD Cereal products overall NW OB girls NW OB boys NW OB 5.52 ( 0.71( 5.01 ( 0.98 5.36 ( 0.66 4.93 ( 0.94 5.61 ( 0.72 5.10 ( 1.06 Milk and dairy products overall NW OB girls NW OB boys NW OB5.51 ( 0.98 5.58 ( 0.72 5.45 ( 0.98 5.45 ( 0.81 5.54 ( 0.99 5.74 ( 0.61 Meat overall NW OB girls NW OB boys NW OB 5.55 ( 0.84( 5.07 ( 0.97 5.18 ( 0.91 4.76 ( 1.04 5.75 ( 0.74( 5.43 ( 0.78 Fish overall NW OB girls NW OB boys NW OB4.87 ( 1.89 4.69 ( 1.95 4.85 ( 1.95 5.00 ( 2.07 4.89 ( 1.89 4.33 ( 1.83 Eggs overall NW OB girls NW OB boys NW OB5.59 ( 1.29 5.61 ( 1.07 5.46 ( 1.42 5.79 ( 1.10 5.66 ( 1.23 5.42 ( 1.04 Fats and products overall NW OB girls NW OB boys NW OB4.71 ( 1.36 4.49 ( 1.24 4.30 ( 1.45 4.17 ( 1.39 4.92 ( 1.27 4.87 ( 0.95 Vegetables overall NW OB girls NW OB boys NW OB5.06 ( 0.94 4.79 ( 1.04 5.05 ( 1.07 4.53 ( 1.14 5.06 ( 0.88 5.09 ( 0.87 Fruits overall NW OB girls NW OB boys NW OB6.38 ( 0.77 6.28 ( 1.04 6.33 ( 0.84 6.64 ( 0.55 6.41 ( 0.73 5.86 ( 1.31 Confectionery overall NW OB girls NW OB boys NW OB 5.77 ( 0.99( 5.27 ( 0.95 5.23 ( 1.19 5.15 ( 1.03 6.05 ( 0.75(( 5.41 ( 0.86 ( -significantly higher than NW girls (p<0.05); ( -significantly higher than OB boys (p<0.05) ( -significantly higher than OB overall (p<0.05) PAGE 14 PAGE 14 #n.Annn 7.ASSS.Aee.ASSSSn.:H  .1  &`d & MathType-DfDPTimes New Romanp- 2 =X & "System-F/&-ikࡱ> Ole PIC  LMETA hCompObjfLࡱ> B  .1  &`` & MathType "-(e(OTimes New Romant- 2 `@X & "System-"System-ࡱ FMicrosoft Equation 2.0 DS Equation Equation.29qࡱ>ࡱ> C EHFF 2X.#dqࡱ> Lࡱ> B  .ObjInfoEquation Native <_951126689FN NOle PIC LMETA hCompObj%fObjInfo'1  &`` & MathType "-(e(OTimes New Romant- 2 `@X & "System-"System-ࡱ FMicrosoft Equation 2.0 DS Equation Equation.29qࡱ>ࡱ> Equation Native (<_951126688'F[NNOle )PIC *LC EHFF 2X.#dqࡱ> Lࡱ> B  .1  &`` & MathType "-(e(OTimes New Romant- 2 `@XMETA ,hCompObj2fObjInfo4Equation Native 5< & "System-"System-ࡱ FMicrosoft Equation 2.0 DS Equation Equation.29qࡱ>ࡱ> C EHFF 2X.#dqࡱ> L_951126687"F NSNOle 6PIC !$7LMETA 9hࡱ> B  .1  &`` & MathType "-(e(OTimes New Romant- 2 `@X & "System-"System-ࡱ FMicrosoft Equation 2.0 DS EqCompObj#%?fObjInfo&AEquation Native B<_951126686. )F`_NNuation Equation.29qࡱ>ࡱ> C EHFF 2X.#dqࡱ> Lࡱ> B  .1  &`` &Ole CPIC (+DLMETA FhCompObj*,Lf MathType "-(e(OTimes New Romant- 2 `@X & "System-"System-ࡱ FMicrosoft Equation 2.0 DS Equation Equation.29qࡱ>ࡱ> C EHFF 2X.#dqObjInfo1-FNEquation Native O<_9511266850FN NLOle Pࡱ> Lࡱ> 7  .1  &`d & MathType-DfDPTimes New Romanp- 2 =X & "System-PIC /2QLMETA ShCompObj13YZObjInfo4[Fࡱ FMicrosoft Equation 2.0 DS Equation Equation.2ࡱ> ࡱ>  =W2 W2 2X)B1 ldw_Oh+'0 D h   @d Equation Native \<SummaryInformation(]ObjInfo4Equation Native5<;N[yC:\WINWORD\TEMPLATE\NORMAL.DOT0UHRANJENOST ADOLESCENATA I SKLONOST PREMA HRANI Robertin Robertin@J:N@Y@J:Nx C@Microsoft Word 6.0 2ࡱ> -/`i ! 5 7 I J _ ` q s I Y F G Z 1 3 89:;'(23UVWX   JKLMLMNOJ]cJ[cVJ@cUcchcUUccUccJ@cUccRfgij<=?@hiklOPRSRSUVV####$$%$5$6$$$$$P0Q0444455556666{7|7~77#8$8*8+8#:$:.:/:l;m;n;o;;;;;@@@@AJ]cJ[cJcJccJ[cJ]ccWAAAATCUC^C_C"E#E%E&EGGGGGGGGGGGG7I8IKILIMINIIIIIIILL L LLLLL0N1NDNENFNGNXNYNlNmNnNoNNNNuD 8ceKuD 8]abcvKuD 8ceKuD 8]abcvKchuD 8ceKuD 8]abcvKuD 8ceKuD 8]abcvK uDcJ]ccJ[c:NNNNOOOOOOTTaa'a(a+a,a;a