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Validation of the Radimer/Cornell measures of hunger and food insecurity.

Hunger and food insecurity have been identified as core indicators of an individual's nutritional state that should be assessed in nutrition surveillance activities. Such an assessment requires a valid measure of these phenomena. This paper describes further work on the construction of measures of hunger and food insecurity based on the Radimer/Cornell items and provides an assessment of their validity. A random sample survey of 193 households with women and children living at home was conducted in 1993 in a rural county in New York State. A questionnaire containing the Radimer/Cornell hunger and food insecurity items, information about demographic characteristics, frequency of fruit and vegetable consumption, and household food supplies was administered to subjects. Measures were constructed that identified households experiencing household- and individual-level food insecurity and households with hungry children. The construct and criterion-related validity of the measures was assessed. In relation to criterion-related validity, as food insecurity worsened, there was a significant and progressive increase in the percentage of subjects participating in food programs and having low income, education and employment and a significant decline in average household food availability and fruit and vegetable consumption. These results support the validity of the Radimer/Cornell measures and illustrate their ability to differentiate among groups of households experiencing increasingly severe food insecurity and hunger.

Adolescent↗

Cortisol, hunger, and desire to binge eat following a cold stress test in obese women with binge eating disorder.

OBJECTIVE: Increased basal cortisol levels have been found in bulimia nervosa. After stress, increased cortisol levels have been associated with increased food intake in healthy women. Therefore, we assessed cortisol, hunger, and desire to binge eat after a cold pressor test (CPT) among women with binge eating disorder (BED). METHODS: Twenty-two obese (body mass index [BMI] = 36.7 +/- 6.5 SD) females (11 non-BED, 11 BED) completed the Zung depression scale and underwent the CPT, hand submerged in ice water for 2 minutes. Over 60 minutes, periodic ratings of hunger and desire to binge eat were obtained, just before blood draws for cortisol, as well as insulin. On a separate day, participants had a 1-mg oral dexamethasone suppression test (DST). RESULTS: The BED group had higher depression scores than the non-BED (p = .04), but depression was not a significant covariate for the cortisol response or to DST. After controlling for contraceptive use (n = 3), the BED group had higher basal cortisol than the non-BED group (p = .03), but cortisol did not differ after DST (p = .40). The BED group had nearly significant greater cortisol AUC after the CPT (p = .057) after controlling for insulin AUC and contraceptive use (p = .057). The BED group also had greater AUC for hunger (p = .03) and desire to binge eat (p = .02) after the CPT. CONCLUSION: These findings support our hypothesis of a hyperactive HPA-axis in BED, which may contribute to greater hunger and binge eating.

Adult↗

Neurological complications of prolonged hunger strike.

We investigated neurological findings in 41 prisoners (mean age: 28.6) who participated in a hunger strike between 2000 and 2002. All cases were evaluated using neuropsychological, neuroradiological, and electrophysiological methods. The total duration of fasting ranged from 130 to 324 days (mean 199 days). All cases had 200-600 mg/day thiamine orally for 60-294 days (mean 156) during the hunger strike, and had neurological findings consistent with Wernicke-Korsakoff syndrome. All 41 patients exhibited altered consciousness which lasted from 3 to 31 days. All patients also presented gaze-evoked horizontal nystagmus and truncal ataxia. Paralysis of lateral rectus muscles was found in 14. Amnesia was apparent in all cases. Abnormal nerve conduction study parameters were not found in the patient group, but the amplitude of compound muscle action potential of the median and fibular nerves and sensory nerve action potential amplitude of the sural nerve were lower than the control group, and distal motor latency of the posterior tibial nerve was significantly prolonged as compared with the control group. The latency of visual evoked potential was prolonged in 22 cases. Somatosensory evoked potential (P37) was prolonged but not statistically significant. Our most significant finding was that the effect of hunger was more prominent on the central nervous system than on the neuromuscular system, despite the fact that all patients were taking thiamine. In our opinion, partial recovery of neurological, and neurocognitive signs in prolonged hunger could be a result of permanent neurological injury.

Adult↗

Evidence for the anorexia of aging: gastrointestinal transit and hunger in healthy elderly vs. young adults.

Animal studies suggest that aging is associated with anorexia and disordered gastrointestinal transit. To determine whether there is a relationship between the effects of aging on appetite and gastrointestinal transit in humans, 19 young (age 23-50 yr) and 14 elderly (age 70-84 yr) normal volunteers underwent measurements of 1) desire to eat, hunger, and fullness (visual analog scales); 2) gastric emptying (scintigraphy); 3) orocecal transit (breath hydrogen); 4) total gut transit (radiopaque markers); and 5) autonomic nerve function (cardiovascular reflexes). We found that, postprandially, elderly subjects had less desire to eat (P < 0.05) and less hunger (P < 0.05), but not a significantly greater fullness than younger subjects. Gastric emptying (50% emptying time) for solid (182 +/- 26 vs. 127 +/- 13 min, P < 0.05) and liquid (47 +/- 4 vs. 35 +/- 3 min, P < 0.05) meal components was slower in elderly subjects. Postprandial hunger was inversely related (r = -0.39, P < 0.05) to solid gastric emptying. There were no significant differences in orocecal and total gut transit times between the two groups. Autonomic nerve function was abnormal in 11 elderly but none of the young subjects (P < 0.01). We conclude that aging is associated with 1) diminished desire to eat and hunger, 2) slowing of solid and liquid gastric emptying, 3 no change in orocecal and total gut transit, and 4) autonomic nerve dysfunction. The slowing of gastric emptying may contribute to anorexia in aging subjects.

Adult↗

Promotion of the feeding minds and fighting hunger initiative in selected rural schools in Andhra Pradesh, India.

BACKGROUND: Schoolchildren are good agents of change and need to be educated and sensitized to specific issues of hunger and malnutrition through a question-and-answer process. Feeding Minds and Fighting Hunger (FMFH), a global project initiated by the Food and Agriculture Organization and partner organizations, attempts to help schoolchildren learn about these issues by introducing concepts in the prevention of hunger and malnutrition to teachers, and by facilitating transfer of knowledge to the children through a set of model lessons. OBJECTIVE: To test the feasibility of the FMFH approach to improve the nutrition knowledge of rural schoolchildren in three rural schools in Medak District of the South Indian state of Andhra Pradesh. METHODS: Participatory workshops for teachers were conducted to facilitate knowledge transfer to the children through interactive classroom teaching and other activities. The change in knowledge and thinking of children in the seventh and eighth grades was assessed by a ques- tionnaire administered before and after the intervention. The questionnaire also assessed, in part, the status of local food security based on the sources of different food items in the households. RESULTS: The responses to the questionnaire suggested that the children's knowledge of nutrients and their functions was not good initially but improved after the intervention. However, their understanding of the social factors responsible for hunger and malnutrition was fairly good prior to the intervention. Improvement in responses to the question of what should be done to combat malnutrition also occurred after intervention. The community had village-level food security for rice and maize but depended partially or fully on outside sources for pulses, fruits and vegetables, and animal products. CONCLUSIONS: The FMFH approach can be applied in rural schools where "the poorest of the poor" children can improve their understanding of balanced diets, better nutrition, the causes of malnutrition, and approaches to combat malnutrition.

Adolescent↗

Eating behavior and the experience of hunger following gastric bypass surgery for morbid obesity.

BACKGROUND: Numerous different factors may contribute to the varying degrees of success observed following gastric bypass surgery. It is likely that alterations in the subjective experiences of hunger and satiety, as well as behavioral factors, are important. Our aim was to investigate the association of several factors, including qualitative aspects of hunger and satiety, eating patterns, and the emotional valence of different foods, to the weight loss that occurred following obesity surgery. METHODS: A questionnaire covering aspects of hunger, eating and satiety was administered to three groups: (1) a group of people who had undergone gastric bypass surgery with an acceptable weight loss; (2) a morbidly obese group of patients prior to their surgical intervention; (3) a group of people of normal weight. RESULTS: There were significant differences amongst the three groups in scoring on standardized eating disorder scales, in the amount they could eat, and in the experience of hunger. The presurgery, waiting-list group was more receptive to food-related than interoceptive cues when deciding to stop eating. 'Eating styles' also differed across the groups. CONCLUSIONS: It is concluded that changes in specific food-related behaviors and other psychological variables interact with the physical restriction to eating. The relative weighting of other variables needs further exploration.

Attitude↗

[Scientific production in nutrition and the public perception of hunger and eating in Brazil].

There is a contradiction between the perceptions held by different sectors of the Establishment with regard to the questions of hunger and nutrition in Brazil. On the one hand, the flagship of the present Brazilian government's social policy is the "Fome Zero" program. This program is based on the notion that the condition of hunger is socially relevant in this country. On the other hand, the scientific community in the field of nutrition has, through epidemiological studies, highlighted obesity as one of the most serious public health problems in Brazil. The reason why the public perception is dissociated from the production of knowledge on this subject has old roots that are related to the difficulties in institutionalizing science in Brazil. This has been reflected in a relative lack of legitimacy for scientific discourse. The new factor in this situation is the attainment of greater international visibility by the scientific community in nutritional de epidemiology. The future of the practical application of the results from nutritional epidemiology research in Brazil depends on the dynamics of the political agenda regarding hunger and nutrition, and of the sectors associated with this. The objective of this study was to explore this situation by means of analyzing scientometric data on the scientific production, historical data and documents relating to discourse about hunger.

Bibliometrics↗

When violence has a benevolent face: the paradox of hunger in the world's wealthiest democracy.

During the last two decades, Americans initially discovered that millions of fellow-citizens were going hungry, then acted to virtually eliminate the problem, and, in the 1980s, learned that hunger has reappeared in epidemic proportions. Hunger, particularly in a wealthy democracy, is most appropriately seen as a form of institutionalized violence, the product of ideologies that fail to distribute national abundance in a manner that achieves the possible goal of preventing hunger. The return of hunger to the United States is associated with economic and tax policies that have reallocated income distribution from poor and middle-income groups to the wealthy, and with a concomitant reluctance to utilize the federal government to protect needy citizens from undernutrition associated with growing economic deprivation.

Adolescent↗

[The thermal activity of the rabbit brain during the interaction of "animal hypnosis" and of the hunger dominant].

The character of interaction between two dominant foci (motivation hunger dominant and "animal hypnosis") which had been formed in the rabbit brain was ambiguous: the foci could either function simultaneously or compete. In the first case, summation food reactions were observed when the hunger dominant was tested during a hypnotic episode against the background of deep and continuous hypnotic state. Brain thermal activity was asymmetric the temperature being higher in the parieto-occipital areas of the left hemisphere. If the hypnosis inhibited the hunger dominant, summation reactions were absent and the brain temperature was higher in the parieto-occipital areas of the right hemisphere. In cases when despite the repeated immobilization sessions the hunger dominant prevented from induction of hypnosis, the left-hemisphere thermal dominance persisted against the background of general brain cooling.

Acoustic Stimulation↗

Time of day type of food--relation to mood and hunger during 24 hours of constant conditions.

A six-day high-carbohydrate meal (HC; 65 E% (energy percent) carbohydrates, 20 E% fat and 15 E% protein) and a six-day high-fat meal (HF; 40 E% carbohydrates, 45 E% fat and 15 E% protein) were given to seven healthy subjects in a crossover design. On the last day subjects were kept awake for 24 hours in a metabolic laboratory while substrate utilisation and energy expenditure were measured by indirect calorimetry. The subjects were given isocaloric meals every four hours. Results showed that hunger decreased at night (F = 4.2, p < 0.05) and linearly increased after meal intake. Macronutrient composition (fat/carbohydrates) seemed to be of less importance for hunger. Hunger and thirst were found to be strongly associated with gastrointestinal substances, for hunger the strongest being a negative correlation with triacylglycerol (partial correlation = -0.39). It is suggested that it might not be necessary for shift workers to eat full portions at night but that satiation will occur with less food. Possibly lack of adjustment of nocturnal food intake might be one reason why overweight is common in shift work populations.

Adult↗

Motivational control of instrumental performance following a shift from thirst to hunger.

Thirsty rats were trained to press a lever for either a sucrose solution or saline before performance was tested in extinction while the animals were either hungry alone or experiencing both hunger and a sodium appetite. Reinforcer-specific motivational control was observed in that the animals trained with the sucrose solution pressed more than those trained with the saline when they were tested hungry, but not when they were tested under combined hunger and sodium appetite. In order to assess the role of a Pavlovian incentive process in this effect, thirsty animals received non-contingent pairings of one stimulus with the sucrose solution and another with saline in the second experiment. In an extinction test the sucrose stimulus augmented lever pressing relative to the saline stimulus when the animals were hungry, but not when they were thirsty. In the subsequent experiments the contribution of the Pavlovian process was equated by giving concurrent training with both incentives. Lever pressing and chain pulling were reinforced concurrently, one with the sucrose solution and the other with saline, while the animals were thirsty. Once again, the animals pressed more in extinction if this action had been trained with the sucrose solution rather than the saline, but only if they were hungry rather than thirsty. Thus, instrumental performance across a thirst-to-hunger shift can also be controlled by an instrumental incentive process. The direct engagement of the instrumental process by this motivational shift contrasts to the absence of such control following a hunger-to-thirst transition (Dickinson & Dawson, 1987a), a fact attributed to the asymmetrical motivational interactions produced by water and food deprivation.

Animals↗

Short-term effects of energy density on salivation, hunger and appetite in obese subjects.

Obese patients were admitted to a metabolic unit for weight loss. On two paired-test days subjects were given disguised preloads of 100 kcal (0.42MJ) or 300 kcal (1.26MJ). When presented with a meal one hour after the preload, subjects salivated more and reported more hunger, but not appetite, after the low compared to the high preload. A different group of 14 subjects were given preloads of the same energy content (200 kcal, 0.84MJ) on paired-test days. On one day they took 1 g methyl cellulose with 100 ml water drink immediately before the preload. Neither the energy-dilution effect of the water, nor the effect of the methyl cellulose caused a significant decrease in salivation, hunger or appetite scores one hour after the preloads of equal energy content. These results show that salivation and hunger are inversely related to short-term changes in energy intake in obese subjects. Alterations in energy density without changing energy intake or the ingestion of methyl cellulose have no effect on salivation, hunger or appetite.

Adolescent↗

Drinking water with a meal: a simple method of coping with feelings of hunger, satiety and desire to eat.

This study examined whether drinking of water with breakfast affects the feelings of satiety and hunger, and how long after the meal this effect is maintained. Eight healthy, normal-weight women had three breakfasts with two extra glasses (4 dl) of water and three similar breakfasts without water. The breakfasts were served on three successive mornings during a 2 week period. The subjects filled in forms with visual analogue scales on feelings of hunger, satiety and desire to eat. The forms were filled just before the breakfast, in the middle of the breakfast before and after drinking of water, after finishing the meal, and thereafter every 30 min until 11.15 a.m. The results show that drinking two glasses of water affects subjective feelings of hunger and satiety during the meal, but this effect is not maintained after the meal. It is suggested that during a meal subjective feelings of hunger and satiety change independently of the food energy consumed. This study allows, however, no conclusions on the possible influence of drinking water on actual food intake during and after a meal.

Adult↗

[EEG spectral analysis in the hunger dominant in man].

EEG spectral characteristics were studied in the states of satiation, short-term food deprivation, and hunger dominant in 10 healthy right-handed subjects. The dominant of hunger was created at the background of short-term food deprivation by using sensory stimuli. Appearance of the swallowing movements in response to the applied stimuli was a criterion of dominant formation. Both food deprivation and hunger dominant were associated with a decrease of the EEG spectral power in the delta range and its increase in the alpha range. Food deprivation, additionally, was accompanied by an increase of the spectral power in the theta 2 range. Apart from the spectral changes, reduction of the alpha-rhythm frequency was observed in the states of food deprivation. This phenomenon was absent in the dominant state. In the states both of food deprivation and hunger dominant, EEG spectral characteristics, predominantly, changed in the left hemisphere, especially, in the alpha- and delta-ranges.

Acoustic Stimulation↗

Patterns of molar wear in hunger-gatherers and agriculturalists.

Tooth wear records valuable information on diet and methods of food preparation in prehistoric populations or extinct species. In this study, samples of modern and prehistoric hunger-gatherers and agriculturalists are used to test the hypothesis that there are systematic differences in patterns of tooth wear related to major differences in subsistence and food preparation. Flatness of molar wear is compared for five groups in hunger-gatherers (N = 298) and five groups of early agriculturalists (N = 365). Hunger-gatherers are predicted to develop flatter molar wear due to the mastication of tough and fibrous foods, whereas agriculturalists should develop oblique molar wear due to an increase in the proportion of ground and prepared food in the diet. A method is presented for the quantitative measurement and analysis of flatness of molar wear. Comparisons of wear plane angle are made between teeth matched for the same stage of occlusal surface wear, thus standardizing all groups to the same rate of wear. Agriculturalists develop highly angled occlusal wear planes on the entire molar dentition. Their wear plane angles tend to exceed hunger-gatherers by about 10 degrees in advanced wear. Wear plane angles are similar within subsistence divisions despite regional differences in particular foods. This approach can be used to provide supporting evidence of change in human subsistence and to test dietary hypotheses in hominoid evolution.

Agriculture↗

Reduced tidal volume increases 'air hunger' at fixed PCO2 in ventilated quadriplegics.

The act of breathing diminishes the discomfort associated with hypercapnia and breath-holding. To investigate the mechanisms involved in this effect, we studied the effect of tidal volume (VT) on CO2-evoked air hunger in 5 high-level quadriplegic subjects whose ventilatory capacity was negligible, and who lacked sensory information from the chest wall. Subjects were ventilated at constant frequency with a hyperoxic gas mixture, and end-tidal PCO2 was maintained at a constant but elevated level. VT was varied between the subjects' normal VT and a smaller VT. Subjects used a category scale to rate their respiratory discomfort or 'air hunger' at 30-40 sec intervals. In 4 of 5 subjects there was a strong inverse relationship between breath size and air hunger ratings. The quality of the sensation associated with reduced VT was nearly identical to that previously experienced with CO2 alone. We conclude that afferent information from the lungs and upper airways is sufficient to modify the sensation of air hunger.

Adult↗

Dynamic underpinnings of father hunger as illuminated in the analysis of an adolescent boy.

Growing sensitivity to the importance of the father in child development has contributed to research demonstrating the existence of "father hunger" in children who have lost their fathers (Herzog, 1982), manifested in serious problems modulating aggression. Vignettes from a five-year analysis of an adolescent boy who lost his father at age five are presented to demonstrate the complex psychodynamic underpinnings of father hunger. These clinical data lead to the conclusion that father hunger should be considered an ego state involving highly complex compromise formations manifested in fantasies. These are affected by the child's personal history with each parent, his or her developmental stage when the loss occurred, constitutional endowment, and the reaction of the mother to the father's death. The case material presented highlights the primarily defensive nature of the aggression characterizing father hunger. This essay also briefly discusses technical complications of analyzing such cases, including the patient's denial of mourning, management of the patient's aggression, transference-countertransference interactions, and a vulnerability to premature separation.

Adolescent↗

Guest Editorial: The New Faces of Food Insecurity and Hunger.

Food insecurity and hunger have had a volatile history in the United States during the past 40 years. The earliest concepts of hunger were linked to clinical signs of malnutrition. With renewed interest in food insecurity and hunger, policy makers and program implementers have been seeking measurements that are simple to use and easy to analyze and interpret. New paradigms for assessing food insecurity and hunger are discussed.

Editorial↗