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Eating habits and appetite control: a psychobiological perspective.

An individual's eating behaviour is shaped by factors ranging from economic conditions and cultural practices to biological influences. The physiological system controlling appetite appears to be adapted to solving the problem of an unevenness of food supply across time, and is fairly permissive in its response to undereating and overeating. Consequently, when food is abundant, the diet is energy dense and energy expenditure is low, there is a strong tendency to become obese (i.e. obesity is better viewed as due to a 'toxic' environment than to faulty physiological control of appetite). Under such conditions the most common method of avoiding obesity is through the cognitive control of eating. However, dietary restraint and dieting are demanding tasks, and are associated with psychological costs, including significant impairment of cognitive performance. Restraint is also prone to disinhibition, with the result that it can sometimes undermine eating control, even leading to the development of highly disordered eating patterns. In part, these difficulties are due to the self-perpetuating nature of dietary habits: for example, hunger tends to be diminished during strict unbroken dieting, but increased in individuals having a highly variable eating pattern (such as occurs when eating is frequently disinhibited). These features of appetite control provide both barriers and opportunities for changing behaviour. Accordingly, there is a need for future research to focus on the psycho-social factors and the dieting practices predicting successful eating and weight control, with the objective of identifying the actual cognitive and behavioural strategies used by the many dieters and restrained eaters who are able to achieve weight loss and maintain long-term weight stability.

Appetite Regulation↗

Impaired cholecystokinin secretion and disturbed appetite regulation in women with polycystic ovary syndrome.

Increased amount of abdominal fat and obesity are common in polycystic ovary syndrome (PCOS). A higher prevalence of bulimia nervosa and greater cravings for sweets have also been reported in these patients. The present study aimed to compare meal-related appetite and secretion of the 'satiety peptide' cholecystokinin (CCK) and glucose regulatory hormones in PCOS women and controls. Sixteen pairs of women with PCOS and controls matched for age and body mass index participated in the study. After an overnight fast, blood samples were collected during ingestion of a standardized meal. We determined basal and postprandial blood levels of CCK, insulin, C-peptide, glucagon, cortisol, growth hormone and glucose. Self-ratings of appetite were assessed by a visual analog scale. PCOS women had a significantly lower meal-related CCK response (p < 0.05) with no association with satiety, as in the controls (r = 0.64). There was a tendency to higher ratings of craving for sweets in PCOS women (p = 0.07) but no correlation with insulin, as in the controls (r = 0.50). Within the PCOS group, ratings of craving for sweets were inversely related to testosterone (r = - 0.60) and the CCK response was positively correlated with levels of free testosterone (r = 0.50). We conclude that women with PCOS have reduced postprandial CCK secretion and deranged appetite regulation associated with increased levels of testosterone. Impaired CCK secretion may play a role in the greater frequency of binge eating and overweight in women with PCOS.

Adult↗

Influence of dietary carbohydrates and glycaemic response on subjective appetite and food intake in healthy elderly persons.

Increased satiety and decreased food intake are reported following the consumption of low glycaemic index (GI) foods, which gradually increase blood glucose. This observation, however, is not uniformly supported and few studies have examined the impact of different GI foods on satiety and intake in the elderly. After an overnight fast, 10 men and 10 women (aged 60-82 years) consumed similar amounts of available carbohydrate as high (glucose drink or potatoes) or low (barley) GI foods or a non-energy placebo drink on four mornings. Blood glucose and subjective appetite were measured throughout a 120 min post-ingestion period, followed by consumption of an ad libitum lunch. Differences in plasma glucose after test food ingestion (glucose > potatoes > barley > placebo; P < 0.03) did not predict subjective appetite or lunch intake. Potatoes increased subjective satiety the most, followed by barley, then glucose, which trended towards greater satiety than placebo. Potatoes led to less hunger than placebo (P = 0.0023) and less prospective consumption than the other three foods (P < 0.0083), and potatoes and barley led to greater fullness than glucose and placebo (P < 0.0001). Lunch intake was decreased, compared with placebo (502 +/- 47 kcal, P < 0.031), by potatoes (405 +/- 40 kcal) and barley (441 +/- 41 kcal); however, only potatoes (41.9 +/- 12.3%) led to greater compensation at lunch for test food ingestion compared with glucose (11.9 +/- 9.5%, P = 0.016). These results suggest that elderly subjects are sensitive to the effects of different foods on subjective appetite and food intake, and that the GI of the foods tested did not predict their effects on satiety and food intake.

Aged↗

Mood and appetite during minimal-carbohydrate and carbohydrate-supplemented hypocaloric diets.

After a baseline period of free-feeding, 20 obese outpatients alternated between four 2-wk periods of minimal-carbohydrate diet (800 kcal; 58% protein and 42% fat by weight) and of a carbohydrate-supplemented diet (1,000 kcal; 42% protein, 30% fat, and 28% carbohydrate). In a comparison of psychological adjustment during the baseline and low-calorie diets, the initial 2 wk of dieting was associated with a decrease in appetite and elevation of psychological well-being, regardless of the composition of the diet. Thereafter, appetite and mood approached basal levels. Further changes in these psychological reactions to dieting did not vary with the type of diet. There was no support for the idea that a minimal-carbohydrate, protein-supplemented fast decreases appetite and elevates mood more in comparison with a similar diet containing enough carbohydrate to minimize ketosis.

3-Hydroxybutyric Acid↗

Carbohydrates and human appetite.

Experiments indicate that exposure to high-carbohydrate foods can give rise to a clear modulation of the expression of human appetite. The potency and time course of the effects of various carbohydrates on satiety vary with the amount consumed and the chemical structure. There is evidence that this biological effect can modulate the temporal profile of hunger and the eating pattern of meals and snacks. One important issue is the action of carbohydrate foods on satiation (within meals) and satiety (after meals). These effects can be compared with the effects of high-fat foods. The physiological mechanisms through which carbohydrates exert an action on appetite are not completely identified, although plasma glucose values are likely to play a role. The experimental evidence suggests that it is possible to design high-carbohydrate diets that provide good nutrition with adequate control over appetite and a beneficial effect on body weight.

Appetite↗

Effects of age on concentrations of plasma cholecystokinin, glucagon-like peptide 1, and peptide YY and their relation to appetite and pyloric motility.

BACKGROUND: Aging is associated with a decrease in appetite and a slowing of gastric emptying. The gastrointestinal hormones cholecystokinin (CCK), glucagon-like peptide 1 (GLP-1), and peptide YY (PYY) may mediate these changes. OBJECTIVE: We investigated whether aging influenced the secretion of CCK, GLP-1, and PYY and their effects on appetite and pyloric motility. DESIGN: Eight healthy older (65-80 y) and 7 younger (20-34 y) men received isoenergetic (12.1 kJ/min) intraduodenal infusions of lipid and glucose for 120 min on separate days. Plasma CCK, GLP-1, and PYY concentrations were measured. RESULTS: Plasma CCK concentrations were higher in older than in younger subjects (P = 0.004) as a result of higher baseline values (4.7+/-0.2 compared with 3.2+/-0.2 pmol/L; P < 0.0001) and a greater rise during lipid infusion (increase from baseline: 7.1+/-0.5 compared with 5.3+/-0.6 pmol/L; P = 0.048). Plasma GLP-1 and PYY concentrations were not significantly different between groups. The decrease in hunger during intraduodenal lipid infusion was inversely related to the increase in CCK, GLP-1, and PYY in younger but not older subjects. During intraduodenal lipid infusion, the increase in isolated pyloric pressure wave (IPPW) frequency was positively related to GLP-1 and PYY and the increase in IPPW amplitude was positively related to CCK in older but not younger subjects, whereas the increase in IPPW amplitude and pyloric tone was negatively related to GLP-1 and PYY in younger subjects. CONCLUSIONS: Human aging is associated with increased CCK concentrations, which may contribute to the slowing of gastric emptying, mediated by increased pyloric motility. The role of increased plasma CCK concentrations in mediating the age-related decrease in appetite remains to be established.

Adult↗

Energy intake and appetite are related to antral area in healthy young and older subjects.

BACKGROUND: Gastric distension reduces food intake, and antral, rather than proximal, gastric distension may be the dominant mechanism in the induction of appetite-related sensations. Healthy aging is associated with reduced appetite. OBJECTIVE: We examined the effects of different energy preloads on appetite, plasma cholecystokinin, antral area, and subsequent energy intake in healthy older and young subjects. DESIGN: On 3 separate days, 12 young and 12 older subjects consumed 400 mL of a drink containing either 0 kcal (water), 250 kcal, or 750 kcal 70 min before a buffet-style meal. RESULTS: Hunger was less in the older than in the young subjects (P < 0.001). Both nutrient preloads reduced hunger and increased fullness more than did water (P < 0.02), and older subjects were more full than were the young (P < 0.05). Antral area was greater after the nutrient preloads than after water (P = 0.001) and greater in the older than in the young subjects (P = 0.005). In both groups, food intake was suppressed in an energy-dependent manner (P = 0.008). Plasma cholecystokinin was greater in the older than in the young subjects (P = 0.003). Immediately before the meal, hunger (r = -0.59) and energy intake (r = -0.90) were inversely related and fullness (r = 0.66) was directly related to antral area (all: P < 0.001). Antral area, but not plasma cholecystokinin, was a predictor of subsequent energy intake. CONCLUSION: In healthy young and older subjects, the suppression of subsequent energy intake by a liquid preload is nutrient dependent and comparable, and both satiation and satiety are related to antral area and (presumably) antral distension.

Adolescent↗

Dissecting the role of cocaine- and amphetamine-regulated transcript (CART) in the control of appetite.

Cocaine- and amphetamine-regulated transcript (CART) codes for a neuropeptide system with a number of biological roles. The high conservation of CART across species suggests that it has an important role in mammalian physiology. CART is widely expressed in the central nervous system and the periphery, but is particularly concentrated in the hypothalamus. CART peptides, particularly CART (55-102), appear to have an important function in the regulation of energy homeostasis. This review aims to dissect the role of CART in appetite and energy expenditure. CART interacts with a number of central appetite circuits. Hypothalamic CART expression is regulated by a number of peripheral factors, including the adipose hormone leptin. Intracerebroventricular administration of CART (55-102) reduces appetite and stimulates energy expenditure. Hypothalamic CART may also play an orexigenic role under specific circumstances, however, as injection of CART (55-102) into specific hypothalamic nuclei increases food intake.

Amino Acid Sequence↗

Regulation of calcium appetite in broiler chickens.

The regulation of the appetite for calcium was studied in broiler chickens which had been trained to meet their calcium requirement by consuming a calcium supplement (10% Ca) provided separately from a calcium-deficient feed (0.12% Ca). Calcium supplement intake was reduced within 150 minutes after intravenous injection of 60 U/kg parathyroid hormone or continuous infusion of 0.077 mg/minute calcium into one common carotid artery. Supplement consumption was also depressed during the first 8 days of continuous infusion of 1 U/kg/hour parathyroid hormone; after 8 days the birds became refractory. Continuous infusion of 0.2 Medical Research Council (MRC) units/kg salmon calcitonin for 10 days or daily intramuscular injections of 1 mg/kg testosterone propionate and 2 mg/kg estradiol dipropionate for 12 days, either alone or in combination, had no effect on calcium appetite. It is concluded that the calcium appetite may be inhibited by increased concentrations of ionic calcium in blood and that the change in behavior is sufficiently rapid to play a role in the calcium homeostasis of birds.

Animals↗

Physical fitness, growth and appetite of Kenyan school boys with hookworm, Trichuris trichiura and Ascaris lumbricoides infections are improved four months after a single dose of albendazole.

We studied physical fitness with the Harvard Step Test, growth, and appetite in primary school boys infected with hookworm (96% baseline prevalence), Trichuris trichiura (98% prevalence) and Ascaris lumbricoides (41% prevalence) who received a single 600-mg dose of albendazole or an identical placebo. Boys were examined, allocated at random within pairs by descending hookworm egg count to placebo (n = 26) or albendazole (n = 27) groups, treated, and re-examined 4 mo later. Four months after treatment, the albendazole group showed highly significant improvements in fitness score, resting heart rate, and heart rates at 1, 2, 3 and 4 min after the Harvard Step Test, whereas the placebo group had not changed significantly. The albendazole group also exhibited significantly more rapid growth judged by weight gain (1.0 kg greater than the placebo group, P < 0.0002), height increment (0.6 cm more, P < 0.003), arm circumference (0.3 cm more, P < 0.0002), and triceps and subscapular skinfolds (1.0 mm more, P < 0.0002), and showed improved appetite with objective and subjective measures. We conclude that single-dose treatment with albendazole can allow improved physical fitness, growth, and appetite in school-age children in areas where these helminths and poor growth are highly prevalent.

Adolescent↗

1. Appetite suppressant activity of supplemental dietary amino acids and subsequent compensatory growth of broilers.

This study was conducted to take advantage of the appetite-suppressant effect of excessive dietary amino acids in reducing feed intake and, in turn, restricting the early rapid growth of broilers to minimize metabolic disorders. Dietary amino acids were supplemented to a basal diet to yield a total of 1.57, 2.57, and 3.57% His; 2.7, 4.3, and 5.9% Lys; 1.36, 2.16, and 2.96% Met; 2.8, 3.8, and 4.8% Thr; and 1.27, 2.27, and 3.27% Trp and were fed to 408 chicks from 4 to 11 d of age. Fifteen dietary treatments of His, Lys, Met, Thr, and Trp were compared to the basal diet. Feed consumption was measured daily. Body weight measurements were taken at 0, 4, 7, 11, 14, and 21 d. At 21 d, pectoralis major and minor muscles, liver, and abdominal fat pad were weighed. High levels of Met and His caused the greatest depression in appetite from 4 to 11 d, and Thr, Trp, and Lys were found to be less potent. The exponential growth rate (EGR) of birds from 4 to 11 d of age was significantly reduced by the intermediate and high levels of the amino acid supplementation. From 11 to 14 d, EGR was greatest with high levels of Met or Trp, indicating more potential compensatory growth realized with these treatments. The high level of His decreased the percentage of pectoralis minor muscle yield, whereas the high level of Lys and Met increased the percentage of liver compared to those fed the basal diet. These results indicate that it is possible to use excessive individual amino acids in diets to suppress the appetite and early rapid growth to alleviate or minimize metabolic disorders.

Abdomen↗

Appetite suppressants and valvular heart disease.

The association between valvular heart disease and diet pills was discovered several years ago in a small cohort of patients. Subsequent uncontrolled surveys and reports suggested a prevalence of cardiac abnormalities as high as 30%. These results led to widespread concern by millions of appetite suppressant users and the withdrawal of both fenfluramine and dexfenfluramine from the market. Through this review of the literature, it becomes apparent that we have better defined the association between valvular heart disease and appetite suppressants; nonetheless, many questions and controversies remain. Most large scale, multicenter, controlled studies have shown that a prevalence of significant valve regurgitation is between 2 and 12% and that the likelihood of disease increases with increasing dose and/or duration of appetite suppressant use, but several other issues, such as the mechanism of action, remain unanswered.

Age Factors↗

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↗

Diminished salt appetite in spontaneously hypertensive rats following local administration of the angiotensin II antagonist saralasin in the median preoptic area.

Previous studies have suggested that angiotensin (ANG) synthesis, receptor activation, or both, in the median preoptic nucleus (MnPO) are responsible for initiating ANG-related salt appetite in normotensive rats. The present study was designed to test whether treatment with saralasin (Sar), an ANG II antagonist, in the MnPO area causes changes in saline (0.3 M NaCl solution) and water intakes in the spontaneously hypertensive rat (SHR), which is known to show greater salt appetite compared to normotensive Wistar-Kyoto (WKY) rats. Treatment with Sar in the MnPO area produced significantly attenuated saline intake, but had no effect on water intake. The results may support the importance of the ANG system in the MnPO area for salt appetite, and suggest that a disorder in the system may cause abnormal salt intake in SHR.

Angiotensin II↗

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↗

Programming of the appetite-regulating neural network: a link between maternal overnutrition and the programming of obesity?

The concept of a functional foetal "appetite regulatory neural network" is a new and potentially critical one. There is a growing body of evidence showing that the nutritional environment to which the foetus is exposed during prenatal and perinatal development has long-term consequences for the function of the appetite-regulating neural network and therefore the way in which an individual regulates energy balance throughout later life. This is of particular importance in the context of evidence obtained from a wide range of epidemiological studies, which have shown that individuals exposed to an elevated nutrient supply before birth have an increased risk of becoming obese as children and adults. This review summarises the key pieces of experimental evidence, by our group and others, that have contributed to our current understanding of the programming of appetite, and highlights the important questions that are yet to be answered. It is clear that this area of research has the potential to generate, within the next few years, interventions that could begin to alleviate the adverse long-term consequences of being exposed to an elevated nutrient supply before birth.

Adult↗

The effect of captopril or enalaprilic acid on the Na appetite of Na-deplete rats.

1. The converting enzyme inhibitors, captopril (SQ14 225, Squibb) or enalaprilic acid (MK 422, Merck Sharp and Dohme), were used to evaluate the role of angiotensin II in sodium (Na) appetite of Na-deplete rats given a choice of water and 0.5 mol/l NaCl to drink. Also, the effect of these drugs on taste was evaluated in water-deprived Na-replete rats and in Na-deplete rats given a choice of NaCl, sucrose and water. 2. Intraperitoneal (i.p.) injection of furosemide (20 mg/kg) increased urinary Na loss by 1.3-1.4 mmol and subsequent Na intake by 1.5-1.8 mmol. This increase in Na intake was abolished by a high dose of captopril (50 mg/kg, i.p.) or enalaprilic acid (80 mg/kg, i.p.), but was enhanced by a low dose of captopril (50 micrograms/kg, i.p.). 3. There was no clear evidence that either captopril or enalapril affected taste for NaCl, sucrose or water in water-deprived Na-replete rats. However, the high dose of captopril or enalapril decreased the intake of NaCl and sucrose in Na-deplete rats. 4. Thus, while the results are consistent with the possibility that angiotensin II is involved in Na appetite induced by Na depletion and that the difference between the high and low doses of converting enzyme inhibitors on Na appetite may be related to their relative effectiveness in blocking angiotensin I conversion at central sites, the observation that sucrose intake is decreased by high dose converting enzyme inhibitor in Na-deplete rats suggests that other actions of the converting enzyme inhibitors may be involved.

Angiotensin II↗

Selective excitotoxic lesions of the hippocampus and basolateral amygdala have dissociable effects on appetitive cue and place conditioning based on path integration in a novel Y-maze procedure.

The hippocampus and amygdala are thought to be functionally distinct components of different learning and memory systems. This functional dissociation has been particularly apparent in pavlovian fear conditioning, where the integrity of the hippocampus is necessary for contextual conditioning, and of the amygdala for discrete cue conditioning. Their respective roles in appetitive conditioning, however, remain equivocal mainly due to the lack of agreement concerning the operational definition of a 'context'. The present study used a novel procedure to measure appetitive conditioning to spatial context or to a discrete cue. Following selective excitotoxic lesions of the hippocampus (HPC) or basolateral amygdala (BLA), rats were initially trained to acquire discrete CS-sucrose conditioning in a Y-maze apparatus with three topographically identical chambers, the chambers discriminated only on the basis of path integration. The same group of animals then underwent 'place/contextual conditioning' where the CS presented in a chamber assigned as the positive chamber was paired with sucrose, but the same CS presented in either of the other two chambers was not. Thus, spatial context was the only cue that the animal could use to retrieve the value of the CS. HPC lesions impaired the acquisition of conditioned place preference but facilitated the acquisition of cue conditioning, while BLA lesions had the opposite effect, retarding the acquisition of cue conditioning but leaving the acquisition of conditioned place preference intact. Here we provide strong support for the notion that the HPC and BLA subserve complementary and competing roles in appetitive cue and contextual conditioning.

Amygdala↗