Consumo de alimentos altamente procesados y de alta palatabilidad y su relación con el sobrepeso y la obesidad / Ultra-processed and highly palatable foods on the development of obesity

Resumen Introducción: la obesidad es un rasgo multifactorial determinado por la interacción de factores biológicos, ambientales, psicosociales y político-socioeconómicos. Propósito: el objetivo de esta revisión descriptiva-exploratoria es discutir el papel del consumo de alimentos altamente procesados y de alta palatabilidad (APAP) en la epidemia de la obesidad, así como presentar algunas propuestas para disminuir su ingesta. Argumentos para la discusión: los APAP se caracterizan por ser energéticamente densos, ricos en grasas y azúcares. En su formulación se utiliza una gran cantidad de aditivos industriales para potenciar su sabor, vida útil y la estabilidad de sus componentes. Suelen contener sustancias químicas conocidas como disruptores endocrinos (EDC) que se transfieren de los empaques al alimento, como el bisfenol A y los ftalatos, y afectan distintas vías de señalización hormonal, promoviendo alteraciones en el metabolismo del tejido adiposo y otros sistemas endocrinos. El sobreconsumo de APAP induce a cambios neuroplásticos en el sistema de recompensa y esto aumenta, a la vez, el número de porciones, con la subsecuente acumulación de grasa corporal; además, dicho abuso causa desbalances en la composición del microbioma intestinal (disbiosis) asociados al desarrollo de obesidad. Conclusiones: el sobreconsumo de APAP incrementa el riesgo de obesidad y enfermedades crónicas no transmisibles, máxime si se inicia a edades tempranas. Para contrarrestar esta problemática, se plantea cambiar la estructura de la canasta básica, regular la venta dentro y alrededor de centros educativos, crear mayores impuestos y fortalecer la investigación en obesidad, APAP y EDC.

Abstract Introduction. Obesity is a multifactorial trait provoked by the interaction of biological, environmental, psychosocial, and socioeconomic factors. Proposal: The goal of the present review is to discuss the role of ultra-processed and highly palatable foods (UPHP) in the development of the obesity epidemic through an exploratory-descriptive review and to present some suggestions for controlling its consumption. Arguments for discussion: UPHP are energy dense foods with high contents of fat and sugar. UPHP are formulated with many industrial additives used for enhancing flavor, shelf life, and the stability of their components. UPHP used to contain diverse chemicals known as endocrine disruptors (EDC), which are transferred from packaging to foods, with bisphenol A and phthalates as the most common EDC. The EDC disrupt different hormonal signaling pathways affecting the metabolism of the adipose tissue and other endocrine systems. The overconsumption of UPHP induces neuroplastic changes in the brain reward system that increases their consumption, leading to body fat accumulation. In addition, the overconsumption of UPHP alters the composition of the intestinal microbiome (dysbiosis), which is associated with the development of obesity. Conclusions: The overconsumption of UPHP increases the risk of obesity and its related chronic, non-communicable diseases, especially when consumption initiates during early life. To counteract this problem, we proposed the following actions: changing the structure of the market-food basket, incorporating regulations to reduce the UPHP supply in and around educational centers, creating new taxes upon UPHP, and strengthening the research regarding obesity, and the effects of UPHP and EDC.

Neural circuit mechanisms in mesolimbic reward system underlying opioid addiction / 中国药理学通报

Opioid addiction has high incidence and does great harm to individuals and society. The mesolimbic reward system plays an important role in opioid addiction. Previous studies have focused on functional adaptations in specific brain regions of the mesolimbic reward system, but the neuronal interactions in mesolimbic reward system underlying opioid addiction remain unknown. The paper reviews the neural circuit mechanisms in mesolimbic reward system involved in opioid addiction, in order to provide a broader vision for understanding the mechanisms of opioid addiction.

Estrés y cortisol: implicaciones en la ingesta de alimento / Stress and cortisol: implications on food intake

La búsqueda de alimento y su consumo son conductas dirigidas a satisfacer la obtención de los sustratos energéticos necesarios para sostener las diferentes funciones orgánicas que un individuo requiere para garantizar su supervivencia. La conducta alimentaria cuenta con dos sistemas reguladores, uno homeostático ubicado en hipotálamo y otro de tipo hedónico, representado por el sistema de recompensa cerebral. Dichos sistemas están modulados por señales estimuladoras (orexigénicas) e inhibidoras (anorexigénicas) del apetito. En condiciones de estrés crónico, la actividad del eje hipotálamo-hipófisis-adrenal, que regula la concentración de cortisol plasmático, dará lugar al establecimiento de diferentes mecanismos que promuevan la ingesta de alimento de elevada densidad energética, los cuales son considerados como poderosos disruptores de los procesos de regulación del apetito, condición potencialmente capaz de favorecer el desarrollo de una conducta compulsiva en la búsqueda de alimento, una disrupción en el balance energético y obesidad. El consumo repetido de alimentos apetitosos representa para los individuos vulnerados una oportunidad de automedicación dirigida al alivio del estrés, brindando una condición u oportunidad de confort. Los datos epidemiológicos sustentan la idea de un fuerte vínculo entre glucocorticoides y síndrome metabólico. La relación entre estrés crónico, cortisol e ingesta elevada de alimento tienen a la adiposidad visceral y a la resistencia a la insulina como factores predisponentes de una disrupción metabólica con consecuencias importantes al estado de salud de los seres humanos. El presente artículo tiene como objetivo valorar las implicaciones del estrés y cortisol sobre la ingesta de alimento.

Behaviors such as the search and consumption of food are aimed to obtain the energy substrates needed to sustain diverse organic functions required to guarantee the survival of an individual. The alimentary behavior has two regulatory systems: the homeostatic system, located in the hypothalamus and the hedonic system, represented by the cerebral reward system. These systems are modulated by both stimulatory (orexigenic) and inhibitory (anorexigenic) signals of appetite. Under chronic stress conditions, the activity of the hypothalamic-pituitary-adrenal axis, which regulates the plasma cortisol concentration, will lead to the establishment of different mechanisms that promote the ingestion of food with high energy density, which are considered as powerful disruptors of appetite regulation processes, a condition potentially capable of promoting the development of compulsive food search behavior, a disruption in the energy balance and obesity. Repeated consumption of appetizing foods represents an opportunity for self-medication aimed at stress relief, providing a condition or opportunity for comfort. Epidemiological data suggests a strong link between glucocorticoids and metabolic syndrome. The relationship between chronic stress, cortisol and high food intake has visceral adiposity and insulin resistance as predisposing factors of metabolic disruption with important consequences to the health status of humans. The purpose of this article is to evaluate the implications of stress and cortisol on food intake.

Different levels of brain-derived neurotrophic factor and cortisol in healthy heavy smokers

Studies suggest that brain-derived neurotrophic factor (BDNF) and the hypothalamic-pituitary-adrenal (HPA) axis modulate dopaminergic activity in response to nicotine and that the concentrations of BDNF and cortisol seem to be dependent on the amount and duration of smoking. Therefore, we investigated BDNF and cortisol levels in smokers ranked by daily cigarette consumption. Twenty-seven adult males (13 non-smokers and 14 smokers) participated in the study. The smokers were divided in two groups: light (n=7) and heavy smokers (n=7). Anthropometric parameters and age were paired between the groups, and plasma BDNF and salivary cortisol levels were measured. Saliva samples were collected on awakening, 30 min after awakening, at 10:00 and 12:00 am, 5:00 and 10:00 pm. Additionally, cotinine serum levels were measured in smokers. Heavy smokers had higher mean values of BDNF compared to the control group (P=0.01), whereas no difference was observed in light smokers. Moreover, heavy smokers presented lower cortisol levels in the last collection (10:00 pm) than the control group (P=0.02) and presented statically higher values of cotinine than the light smokers (P=0.002). In conclusion, changes in BDNF and cortisol levels (10:00 pm) appear to be dependent on heavy cigarette smoking and can be involved in activation and in the relationship between the mesolimbic system and the HPA axis.

Reward and aversion systems of the brain as a functional unit. Basic mechanisms and functions / Sistemas de recompensa y aversión del cerebro como una unidad funcional. Mecanismos básicos y funciones

INTRODUCTION: It is increasingly important to recognize the reward and aversion systems of the brain as a functional unit. A fundamental task of the mammalian brain is to assign an emotional/motivational valence to any stimuli by determining whether they are rewarding and should be approached or are aversive and should be avoided. Internal stimuli are also assigned an emotional/motivational valence in a similar fashion.OBJECTIVE: To understand the basic mechanisms and functions of the reward and aversion system of the brain.METHOD: A bibliographical search was conducted in the Pubmed database using different key words. Documents on relevant aspects of the topic were selected.RESULTS: In the ventral tegmental area, dopaminergic (VTA-DA) neurons play a role in reward-dependent behaviors. It is also known that the inhibition of the VTA-DA neurons by GABAergic neurons contributes to a reward prediction error calculation that promotes behaviors associated with aversion. The ventral dopaminergic mesolimbic system and the nucleus accumbens are activated during reward and inhibited during aversions. The amygdala is activated during aversive behavior.DISCUSSION AND CONCLUSION: The reward/aversion system is highly relevant for survival, which is most likely its primary function. It is involved in important pathologies such as addiction, depression and autonomic and endocrine disturbances. Therefore, its knowledge has become of clinical importance.Although great advances have been made in the knowledge of the basic mechanisms of the reward/aversion system, the detailed circuits within the VTA that mediate reward and aversion and the anatomical substrates are not completely clear.

INTRODUCCIÓN: Es muy importante reconocer el sistema de recompensa y aversión del cerebro como una unidad funcional. Una de las funciones fundamentales del cerebro de los mamíferos es la capacidad para designar un valor emocional/motivacional a cualquier estímulo. Esta capacidad permite identificar un estímulo como gratificante y aproximarnos a él, o reconocerlo como aversivo y evitarlo.OBJETIVO: Comprender los mecanismos fisiológicos del sistema de recompensa-aversión.MÉTODO: Se realizó una búsqueda bibliográfica en la base de datos Pubmed con las diferentes palabras clave. Se seleccionaron los documentos sobre los aspectos relevantes.RESULTADOS: Las neuronas dopaminérgicas del área tegmental ventral (ATV) cumplen un papel importante en los comportamientos dependientes de la recompensa. Asimismo, la inhibición de las neuronas dopaminérgicas ATV por parte de las neuronas GABAérgicas contribuye a predecir la recompensa y promueve comportamientos aversivos. Este sistema se activa durante actividades de recompensa y se inhibe durante la aversión. La amígdala es la principal estructura relacionada con la aversión.DISCUSIÓN Y CONCLUSIÓN: Este sistema se considera de gran importancia para la supervivencia de las especies, la que parece ser su función primordial. Interviene en distintas patologías como adicciones, depresión, trastorno por estrés postraumático, fobias y trastornos endocrinos y autonómicos, por lo que el conocimiento de este sistema es de gran importancia clínica.Aunque se ha avanzado mucho en el estudio y entendimiento de este sistema y de sus circuitos anatómicos ubicados en el ATV mesencefálica y sus conexiones con áreas subcorticales, el conocimiento de este sistema funcional sigue siendo un desafío científico.

Efeitos da exposição à nicotina e à fumaça de cigarro durante a lactação sobre o sistema de recompensa cerebral em ratos / Effects of exposure to nicotine and cigarette smoke during lactation on the brain reward system in rats

Crianças de mães fumantes são mais suscetíveis a se tornarem adultos obesos e se viciarem em drogas ou alimentos palatáveis. Drogas e alimentos ativam a via mesolímbica de recompensa, causando sensação de prazer que induz ainda mais o consumo. Assim, avaliamos a relação entre a exposição apenas à nicotina ou à fumaça do cigarro durante a lactação com a preferência alimentar e sistema dopaminérgico de recompensa cerebral das proles, em dois modelos de programação: Modelo I: no 2o dia pós-natal (PN), lactantes receberam implante de minibombas osmóticas que liberam nicotina (NIC) ou salina (C), durante 14 dias. Em PN150 e novamente em PN160, as proles foram divididas em 4 grupos para um desafio alimentar: N-SC e C-SC que receberam ração padrão; N-SSD e C-SSD que podiam escolher livremente entre as dietas hiperlipídica e hiperglicídica. A ingestão alimentar foi avaliada após 12 h. As mães foram sacrificadas apenas na 21ª da lactação (desmame) e as proles em PN15 (com nicotina), PN21 e PN170 (ausência da NIC). Ao desmame, as ratas lactantes NIC apresentaram menor conteúdo de tirosina hidroxilase (TH), maior OBRb e SOCS3 na area tegmentar ventral (VTA); menor TH, maior receptor de dopamina 1 (D1R), receptor de dopamina 2 (D2R) e transportador de dopamina (DAT) no núcleo accumbens (NAc); maior conteúdo de TH no estriado dorsal (DS); e maior D2R e SOCS3 no núcleo arqueado (ARC). Em PN15, os filhotes NIC apresentaram maior conteúdo de D1R, D2R e menor DAT no NAc, enquanto em PN21, apresentaram apenas menor DAT no DS, e menor conteúdo de pSTAT3 em ARC. Aos 170 dias, as proles SSD demonstraram maior preferência para a ração hiperlipídica. No entanto, os animais N-SSD consumiram mais ração hiperglicidica do que as proles C-SSD...

Children from smoking mothers are more susceptible to become obese adults and to become drug or food addicts. Drugs and food activate the mesolimbic reward pathway, causing a sense of pleasure that induces further consumption.Thus, we studied the relationship between only nicotine or tobacco smoke exposure during lactation with feeding behavior and brain dopaminergic reward system at adulthood, in two programming models: Model I, on the postnatal day (PN) 2, lactating rats were implanted with minipumps releasing nicotine (NIC) or saline (C) for 14 days. On PN150 and again on PN160, offspring were divided into 4 groups for a food challenge: N-SC and C-SC received standard chow; N-SSD and C-SSD could freely select between hyperlipidic and hyperglicidic diets. Mothers were euthanized only in 21ª of lactation and offspring were euthanized in PN15 (with nicotine), PN21 and PN170 (withdraw). At weaning (PN21), NIC dams had: lower tyrosine hydroxylase (TH), higher OBRb and SOCS3 contents in ventral tegmental area (VTA); lower TH, higher dopamine receptor 1 (D1R), dopamine receptor 2 (D2R) and dopamine transporter (DAT) contents in nucleus accumbens (NAc); higher TH content in dorsal striatum (DS); and higher D2R and SOCS3 contents in arcuate nucleus (ARC). On PN15, NIC pups had higher D1R, D2R and lower DAT contents in NAc, while on PN21 they had lower DAT in DS, and lower pSTAT3 content in ARC. On PN170, SSD animals showed an increased food intake compared with SC ones and a preference for the hyperlipidic chow. However, N-SSD animals consumed relatively more hyperglicidic chow than C-SSD ones. N offspring presented lower D2R and DAT contents in the NAc, and lower D2R in the ARC. Model II, nursing rats and their pups were divided into: tobacco smoke-exposed (S group: 4 times/day, from the 3rd to the 21th day of lactation), and ambient air-exposed (C group)...

Roles of monoamine neurotransmitters in the mechanism of drug addiction / 中国药理学通报

Drug addiction is a chronic recrudescent brain dis-ease. Various addictive drugs acting on the reward system result in rewarding effects through changes in neurotransmitter patholog-ical release. Among these monoamine neurotransmitters, 5-hydroxytryptamine, norepinephrine and dopamine play key roles in drug addiction. This paper reviews, from a comprehensive perspective, the roles which monoamine neurotransmitters play in the drug addiction and the process of getting addictive.

Inteligencia para la alimentación: alimentación para la inteligencia / Intelligence for food: food for intelligence

Eating is a behavior oriented to get the energy necessary for the organism to survive and to contend with the demands of its environment. Food, besides of energy, provides structure and function, as amino acids are converted into structural or secretion proteins or enzymes. These proteins are synthesized following a strict genetic code. Variants in the genome happen frequently, but only those changes that result in a poor adaptive phenotype are well documented. There are other changes that may go unnoticed due to culture influence, and they may be seen as adaptive because they seem to favor individuals in the short-term. A child that overeats and becomes overweighed is culturally appreciated as a healthy child. However, systematic studies have shown that these feeding styles influenced by culture, in the long-term, result on an irreversible damage to the individual. Food selection also depends on the functioning of homeostatic and hedonistic systems. The homeostatic system involves the hypothalamus that includes nuclei that promote both appetite and satiety. The hedonic system is constituted by the ventral tegmental area and the nucleus accumbens. Stimulation of the ventral tegmental area induces the release of dopamine into the nucleus accumbens, making the individual to experience pleasure. This system also interacts with the hypothalamic systems that promote appetite. As it can be seen, food intake is regulated by diverse cerebral systems that are under the influence of one another. Failure in one of these systems may lead the subject to a compulsive, or defective, food intake. We have allowed media and mercantilist interests to govern our diet, instead of allowing our brain and its systems to do it. We should have psycoeducation as a priority in medicine to improve our capacity to select better quality food to eat, without compromising the pleasure of eating.

Comer es una conducta dirigida a conseguir la energía para llevar a cabo las funciones que mantienen al organismo y le permiten contender contra las demandas del medio. Debido a que nuestro organismo evolucionó dentro de un ambiente con escasez de alimentos, los genes que nos adaptaron al medio fueron los que promueven el almacenamiento y optimización de los nutrientes, así como aquellos que promueven la habilidad de generar estrategias de cacería y otras conductas orientadas a ese objetivo. Estos mecanismos fisiológicos y bioquímicos incluyen una amplia variedad de genes, desde aquellos que codifican para enzimas que almacenan el glucógeno hasta enzimas que sintetizan o degradan a los neurotransmisores. Diversos sistemas cerebrales regulan la ingestión del alimento: El homeostásico involucra al hipotálamo lateral como promotor de la ingestión de alimento por medio de neuronas orexinérgicas y MCHérgicas, al núcleo arcuato que sintetiza y libera neuropéptido Y y al péptido relacionado al gen agouti y como promotor de la saciedad a través de la POMC y del CART. Diferentes hormonas y proteínas hipotalámicas participan en la función del sistema hedónico compuesto por el área ventral tegmental y el núcleo accumbens, produciéndose un diálogo entre los sistemas homeostásico y hedónico. Otros sistemas cerebrales que participan son la amígdala y el lóbulo de la ínsula que promueven la selección de los alimentos con base en la experiencia. La corteza prefrontal participa en la preferencia por los alimentos y la toma de decisiones tales como qué, cuándo y dónde comer. Es importante reconocer que los sistemas neuroquímicos que regulan la ingestión del alimento también participan en funciones cognitivas y que la falla en estos sistemas afecta la forma en que el individuo elige su alimentación y, a su vez, el estado cognitivo del sujeto. Por lo tanto, la psicoeducación para regular los hábitos alimenticios debe ser una prioridad en el campo de la medicina.

Smoking as an Addictive Disorder / 신경정신의학

Nicotine is the major substance that accounts for the addictive nature of smoking. Nicotine induces neurobiological and behavioral responses through diverse neurochemical mechanisms over the central nervous system. The brain reward system, particularly the dopaminergic pathway from the ventral tegmental area to nucleus accumbens, is central to understanding the behavioral reinforcement underlying substance addictions such as the addiction to nicotine. Nicotine acts as an agonist provoking activation or desensitization of nicotinic acetylcholine receptors in different brain areas including the brain reward system. Nicotine also indirectly influences the glutaminergic, GABAergic, noradrenergic, and serotonergic neurotransmission that lead ultimately to activation of the dopaminergic pathway in the brain reward system. Chronic exposure to nicotine activates neuroadaptation and associative learning with the nicotine-related stimulus through dopaminergic or cholinergic systems, which can lead to nicotine dependence or withdrawal. In sum, the neurobiological processes described above are deeply involved in the basis of nicotine dependence and underlie the frequent failure of attempts to quit smoking. In this review we discuss the neurobiological mechanisms of nicotine addiction focusing on the roles of the nicotinic acetylcholine receptor.

Smoking as an Addictive Disorder / 신경정신의학

Nicotine is the major substance that accounts for the addictive nature of smoking. Nicotine induces neurobiological and behavioral responses through diverse neurochemical mechanisms over the central nervous system. The brain reward system, particularly the dopaminergic pathway from the ventral tegmental area to nucleus accumbens, is central to understanding the behavioral reinforcement underlying substance addictions such as the addiction to nicotine. Nicotine acts as an agonist provoking activation or desensitization of nicotinic acetylcholine receptors in different brain areas including the brain reward system. Nicotine also indirectly influences the glutaminergic, GABAergic, noradrenergic, and serotonergic neurotransmission that lead ultimately to activation of the dopaminergic pathway in the brain reward system. Chronic exposure to nicotine activates neuroadaptation and associative learning with the nicotine-related stimulus through dopaminergic or cholinergic systems, which can lead to nicotine dependence or withdrawal. In sum, the neurobiological processes described above are deeply involved in the basis of nicotine dependence and underlie the frequent failure of attempts to quit smoking. In this review we discuss the neurobiological mechanisms of nicotine addiction focusing on the roles of the nicotinic acetylcholine receptor.