More information about text formats
I congratulate Yumi Hurst and Haruhisa Fukuda for their very good "eating speed" study in the January 2018 issue of the BMJ Open, which I absolutely support . It is poorly known that first reports on the potential significant association between eating speed and obesity in children and adults have been published more than 40 years ago [2-3]. The evidence-based data on this obesogenic relationship are becoming more and more [4-12]. In the word meal the term time is included. We should take our time for the meal. And we should grind the food, not devour it. Since the 17th century, German physicians have repeatedly referred to this essential and modifiable lifestyle factor in numerous medical writings .
Christoph Schorer (1618-1671): „One should not devour food, as if one were on the run or hunt, but to do something finicky, and let him have a love for it, sometimes even pause for a while, until the meal has settled down.” 
Johann Georg Krünitz (1728-1796): „Those who eat slowly and chew well can expect the benefit of complete digestion. But those are constantly martyred with indigestibility and their terrible consequences, which swallow down the food quickly, and chew only half.“ 
Johann August Unzer (1727-1799): „A general remark should be added, namely, that the habit of farmers eating slowly, and chewing food carefully, diminishes infinitely the dangers of an evil order of life, and one can safely believe t...
Johann August Unzer (1727-1799): „A general remark should be added, namely, that the habit of farmers eating slowly, and chewing food carefully, diminishes infinitely the dangers of an evil order of life, and one can safely believe that this is a principal cause of his good health.” 
Georg Gottlieb Offterdinger (1737-1783): „We should get into the habit, not hot, and very slowly to eat, and chew well with your teeth first.” 
Christoph Wilhelm Hufeland (1762-1836): „It is not what we eat, but what we digest, that does us good, and serves to nourish our bodies. He who wishes to live long ought, therefore, to eat slowly; as our food must obtain in the mouth the first degree of preparation and assimilation. This is effected by its being sufficiently chewed and mixed with saliva; both which I consider as a principal part of the business of restoration, and consequently set great value upon them in regard to the prolongation of life, especially as it appears by my researches that all those who were accustomed to eat slowly attained to a great age.” 
Christian August Struve (1767-1807): „Eat slowly, do not eat the food too greedily, but get its attention on the food so much, rather than on any occupation that one does with full consciousness and not as a habit. Then the pleasure of eating is all the more pleasant when accompanied with a conscious sensation of taste. By chewing the food becomes more digestible; and rightly so said the Arab doctors; "Who chews not well, doesn't love his life."” 
Christian Friedrich Ludwig Wildberg (1765-1850): „The right food order wants us to chew properly all solid food, and eat at all slow. The saying: well chewed is half digested, but contains truth. The proper division and reduction of food by the teeth, and the mixing of them with oral saliva taking place at the same time, is the first condition of good digestion, and so slow eating and careful chewing is also a condition of good nutrition of man.” 
Hermann Klencke (1813-1881): „There is a saying: "If you eat slowly, you eat for a long time." To eat slowly means to keep the food in the mouth for a long time, to chew it properly, to salivate it well, and to prepare it better for the stomach to swallow.” 
When comparing the experience of the early outstanding physicians with today's scientific findings, it becomes clear: The old eating rule "eat slowly" has timeless validity, especially in today's obesogenic environment [4, 13]. The current significant results of Hurst and Fukuda show once again that it must be an important goal of parental and institutional nutrition education, to eat slowly without haste . Primary care physicians / practitioners and other front-line health care professionals should continue to support patients in lifestyle modification.
The following practical tips can help to reduce the eating speed . However, those who want to change should internalize that it takes eight weeks for a small lifestyle change to become an automatic habit. Therefore, it is better for a permanent implementation in everyday life at the beginning to implement only one tip (for example, drink 1 or 2 cups of water before each meal) and the next after two months.
- Take time: Reserve enough time - at least 20 minutes.
- Dine sitting at the table with knife, fork and spoon.
- Drink enough: Drink a large glass of water before and during each meal.
- Take small bites and chew well before swallowing: At the beginning, bite each bite at least 10 times and slowly increase to 20 times or more. Only when the mouth is empty, take another bite.
- Eat in concentration and do not be distracted: Do not do anything else while you eat. People tend to eat faster when they read, watch television, use a smartphone, play computer or do homework.
- Use smaller utensils: The less fit on the fork and spoon, the slower you will eat. Select utensils that are intended for children or eat with chopsticks. For smaller plates, smaller portions are taken. You eat less and the plate is empty faster. An empty plate triggers saturation signals.
- Put down the cutlery after each bite and pick it up again when the bite is chewed enough and swallowed.
- Take a break after eating a normal serving size (for example, taking a small break after every third bite).
- Talk to others only when the mouth is empty.
- Fill only once: put a serving on the plate and do not refill.
- Nutrition varies: In dishes with a variety of flavors and textures, people tend to eat more slowly.
- A pleasant dining atmosphere helps to relax and less rush. Avoid eating alone and reinforce conversation with table companions.
- If possible, always take the food in the same place.
- Decorate table and plate nicely: For example, some flowers in the middle of the table provide color.
Sincerely (for young and old, slow eating should become "in"),
Dr. Martin Hofmeister, Consumer Centre of the German Federal State of Bavaria, Department Food and Nutrition, Germany
1. Hurst Y, Fukuda H. Effects of changes in eating speed on obesity in patients with diabetes: a secondary analysis of longitudinal health check-up data. BMJ Open 2018;8(1):e019589.
2. Hill SW, McCutcheon NB. Eating responses of obese and nonobese humans during dinner meals. Psychosom Med 1975;37(5):395-401.
3. Epstein LH, Parker L, McCoy JF, McGee G. Descriptive analysis of eating regulation in obese and nonobese children. J Appl Behav Anal 1976;9(4):407-415.
4. Hofmeister M. Essgeschwingkeit und Adipositas – Eine Meta-Analyse. Ernährung im Fokus 2011;11(9):390-397.
5. Robinson E, Almiron-Roig E, Rutters F, de Graaf C, Forde CG, Tudur Smith C, et al. A systematic review and meta-analysis examining the effect of eating rate on energy intake and hunger. Am J Clin Nutr 2014;100(1):123-151.
6. Ohkuma T, Hirakawa Y, Nakamura U, Kiyohara Y, Kitazono T, Ninomiya T. Association between eating rate and obesity: a systematic review and meta-analysis. Int J Obes (Lond) 2015;39(11):1589-1596.
7. Fogel A, Goh AT, Fries LR, Sadananthan SA, Velan SS, Michael N, et al. Faster eating rates are associated with higher energy intakes during an ad libitum meal, higher BMI and greater adiposity among 4·5-year-old children: results from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) cohort. Br J Nutr 2017;117(7):1042-1051.
8. McCrickerd K, Forde CG. Consistency of eating rate, oral processing behaviours and energy intake across meals. Nutrients 2017;9(8):E891.
9. Okubo H, Miyake Y, Sasaki S, Tanaka K, Hirota Y. Rate of eating in early life is positively associated with current and later body mass index among young Japanese children: the Osaka Maternal and Child Health Study. Nutr Res 2017;37:20-28.
10. Yamagishi K, Sairenchi T, Sawada N, Sunou K, Sata M, Murai U, et al. Impact of speed-eating habit on subsequent body mass index and blood pressure among schoolchildren - The Ibaraki Children's Cohort Study (IBACHIL). Circ J 2018;82(2):419-422.
11. Canterini CC, Gaubil-Kaladjian I, Vatin S, Viard A, Wolak-Thierry A, Bertin E. Rapid eating is linked to emotional eating in obese women relieving from bariatric surgery. Obes Surg 2018;28(2):526-531.
12. Wakasugi M, James Kazama J, Narita I. Self-reported slower eating is associated with a lower salt intake: A population-based cross-sectional study. Intern Med. 2018 Jan 11. doi: 10.2169/internalmedicine.9725-17. [Epub ahead of print].
13. Hofmeister M. „Slow eating“-Ratschläge mit zeitloser Gültigkeit: „Wer nicht gut kaut, hat sein Leben nicht lieb.“ VFEDaktuell 2011;125:30-33.
14. Schorer C. Regeln der Gesundheit, Reisenden und Anheimischen, Hohen und Nideren, Gelehrten und Ungelehrten, nutzlich zu lesen, und noch nutzlicher ihnen nachzukommen. Augsburg: Göbels; 1677.
15. Krünitz JG. Oeconomische Encyclopädie, allgemeines System der Land- Haus- und Staats-Wirtschaft, in alphabetischer Ordnung. Berlin: Pauli; 1773.
16. Unzer JA: Der Arzt: Eine medicinische Wochenschrift (Sechster Band). Wien, Leipzig: Gräffer; 1778.
17. Offterdinger GG. Anleitung für das Landvolk in Absicht auf seine Gesundheit. Oder Fortsetzung der Kenntniß u. Heilung von hitzigen und geheimgehaltenen Krankheiten, welche von Herrn Tissot nicht ausgeführt worden. – 2. Verm. und verb. Aufl. - Zürich: Orell, Geßner, Füßlin; 1782.
18. Hufeland CW. Die Kunst das menschliche Leben zu verlängern. Jena; 1796.
19. Struve CA. Der Gesundheitsfreund der Jugend oder praktische Anweisung, wie man in der Jugend den Grund zu einer dauerhaften Gesundheit legen und sie bis ins späteste Alter erhalten könne. Hannover: Eigenverlag; 1804.
20. Wildberg CFL: Hygiastik oder die Kunst, die Gesundheit der Menschen zu erhalten und zu befoerdern, und die Lebensdauer zu verlaengern. - 2. verm. und verb. Ausg. - Berlin: Flittner; 1822.
21. Klencke H. Die physische Lebenskunst oder praktische Anwendung der Naturwissenschaften auf Förderung des persönlichen Daseins: Ein Familienbuch. Leipzig: Kummer; 1864.