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PubMed1991

Principles for effective surveys of hunger and malnutrition in the United States.

To be effective, the information derived from a survey must be used to make decisions that affect policies and programs. This paper discusses why scientifically sound surveys may not be effective and vice versa. Effectiveness depends on the information being relevant to the decision-maker's understanding of the problem to be solved. To the extent that science contributes to both understanding the problem and providing the information for a decision, the survey will be scientific and effective. The measurement of malnutrition and barriers to communication are not at present the major obstacles to effective scientific surveys relative to hunger and malnutrition in the United States. Rather, the obstacles seem to be poor scientific conceptualization and measurement of hunger, on the one hand, and poor sampling techniques for malnutrition, on the other hand. These frontiers of knowledge have implications for science and policy beyond surveys. The challenge for the American Institute of Nutrition is to recruit the scientific skills need to understand hunger and identify pockets of malnutrition and their causes--scientific skills that go beyond those traditionally associated with nutrition research.

Epidemiologic Methods↗
PubMed1999

Nutrition and health outcomes associated with food insecurity and hunger.

This paper explores how food insecurity and hunger relate to health and nutrition outcomes in food-rich countries such as the United States. It focuses on two subgroups of the population for whom data are available: women of childbearing age and school-age children. Special consideration is given to examining how food insecurity relates to these outcomes independently of socioeconomic status and poverty. In a population-based sample of women of childbearing age, the least severe level of food insecurity (household food insecurity) was correlated with higher body mass index (BMI), controlling for other available and known influences on obesity including income level. In low income school-age children from two large urban areas of the U.S., risk of hunger and hunger were associated with compromised psychosocial functioning, controlling for maternal education and estimated household income. The nutrition and health consequences of food insecurity comprise a potentially rich area for future, socially relevant research in the field of nutritional sciences.

Adult↗
PubMed1980

The long-term effect of energy intake on salivation, hunger, and appetite ratings, and estimates of energy intake in obese patients.

The relationship between salivation, hunger, appetite, and estimates of energy intake was examined in female obese inpatients undergoing a course of weight reduction. On a constant low-energy intake (800 kcal/day) salivation, hunger, and appetite scores all declined. Estimates of energy intake did not. Sixteen different subjects were fed 1000 kcal/day for seven days, 500 kcal/day for seven days, and 1000 kcal/day for seven days. After acclimatization to the diet for a minimum of five days, salivation was directly related to energy intake; hunger and appetite ratings did not change significantly; and estimates of energy intake were sensitive to the decrease but not increase in energy intake. The limitations of each method of assessment are discussed.

Adolescent↗
PubMed1987

The feeling of hunger.

Hunger symptoms were assessed in two groups of normal subjects at a variety of times of day. The data showed that relatively few symptoms were endorsed even after longer deprivation periods, and they confirmed other experimental results suggesting that there is no strong and characteristic pattern of hunger symptoms. It is suggested that any notions of disturbed hunger sensations in patients with eating disorders must be evaluated carefully.

Feeding and Eating Disorders↗
PubMed1977

Hunger in humans induced by 2-deoxy-D-glucose: glucoprivic control of taste preference and food intake.

Intracellular glucopenia induced by 2-deoxy-D-glucose (2DG) administration in man produces increased hunger ratings and magnitude estimates of pleasantness for sucrose solutions. Augmented food intake substantiates these changes in affective behavior and relieves experimentally induced hunger. Intracellular glucopenia activates counterregulatory mechanisms to raise plasma glucose concentrations. Inducing hunger experimentally with 2DG provides a useful method for studying appetitive behavior in humans. The neurohumoral control of pituitary hormone release and other hypothalamic functions may be examined after 2DG infusion.

Adult↗
PubMed1996

Children on hunger strike: child abuse or legitimate protest?

The issue of children on hunger strike (voluntary total fasting) has not been reported before. The World Medical Association Declaration of Tokyo 1975 and the Declaration of Malta 1991 (revised 1992) provide clinicians with guidelines for the management of adult patients on hunger strike but do not mention children. We report the management of 14 Vietnamese children, aged 1 to 12 years, who took part in a hunger strike at a refugee detention centre in Hong Kong.

Child↗
PubMed2004

Plasma ghrelin levels and hunger scores in humans initiating meals voluntarily without time- and food-related cues.

Ghrelin is an orexigenic hormone that is implicated in meal initiation, in part because circulating levels rise before meals. Because previous human studies have examined subjects fed on known schedules, the observed preprandial ghrelin increases could have been a secondary consequence of meal anticipation. A causal role for ghrelin in meal initiation would be better supported if preprandial increases occurred before spontaneously initiated meals not prompted by external cues. We measured plasma ghrelin levels among human subjects initiating meals voluntarily without cues related to time or food. Samples were drawn every 5 min between a scheduled lunch and a freely requested dinner, and hunger scores were obtained using visual analog scales. Insulin, glucose, fatty acids, leptin, and triglycerides were also measured. Ghrelin levels decreased shortly after the first meal in all subjects. A subsequent preprandial increase occurred over a wide range of intermeal intervals (IMI; 320-425 min) in all but one subject. Hunger scores and ghrelin levels showed similar temporal profiles and similar relative differences in magnitude between lunch and dinner. One subject displayed no preprandial ghrelin increase and was also the only individual whose insulin levels did not return to baseline between meals. This finding, along with a correlation between area-under-the-curve values of ghrelin and insulin, suggests a role for insulin in ghrelin regulation. The preprandial increase of ghrelin levels that we observed among humans initiating meals voluntarily, without time- or food-related cues, and the overlap between these levels and hunger scores are consistent with a role for ghrelin in meal initiation.

Adult↗
PubMed1993

Hunger.

The term 'hunger' has a variety of meanings, and numerous physiological mechanisms underlying the sensation have been proposed. This review delineates the most common uses of the term, examines methods for measuring features of the experience and critically evaluates the evidence supporting its physiological basis. In addition, the association between reported hunger and ingestive behavior in healthy and selected clinical populations is discussed. Hunger is an important psychological and physiological phenomena that exerts a strong influence on behavior. When better characterized, it should be more amenable to monitoring and manipulation for therapeutic purposes.

Eating↗
PubMed2006

Glucagon-like peptide-1, peptide YY, hunger, and satiety after gastric bypass surgery in morbidly obese subjects.

CONTEXT: The mechanisms underlying weight loss after Roux-en-Y gastric bypass (RYGBP) are not well understood. OBJECTIVE: The objective of the study was to assess the changes in active glucagon-like peptide 1 (GLP-1) and total peptide YY (PYY) after RYGBP and examine their relationship with changes in hunger and satiety. DESIGN: This was a prospective study on the changes in active GLP-1, PYY, hunger, and satiety in response to a standardized test meal in nine normal-glucose-tolerant obese subjects [body mass index (BMI) 47.4 +/- 6.1 kg/m(2)] before and 6 wk after RYGBP. RESULTS: Before surgery, meal ingestion failed to stimulate GLP-1 and PYY secretion. Six weeks after surgery, despite subjects still being markedly obese (BMI 43.6 +/- 7.8 kg/m(2)), the area under the curve(0-120') of GLP-1 and of PYY in response to the standardized test meal were significantly elevated (P < 0.05 and P < 0.01, respectively). These hormonal responses were significantly larger (P < 0.01) than those observed in a group matched for the BMI attained 6 wk after surgery. The 2.9 +/- 1.2- and 1.6 +/- 1.9-fold increase, respectively, in the area under the curve(0-120') of GLP-1 and PYY were accompanied by a significant decrease in fasting (P < 0.05) and postprandial hunger (P = 0.05) and a significant increase in satiety (P < 0.05) after meal intake. Nevertheless, a significant correlation between changes in the hormonal and eating behavior parameters was not found. CONCLUSION: Our data show that RYGBP is associated with an improvement in the active GLP-1 and total PYY response to a liquid-meal intake. Moreover, we provide circumstantial evidence for a potential role of these gastrointestinal hormones on the decreased appetite after RYGBP.

Adult↗
PubMed1994

Hunger and the temporal lobe.

A boy experienced two episodes of intracerebral hemorrhage in the region of the right anterior temporal lobe. On both occasions, the bleeding was ushered in by an exclamation of intense hunger. The patient provides further evidence for the temporal lobe localization of the sensation of hunger. We describe a model of the neural system subserving feeding that incorporates the cortical locus of hunger.

Cerebral Hemorrhage↗
PubMed1992

Hunger: a hospital survey.

Patients at a New York City municipal hospital were surveyed in 1985 and 1989 to ascertain the extent of hunger and its possible correlates. Twenty-two percent (22%) of the 382 subjects in 1985 and 23% of the 332 subjects in 1989 experienced hunger. Hunger was related significantly to homelessness, social isolation and the physical inability to buy and/or prepare food. Between 1985 and 1989, there was a large increase in the use of institutional resources for food; a decline in reliance on Food Stamps; and an increase in household density. Inpatients were found to be poorer than outpatients, and to rely more heavily upon soup kitchens. Practice, policy and research implications are noted.

Food Deprivation↗
PubMed2005

Circulating ghrelin in thyroid dysfunction is related to insulin resistance and not to hunger, food intake or anthropometric changes.

OBJECTIVE: Ghrelin is a gastric peptide that plays a role in appetite stimulation, energy balance and possibly in insulin resistance. Hyperthyroidism is a situation where negative energy balance and insulin resistance coexist, while in hypothyroidism a positive energy balance and normal insulin sensitivity predominate. We investigated ghrelin levels and their relationship with hunger, food intake and both anthropometric and insulin resistance parameters in patients with thyroid dysfunction. DESIGN AND METHODS: We studied 24 hyperthyroid and 17 hypothyroid patients before and after normalisation of thyroid hormone levels and their respective body mass index (BMI)-matched control group. We measured plasma ghrelin levels, homeostasis model assessment of insulin resistance (HOMA-IR) index, a hunger score, mean three-day calorie intake and anthropometric parameters. RESULTS: In hyperthyroidism, HOMA-IR index was higher (3.21 +/- 0.60 vs 1.67 +/- 0.15 mMmU/l; P = 0.014, t test for independent data) and ghrelin levels were lower (463.6 +/- 36.4 vs 561.1 +/- 32.1 pg/ml; P = 0.041, Mann-Whitney U-test) than in its control group and both normalised after treatment (HOMA-IR: 2.28 +/- 0.38 mMmU/l; P = 0.106, t test for independent data, and ghrelin: 539.7 +/- 45.4 pg/ml; P = 0.549, Mann-Whitney U-test). Glucose, as a component of HOMA-IR index was the only predictor for ghrelin levels (beta = -0.415, P = 0.044, stepwise multiple regression analysis). In hypothyroidism, HOMA-IR index and ghrelin levels were similar to those in its control group both before and after treatment. In both thyroid dysfunction states, no correlations were observed between changes in ghrelin levels and in free T4, free T3, anthropometric parameters, total calorie intake and hunger score. CONCLUSIONS: In thyroid dysfunction states, ghrelin levels seemed to be in relation to insulin resistance and not to energy balance and food intake regulation, as seen in other physiological and pathological states.

Adult↗
PubMed1984

Nutribusiness: an aspect of the political economy of persistent hunger.

The failure of nutrition programs to significantly impact on the prevalent hunger in underdeveloped countries is attributed to nutribusiness. This term conceptually links the activities of profit-motivated capitalist enterprises to the continuous generation of poverty and hunger. The actors are all part of a hierarchy dominated by multinational corporate interests and including bilateral and multilateral aid agencies, nutrition institutes, and nutrition professionals at various levels. Although many lower-level nutrition workers are unwittingly caught up in the system, most of the higher-level professionals are conscious of their roles, which they selfishly perform for personal advancement. The Philippine nutrition system is examined as an example of nutribusiness, albeit in a very obvious and extreme form. On the available evidence, the conclusion is drawn that in countries dominated by capitalist production, nutrition activities amount to nutribusiness. Consequently, the elimination and prevention of persistent hunger in underdeveloped countries must start with their disengagement from the world capitalist system and their pursuit of socialist transformation.

Allied Health Personnel↗
PubMed1993

Memory of Northern Irish Catholics and Protestants for violent incidents and their explanations for the 1981 hunger strike.

The aim of this study was to examine the memory of Northern Irish Catholics (n = 20) and Protestants (n = 21) for violent events which had occurred over the previous 11 years and their explanations for those events. It was predicted that Catholics would recall more events involving Catholic deaths than Protestants and that Protestants would recall more events involving Protestant deaths than Catholics. Although Catholics were as likely as Protestants to recall incidents which resulted in Protestant deaths, Protestants were less likely than Catholics to recall incidents involving Catholic deaths. Also, there were divergent explanations for the 1981 hunger strike with most Protestants attributing responsibility to factors internal to the hunger strikers and most Catholics attributing responsibility to factors external to the hunger strikers.

Adolescent↗
PubMed1996

A preliminary investigation into individual differences in the circadian variation of meal tolerance: effects on mood and hunger.

A forced desynchrony methodology was used to assess postprandial blood glucose in 9 female volunteers during a 3-h period following a mixed meal presented at four times of day (08:00, 14:00, 20:00, 02:00). The influence of time of day on the postmeal glucose responses was evaluated by calculating the area under the curve, largest increase, time taken to reach peak, and fasting level. Circadian variations in meal tolerance were found for the area under the curve and largest increase, responses were greater (indicating poorer meal tolerance) in the evening than the morning. Fasting blood glucose exhibited diurnal variation although in the opposite direction to meal tolerance; levels were higher in the morning than the evening. Time taken to reach peak levels was not modulated by circadian rhythmicity. Estimates of the timing of poorest meal tolerance and the magnitude of this intolerance were computed for each subject. Individual differences in the magnitude of meal intolerance were found to influence hunger and self-reported calmness. Subjects with good tolerance had rhythms in both calmness and hunger, which were not found in those with poor tolerance. Subjects with good tolerance also tended to rate themselves as feeling more calm. These mood and hunger effects may result from differences in insulin resistance, which is hypothesized to underlie the circadian variations in meal tolerance.

Adult↗
PubMed2004

Brief communication: Sleep curtailment in healthy young men is associated with decreased leptin levels, elevated ghrelin levels, and increased hunger and appetite.

BACKGROUND: Total sleep deprivation in rodents and in humans has been associated with hyperphagia. Over the past 40 years, self-reported sleep duration in the United States has decreased by almost 2 hours. OBJECTIVE: To determine whether partial sleep curtailment, an increasingly prevalent behavior, alters appetite regulation. DESIGN: Randomized, 2-period, 2-condition crossover clinical study. SETTING: Clinical Research Center, University of Chicago, Chicago, Illinois. PATIENTS: 12 healthy men (mean age [+/-SD], 22 +/- 2 years; mean body mass index [+/-SD], 23.6 +/- 2.0 kg/m2). MEASUREMENTS: Daytime profiles of plasma leptin and ghrelin levels and subjective ratings of hunger and appetite. INTERVENTION: 2 days of sleep restriction and 2 days of sleep extension under controlled conditions of caloric intake and physical activity. RESULTS: Sleep restriction was associated with average reductions in the anorexigenic hormone leptin (decrease, 18%; P = 0.04), elevations in the orexigenic factor ghrelin (increase, 28%; P < 0.04), and increased hunger (increase, 24%; P < 0.01) and appetite (increase, 23%; P = 0.01), especially for calorie-dense foods with high carbohydrate content (increase, 33% to 45%; P = 0.02). LIMITATIONS: The study included only 12 young men and did not measure energy expenditure. CONCLUSIONS: Short sleep duration in young, healthy men is associated with decreased leptin levels, increased ghrelin levels, and increased hunger and appetite.

Adult↗
PubMed1992

The metabolic signal of hunger and satiety, and its pharmacological manipulation.

Hunger is elicited by the depletion of available macronutrients to the cells. The question is how the depletion is sensed and transduced into a biologically meaningful signal of hunger. Accumulating data show that the signal comes not from depletion of carbohydrates alone or from one of the other major macronutrients. Instead, the signal is generated by the overall cellular power production that induces hunger when it decreases and satiety when it increases. As for satiation, i.e. the state that causes the termination of a meal before nutrients cross the intestinal barrier, it is induced by early metabolic events elicited reflexly from orogastric afferences and tuning the preprandial metabolism towards the level of the postprandial metabolism. Neuronal responses from the medial hypothalamus suggest that they may integrate information on the degree of utilization of glucose and of lipids. Some of the pharmacological agents that reduce feeding seem to operate by increasing the metabolic rate in a way similar to that induced by a meal. These pharmacological agents are active because they mobilize endogenous metabolites, such as lipids, so inducing a sort of 'autocanibalic' meal.

Animals↗
PubMed2003

Use of a web site to increase knowledge and awareness of hunger-related issues.

The purpose of this study was to determine the current level of knowledge and awareness of hunger-related issues among a convenience sample of Delawareans. We also assessed whether raising knowledge and awareness of the hunger problem through the FBD's newly designed web site would encourage participation in antihunger activities. Via e-mail, 1,719 individuals were invited to participate in a three-phase, online survey, and 392 agreed. Phase-I questions were answered prior to viewing the web site, phase II (n=217) immediately afterward, and phase III (n=61) six weeks later. Responses indicated a high level of awareness about general hunger issues but specific knowledge proved to be at a lower level. No statistically significant differences were noted when data were collapsed across gender, age, educational level, or work setting. In a six-week post-survey, 41% of subjects were motivated by the web site to engage in an antihunger activity; 34% had told others about the web site and indicated it may be a useful tool in antihunger outreach efforts for the FBD.

Adult↗