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Contributions of obesity, gender, hunger, food preference, and body size to bite size, bite speed, and rate of eating.

College students ate two high preference or two low preference doughnuts under high or low hunger conditions. Subjects were led to believe that we were interested in preference ratings made after eating the doughnuts. The number of bites and the total snack time were covertly recorded. Having weighed the doughnuts previously, we calculated the bite size (amount per bite), bite speed (time per bite), and eating rate (amount per second). Eating rate increased as obesity, body size, hunger, and preference increased; men ate at a faster rate than women. Larger bites accounted for the increased rate of the obese, the high preference subjects, and those having a larger body size. The hungry subjects increased their eating rate by taking faster bites. Men ate faster than women by taking both larger but slower bites. Thus eating rate is under multiple control. The data also suggest that the effects of obesity and, in part, gender on these eating responses may be more parsimoniously explained as body size effects. Modification of these within-session eating responses in order to regulate food intake will be successful only when the relationships among these measures are understood.

Adolescent↗

Effects of slow release carbohydrates in the form of bean flakes on the evolution of hunger and satiety in man.

This study was undertaken to test the effects of plausible meals containing slow release starches in the form of bean flakes on plasma glucose and hunger in man. In a first study, volunteers consumed a hachis paramentier (shepherd's pie) containing either bean purée or potato purée. After the meal containing potato, plasma glucose levels rose sharply, peaked at 30-45 min and fell below initial levels 2 to 3 h later. With bean purée there was a low, sustained increase in blood glucose. In a second study, volunteers consumed six hachis parmentier (three with bean purée, three with potato purée, topped with spinach, ratatouille or tomatoes). Relative to potato, the bean purée delayed the return of hunger and decreased ratings for propensity to eat a tasty snack.

Adult↗

Hunger-induced finickiness in humans.

Two experiments were conducted to examine the effect of hunger on finickiness in humans. Subjects (a total of 157 undergraduate female dieters and non-dieters) were food-deprived and then subsequently either given a snack (not-hungry group) or left food-deprived (hungry group) before being given ad libitum access to either good-tasting or bad-tasting (quinine-adultered) milkshake. Common sense predicted that hungry subjects would drink more milkshake than would not-hungry subjects, regardless of milkshake palatability. Hungry subjects did in fact drink more of the good-tasting milkshake than did not-hungry subjects, but they also drank less of the bad-tasting milkshake. We discuss possible reasons why hunger might increase rejection of bad-tasting food, as well as the limiting conditions of the effect.

Animals↗

Effects of three doses of transdermal nicotine on post-cessation eating, hunger and weight.

Smokers were randomly assigned to 0, 7, 14 or 21 mg doses of transdermal nicotine and had their eating and weight followed for 6 weeks. Among the 66 subjects who were abstinent for all 6 weeks, caloric, carbohydrate and fat intake, hunger, and weight increased in those on placebo, but alcohol, caffeine and protein intake did not. Nicotine patch decreased caloric, carbohydrate and fat intake in a dose-related manner, showed a trend for weight and showed no effect for hunger. Neither abstinence from smoking nor nicotine therapy shifted the percent of calories from sweets or carbohydrates. We conclude nicotine replacement reduces post-cessation increases in eating but does not have a specific effect on sweet intake.

Administration, Cutaneous↗

Hunger, eating, and ill health.

Humans and other warm-blooded animals living with continuous access to a variety of good-tasting foods tend to eat too much and suffer ill health as a result--a finding that is incompatible with the widely held view that hunger and eating are compensatory processes that function to maintain the body's energy resources at a set point. The authors argue that because of the scarcity and unpredictability of food in nature, humans and other animals have evolved to eat to their physiological limits when food is readily available, so that excess energy can be stored in the body as a buffer against future food shortages. The discrepancy between the environment in which the hunger and eating system evolved and the food-replete environments in which many people now live has led to the current problem of overconsumption existing in many countries. This evolutionary perspective has implications for understanding the etiology of anorexia nervosa.

Animals↗

Restraint and internal responsiveness: effects of placebo manipulations of hunger state on eating.

Restrained and unrestrained subjects were given a "vitamin" (placebo) prior to an ad-lib taste test. Subjects were either told nothing about the placebo or told that previous subjects had reported that the vitamin had made them feel either hungry or full. As predicted, restrained subjects, in two separate studies, behaved in accordance with placebo messages, eating more when given "hungry" messages than when given "full" messages. Unrestrained subjects showed an apparent reverse-placebo effect; they ate less ice cream when given "hungry" information than when given "full" information. Hunger ratings did not parallel eating behavior; possible explanations for this discrepancy are considered. We conclude that unresponsiveness to internal hunger state, and an overreliance on external cognitive cues, characterizes restrained but not unrestrained individuals.

Adolescent↗

Insulin levels, hunger, and food intake: an example of feedback loops in body weight regulation.

The paper reviews studies considering whether hyperinsulinemia, and its resultant effects on adipose tissue mass, can alter perceived hunger, taste, and food consumption. It also describes work addressing the reciprocal question of whether cues associated with food can affect insulin response. Specifically, four general categories of studies are presented. First, studies considering the causes and physiological consequences of chronic hyperinsulinemia are reviewed. Second, work investigating environmental and cognitive influences on insulin secretion are described. These show that high acute levels of insulin can be produced by simply seeing and thinking about food and that individuals showing this response show a greater tendency toward weight gain in a food-abundant environment. Third, studies are covered in which direct manipulations of insulin level, controlling for blood glucose, are performed. These experiments show that elevations in insulin produce increased hunger, heightened perceived pleasantness of sweet taste, and increased food intake. Finally, a study is described that considers how different insulin levels, produced by the type of food ingested, may affect subsequent food intake. Together, these studies show that "overeating" is caused by a complex feedback system of environmental, behavioral, and biological factors.

Appetite Regulation↗

Failure of sodium- and calcium-deficient rats to acquire conditioned taste aversions to the object of their specific hunger.

Attempts were made to condition taste aversions to the objects of two mineral-specific hungers. Both the innate preference of adrenalectomized rats for sodium and the learned preference of parathyroidectomized rats for calcium were studied. None of the sodium-deficient rats poisoned after drinking sodium chloride (NaCl) reached a taste-avoidance criterion, even after nine pairings of salt ingestion with aversive lithium chloride injections. Six of 11 calcium-deficient rats did not meet the salt-avoidance criterion after 10 pairings. Nondeficient control subjects learned to avoid these salt solutions completely after an average of only three such pairings. Besides unmasking a surprising degree of similarity between the learned and innate specific hungers studied, the results clearly demonstrate a powerful influence of physiological need on aversion conditioning.

Adrenal Glands↗

Night eating syndrome is associated with depression, low self-esteem, reduced daytime hunger, and less weight loss in obese outpatients.

OBJECTIVE: The objective of this study was to assess the relationship between the night eating syndrome (NES), measures of depression and self-esteem, test meal intake, and weight loss in obese participants. RESEARCH METHODS AND PROCEDURES: The study included 76 overweight (body mass index = 36.7 +/- 6.5 SD) outpatients (53 women and 23 men; aged 43.5 +/- 9.5 years) entering a weight loss program. They completed a Night Eating Questionnaire, the Zung Depression Inventory, and the Rosenberg Self-Esteem SCALE: Based on criteria by Stunkard et al. (Stunkard A, Berkowitz R, Wadden T, Tanrikut C, Reiss E, Young L. Binge eating disorder and the night eating syndrome. Int J Obes Relat Metab DISORD: 1996;20:1-6), participants had NES if they reported: (1) skipping breakfast > or =4 d/wk, interpreted as morning anorexia; (2) consuming more than 50% of total daily calories after 7 PM; and (3) difficulty falling asleep or staying asleep > or =4 d/wk. Eleven (14%) participants met the criteria for NES. After an 8-hour fast, all participants ingested a nutritionally complete liquid meal through a straw from a large opaque cooler until extremely full. They also completed ratings of hunger and fullness before and after this meal. RESULTS: Night eaters had higher depression (p = 0.04), lower self-esteem (p = 0.003), and less hunger (p = 0.005), and a trend for more fullness (p = 0.06) before the daytime test meal than the others. However, there were no significant differences in test-meal intake between groups. Nevertheless, test-meal intake was greater later in the day only for the night eaters (p = 0.01). Over a 1-month period, the night eaters lost less weight (4.4 +/- 3.2 kg) than the others (7.3 +/- 3.2 kg; p = 0.04), after controlling for body mass index. DISCUSSION: NES is a syndrome with distinct psychopathology and increased food intake later in the day, both of which may contribute to poorer weight loss outcome. NES criteria need to be better quantified and NES deserves consideration as a diagnostic eating disorder.

Adult↗

Social and cultural perspectives on hunger, appetite and satiety.

The aim of this review is to show how hunger, satiety and appetite can be seen as a central research subject for the social sciences, both as the locus where food consumption is bodily regulated and as the nexus where biology, social praxis and cultural meanings meet and are negotiated by the individual. The number of people developing overweight and obesity is increasing, as is the prevalence of eating disorders and weight preoccupation. These tendencies can be considered as expressions of a polarization of eating habits in modern societies, where lack of control or exaggerated control over eating are still more common phenomena. At the same time the tendencies may be seen as the result of a more general ambivalence in relation to food, which influences the experiences of hunger, satiety and appetite and their regulating effect on food consumption.

Appetite↗

Leptin deficiency due to lipid apheresis: a possible reason for ravenous hunger and weight gain.

OBJECTIVE: To investigate how extracorporal cholesterol lowering therapy affects circulating leptin levels in patients with ravenous hunger after treatment and permanent weight gain. DESIGN: A case report. SUBJECT: 51 y old caucasian male patient with moderate chronic renal failure. MEASUREMENTS: Serum Leptin concentration (RIA, Linco Research Inc, St. Louis, MO, USA), total cholesterol, low density lipoprotein cholesterol, blood glucose levels, calorie intake by food records. RESULTS: During treatment total cholesterol was reduced by 50%. Serum Leptin levels showed a 42% reduction at the end of treatment, that by far exceeds the physiological diurnal variation. Calorie intake was significantly increased on days of treatment. CONCLUSION: We conclude that this artificial reduction in circulating leptin plays an important role in the pathogenesis of ravenous hunger and weight gain under extracorporal cholesterol lowering therapy in this case.

Blood Glucose↗

Effect of two breakfasts, different in carbohydrate composition, on hunger and satiety and mood in healthy men.

OBJECTIVE: To study the effect of simple vs complex carbohydrates (SCHO and CCHO respectively) containing breakfasts on blood parameters, hunger and satiety and mood. DESIGN: A 2-day, open, randomised, cross-over trial. SUBJECTS: A total of 26 male subjects (34+/-6 y; BMI 23.4+/-2.2 kg m(-2)). MEASUREMENTS: Blood glucose, insulin, triacylglycerols (TG), free fatty acids (FFA) and cholecystokinin (CCK) were determined repeatedly for 4 h on both test days after a breakfast containing SCHO or CCHO. Feelings of hunger and satiety were determined at similar time points as well. Mood state was examined 3 h after breakfast consumption. RESULTS: Consumption of a SCHO breakfast resulted in higher glucose and insulin levels at 30 min after breakfast consumption. TG at 180 min, and FFA at 180 and 240 min were higher after SCHO breakfast than after CCHO breakfast. Satiety scores were higher after CCHO breakfast consumption for the first 90 min after intake. Furthermore, the item 'fatigue' was scored higher after SCHO breakfast than after CCHO breakfast intake. CONCLUSION: Consumption of a CCHO breakfast is favourable in comparison to a SCHO breakfast, because of the lower perception of 'fatigue' and the higher degree of satiety after consumption.

Adult↗

Night eating syndrome: effects of brief relaxation training on stress, mood, hunger, and eating patterns.

BACKGROUND: Night eating syndrome (NES) is characterized by a lack of appetite in the morning, consumption of 50% or more of daily food intake after 6:00 p.m., and difficulty falling and/or staying asleep. It has been associated with stress and with poor results at attempts to lose weight. OBJECTIVE: The purpose of this study was to determine whether a relaxation intervention (Abbreviated Progressive Muscle Relaxation Therapy, APRT) that has been shown to significantly reduce stress levels in normal, healthy adults would also benefit an NES sample. RESEARCH METHODS AND PROCEDURES: A total of 20 adults with NES were randomly assigned to either a relaxation training (APRT) or a Control (quietly sitting for the same amount of time) group, and all subjects attended two laboratory sessions 1 week apart. Pre- and postsession indices of stress, anxiety, relaxation, and salivary cortisol were obtained, as well as Day 1 and Day 8 indices of mood. Food diaries and hunger ratings were also obtained. RESULTS: The results indicated that 20 min of a muscle relaxation exercise significantly reduced stress, anxiety, and salivary cortisol immediately postsession. After practicing these exercises daily for a week, subjects exhibited lowered stress, anxiety, fatigue, anger, and depression on Day 8. APRT was also associated with significantly higher a.m. and lower p.m. ratings of hunger, and a trend of both more breakfast and less night-time eating. DISCUSSION: These data support the role of stress and anxiety in NES and suggest that practicing relaxation may be an important component of treatment for this condition.

Adult↗

Neural representations of hunger and satiety in Prader-Willi syndrome.

OBJECTIVE: To investigate the neural basis of the abnormal eating behaviour in Prader-Willi syndrome (PWS), using brain imaging. We predicted that the satiety response in those with PWS would be delayed and insensitive to food intake. DESIGN AND PARTICIPANTS: The design of this study was based on a previous investigation of the neural activation associated with conditions of fasting and food intake in a nonobese, non-PWS group. The findings were used to generate specific hypotheses regarding brain regions of interest for the current study, in which 13 adults with PWS took part (mean +/- s.d. age = 29 +/- 6; BMI = 31.5 +/- 5.1; IQ = 71 +/- 8, six were female). MEASUREMENTS: Regional cerebral blood flow was measured using positron emission tomography in three sessions: one following an overnight fast and two following disguised energy controlled meals of similar volume and appearance--one of 1674 kJ (400 kcal) and another of 5021 kJ (1200 kcal). Subjective ratings of hunger, fullness and desire to eat, and blood plasma levels of glucose, insulin, leptin, ghrelin and PYY were measured before and after each imaging session. RESULTS: The neural representation of hunger, after an overnight fast, was similar to that found in nonobese individuals in the control study. In contrast, after food intake, the patterns of neural activation previously associated with satiety were not found, even after the higher-energy load. Lateral and medial orbitofrontal cortical activation was associated with consumption of the 400- and 1200-kcal meals, respectively. The medial orbitofrontal activation, however, was only found in those who had shown a large percentage change in fullness ratings following the higher-energy meal. CONCLUSION: We conclude that there is a dysfunction in the satiety system in those with PWS. These findings suggest that brain regions associated with satiety are insensitive even to high-energy food intake in those with the syndrome. This may be the neural basis of the hyperphagia seen in PWS.

Adult↗

Plasma leptin, energy intake and hunger following total hip replacement surgery.

1. This study aimed to investigate the possible role of leptin in post-traumatic anorexia by making pre- and post-operative (0-8 days) measurements of circulating leptin concentrations in six patients undergoing elective total hip replacement for osteoarthritis. 2. Mean daily hunger rating (four categories) and food intake (assessed by food record charts) were measured pre-operatively, as well as post-operatively for the first 5 days (days 0-5). Leptin concentrations, circulating metabolites [glucose, non-esterified fatty acids, glutamine and 3-hydroxybutyrate] and insulin and cortisol concentrations were measured pre-operatively (day 0) and post-operatively (days 1, 2, 3, 5 and 8). 3. Mean leptin concentrations were significantly increased only on day 1 (56% increase compared with pre-operative values, P < 0.009), whereas food intake (only 0.6 MJ on day 0) and hunger (5/6 patients 'not hungry' on day 0) only gradually improved over the next few days. (The energy intake over the first 5 days was 56% of the pre-operative value.) 4. Circulating insulin and cortisol concentrations were elevated on day 1 compared with pre-operative values on day 0 (P < 0.05). Of the measured metabolites implicated in the control of food intake, circulating non-esterified fatty acids and 3-hydroxybutyrate were not significantly altered in the post-operative period, but significant hyperglycaemia was noted on day 1 compared with day 0 pre-operatively (8.8 compared with 6.4 mmol/l glucose; P < 0.01). 5. It is concluded that circulating leptin is involved in the early (< 24 h) acute-phase response after moderately severe surgical trauma (characterized biochemically by a substantial acute-phase protein response, hypoalbuminaemia, hyperglycaemia and hypoglutaminaemia). Therefore, leptin may be implicated in post-traumatic anorexia, although other factors are likely to be involved, especially after the first 24 h when circulating leptin concentrations are no longer elevated.

Acute-Phase Reaction↗

Hunger disease.

This paper examines three aspects of hunger disease: the effect of initial fat stores on macronutrient fuel selection during total starvation (no energy) and how it influences survival; the effects of different rates of weight loss on tissue and body function; and the importance of appetite sensations, including hunger, during malnutrition and during enteral and parenteral nutritional support. Long-term starvation studies in humans reveal major differences in fat carbohydrate and protein metabolism between lean and obese subjects, including a 2-4-fold lower contribution of protein oxidation to energy expenditure in obese subjects, which ensures that more of the excess body fat is oxidized. The rate of weight loss, determined by recent dietary intake, can have major effects on tissue and body function, including wound healing, the acute phase protein response, muscle fatigue and psychological/behavioural function in both clinical and non-clinical settings. In depleted states uncomplicated by disease, changes in appetite sensations can result in energy intakes as high as 6000 to 10,000 kcal/day ( 25-42 MJ/day). Long-term enteral tube feeding and parenteral nutrition are associated with frequent disturbances in appetite sensations, and in those able to eat normally they tend to add rather than replace oral intake to an extent that appears to depend on the regimen. It is concluded that 1) differences between lean and obese subjects in macronutrient fuel selection during starvation are adaptive because they optimize survival in both groups of subjects; 2) the rate of weight loss in health and disease has a major effect on certain tissue and body functions, independently of the magnitude of weight loss; and 3) clinically relevant disturbances in appetite sensations are common subjects receiving long-term enteral and parenteral nutrition. The clinical modulation of all these variables would be aided by greater knowledge of the mechanisms involved.

Adaptation, Physiological↗

Role of gastrointestinal factors in hunger and satiety in man.

There is, we feel, a strong case to be made for a major influence of gastrointestinal factors in the control of eating behaviour in humans. Moreover, the findings suggest that satiety and hunger are controlled by different gastrointestinal mechanisms. Gastric distension is perhaps the most important factor that stops people eating, but a true feeling of satiety also requires the presence of nutrients in the small intestine. Hunger appears to be little influenced by the amount of food in the stomach and appears to be more dependent on the nutrient load in the small intestine. I do not mean by this to suggest that the gastrointestinal mechanisms are the only mechanisms controlling eating behaviour in humans or even the most important. Nevertheless they constitute an important and fundamental control system that links with the post-absorptive mechanisms and a plethora of social and conditioning factors to influence what we eat.

Digestive System Physiological Phenomena↗

Food intake, hunger, and satiety after preloads in women with eating disorders.

Food intake, food selection, macronutrient intake, sensory-specific satiety, and ratings of hunger and satiety were measured after high- and low-energy salad preloads (2414 kJ, or 172 kJ) or no preload to determine whether patients with eating disorders compensate appropriately for different energy intakes. Subjects were female patients with a DSM-III-R diagnosis of anorexia nervosa with bulimic features or bulimia nervosa, or non patient, normal-weight, nondieters (n = 9/group). At a self-selected lunch 30 min after the preloads, all of the groups reduced intake after the high-energy preload, with the bulimics showing the best compensation. The anorexics chose low-energy foods and in some conditions ate a smaller proportion of fat than did the other groups. The bulimics ate more high-energy foods than did the anorexics. The anorexics demonstrated sensory-specific satiety only after the high-energy salad and the bulimics only after the low-energy salad. Overall, these data suggest that while many of their responses to food are abnormal, patients with eating disorders have some capacity to respond to physiological hunger and satiety cues.

Adult↗