Methicillin-resistant Staphylococcus aureus in intensive care units.
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Biomedical subjects
Publications and source records attributed to Stephen French.
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The present review summarises the effects of different carbohydrate and fat structures on food intake and appetite and the differences in response at various levels of processing of macronutrients. Several physico-chemical properties of carbohydrate and fat molecules appear to influence the short-term satiating properties. However, long-term substantiation of these findings expressed in terms of food intake or body weight is not currently available. Such studies will be required to make clear recommendations regarding dietary composition to aid satiety.
PURPOSE OF REVIEW: Given the global rates of obesity and the potential link to dietary fat intake, understanding the role of fat in the regulation of food intake is critical. Some short-term, laboratory-based studies demonstrate poor compensation for manipulation of fat content, leading to passive overconsumption, while others demonstrate compensation to levels similar to other macronutrients. The observation of compensation in the short term does not concur with long-term rates of obesity increase. This review discusses factors that may explain at a physiological level these discrepancies, in particular fat structure, dietary adaptation, and palatability. RECENT FINDINGS: Medium-chain triglycerides have been demonstrated to be more satiating and promote weight loss. Recent data suggest different gastrointestinal transduction mechanisms elicit vagal afferent firing for fatty acids of different chain length. Dietary adaptation to fat can influence the sensitivity of the feedback response, which appears to be nutrient specific and relate to gastric emptying rates and hormonal feedback. Fat content has been found to influence palatability of foods. Recently it has been demonstrated that increasing palatability can partially override the satiating effects of covertly manipulated macronutrient preloads. Recent data suggest that hormonal influences may also affect the palatability response. SUMMARY: It is becoming increasingly clear that although energy density of diets is a major factor determining intake, macronutrient structure, subject, dietary and taste differences can all play an important modulatory influence on the final response on food intake. Further understanding of these factors and interactions may provide strategies to help aid weight regulation.
Previous research suggests that enhancing the volume of a food preload without altering energy content can result in reduced appetite, although the limited evidence means that the conditions under which this effect will occur are not yet clear. In the present study, we used a Universal Eating Monitor (UEM) to record test meal intake constantly, in parallel with appetite ratings, following soup-based preloads that varied both in volume (150 vs. 450 ml) and energy density (1.4 vs. 4.2 kJ/ml). Healthy young men (n=20) received four different preload conditions (repeated measures) followed by unlimited hot pasta test meals (interval 30 min). They completed appetite ratings during and after each laboratory session, and food diaries for the afternoon and evening following each session. Subjective appetite after the preloads was reduced by the high-volume preloads relative to low-volume preloads, with no difference between the two at each volume level. This indicates an effect of volume, but no effect of energy. Test meal intake in the high-volume, high-energy-density condition was reduced relative to the other conditions, which did not differ from one another. This indicates an effect of total energy, but no effect of volume. The dissociation between these different measures of appetite might be explained in terms of largely cognitive influences on subjective appetite between preload and test meal, contrasted with stronger physiological influences on actual intake during the test meal. With regard to previous studies, it is argued that food volume is more influential under circumstances where gastric volume is closer to its normal limits.
Gamma scintigraphy is considered the gold standard for the measurement of gastric emptying in humans. Recently, it has been proposed that a [(13)C]octanoate breath test can be used as an alternative technique for measuring gastric emptying of the solid phase, but the results from the two methods are not directly equivalent since in the breath test the label is subject to post-absorptive processing and consequently the emptying functions cannot be observed directly. This work investigates an alternative stable isotope method using deuterated octanoate where the kinetics of redistribution between and elimination from the various body pools are much more easily modelled. Gastric emptying was studied in healthy human volunteers by simultaneous measurement using both [(13)C]octanoate and [(2)H]octanoate as well as gamma scintigraphy. Comparison of the gastric emptying functions from the deuterium method and scintigraphy indicated that the two methods gave equivalent results. The new method can therefore be used in populations considered too vulnerable to ionising radiation to allow gamma scintigraphy to be performed, or as a proxy gold standard in laboratories where scintigraphic methods are unavailable, allowing further comparisons with the breath test method to be made to validate the latter in different population groups.
Since the discovery of the protein product of the ob/ob gene, leptin, knowledge of the neurochemical pathways involved in the regulation of feeding has increased enormously. Our understanding of the mechanisms regulating food intake in man has also progressed greatly over a similar time span. Previous research into the regulation of food intake has largely proceeded through a reductionist approach, defining ever-smaller components of these mechanisms. This research strategy has been very productive and instructive, and has yielded a great deal of information on the specific putative components linking energy status and food intake. However, to fully understand the regulation of feeding it is important that these components are systematically reconstructed to investigate relevant interactions. In the present review recent data relating to interactions between systems proposed to be involved in feeding regulation will be highlighted. The review will be directed predominantly (but not exclusively) towards the regulation of human feeding.