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Neuroimaging and obesity: mapping the brain responses to hunger and satiation in humans using positron emission tomography.

The hypothalamus has a major role in the control of food intake. However, neurotracing studies have shown that the hypothalamus receives input from several other regions of the brain that are likely to modulate its activity. Of particular interest to the understanding of human eating behavior is the possible involvement of the cortex. Using positron emission tomography (PET), we generated functional brain maps of the neuroanatomical correlates of hunger (after a 36-h fast) and satiation (after oral administration of a liquid formula meal) in lean and obese subjects. Results in lean individuals indicate that the neuroanatomical correlates of hunger form a complex network of brain regions including the hypothalamus, thalamus, and several limbic/paralimbic areas such as the insula, hippocampal/parahippocampal formation, and the orbitofrontal cortex. Satiation was associated with preferentially increased neuronal activity in the prefrontal cortex. Our studies also indicate that the brain responses to hunger/satiation in the hypothalamus, limbic/paralimbic areas (commonly associated with the regulation of emotion), and prefrontal cortex (thought to be involved in the inhibition of inappropriate response tendencies) might be different in obese and lean individuals. In conclusion, neuroimaging of the human brain is proving to be an important tool for understanding the complexity of brain involvement in the regulation of eating behavior. PET studies might help to unravel the neuropathophysiology underlying human obesity.

Adolescent↗

[Combating poverty and rebuilding social ties: the lessons of Citizens' Action in the Struggle Against Hunger and Destitution and in Defense of Life].

To reflect on Citizens' Action in the Struggle Against Hunger and Destitution and in Defense of Life is to seek to approach the dilemmas and challenges involving the consolidation of citizenship and social justice, as well as the forces in action in contemporary Brazilian society. However, many questions remain open in this effort. The intertwining issues of poverty, politics, and solidarity and the concrete shapes and multiple social developments of Brazil's "Campaign Against Hunger" leave room for various possible interpretations. Thus, considering the breadth of the theme on the one hand and the limits of this article on the other, the objective is to explore some relevant issues in the debate on destitution and exclusion and the process of constructing new kinds of public social intervention and civic participation, arising over the course of the study conducted by the "Citizens' Action Committees" in Rio de Janeiro during 1996 and 1997. The basic idea is to focus on volunteer practices to discuss the dilemmas posed for solving impoverishment and social fragmentation through cooperative activities and mutual help in Brazil.

Brazil↗

[EEG-correlates of alimentary behavior in rabbits with different levels of hunger and satiety].

The electrical activity of the rabbit brain at different stages of hunger and satiation was correlated with the animal's behavioral reactions. It has been found that alimentary reactions are attended with the appearance of complex high-amplitude and high-frequency electrical potentials in the lateral hypothalamic area, which increased with the longer duration of the animal's hunger, as well as during search, in response to natural and conditioned alimentary stimuli, and when feeding. As satiation sets in, they fade and disappear after food refusal. It is assumed that this form of activity is an EEG expression of alimentary motivational excitation. Its constituent rhythms reflect the different components of alimentary excitation.

Animals↗

Administering the "AHSP Questionnaire" (appetite, hunger, sensory perception) in a geriatric rehabilitation care.

BACKGROUND: Frail elderly people, living in nursing homes, usually show a malnutrition state caused by an increased need of energy or an inadequate food intake. Among the causes leading to reduction of food intake in elderly people and consequently to malnutrition, is the loss of appetite, often marker of depression and alterations of taste and smell perception. OBJECTIVE: The aim of this research is to verify the application of the AHSP Questionnaire and relate its score to nutritional state of a frail elderly population hospitalized in a geriatric rehabilitation care. SETTING AND SUBJECTS: All patients of the "3rd Rehabilitation Department" of the Istituto Geriatrico "Villa delle Querce" Nemi (Rome-Italy). METHODS: Informations, number and type of medical conditions, prescribed drugs, other parameters that can affect taste, smell, hunger and nutritional status, mood, cognitive and nutritional status have been collected from the clinical folders. To assess appetite, hunger smell and taste perception had been submitted the AHSP Questionnaire. RESULTS: The AHSP Questionnaire had been administered only to 44 of the 103 patients present at the survey because of the high prevalence of cognitive impairment. AHSP score is lower in presence of malnutrition assessed with MNA (Mini Nutritional Assessment). MNA, expressed as proportional score, seems to present a clear correlation with AHSP's (r=0.59; p=0.000). CONCLUSION: The results achieved show the scarce adaptability of the AHSP Questionnaire to frail elderly people living in geriatric rehabilitation care. MNA is at the moment the most reliable tool to single out dietary deficiency on geriatrics population.

Aged↗

[Ghrelin: beyond hunger regulation].

Man ingests food to mitigate hunger (mediated by physiological and biochemical signals), satisfy appetite (subjective sensation) and because of psychosocial reasons. Satiation biomarkers (stop feeding) are gastric distention and hormones (CCK, GLP-1) and satiety biomarkers (induce feeding) are food-induced thermogenesis, body temperature, glycaemia and also hormones (insulin, leptin and ghrelin). Oxidative metabolism/body composition, tryptophan/serotonin and proinflammatory cytokines are also implicated on hunger physiology. At the present time, ghrelin is the only known circulating orexigenic with potential on hunger/body weight regulation. It is a neuropeptide (endogenous ligand for the GH secretagogue) recently isolated from the oxyntic mucosa and synthesized mainly in the stomach. Its blood concentration depends on diet, hyperglucemia and adiposity/leptin. It is secreted 1-2 hours preprandially and its concentration decreases drastically during the postprandium. Ghrelin acts on the lateral hypothalamus and theoretically inhibits proinflammatory cytokine secretion and antagonizes leptin. Ghrelin physiologically increases food intake and stimulates adipogenesis, gastrointestinal motility and gastric acid secretion, and has other hormonal and cardiovascular functions. Ghrelin blood concentration is reduced in massive obesity, non-alcoholic steatohepatitis, polycystic ovary syndrome, acromegaly, hypogonadism, ageing, short bowel syndrome and rheumatoid arthritis; and increased in primary or secondary anorexia, starvation, chronic liver disease and celiac disease. Cerebral and peritoneal ghrelin administration (rats) and systemic administration (rats and healthy volunteers, cancer patients or patients on peritoneal dialysis) promotes food consumption and increases adiposity, of utmost importance in the treatment of patients with anorexia.

Appetite↗

Eating behaviour: investigation on the recursive components of hunger sensation by iterative rhythmometry.

The periodic components of hunger have been investigated in the spectrum of ultradian and circadian rhythms by means of iterative rhythmometry analysis, a method for resolving harmonic components in time series data. The cyclical scanning has been applied in human subjects with eating disorders associated with leanness, ponderosity and obesity. The sensation of hunger was rhythmometrically resolved into ultradian and circadian components which are peculiar for the group investigated. Harmonic modelling can be used on an individualized basis for group-specific configurations and, on that basis, for unphysiologic patterns. A comparison with the rhythmometric model of healthy subjects may have a practical use in identifying and manipulating behavioural disorders in the propensity to eat.

Adolescent↗

[Dietary fiber added to a very-low caloric diet reduces hunger and alleviates constipation].

To investigate whether supplement dietary fibre improves compliance to very low calorie diets (VLCD), a nutritional powder providing 388 kcal/day was compared with a similar preparation containing 30 plant fibre per day. Twenty-two obese patients participated in the study. After three days on their habitual diet they were allocated at random according to a single blind design to VLCD either with or without dietary fibre for two weeks. Thereafter, they were crossed over to the other form of diet for two further weeks. All of the patients completed the study. Both of the groups had considerable weight losses which were similar (about 10 kg/4 weeks) and dietary fibre did not improve the result further. During the period with VLCD with fibre, hunger ratings were significantly lower than on diets with VLCD without fibre (fibre effect p less than 0.01). Bowel movements decreased from 1.9 per day on the habitual diet to 0.7 per day on VLCD without fibre but increased to 1.0 per day with the fibre supplement (fibre effect p less than 0.01). No differences were found between the effects of the two types of diet on satiety, consistency of the faeces and flatulence. The supplement of dietary fibre did not influence plasma concentrations of divalent cations such as calcium, iron or magnesium nor did it contribute to the lowering effect of VLCD on plasma glucose, cholesterol or triglyceride. It is concluded that supplementation of VLCD with dietary fibre may improve compliance by normalising hunger and increasing the number of bowel movements without impairing the absorption of divalent cations.

Adolescent↗

Dietary fibre added to very low calorie diet reduces hunger and alleviates constipation.

To examine whether supplement of dietary fibre may improve compliance to a very low calorie diet (VLCD) a nutrition powder providing 388 kcal/day (men: 466 kcal/day) was compared with a similar version containing plant fibre 30 g/day. Twenty-two obese patients entered the study. After a baseline habitual diet, they were randomized to two weeks of treatment in a single blind design to either VLCD with or without dietary fibre. Subsequently, they were crossed over for further 2 weeks of treatment. All patients completed the study. The two groups had similar weight losses (about 10 kg/4 weeks), and dietary fibre did not improve this result. During VLCD with fibre hunger ratings were significantly lower than during VLCD without fibre (fibre effect, ANOVA; P less than 0.01). Bowel movements decreased from 1.9/day on habitual diet to 0.7/day on VLCD without fibre, but increased to 1.0/day by fibre supplement (fibre effect, P less than 0.01). No effect of fibre supplementation to VLCD was found on satiety, consistency of faeces and flatulence. The supplement of dietary fibre did not influence plasma concentrations of divalent cations as calcium, iron or magnesium, nor did it add any lowering effect on plasma glucose, cholesterol or triglyceride to that of VLCD. In conclusion, the supplement of dietary fibre to VLCD may improve compliance by reducing hunger and increasing the number of bowel movements, without impairment of absorption of divalent cations.

Adolescent↗

Hunger pain: a poor indicator of peptic ulcer in a developing country.

Endoscopy of the esophagus, stomach, and duodenum and stool examinations for ova and parasites were performed in 63 adult Peruvian patients with "hunger pain" (HP) and other dyspeptic symptoms. No lesion capable of provoking HP was found at endoscopy in 50 (78%) of the 63 patients. Only 7 (12%) of the patients had evidence of active or healed peptic ulcers. Another 6 patients (10%) had either gastric erosions or duodenitis. One (2%) of the patients was infected with hookworm, a parasite that produces epigastric pain mimicking HP. The 12% rate of peptic ulcer in Peruvian patients with HP contrasts strongly with accumulated experience in most developed countries, whose rates of peptic ulcer associated with HP range from 60 to 75%. As the frequency of peptic ulcer is so variable in patients with HP, we suggest that the simple term "hunger pain" be used instead of "peptic ulcer pain" or "ulcer dyspepsia" to refer to the complaint of such patients.

Abdominal Pain↗

The paradox of hunger and economic prosperity in America.

Within a period of twenty years, America discovered that many of its citizens were hungry, acted to greatly reduce this problem through an array of federal programs, and, in the 1980s, learned that hunger has reappeared in epidemic proportions. The return of hunger to the U.S. is associated with economic and tax policies that have reallocated income distribution from poor and middle-income groups to the wealthy, and with a corresponding failure to utilize the federal government to protect high-risk population groups from undernutrition associated with growing economic deprivation in the nation.

Humans↗

The effect of high and low-fibre breakfasts on hunger, satiety and food intake in a subsequent meal.

Twenty normal weight female volunteers divided into high and low restraint groups consumed breakfast meals of high and low-fibre content (12.0 g and 3.0 g fibre respectively) on two separate occasions. Visual analogue scales were used to record hunger, fullness, desire to eat, and a measure of prospective consumption for 21/2 hours after each meal. At this point, a tray of pre-weighed lunch foods was offered and subjects were requested to eat as much or as little as they desired. The two breakfast meals (of equal weight) were based on toast, breakfast cereal, milk, butter and orange marmalade. No significant difference in energy intake at lunch was found after the high and low fibre breakfasts, or between the restraint groups. There was no significant difference between ratings after the high and low-fibre meals except for fullness, which was greater after the high-fibre breakfast. The effect of fibre overall, was relatively weak compared to the differences between the two restraint groups, with the high restraint group consistently expressing significantly less hunger before, during and after the breakfasts compared to the low restraint group.

Dietary Fiber↗

Factors that may effect the reduction of hunger and body weight following d-fenfluramine administration.

Three studies have been undertaken to investigate why there are individual differences in the response to d-fenfluramine with respect to food intake and hunger in the short term and on body weight loss in the long term. Fenfluramine and norfenfluramine plasma levels have been used as probes to help detect and normalize these variances. In a single dose ranging volunteer study (0, 30, 40, and 60 mg), d-fenfluramine levels were significantly related to caloric intake and hunger rating scales when compared individually, and the slopes of the regression lines showed intersubject variation. These slopes, an index of each subject's response to fenfluramine, appear to be related to both the percentage underweight and more weakly to the percentage overweight. Those subjects at the extremes of weight showed a greater response to a given drug level. In two placebo-controlled 3 month studies (30 mg/day), the variances in weight loss were not explained by steady state drug levels, the percentage overweight, initial weight, duration of obesity, or caloric intake even when weight loss was normalized for differences in drug levels. Age, however, was significantly related to weight loss, with each additional 10 years increasing weight loss by approximately 1 kg. If confirmed, the sensitivity of fenfluramine anorexia may be an objective acute test of the central control of food intake. However, in long term clinical studies, drug levels were only weakly related to weight loss and other undefined factors seem to determine which patients responded better to fenfluramine treatment.

Adult↗

Less food, less hunger: reports of appetite and symptoms in a controlled study of a protein-sparing modified fast.

This study compared reports of appetite and symptoms in 28 obese subjects randomly assigned to either a 500 calorie protein-sparing modified fast (PSMF) or a 1200-kcal balanced diet. During the first comparison month, subjects consuming the PSMF lost significantly more weight and reported significantly less hunger than did subjects consuming the 1200 kcal diet. Similar results were obtained for the second month, but differences in hunger were not statistically significant. There were no significant differences between conditions in subjects' ratings of their preoccupation with eating or in their ratings of the acceptability or disruptiveness of their diets. PSMF subjects reported significantly greater problems with cold intolerance, constipation, dizziness, dry skin, and fatigue. These symptoms remitted completely, however, when PSMF subjects consumed a 1200-kcal balanced diet. There were no significant differences between conditions in subjects' reports of psychological functioning. Results are discussed in terms of the need for further research to identify the characteristics of PSMF which confer anorexia.

Adult↗

Hunger enhances the expression of calorie- but not taste-mediated conditioned flavor preferences.

Rats learned to associate one flavor conditioned stimulus (CS; grape or orange) with an ethanol (caloric) or saccharin (sweet but noncaloric) solution unconditioned stimulus (US), and the other flavor CS with either the other US or plain tap water. They were then given two-bottle choice tests between the flavor CSs apart from the USs. Flavors associated with 5% ethanol were preferred over saccharin-paired and water-paired flavors by sated rats, and food deprivation during the choice test enhanced this preference. The ethanol-paired flavor preference was not affected by feeding conditions (deprived vs. ad lib) during CS-US conditioning. Flavors associated with 8% sucrose (caloric + sweet tasting) were preferred over water-paired flavors during ad lib testing, and this preferences was also enhanced by food deprivation. Flavors associated with 0.028% or 0.25% saccharin were preferred over flavors paired with water; however, these preferences were not enhanced by deprivation at test time. In all cases, calorie-mediated preferences, at their highest levels, were stronger than taste-mediated preferences. These experiments indicate that preferences for flavors associated with caloric substances are positively related to hunger level at test time, but preferences mediated by a prior preferred taste are independent of test-time hunger level.

Alcohol Drinking↗

Salt hunger in the rhesus monkey.

Five rhesus monkeys (Macaca mulatta) were placed on a low-sodium diet and given injections of furosemide in order to promote sodium loss. The results indicated that these methods elicit a substantial and specific salt hunger. Issues surrounding salt hunger are discussed.

Animals↗

[The spectral characteristics of the electrical activity of the rabbit brain in a state of hunger].

Brain electrical activity of rabbits in the state of hunger, induced by food deprivation, was processed by spectral analysis using FFT algorithm. State of hunger lead to complex pattern of electrical activity modification: i.e., enhancement of the low-frequency band spectral power in the lateral hypothalamus and decrease of the spectral power of potentials of orbitofrontal, sensorimotor cortices, medial preoptic zone, ventromedial hypothalamus. One-day food deprivation produced interhemispheric asymmetry of neocortical electrical activity due to greater decrease of the spectral power of in the left hemisphere.

Animals↗

[A coherence analysis of the electrical activity of the rabbit brain with a hunger dominant].

Hunger dominant was created in daily (for 24 hours) food deprived rabbits. The presence of summation was judged by the appearance of the swallowing of the chewing movements in response to sound. At creation of the hunger dominant the coherence (Cog) of the electrical activity of the sensorimotor, frontal, and parietal areas of the cerebral cortex raised. There established the differently directed Cog of the potentials of the lateral (LH), medial (VmH) hypothalamus and the cortex, especially regular in the delta- and the theta-bands. Cog between the potentials of the LH and the cortex lowered, and Cog between that of the VmH and the cortex, on the contrary, raised. There appeared a certain mosaic of coherent connections of the hypothalamic electrical processes: Cog between the potentials of the LH and the VmH raised and Cog between that of the medial and lateral preoptic areas lowered.

Animals↗

[The thermal activity of the rabbit brain in motivational states of hunger or thirst].

Motivational states of hunger or thirst in rabbits were produced by the relevant deprivation of different duration (24 and 48 h). The distribution of brain thermal fields was studied by the method of thermoencephaloscopy. The thermal asymmetry was observed in the states of thirst and hunger the temperature of the left hemisphere being higher. Generalization of the brain temperature reaction depended on the level of motivational excitation. The interhemispheric brain asymmetry with higher temperature in the left hemisphere in the states of food and drinking deprivation had a pronounced trace effect, i.e., persisted for some time after satisfaction of the corresponding need. Evidently, the interhemispheric asymmetry with higher temperature of the left hemisphere reflects its predominant activation in the studied states.

Animals↗