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Hunger and undernutrition in the United States.

In the United States, where food is plentiful nationwide, detection of populations at risk of hunger and malnutrition must rely more on social and economic indicators than on physiological indices, important as these are. Large federal programs expanded or created after the 1969 White House Conference on Food, Nutrition, and Health were shown to be successful during the 1970s in reducing hunger and malnutrition as a massive social phenomenon, even though poverty conditions remained the same. Studies that apply our knowledge of nutritional and dietary requirements to construct a "market basket" of inexpensive, commonly used foods that meet the Recommended Dietary Allowances (RDA) and that set estimated minimum incomes as a multiple of the cost of such an "RDA-based market basket" plus the costs of other necessities would identify populations and families at risk and permit better targeting of food programs.

Child, Preschool↗

Measuring food insecurity and hunger in the United States: development of a national benchmark measure and prevalence estimates.

Since 1992, the U.S. Department of Agriculture Food and Nutrition Service (FNS) has led a collaborative effort to develop a comprehensive benchmark measure of the severity and prevalence of food insecurity and hunger in the United States. Based on prior research and wide consultation, a survey instrument specifically relevant to U.S. conditions was designed and tested. Through its Current Population Survey (CPS), the U.S. Bureau of the Census has fielded this instrument each year since 1995. A measurement scale was derived from the data through fitting, testing and validating a Rasch scale. The unidimensional Rasch model corresponds to the form of the phenomenon being measured, i.e., the severity of food insufficiency due to inadequate resources as directly experienced and reported in U.S. households. A categorical measure reflecting designated ranges of severity on the scale was constructed for consistent comparison of prevalence estimates over time and across population groups. The technical basis and initial results of the new measure were reported in September 1997. For the 12 months ending April 1995, an estimated 11.9% of U.S. households (35 million persons) were food insecure. Among these, 4.1% of households (with 6.9 million adults and 4.3 million children) showed a recurring pattern of hunger due to inadequate resources for one or more of their adult and/or child members sometime during the period. The new measure has been incorporated into other federal surveys and is being used by researchers throughout the U.S. and Canada.

Adult↗

Peripheral signals in the control of satiety and hunger.

PURPOSE OF REVIEW: Food intake is critical for survival and is a complex behavior with multiple levels of control. Short-term, meal-related signals arise from many sources including the gastrointestinal tract, the environment, and higher centers in the brain. As described in this review, inputs from the gastrointestinal tract can exert potent effects on meal initiation, meal termination, and meal frequency. The complex array of signals generated from the gastrointestinal system and from adipose tissue, which participate in the regulation of food intake, and specifically how these signals relate to satiety and hunger, is the focus of this review. RECENT FINDINGS: Literature on the role of the well-studied gastrointestinal peptide, cholecystokinin, in satiety, in addition to its interaction with long-term adiposity signals in mediating food intake will be reviewed. In addition, literature on the gastrointestinal hormones glucagon-like-peptide 1, apolipoprotein A-IV and peptide YY, and how they may act to regulate satiety, is described. Finally, the newly discovered hormone, ghrelin, and how it relates to meal initiation and hunger is discussed. SUMMARY: A better understanding of these systems and how they relate to body adiposity will prove to have important clinical applications. The available data suggest that interventions directed at multiple targets in the energy homeostasis system may be necessary to achieve and maintain weight loss.

Adipose Tissue↗

Climate change, global food supply and risk of hunger.

This paper reports the results of a series of research projects which have aimed to evaluate the implications of climate change for food production and risk of hunger. There are three sets of results: (a) for IS92a (previously described as a 'business-as-usual' climate scenario); (b) for stabilization scenarios at 550 and 750 ppm and (c) for Special Report on Emissions Scenarios (SRES). The main conclusions are: (i) the region of greatest risk is Africa; (ii) stabilization at 750 ppm avoids some but not most of the risk, while stabilization at 550 ppm avoids most of the risk and (iii) the impact of climate change on risk of hunger is influenced greatly by pathways of development. For example, a SRES B2 development pathway is characterized by much lower levels of risk than A2; and this is largely explained by differing levels of income and technology not by differing amounts of climate forcing.

Africa↗

Stereospecific effects of tryptophan on gastric emptying and hunger in humans.

The amino acid tryptophan (tryp) is a potent inhibitor of gastric emptying in both animals and humans. Animal studies suggest that this effect may be specific for the L-enantiomer. The effects of D- and L-tryptophan on gastric emptying, intragastric distribution and appetite in humans were evaluated. Ten volunteers ingested 300 mL of either L-tryp (50 mmol/L), D-tryp (50 mmol/L) or normal saline labelled with 99mTc sulfur colloid on three occasions, separated by between 3 and 7 days. Hunger and fullness were measured with a visual analogue scale at -2, 15, 30 and 60 min after ingestion of each drink. Saline emptied faster from the stomach than both L-tryp and D-tryp (P < 0.05) and D-tryp emptied faster than L-tryp (P < 0.005). Emptying from the proximal stomach was fastest for saline (P < 0.05) and faster for D-tryp than L-tryp (P < 0.005). Emptying from the distal stomach was faster for saline than both D- and L-tryp (P < 0.05). A reduction in hunger (P < 0.05) and a non-significant trend for an increase in fullness were observed after all three drinks. At 60 min, fullness was greater after L-tryp than after ingestion of D-tryp (P < 0.01). These observations indicate that the effect of tryptophan on gastric emptying in humans is stereospecific, consistent with the concept that stereospecific receptors for tryptophan exist in the human small intestine.

Adult↗

The state of world hunger.

Three distinct but related concepts have been used to estimate the numbers of people affected by hunger and to analyze the global food situation: food shortage, food poverty, and food deprivation. They focus on different aspects of the phenomenon of hunger and different levels of aggregation involved in its study. Food shortage occurs when total food supplies within a designated area--the world as a whole or continents, countries, or regions within countries--are insufficient to meet the needs of its population. Food poverty refers to the situation in which households cannot obtain enough food to meet the needs of all their members. Food deprivation refers to inadequate individual consumption of food or specific nutrients, also known as undernutrition. The relationships between food shortage, food poverty, and food deprivation are complex. If a region suffers a food shortage, some households will be food poor, and at least one household member will suffer food deprivation. Conversely, food poverty also can (and does) occur within regions where there is no aggregate food shortage, and individual food deprivation can occur in households that are not food poor. The key factor in both cases is distribution.

Adolescent↗

The responsiveness of neurones in the frontal opercular gustatory cortex of the macaque monkey is independent of hunger.

1. In order to determine whether the responsiveness of neurones in the primary gustatory cortex is influenced by hunger, the activity of neurones in the gustatory cortex in the frontal operculum was recorded while macaque monkeys (Macaca fascicularis) were fed to satiety. The responses of single neurones in the gustatory cortex to the prototypical taste stimuli glucose, NaCl, HCl and quinine hydrochloride, and to fruit juice, were measured before, while, and after the monkey was fed to satiety with glucose or fruit juice. 2. While behaviour turned from avid acceptance to active rejection upon repletion, the responsiveness of the neurones to the stimulus array, including the satiating solution, was unmodified. 3. It is concluded that in the gustatory cortex in the frontal operculum, neuronal responses to gustatory stimuli are not influenced by the normal transition from hunger to satiety. This is in contrast to the responses of a population of neurones recorded in the hypothalamus, which only occur to the taste of food when the monkey is hungry. Thus the neurones in the primary gustatory cortex are involved in a motivation-independent analysis of gustatory stimuli, whereas the hypothalamic neurones may be more closely related to the influence of motivational state on behavioural responsiveness to gustatory stimuli.

Action Potentials↗

Cholecystokinin (CCK-8) affects gastric pressure and ratings of hunger and fullness in women.

Cholecystokinin (CCK) may affect food intake by augmenting neural activity from the distended stomach, thereby amplifying satiety signals. To test the hypothesis that subjects would report more fullness and less hunger with gastric distension when CCK-8 (112 ng/min) was infused than when saline was infused, a gastric balloon was inflated in the stomachs of four women. When the balloon was inflated to 500 ml, there was no difference in gastric pressure between the CCK-8 and saline conditions. Nonetheless, ratings of fullness were higher with CCK-8 administration. When the balloon was inflated to the maximum volume tolerated, the pressure rise was significantly smaller with CCK-8 infusion. In addition, fullness ratings rose and hunger ratings declined more steeply in relation to gastric pressure when CCK-8 was infused. In all conditions, gastric contractions were practically abolished with CCK-8 infusion. CCK-8 relaxed the stomach and concurrently sensitized the subjects to gastric pressure.

Adult↗

Loxiglumide, a CCK-A receptor antagonist, stimulates calorie intake and hunger feelings in humans.

Exogenous cholecystokinin (CCK) induces early satiety when infused into humans. Whether alimentary CCK (CCK-A) receptor blockade stimulates food intake in humans is, however, uncertain. The aim of the present investigation was, therefore, to establish the effect of CCK-A receptor blockade on satiety and eating behavior in healthy volunteers. To further explore the role of endogenous CCK, the effects of the specific CCK-A receptor antagonist loxiglumide (Lox; 22 micromol. kg(-1). h(-1)) on satiety and eating behavior were investigated in healthy men and compared with saline infusions (as placebo) in a series of randomized, double-blind, placebo-controlled, crossover studies. Lox produced a slight (7%), but not significant (P = 0.104), increase in food intake that was accompanied by a modest (10%), but significant (P < 0.004), increase in calorie intake. Fluid ingestion was not affected by Lox. Subjects experienced more hunger and delayed fullness during Lox infusion than during saline infusion (P < 0.05). This study provides further evidence that CCK is an endogenous physiological satiety signal acting through CCK-A receptor-mediated mechanisms. Repeated-dose studies comparing hunger and satiety responses after CCK-A receptor blockade in healthy subjects and patients with eating disorders may help clarify the possible involvement of endogenous CCK in these conditions.

Adult↗

Hunger and satiety modify the responses of olfactory and visual neurons in the primate orbitofrontal cortex.

1. The primate orbitofrontal cortex is the site of convergence of information from primary taste and primary olfactory cortical regions. In addition, it receives projections from temporal lobe visual areas concerned with the representation of objects such as foods. Previous work has shown that the responses of gustatory neurons in the secondary taste area within the orbitofrontal cortex are modulated by hunger and satiety, in that they stop responding to the taste of a food on which an animal has been fed to behavioral satiation, yet may continue to respond to the taste of other foods. 2. This study demonstrates a similar modulation of the responses of olfactory and visual orbitofrontal cortex neurons after feeding to satiety. Seven of nine olfactory neurons that were responsive to the odors of foods, such as blackcurrant juice, were found to decrease their responses to the odor of the satiating food in a selective and statistically significant manner. 3. It also was found for eight of nine neurons that had selective responses to the sight of food, that they demonstrated a sensory-specific reduction in their visual responses to foods after satiation. 4. The responses of orbitofrontal cortex neurons selective for foods in more than one modality also were analyzed before and after feeding to satiation. Satiety often affected the responses of these multimodal neurons across all modalities, but a sensory-specific effect was not always demonstrable for both modalities. 5. These findings show that the olfactory and visual representations of food, as well as the taste representation of food, in the primate orbitofrontal cortex are modulated by hunger. Usually a component related to sensory-specific satiety can be demonstrated. The findings link at least part of the processing of olfactory and visual information in this brain region to the control of feeding-related behavior.

Analysis of Variance↗

Regulation of hunger and satiety in man.

From the perspective presented in this minireview, it is clear that a variety of psychological and physiological factors interact to regulate feeding behavior. The hunger-satiety cycle involves preabsorptive and postabsorptive humoral and neuronal mechanisms. Psychological, social and environmental factors, nutrients and metabolical processes and gastric contractions originate hunger signals. Eating, in turn, activates inhibitory signals to produce satiety. Because of the delay between the swallowing of food and the digestion of food, the satiety mechanism requires a short-term signal to prevent over-eating. This short-term satiety signal is activated by psychological factors (such as sensory-specific satiety), chemical senses (taste and smell) and mechanical factors related to the process of swallowing and gastric distension. The long-term satiety is then activated by the chemoreception of nutrients and peptides by the gastrointestinal system (including the liver), the CNS and by intrinsic CNS mechanisms. The fine regulation of feeding behavior through these mechanisms will ensure the maintenance of normal energy metabolism. It is important to note, however, that despite all the efforts that have gone into the study of peripheral and central mechanisms of ingestive behavior--expressed in thousands of publications related to the anatomy, chemistry and metabolism, physiology and behavioral aspects of feeding--we will lack an understanding of the interactions among signals within a system or among different systems.

Acute Disease↗

Policy considerations for a realistic approach to hunger in Nigeria.

Hunger is usually caused by a break down in the food security mechanisms of a society and lack of purchasing power. In Nigeria, food shortages have become common since 1972, culminating in the food crises of the 1980s, made worse by the implementation of a macroeconomic economic adjustment policy in 1986. The paper confirms the hunger situation and presents evidence to show that it is of wider significance than hitherto acknowledged. The paper proposes policy options to tackle the situation and these include the development of agriculture to attain self-sufficiency in staple food production which must be backed by political will using a widely accepted framework and well articulated set of programmes and strategies borne out or consensus.

Adolescent↗

Hunger and food insecurity in the elderly: its nature and measurement.

To better understand the nature of food insecurity in the elderly and to improve its measurement, in-depth interviews were conducted with 41 urban Black and rural White elderly in 35 households, followed by telephone administration of commonly used measures of food insecurity in 24 of these elderly. Elderly food insecurity appears to follow a progression of severity, beginning with compromised diet quality, followed by food anxiety, socially unacceptable meals, use of emergency food strategies, and finally actual hunger. The five quantitative measures tested were compared to each elderly person's food insecurity status based on the in-depth interview. All measures had reasonable specificity, and good sensitivity for those experiencing severe food insecurity. However, the Cornell-Radimer, Community Childhood Hunger Identification Project (CCHIP) and Nutrition Screening Initiative (NSI) measures appeared more sensitive than the USDA food sufficiency or Urban Institute measures in correctly identifying those in the lesser stages of food insecurity.

Aged↗

Reducing hunger-associated symptoms: the midmorning nutrition break.

This study measured the effectiveness of a 9 a.m. nutrition break after it had been implemented for 1 academic year at an inner-city high school. Effectiveness was measured by student participation rates, student and teacher evaluations of hunger-associated symptoms experienced by students, and teacher evaluations of the effects on the learning environment. Sixty-nine percent of students participated. The most frequently cited reason for nonparticipation was dislike of the food offered (53%), with an additional 15% citing problems with food distribution. As the frequency of participation rose, the frequency of inability to focus, tiredness, stomachache, headache, and midmorning hunger fell. All of the associations were statistically significant except for headache. Seventy-four percent of staff stated that the nutrition break had positive effects on the learning environment, and 71% referred fewer students to the school nurse.

Abdominal Pain↗

Analysis of traditional strategies to combat world hunger and their results.

The traditional strategies proposed for development of the agricultural production of the underdeveloped countries are examined in this article. It is shown that the application of these strategies in the past has proven insufficient to eliminate world hunger. The limitations of these strategies are discussed and proposals are made for achieving the agricultural development in the underdeveloped world that will be necessary to eliminate hunger in the near future.

Agriculture↗

Hunger sensation in Graves' disease before and after pharmacological therapy.

PURPOSE: Hunger sensation (HS) provides information about the need of eating in order to counterbalance the energy expenditure (EE). HS was, thus, investigated in patients affected by Graves' disease (PAGD), a clinical condition characterized by excessive EE. MATERIALS AND METHODS: Ten newly diagnosed PAGD were investigated before and after therapy. Thirty clinically healthy subjects (CHS) were investigated as controls. The investigated subjects were asked to provide the 24-h profile of their HS by subjectively self-rating (from 1 to 10 hunger units) their orectic perception (OP) at regular intervals of 30 minutes (orexigram). The orexigrams were investigated via the conventional descriptive statistics as well as the Single-Cosinor method. RESULTS: PAGD were found to show a very consistent increase of their HS (hyperorexia), whose day-night variability was, still, the expression of a circadian rhythm, characterized by an elevation in its oscillatory level and extent. Interestingly, the pre-treatment hyperorexia was seen to show a normalization (eurexia) after pharmacological therapy. CONCLUSIONS: According to these results, it can be affirmed that hyperorexia is a clinical sign of Graves' disease, which is obtained via mechanisms of tonic and amplitude modulation of the HS circadian rhythm. Because of the eurexia after remission, it can be argued that the hyperorexia is a theleological response really aimed at increasing food intake in order to counterbalance the excessive EE which characterizes the thyrotoxicosis.

Adult↗

Involvement of human amygdala and orbitofrontal cortex in hunger-enhanced memory for food stimuli.

We used positron emission tomography to measure regional cerebral blood flow (rCBF) in 10 healthy volunteers performing a recognition memory task with food and non-food items. The biological salience of the food stimuli was manipulated by requiring subjects to fast before the experiment and eat to satiation at fixed time points during scanning. All subjects showed enhanced recognition of food stimuli (relative to non-food) in the fasting state. Satiation significantly reduced the memory advantage for food. Left amygdala rCBF covaried positively with recognition memory for food items, whereas rCBF in right anterior orbitofrontal cortex covaried with overall memory performance. Right posterior orbitofrontal rCBF covaried positively with hunger ratings during presentation of food items. Regression analysis of the neuroimaging data revealed that left amygdala and right lateral orbitofrontal rCBF covaried as a function of stimulus category (i.e., food vs non-food). These results indicate the involvement of amygdala and discrete regions of orbitofrontal cortex in the integration of perceptual (food), motivational (hunger), and cognitive (memory) processes in the human brain.

Adult↗

[Can gene technology in agriculture prevent hunger in the world?].

The world population grows rapidly: the number of mouths to feed increases. Is an agriculture without gene technology able to produce sufficiently in order to prevent hunger? Research indicates that hunger is not the result of short comings in agricultural outputs. It is however the result of poverty. This problem will not be solved by gene technology based agricultural production. This article explains the basic principles of mainstream and organic farming. Literature shows that the production potentials of both kinds of farming are, by far most, not yet exhausted. Gene technology is therefore unnecessary.

Agriculture↗