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The ontogeny of salt hunger in the rat.

Salt hunger is the behaviour of an animal suffering sodium deficiency. It is characterised by an increased motivation to seek and ingest sodium, and the ability to distinguish between sodium and other salts. Here I review the development of salt hunger in the rat. Salt hunger develops rapidly between birth and weaning. It can first be demonstrated 72 h postnatally when an intracerebroventricular injection of renin elicits greater swallowing of NaCl solution than water and greater mouthing of solid fragments of NaCl than of an artificial sweetener. However, sodium deficit per se cannot arouse the hunger at this age, and first elicits increased intake of NaCl only at 12 days-of-age. The next landmark is at 17 days-of-age when the hormonal synergy of aldosterone and central angiotensin II first elicits salt hunger, as it does in the adult. The specificity of the hunger for the sodium ion also develops postnatally: the 72 h-old sodium-hungry neonate does not distinguish between NaCl and other mono- and di-valent chloride salts but, increasingly during development, the sodium hungry pup distinguishes salts and by weaning age NaCl is clearly preferred to other salts almost as it is in adults. Early development may also be a sensitive period for determining lifelong preferences, and indeed, acute perinatal sodium depletion induces a lifelong enhancement of salt intake. Taken together, these findings demonstrate how a behaviour develops precociously and how, when the behaviour becomes important at weaning, the rat pup is competent to meet its sodium requirements, and may be adapted to anticipate sodium deficit.

Aging↗

Effects of food attributes on hunger and food intake.

OBJECTIVE: To explore the relative importance of a food's macronutrient composition, energy value, energy density, fiber content, weight, volume, sensory properties and rheology on hunger and food intake. DESIGN: Preloads of peanuts, peanut butter (rheology control), almonds (tree nut), chestnuts (macronutrient control), chocolate (sensory control), rice cakes (volume control), pickles (weight control) and no load (time control) were consumed by subjects in random order at weekly intervals and hunger was assessed over the subsequent 180 min. Free-feeding energy and macronutrient intake were monitored 24 h before and following preload ingestion. SUBJECTS: Twelve male and 12 female healthy, normal weight (12-28% body fat), adults (mean (s.d.) age 22 +/- 2.5 y) with low dietary restraint. RESULTS: Hunger ratings following consumption of the 2092 kJ (500 kcal) preloads of peanuts, peanut butter, almonds, chestnuts and chocolate were significantly lower than the low energy preloads or no preload condition, but with the exception of peanut butter, did not vary from each other. The rate of hunger recovery was consistent across all preloads so the overall impact of each food on hunger was determined by the initial drop it evoked. Total energy, but not macronutrient, compensation was observed with all preloads. Consequently, the fatty acid profile of the total diet reflected the composition of the preloads. CONCLUSIONS: Energy content may be the primary determinant of a food's impact on hunger. Because macronutrient compensation is weak, a dietary supplement or substitute may influence the daily dietary nutrient profile.

Adult↗

Areca nut, energy metabolism and hunger in Asian men.

BACKGROUND: The nut of the Areca catechu palm has long been attributed effects on hunger and the digestive process. OBJECTIVES: The objectives were to assess experimentally effects of areca nut on fasting and postprandial energy metabolism, substrate utilization and hunger. SUBJECTS AND METHODS: Two randomized, placebo-controlled, double-blind studies were undertaken. In study 1, eight Indian men received bioadhesive gels delivering 0, 5, 10 or 20 mg arecoline to the buccal sulcus after an overnight fast. Resting energy expenditure and substrate utilization were determined by ventilated hood calorimetry over 6 h during which hunger was rated on five occasions. In study 2, 15 Indian men received gels delivering 0 or 10 mg arecoline after consuming a 2.5 MJ meal, and the same protocol was then applied as in study 1. RESULTS: Fasting resting energy expenditures exceeded basal metabolic rate (BMR) by 5.4+/-0.8% (Mean+/-SE) after placebo, and 5.1+/-0.7% after 20 mg arecoline, but by 0.9+/-0.8% and 0.7+/-0.5% following 5 mg and 10 mg arecoline, respectively. Carbohydrate (CHO) utilization rates rose after areca nut compared to placebo (F(3,252)= 7.3, p< 0.001). Hunger varied across doses (chi(2) = 10.5, p < 0.02), being lowest after 10 mg and highest after 20 mg, and was influenced by interaction of dose with delta resting energy expenditure. In study 2, areca dose interacted with fat-free mass (FFM) to lower by 5.4+/-11.2% the thermic effect of a meal (F(1,28) = 4.9, p = 0.05), and retarded peak 'digestive-phase' thermogenesis by 60 min (F(1,58) = 5.7, p = 0.02). Postprandial delta CHO utilization was greater (F(1,28) = 4.5, p = 0.05), and hunger was lower (chi:(2) = 3.8, p = 0.05), after areca nut. The areca nut altered relationships of hunger to thermic effects of the meal, and to delta substrate utilization, in ways consistent with appetite suppression. CONCLUSION: Areca nut constituents modulate metabolic signals regulating appetite in man. This concurs with customary belief.

Adult↗

Short-term hunger intensity changes following ingestion of a meal replacement bar for weight control.

Meal replacement products for weight loss are popular and safe for most unsupervised consumers desiring to lose weight. Previously we reported that the thickness of meal replacement diet shakes had a direct and significant effect on hunger intensity during the first 2 h and that hunger intensity scores for liquid meal replacements were significantly below baseline for 3 h following consumption (Mattes & Rothacker, 2001) This study uses the same protocol to investigate meal replacement bars designed for overweight consumers. Subjects were prescreened to include only those that normally ate breakfast and liked chocolate. The bar used in this study contained 250 calories (about 30 more than most liquid diet shakes), 4 g dietary fiber, 14 g protein and 8 g fat. Subjects were instructed to consume the entire bar with a glass of water following an overnight fast when they would normally consume their first meal of the day and to assess their hunger on a 1 (not hungry at all) to 9 (as hungry as I have ever felt) scale before consumption, immediately after and hourly for 6 h (only on typical weekdays). Similar assessments were made for the perception of stomach fullness (1=empty, 9=extremely full), strength of the desire to eat (1=no desire, 9=extremely strong) and thirst (1=not at all thirsty, 9=extremely thirsty). One-hundred and eight subjects (23 male and 85 female) completed the study. No gender satiety differences were found. Hunger ratings and desire to eat remained significantly below baseline for 5 h following consumption. Stomach fullness scores were significantly above baseline for 5 h. Thirst scores were significantly below baseline for 3 h. In conclusion, although the meal replacement diet bars contained only 30 additional calories than liquids, they provided an additional 2 h of hunger suppression from baseline that may have an impact on overall weightloss success. These results support superior short-term hunger control with solid meal replacements.

Adult↗

Effect of diets high or low in unavailable and slowly digestible carbohydrates on the pattern of 24-h substrate oxidation and feelings of hunger in humans.

BACKGROUND: The pattern of substrate utilization with diets containing a high or a low proportion of unavailable and slowly digestible carbohydrates may constitute an important factor in the control, time course, and onset of hunger in humans. OBJECTIVE: We tested the hypothesis that isoenergetic diets differing only in their content of unavailable carbohydrates would result in different time courses of total, endogenous, and exogenous carbohydrate oxidation rates. DESIGN: Two diets with either a high (H diet) or a low (L diet) content of unavailable carbohydrates were fed to 14 healthy subjects studied during two 24-h periods in a metabolic chamber. Substrate utilization was assessed by whole-body indirect calorimetry. In a subgroup of 8 subjects, endogenous and exogenous carbohydrate oxidation were assessed by prelabeling the body glycogen stores with [(13)C]carbohydrate. Subjective feelings of hunger were estimated with use of visual analogue scales. RESULTS: Total energy expenditure and substrate oxidation did not differ significantly between the 2 diets. However, there was a significant effect of diet (P: = 0.03) on the carbohydrate oxidation pattern: the H diet elicited a lower and delayed rise of postprandial carbohydrate oxidation and was associated with lower hunger feelings than was the L diet. The differences in hunger scores between the 2 diets were significantly associated with the differences in the pattern of carbohydrate oxidation among diets (r = -0.67, P: = 0. 006). Exogenous and endogenous carbohydrate oxidation were not significantly influenced by diet. CONCLUSIONS: The pattern of carbohydrate utilization is involved in the modulation of hunger feelings. The greater suppression of hunger after the H diet than after the L diet may be helpful, at least over the short term, in individuals attempting to better control their food intake.

Adult↗

Unbalanced serum leptin and ghrelin dynamics prolong postprandial satiety and inhibit hunger in healthy elderly: another reason for the "anorexia of aging".

BACKGROUND: In healthy elderly, a reduction from the appetite and food intake of younger years has been defined as the "anorexia of aging," which may cause malnutrition. Leptin and ghrelin may alter the control of hunger and satiety and thus lead to anorexia. OBJECTIVE: The aim of this study was to investigate how aging affects serum leptin and ghrelin concentrations in response to a meal and the relation of those hormones to hunger and satiety sensations. DESIGN: We studied 8 community-dwelling elderly (x +/- SD age: 78 +/- 1 y) subjects and 8 younger (29.5 +/- 1 y) control subjects. Under fasting conditions and for 4 h after an 800-kcal mixed meal, satiety and hunger were evaluated at intervals, by using a visual analogic scale. Blood samples for leptin, ghrelin, and insulin measurements were collected at the following times: 30 min before and immediately and 30, 60, 120, and 240 min after the meal. RESULTS: Postprandial satiety lasted significantly longer in the elderly than in the control subjects, and hunger was suppressed in the elderly throughout the observation. Fasting leptin was higher in the elderly than in the young (x +/- SE: 4.3 +/- 1.9 and 1.3 +/- 0.4 ng/mL, respectively; P < 0.05), and postprandial fluctuation was not significant. Fasting insulin also was significantly higher in the elderly than in the young (6.8 +/- 1.3 and 3.5 +/- 0.6 mU/L, respectively; P < 0.05), and the postprandial insulin rise was greater in the elderly. Fasting and postprandial ghrelin values did not differ significantly between the 2 groups. Insulin was inversely correlated with hunger and directly correlated with satiety scores. CONCLUSIONS: In healthy elderly, anorexigenic signals prevail over orexigenic signals, and they contribute to prolonged satiety and inhibition of hunger. This condition may lead to a calorie deficit and finally to malnutrition in the elderly.

Adult↗

Hunger and aversion: drives that influence food intake of hospitalized geriatric patients.

BACKGROUND: Diminished appetite occurs frequently with aging and is considered an important clinical symptom of malnutrition, a condition associated with negative clinical outcome, decreased quality of life, and increased health care costs in hospitalized geriatric patients. Yet, in this population, research is scant on hunger and aversion, the two underlying drives that shape appetite, or on their influence on food intake. This study aimed (a) to examine their interrelationship and respective contribution to food intake; (b) to determine how each relate to other health-related contemporaneous subjective states preceding the meal (good physical health, positive mood, pain); and (c) to explore clinical variables as moderators of the drives-intake relationships to identify population segments for which these relationships are the strongest. METHODS: 32 patients (21 women, 11 men; age range, 65-92 years) were observed during repeated meals in a geriatric rehabilitation unit (for a total of 1477 meals). Perceived hunger, aversion, and contemporaneous subjective states were reported before each meal. Protein and energy consumption was calculated from plate leftovers. Clinical measures were obtained from participants' medical charts. RESULTS: The hunger-aversion relationship had a low inverse correlation (p =.001), with each uniquely contributing to protein intake (positive and negative effects, respectively; all p <.05). Hunger was positively associated with the perception of physical health and with mood (all p =.001). Aversion was associated with pain (p =.001). Furthermore, aversion-intake relationships were influenced by moderators, whereas hunger-intake relationships remained constant. CONCLUSIONS: From a clinical perspective, these results suggest that nutritional interventions aimed at bolstering hunger and curbing aversion may be necessary to ensure optimal food intake. Subgroups of patients who would particularly benefit from these interventions are suggested.

Affect↗

Event-related brain potential correlates of self-reported hunger and satiety.

Perception of hunger and satiety was examined by means of event-related potential (ERP) recordings. On the basis of Helson's frame-of-reference theory, it was hypothesized that hunger is perceived with reference to an actual adaptation level. ERPs were recorded to adjectives (hungry, thirsty, tired) combined with one of five adverbs (very, almost, somewhat, hardly, not). Subjects indicated whether a particular adverb-adjective combination accurately described their actual feeling of hunger, thirst, or fatigue. They were tested after they had fasted for 16 hr and another time when they were satiated. Area of P300 of the ERP was smallest for adverb-adjective combinations agreeing with the subject's actual state of hunger (i.e., adaptation level), which was almost hungry in fasting subjects and hardly hungry in satiated subjects. These P300 minima were flanked by significantly enhanced (p < 0.001) P300 areas for the immediately adjacent adverbs combined with hungry. P300 areas for adverbs combined with thirsty and tired did not depend on the subject's state of hunger. The data suggest that perception of internal states, such as hunger, refers to an adaptation level that is sensitively indicated by P300 area.

Adult↗

Risk and protective factors for adult and child hunger among low-income housed and homeless female-headed families.

OBJECTIVES: We sought to identify factors associated with adult or child hunger. METHODS: Low-income housed and homeless mothers were interviewed about socioeconomic, psychosocial, health, and food sufficiency information. Multinomial logistic regression produced models predicting adult or child hunger. RESULTS: Predictors of adult hunger included mothers' childhood sexual molestation and current parenting difficulties, or "hassles." Risk factors for child hunger included mothers' childhood sexual molestation, housing subsidies, brief local residence, having more or older children, and substandard housing. CONCLUSIONS: This study found that the odds of hunger, although affected by resource constraints in low-income female-headed families, were also worsened by mothers' poor physical and mental health. Eliminating hunger thus may require broader interventions than food programs.

Adult↗

Hyperglycemia attenuates the gastrokinetic effect of erythromycin and affects the perception of postprandial hunger in normal subjects.

OBJECTIVE: The major aims of this study were to determine in normal subjects whether the effects of erythromycin on gastric emptying, postprandial hunger, and fullness are modified by the blood glucose concentration. RESEARCH DESIGN AND METHODS: A total of 10 normal subjects (aged 20-39 years) underwent concurrent measurements of gastric emptying, blood glucose, hunger, and fullness on four separate occasions: twice during euglycemia (approximately 4 mmol/l) and twice during hyperglycemia (approximately 15 mmol/l). Either erythromycin (3 mg/kg) or saline (0.9%) was administered intravenously immediately before ingestion of a radioisotopically labeled solid meal. RESULTS: Gastric emptying was slower (P < 0.0001) during hyperglycemia when compared with euglycemia after both erythromycin and saline administration. During hyperglycemia, erythromycin reduced the lag phase (77.8 +/- 12.6 vs. 20.3 +/- 7.3 min; P < 0.05) but had no effect on the postlag emptying rate (0.32 +/- 0.077% per min vs. 0.24% per min). Hunger decreased (P < 0.001) and fullness increased (P < 0.001) after the meal. Postprandial hunger was less during hyperglycemia after saline infusion (P < 0.05) but not after erythromycin. Hunger was greater after erythromycin during both hyperglycemia and euglycemia (P < 0.05). CONCLUSIONS: At a blood glucose concentration of approximately 15 mmol/l, 1) gastric emptying of a solid meal is slower, when compared with euglycemia, even after administration of erythromycin; 2) the effect of erythromycin on gastric emptying of a solid meal is attenuated; and 3) the perception of postprandial hunger is reduced.

Adult↗

Assessing appetite in Dutch elderly with the Appetite, Hunger and Sensory Perception (AHSP) questionnaire.

BACKGROUND: In investigating anorexia of ageing, attention is often given to physical and psychological determinants of appetite in the elderly but little has been done to provide information on self-assessment of appetite and sensory perceptions in the elderly. OBJECTIVES: to provide data and detect possible differences in self-assessment of appetite, hunger feelings and sensory perception in different health group of elderly using the Appetite, Hunger feelings and Sensory Perception (AHSP) questionnaire. METHODS: three health categories of elderly subjects were used for the present study: free-living with no help, free-living with help and nursing home elderly. For each group, collected data were general characteristics, anthropometry and answers to the AHSP. The AHSP questionnaire includes 29-items focusing on feelings of hunger and appetite as well as taste and smell perception addressing both the present situation and the period before retirement. RESULTS: Significant differences were observed between the 3 health groups for appetite, hunger feelings, present taste perception and present smell perception (P<0.05). Appetite and hunger were found to be related to body weight in the healthiest but not in the others. CONCLUSION: A decline in health status is paired with a decrease in appetite, hunger feelings and sensory perceptions of elderly subjects.

Aged↗

[The interaction of "animal hypnosis" and the motivational dominant of hunger].

The study of the interaction between the "animal hypnosis" and hunger dominant after its multiple creation showed that the first applications of the forced immobilization against the background of hunger dominant optimum elicited the long-lasting hypnotic state of the animal (4-20 minutes). The hunger dominant was retained in hypnotic state of the animal, i.e., the testing stimuli produced summation swallowing and masticatory movements. Moreover, in some cases facilitatory influence of the "animal hypnosis" was observed on summation properties of the dominant focus in the motivational "hunger center". In the process of repetitions of "animal hypnosis" experiments against the background of the hunger dominant it became difficult to induce the hypnotic state in the majority of the animals, i.e., the longer fixation of rabbits was required and the duration of the hypnotic state reduced. These findings can be indicative of the inhibitory influence of hunger dominant on "animal hypnosis".

Acoustic Stimulation↗

'Air hunger' from increased PCO2 persists after complete neuromuscular block in humans.

The tolerance of totally curarized subjects for prolonged breath hold is viewed by many as evidence that respiratory muscle contraction is essential to generate the sensation of breathlessness. Although conflicting evidence exists, none of it was obtained during total neuromuscular block. We completely paralyzed four normal, unsedated subjects with vecuronium (a non-depolarizing neuromuscular blocker). Subjects were mechanically ventilated with hyperoxic gas mixtures at fixed rate and tidal volume. End-expiratory PCO2 (PETCO2) was varied surreptitiously by changing inspired PCO2. Subjects rated their respiratory discomfort or 'air hunger' every 45 sec. At low PETCO2 (median 35 Torr) they felt little or no air hunger. When PETCO2 was raised (median 44 Torr) all subjects reported severe air hunger. They had reported the same degree of air hunger at essentially the same PETCO2 before paralysis. When questioned afterwards all subjects said the sensation could be described by the terms 'air hunger', 'urge to breathe', and 'shortness of breath', and that is was like breath holding. They reported no fundamental difference in the sensation before and after paralysis. We conclude that respiratory muscle contraction is not important in the genesis of air hunger evoked by hypercapnia.

Adult↗

Self-control of level of mechanical ventilation to minimize CO2 induced air hunger.

Hypercapnia produces an uncomfortable urge to breathe ('air hunger'), which is alleviated by increasing breathing. It has been postulated that awake humans control breathing partly to minimize these sensations; such behavioral control presumably involves the forebrain. To test this postulate, we compared the ventilatory response to hypercapnia when the subject breathed spontaneously to the response when the subject used forebrain commands to control ventilation--on the basis of minimizing air hunger (achieved with subject-controlled positive pressure ventilation). In six healthy adults during hypercapnia (46 mmHg), spontaneous ventilation significantly exceeded, by 17%, the level of (mechanical) ventilation needed to alleviate air hunger. This suggests that spontaneous breathing is not behaviorally controlled to minimize discomfort. Alternatively, mechanical ventilation confers an additional relief of air hunger beyond that provided by spontaneous breathing. Since mechanical ventilation (with reduced respiratory muscle contraction) was more effective than spontaneous breathing in relieving air hunger, our results also suggest afferents that signal the degree of respiratory muscle contraction do not contribute to air hunger relief.

Adult↗

Air hunger and ventilation in response to hypercapnia: effects of repetition and anxiety.

We investigated the effects of anxiety on the intensity of air hunger during gradually increasing levels of CO2 until the end-tidal fractional concentration of CO2 was 7.9% or air hunger was intolerable. Normal high and low (trait) anxious participants (N=23) went through three rebreathing trials (15 min interval). Breathing behaviour was continuously monitored and air hunger was rated every 12 s. The threshold for responding to the increased CO2 was always lower for the subjective rating than for the ventilatory response. Habituation across trials was observed for both the ventilatory response and the air hunger rating regardless of anxiety. However, beyond the threshold, the slope in air hunger ratings decreased across trials in low anxious persons and tended to increase in high anxious persons (interaction P<0.05). No differences occurred in the slopes of the breathing responses. The findings documented uncoupling of the physiological and subjective responses during CO2-induced air hunger.

Adolescent↗

Effect of inhaled furosemide on air hunger induced in healthy humans.

Recent evidence suggests that inhaled furosemide relieves dyspnoea in patients and in normal subjects made dyspnoeic by external resistive loads combined with added dead-space. Furosemide sensitizes lung inflation receptors in rats, and lung inflation reduces air hunger in humans. We therefore hypothesised that inhaled furosemide acts on the air hunger component of dyspnoea. Ten subjects inhaled aerosolized furosemide (40 mg) or placebo in randomised, double blind, crossover experiments. Air hunger was induced by hypercapnia (50+/-2 mmHg) during constrained ventilation (8+/-0.9 L/min) before and after treatment, and rated by subjects using a 100 mm visual analogue scale. Subjects described a sensation of air hunger with little or no work/effort of breathing. Hypercapnia generated less air hunger in the first trial at 23+/-3 min after start of furosemide treatment (58+/-11% to 39+/-14% full scale); the effect varied substantially among subjects. The mean treatment effect, accounting for placebo, was 13% of full scale (P=0.052). We conclude that 40 mg of inhaled furosemide partially relieves air hunger within 1h and is accompanied by substantial diuresis.

Administration, Inhalation↗

Caring for dying patients who have air hunger.

PURPOSE: To understand nurses' experiences of caring for dying patients who have "air hunger." When air hunger occurs in people who are close to death, it often triggers increasing panic and breathlessness. Describing this phenomenon is an initial step toward a more informed and consistent response to air-hungry patients. DESIGN AND METHODS: Phenomenological study of 10 hospice, long-term care, oncology, or emergency medicine nurses who cared for air-hungry dying patients. Analysis was based on van Manen's guidelines for interpretive phenomenology. Interviews with two family members who witnessed their dying spouses suffer from air hunger were used to complement the nurses' accounts. FINDINGS: Themes of (a) the patient's look-panic beckons, (b) surrendering and sharing control, and (c) fine-tuning dying indicated ways nurses responded to relieve a patient's air hunger, including being prepared before air hunger occurs, calming patients and families, medicating patients, improvising care, attending to family members' needs, and drawing a distinction between palliating and killing. CONCLUSIONS: The three themes provide a framework for a new vision of "doing everything" for a dying person who suffers from air hunger. Care encompasses knowing what to do as well as how to stay present during suffering.

Adult↗

Perception of hunger to insulin-induced hypoglycemia in anorexia nervosa.

OBJECTIVE: We studied the effect of insulin-induced hypoglycemia on changes of hunger ratings in anorectic patients before and after cognitive-behavioral therapy. METHOD: The subjects were 17 females with restricting anorexia nervosa at low body weight (AN-R), 6 anorectic patients whose weight was restored after cognitive-behavioral therapy (AN-T), and 11 age-matched female controls. All subjects gave hunger ratings by linear visual analog technique before and after insulin or saline injection. RESULTS: Hunger ratings increased significantly 45 min after insulin injection in control females. However, ratings paradoxically decreased after insulin injection in AN-R females. They increased slightly after insulin injection in AN-T females, but the difference was not statistically significant. One-factor analysis of variance for the peak values of hunger ratings was significant. These values in control females were significantly higher than those in AN-R and AN-T females. DISCUSSION: These results suggest that perception of hunger to insulin-induced hypoglycemia in AN patients is disturbed.

Adolescent↗