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Physiogenomic analysis of weight loss induced by dietary carbohydrate restriction.

BACKGROUND: Diets that restrict carbohydrate (CHO) have proven to be a successful dietary treatment of obesity for many people, but the degree of weight loss varies across individuals. The extent to which genetic factors associate with the magnitude of weight loss induced by CHO restriction is unknown. We examined associations among polymorphisms in candidate genes and weight loss in order to understand the physiological factors influencing body weight responses to CHO restriction. METHODS: We screened for genetic associations with weight loss in 86 healthy adults who were instructed to restrict CHO to a level that induced a small level of ketosis (CHO approximately 10% of total energy). A total of 27 single nucleotide polymorphisms (SNPs) were selected from 15 candidate genes involved in fat digestion/metabolism, intracellular glucose metabolism, lipoprotein remodeling, and appetite regulation. Multiple linear regression was used to rank the SNPs according to probability of association, and the most significant associations were analyzed in greater detail. RESULTS: Mean weight loss was 6.4 kg. SNPs in the gastric lipase (LIPF), hepatic glycogen synthase (GYS2), cholesteryl ester transfer protein (CETP) and galanin (GAL) genes were significantly associated with weight loss. CONCLUSION: A strong association between weight loss induced by dietary CHO restriction and variability in genes regulating fat digestion, hepatic glucose metabolism, intravascular lipoprotein remodeling, and appetite were detected. These discoveries could provide clues to important physiologic adaptations underlying the body mass response to CHO restriction.

Journal Article↗

Immunization against cholecystokinin decreases appetite in lambs.

The effects of immunization against cholecystokinin (CCK) on feed intake, weight gain, and carcass characteristics were studied in sheep. Nine wether lambs at 10 wk of age were immunized with a conjugate of sulphated CCK octapeptide and human serum globulin or against human globulin alone. All CCK-immunized lambs produced antibodies, and the average titer 5 wk after the primary immunization was calculated to be sufficient to bind normal circulating levels of CCK. Mean daily feed intakes and BW were similar in the CCK-immunized and the control-immunized groups at the start of treatment, but after immunization, feed intake, appetite, and BW gain were decreased in the CCK-immunized animals. There was no effect on carcass composition or organ growth relative to body growth. It is concluded that the immunization procedure used in this study may have potentiated the actions of CCK rather than neutralizing its action as an appetite regulator.

Animals↗

Neuro-hormonal control of food intake: basic mechanisms and clinical implications.

Obesity is one of the most common metabolic diseases and the greatest threats of the health because of possibility of numerous complications. In order to design effective drugs or apply the helpful surgical procedure it is essential to understand physiology of appetite control and pathophysiology of obesity. According to the first law of thermodynamics, the energy input in the form of food, equals energy expenditure through exercise, basal metabolism, thermogenesis and fat biosynthesis. The control of body weight actually concerns the control of adipose tissue with the key role of hypothalamus, possessing several neuronal centers such as that in lateral hypothalamic nuclei considered to be "hunger" center and in ventromedial nuclei serving as the "satiety" center. In addition, paraventricular and arcuate hypothalamic nuclei (ARC) are the sites where multiple hormones, released from the gut and adipose tissue, converge to regulate food intake and energy expenditure. There are two distinct types of neurons in ARC that are important in control of food intake; (1) preopiomelanocortin (POMC) neurons activated by an orexigenic hormones and releasing alpha-melanocyte-stimulating hormone (alpha-MSH) in satiety center and (2) neurons activated by orexigenic peptides such as ghrelin that release the substances including neuropeptide Y (NPY) and Agouti-Related Peptide (AgRP) in hunger center. ARC integrates neural (mostly vagal) and humoral inputs such as enteropeptides including orexigenic (ghrelin and orexins) and an orexigenic peptides (cholecystokinin, polypeptide YY, glucagon-like peptide-1, oxyntomodulin, leptin and others) that exert a physiological role in regulating appetite and satiety. The peripherally (gut, adipose tissue) and centrally expressed modulators of appetitive behavior act through specific receptors in the afferent (mostly vagal) nerves and hypothalamic neurons implicated in adiposity signaling and regulation of food intake.

Adiposity↗

Regulation of free and bound leptin and soluble leptin receptors during inflammation in mice.

Leptin, an appetite-regulating hormone/cytokine, circulates both free and bound to soluble leptin receptors (s-leptin R). An electrochemiluminescence (ECL) assay for the quantitative measurement of murine s-leptin R was developed. The absence of s-leptin R immunoreactivity in the serum of db(pas)/db(pas)mice demonstrated the specificity of the assay, which detected s-leptin R both in the free form and complexed with leptin. The distribution of free vs bound leptin and the regulation of s-leptin R were evaluated in mice following administration of the pro-inflammatory stimuli endotoxin (100 microg/mouse) and turpentine (100 microl/mouse). Both endotoxin and turpentine significantly increased serum leptin and s-leptin R levels compared to control mice. The distribution of free vs bound leptin was not altered by administration of endotoxin or turpentine. In fact, approximately 50% of total leptin was present in the free form in either control, endotoxin- or turpentine-injected mice. On the contrary, during the hyperleptinemia of pregnancy, only 10% of total leptin was present in the free form. We conclude that inflammation leads to the increase of both bound and free leptin. Therefore, the total amount of bioactive leptin is increased during acute inflammation, suggesting that leptin participates in the host response to inflammation.

Animals↗

The role of neuropeptide Y, orexins, cocaine and amphetamine-related transcript, cholecystokinin, amylin and leptin in the regulation of feeding in fish.

In fish, as in all vertebrates, the brain is the primary center of regulation of food intake. Afferent signals continuously inform the central nervous system about changes in energy homeostasis. The brain interprets and integrates these signals and responds with efferent signals that help maintain a constant energy balance. Neuropeptides that originate from the hypothalamus regulate food intake either by stimulating (orexigenic factors) or inhibiting (anorexigenic factors) appetite. Studies using brain or peripheral peptide injections have shown that neuropeptide Y (NPY) and orexins are potent orexigenic factors in fish, whereas cocaine and amphetamine-related transcript (CART) peptides decrease food intake. Complex interactions exist between these central neuropeptide systems. For example, NPY and orexins have synergistic effects on food intake and they are both modulated by CART peptides. These systems are also influenced by endocrine factors from the periphery, including hormones from the gut, such as cholecystokinin (CCK), the pancreatic hormone amylin and the adipocyte hormone leptin. Fasting or ingestion of a meal induces changes in the mRNA expression of NPY, orexins and CART, suggesting that nutritional status modulates the action of these systems. This brief review will focus on our current knowledge on the structure and role of these six appetite-regulating peptides in fish.

Amyloid↗

Oxyntomodulin suppresses appetite and reduces food intake in humans.

Oxyntomodulin (OXM) is released from the gut postprandially, in proportion to energy intake, and circulating levels of OXM are elevated in several conditions associated with anorexia. Central injection of OXM reduces food intake and weight gain in rodents, suggesting that OXM signals food ingestion to hypothalamic appetite-regulating circuits. We investigated the effect of iv OXM (3.0 pmol/kg.min) on appetite and food intake in 13 healthy subjects (body mass index, 22.5 +/- 0.9 kg/m(2)) in a randomized, double-blind, placebo-controlled, cross-over study. Infusion of OXM significantly reduced ad libitum energy intake at a buffet meal (mean decrease, 19.3 +/- 5.6%; P < 0.01) and caused a significant reduction in scores for hunger. In addition, cumulative 12-h energy intake was significantly reduced by infusion of OXM (mean decrease, 11.3 +/- 6.2%; P < 0.05). OXM did not cause nausea or affect food palatability. Preprandial levels of the appetite-stimulatory hormone, ghrelin, were significantly suppressed by OXM (mean reduction, 44 +/- 10% of postprandial decrease; P < 0.0001). Elevated levels of endogenous OXM associated with disorders of the gastrointestinal tract may contribute to anorexia.

Adult↗

Leptin receptor expression on T lymphocytes modulates chronic intestinal inflammation in mice.

BACKGROUND: Leptin regulates appetite through the long isoform of its receptor in the hypothalamus. Although leptin regulates immune responses, it is still unknown whether a direct effect of leptin on lymphocytes is required. AIMS: To clarify whether expression of leptin receptors on T lymphocytes modulates intestinal inflammation in mice. METHODS: The model of colitis induced by transfer of CD4(+)CD45RB(high) (RB(high)) cells into scid mice was used. Wild-type (WT) or leptin receptor deficient (db/db) RB(high) cells were transferred into scid mice and development of colitis evaluated. RESULTS: Leptin receptors were expressed on both RB(high) and RB(low) cells. Intestinal lymphocytes of mice with colitis expressed high leptin levels compared with healthy controls whereas the opposite was true for serum leptin levels. Transfer of RB(high) cells from db/db mice induced delayed disease compared with transfer of WT cells. A high rate of apoptosis in lamina propria lymphocytes and reduced cytokine production were observed early on in scid mice receiving db/db RB(high) cells. These effects were not due to the high levels of glucocorticoids present in db/db mice as administration of corticosterone to WT mice failed to reproduce this phenomenon. High expression of peroxisome proliferator activated receptor gamma was observed in the colon of recipients of db/db compared with WT cells. Freshly isolated db/db RB(high) cells produced low levels of interferon gamma. Despite delayed onset of colitis, as disease progressed differences between mice receiving WT or db/db cells were no longer apparent. CONCLUSIONS: These results suggest that leptin affects the immune response, partly by acting on the long isoform of its receptor expressed on T lymphocytes.

Animals↗

Appearance-specific satiety increases appetite and quality of life in patients with metastatic liver tumor: a case report.

Loss of appetite is frequently seen and is a main factor affecting quality of life (QOL) in patients with advanced cancer. The etiology for loss of appetite in patients with cancer is multifactorial. The sensory properties of food are factors regulating appetite. Changes in taste, smell and texture of foods influence food intake. The appearance of the food is also a notable factor in sensory-specific satiety. We described a 46-year-old Japanese woman with multiple metastatic liver tumors. Although there was no obvious factor for loss of appetite, she suffered from a loss of appetite and subsequent malnutrition. In order to improve the appearance of food, we reduced the diet to 1,000 kcal/day from 1,500 kcal/day. On the new diet, the patient's appetite significantly increased and patient's nutritional status was improved. Eating whole diet was an important achievement and increased in mental aspects of QOL. Arrangement for the appearance of food may be a simple and nontoxic therapeutic strategy for patients with cancer suffering a loss of appetite.

Appetite↗

The future of obesity treatment.

Obesity is rapidly becoming a worldwide epidemic, with significant consequences in terms of clinical burden and economic costs in treating its complications, so effective new approaches are urgently needed. Development of new drugs in this therapeutic area requires a detailed understanding of the physiology underlying body weight regulation. Recently several significant advances have been made in this area, including the identification of the appetite regulating hormone, leptin, and a detailed understanding of its targets in the central nervous system (CNS), such as neuropeptide Y (NPY) and the melanocortin-4 receptor. The observation that some humans with severe childhood-onset obesity have defects in these regulatory systems has confirmed their relevance in humans as well as in animal models, and the search is now on to produce drugs which act on these and other CNS targets such as glucagon-like peptide I and the orexins to help reduce body weight. Other recently identified targets outside the central nervous system include agents acting to inhibit digestive enzymes, specifically pancreatic lipase in the form of orlistat (which has recently been licensed for obesity treatment), and looking to the future, the possibility of altering energy expenditure by modulating the newly identified uncoupling proteins is being considered. It should be remembered however, that pharmacotherapy for obesity is unlikely to provide a 'magic bullet', and that diet and lifestyle changes are likely to remain the cornerstone of treatment for the foreseeable future.

Adult↗

Effect of 3 modified fats and a conventional fat on appetite, energy intake, energy expenditure, and substrate oxidation in healthy men.

BACKGROUND: Different dietary fats are metabolized differently in humans and may influence energy expenditure, substrate oxidation, appetite regulation, and body weight regulation. OBJECTIVE: We examined the short-term effects of 4 triacylglycerols (test fats) on subjective appetite, ad libitum energy intake, meal-induced thermogenesis, and postprandial substrate oxidation. DESIGN: Eleven healthy, normal-weight men (mean age: 25.1 +/- 0.5 y) consumed 4 different test fats [conventional fat (rapeseed oil) and 3 modified fats (lipase-structured fat, chemically structured fat, and physically mixed fat)] in a randomized, double-blind, crossover design. RESULTS: No significant differences in appetite sensations or ad libitum energy intakes were observed between the 4 test fats. Overall, the 4 fats exerted different effects on energy expenditure (meal effect: P < 0.01) and substrate oxidation (interaction between meal and time: P < 0.05). In post hoc tests, the 3 modified fats resulted in significantly higher postprandial energy expenditure and fat oxidation than did the conventional fat (P < 0.008, Bonferroni adjusted); no significant differences were observed between the 3 modified fats. CONCLUSIONS: Structured fats do not change short-term postprandial appetite sensations or ad libitum energy intakes but do result in higher postprandial energy expenditure and fat oxidation than do conventional fats and hence promote negative energy and fat balance. In humans, a physically mixed fat (trioctanoate + rapeseed oil) is metabolized as quickly as are structured fats. The position of medium-chain fatty acids on the glycerol backbone of triacylglycerols does not seem to affect energy expenditure or appetite.

Adult↗

Intracerebroventricular administration of leptin-induced apoptosis in the rat small intestinal mucosa.

The localization of leptin and leptin receptors in the stomach and small intestine has been reported. Their function is still unknown, although leptin is a hormone that regulates appetite and fat-related metabolism. The small intestine is one of the important organs for regulating metabolism. The purpose of the present study was to investigate whether leptin regulates apoptosis in the small intestinal mucosa. Intestinal apoptosis was evaluated by percent fragmented DNA, electrophoresis, TUNEL staining, and western blotting analysis of caspase-3. Mucosal apoptosis in the rat jejunum and ileum was evaluated at 0, 3, 6, 12, and 24 hrs after injection. Rats were tested after ad libitum feeding and 24-hr fasting to exclude the anorectic effect of leptin. Leptin was injected intraperitoneally (ip) at a dose of 200 microg/rat and infused into the rat third cerebroventricle (icv) at a dose of 8 microg/rat. Leptin at a dose of 8 microg/rat significantly induced intestinal apoptosis in the small intestine at 3 and 6 hrs after icv administration in both ad libitum feeding and 24-hr fasted rats. This increase in apoptosis was not attenuated by vagotomy. Intestinal apoptosis increased 12 and 24 hrs after ip injection of leptin at a dose of 200 microg/rat. The peak of the increase in apoptosis in icv rats appeared earlier than that in ip rats. Leptin induced jejunal and ileal mucosal apoptosis in the rat, indicating that leptin might control intestinal function through the regulation of intestinal apoptosis.

Animals↗

Neuroendocrine effects of endogenous opioid peptides in human subjects: a review.

In the decade since the discovery of specific opioid receptors in the brain, there have been rapid advances in our understanding of the physiological and pathological roles of the endogenous opioid systems in humans. Endogenous opioid peptides have been demonstrated to play a role as modulators of a number of hormonal functions in humans. In particular they appear to inhibit luteinizing hormone and ACTH release, and the response of arginine vasopressin to osmotic stimuli. They appear to participate in the modulation of carbohydrate homeostasis. In pathophysiological states, they appear to play a role in the decreased pulsatile luteinizing hormone release seen in patients with prolactinomas. Circulating beta-endorphin appears to be an important regulator of immune function. Preliminary studies in humans have suggested a role for endogenous opioid peptides in appetite regulation. In the last few years, a few case reports have suggested the possibility of a series of syndromes due to endogenous opioid excess. Within the next decade, we can expect to see the routine use of opioid antagonists in a variety of pathophysiological states.

Adrenocorticotropic Hormone↗

Chemokines control fat accumulation and leptin secretion by cultured human adipocytes.

In addition to their role in inflammation, cytokines like TNFalpha have been reported to regulate the adipose tissue function suggesting a role for these soluble mediators in metabolism. However, it is not known whether adipocytes have the capacity to secrete chemokines, a group of low molecular weight inflammatory mediators that control leukocyte migration into tissues. Here we show that primary cultures of human preadipocytes constitutively produce three chemokines, interleukin-8 (IL-8), macrophage inflammatory protein-1alpha (MIP-1alpha) and monocyte chemotactic protein-1 (MCP-1), while their level of expression is low in mature adipocytes. Upon TNFalpha treatment, the expression of all the three chemokines is upregulated in adipocytes differentiated in vitro. In addition, we describe the presence of seven different chemokine receptors, mainly in mature adipocytes, both in vitro and in human fat tissue sections. Prolonged stimulation of cultured human adipocytes with exogenous chemokines leads to a decrease in lipid content in association with the downregulation of PPARgamma mRNA expression. Moreover, chemokines positively control the secretion of leptin, a hormone that regulates appetite, by a post-transcriptional mechanism. These findings reveal a new role for chemokines in the regulation of adipose tissue and suggest a novel therapeutic basis for the treatment of obesity, diabetes and cachexia.

Adipocytes↗

Resistance to adenovirally induced hyperleptinemia in rats. Comparison of ventromedial hypothalamic lesions and mutated leptin receptors.

Leptin regulates appetite and body weight via hypothalamic targets, but it can act directly on cultured pancreatic islets to regulate their fat metabolism. To obtain in vivo evidence that leptin may act peripherally as well as centrally, we compared the effect of adenovirally induced hyperleptinemia on food intake, body weight, and islet fat content in ventromedial hypothalamic-lesioned (VMHL) rats, sham-lesioned (SL) controls, and Zucker Diabetic Fatty (ZDF) rats in which the leptin receptor is mutated. Infusion with recombinant adenovirus containing the rat leptin cDNA increased plasma leptin by approximately 20 ng/ml in VMHL and ZDF rats but had no effect on their food intake, body weight, or fat tissue weight. Caloric matching of hyperphagic VMHL rats to SL controls did not reduce their resistance to hyperleptinemia. Whereas prediabetic ZDF rats had a fourfold elevation in islet fat, in VMHL rats islet fat was normal and none of them became diabetic. Isolated islets from ZDF rats were completely resistant to the lipopenic action of leptin, while VMHL islets exhibited 50% of the normal response; caloric matching of VMHL rats to SL controls increased leptin responsiveness of their islets to 92% of controls. We conclude that leptin regulation of adipocyte fat requires an intact VMH but that islet fat content is regulated independently of the VMH.

Adenoviridae↗

[Sugar triggers our reward-system. Sweets release opiates which stimulates the appetite for sucrose--insulin can depress it].

The consumption of sweet food has increased in Sweden, as in other Western countries. The type of food item has changed. The sweet is dominated by soft drinks. Appetite regulation for sucrose has been described in experimental animal models. It has been found that opioids stimulate appetite for sucrose. At the same time sucrose releases endogenous opioids so that a triggering of sucrose consumption occurs. Insulin has been shown to decrease sucrose intake by blocking the opioid response. Sucrose addiction has been described in rat model. With a concentrated sucrose solution to drink an opioid dependence developed with 1) increased consumption of sucrose 2) abstinence symptoms with no sucrose and 3) anxiety with an opiate blocker. Sucrose addiction in man has not been described in the scientific literature. There is an increased liking of sweets with alcoholic persons, which may be significant to support a strongly rewarding effect of sucrose, also in man. We should limit the access to sweet foods, in particular the sweet drinks. Insulin and insulin sensitivity may be an important factor to restrict the intake of sweet food.

Animals↗

Appetite and energy balance signals from adipocytes.

Interest in the biology of white adipose tissue has risen markedly with the recent surge in obesity and its associated disorders. The tissue is no longer viewed simply as a vehicle for lipid storage; instead, it is recognized as a major endocrine and secretory organ. White adipocytes release a multiplicity of protein hormones, signals and factors, termed adipokines, with an extensive range of physiological actions. Foremost among these various adipokines is the cytokine-like hormone, leptin, which is synthesized predominantly in white fat. Leptin plays a critical role in the control of appetite and energy balance, with mutations in the genes encoding the hormone or its receptor leading to profound obesity in both rodents and man. Leptin regulates appetite primarily through an interaction with hypothalamic neuroendocrine pathways, inhibiting orexigenic peptides such as neuropeptide Y and orexin A, and stimulating anorexigenic peptides such as proopiomelanocortin. White fat also secretes several putative appetite-related adipokines, which include interleukin-6 and adiponectin, but whether these are indeed significant signals in the regulation of food intake has not been established. Through leptin and the other adipokines it is evident that adipose tissue communicates extensively with other organs and plays a pervasive role in metabolic homeostasis.

Adipocytes↗

The hypothalamus and obesity.

Obesity, a condition already at epidemic proportions in the developed world, is largely attributable to an indulgent lifestyle. Biologically we feel hunger more acutely than feeling "full-up" (satiety). The discovery over a decade ago of leptin, an adiposity signal, revolutionised our understanding of hypothalamic mechanisms underpinning the central control of ingestive behaviour. The structure and function of many hypothalamic peptides (Neuropeptide Y (NPY), Melanocortins, Agouti related peptide (AGRP), Cocaine and amphetamine regulated transcript (CART), Melanin concentrating hormone (MCH), Orexins and endocannabinoids) have been characterised in rodent models. The pharmacological potential of several endogenous peripheral peptides released prior to, during and/or after feeding are being explored. Short-term signal hormones including Cholecystokinin (CCK), Ghrelin, Peptide YY (PYY(3-36)) and Glucagon-like peptide 1 (GLP-1) control meal size via pathways converging on the hypothalamus. Long-term regulation is provided by the main circulating hormones leptin and insulin. These systems among others, implicated in hypothalamic appetite regulation all provide potential "drugable" targets by which to treat obesity.

Animals↗

Mutational screening of the CART gene in obese children: identifying a mutation (Leu34Phe) associated with reduced resting energy expenditure and cosegregating with obesity phenotype in a large family.

Cocaine- and amphetamine-regulated transcript (CART) inhibits feeding and induces the expression of c-Fos in hypothalamic areas implicated in appetite regulation. Furthermore, the CART peptide is found in neurons regulating sympathetic outflow, which in turn play an integral role in regulating body temperature and energy expenditure. The CART gene was screened by single-strand conformation polymorphism and automatic sequencing in 130 (72 girls) unrelated obese Italian children and adolescents. Their Z-scores (mean +/- SD) of relative to BMI percentiles was 3.9 +/- 1.8, and the average age at obesity onset was 4.7 +/- 2.6 years. Two previously described silent polymorphisms were found in the 3' untranslated region: an adenine deletion at position 1457 in 9 patients (allele frequency 0.035) and an A/G substitution at position 1475 in 11 patients (allele frequency 0.042). We found no difference between the obese patients heterozygous for one of these polymorphisms and those patients homozygous for the wild allele with respect to their age of obesity onset, BMI Z-scores, and leptin levels. A missense mutation of G729C resulting in the substitution of Leu with Phe at codon 34, within the NH2-terminal CART region, has been detected in the heterozygous state in a 10-year-old obese boy who has been obese since the age of 2 years. The patient belongs to a large family of obese subjects. The mutation cosegregated with the severe obesity phenotype over three generations and was not found in the control population. Resting metabolic rates were lower than expected in the propositus (-14%) and his mother (-16%), who carried the mutation. Leucine at codon 34, conserved in this position in the human and in the rat sequences, immediately precedes a couple of lysine residues that may well represent a dibasic processing site. The Leu34Phe mutation might alter the susceptibility to proteolysis of this potential processing site, likely altering the CART effect on thermogenesis and energy expenditure.

Adolescent↗