Alimentação responsiva na primeira infância como fator de autorregulação do apetite e prevenção de obesidade infantil: uma revisão sistemática / Responsive feeding in early childhood as a factor in appetite self-regulation and prevention of childhood obesity: a systematic review

A obesidade infantil é um problema de saúde pública global que afeta cerca de 41 milhões de crianças menores de cinco anos e pode ser causada por diversos fatores. O objetivo deste estudo foi avaliar o efeito da abordagem de alimentação responsiva na primeira infância na autorregulação do apetite e prevenção de obesidade infantil. Foi realizada revisão sistemática da literatura e a síntese e extração de dados foram conduzidas de acordo com as diretrizes PRISMA. Para a pesquisa bibliográfica utilizou-se quatro bases de dados: PubMed, Scopus, Web of Science e EMBASE, sem restrição de idiomas, entre os anos 2012 e 2022. A seleção dos artigos foi realizada por pares e em duas etapas: leitura dos resumos (207) e leitura dos artigos completos (60), tendo sido selecionados 14 artigos. Os critérios de inclusão foram: estudos publicados em periódicos, entre 2012 e 2022, sem restrição por idioma, estudos observacionais e intervencionais que avaliaram a associação entre autorregulação da ingestão alimentar, responsividade dos cuidadores a alimentação das crianças e status de peso em crianças de zero a cinco anos. Foram excluídos os artigos com população de crianças com comorbidade, estudos de bebês com condições que afetam a alimentação e o crescimento, bebês muito prematuros, baixo peso ao nascer (BPN) <2.500 kg. A maioria dos estudos utilizou questionários de alimentação para avaliar comportamentos alimentares infantis e adultos, práticas alimentares parentais e escalas de apetite e saciedade. As medidas antropométricas foram avaliadas através de procedimentos padrão, autorreferidos ou prontuários. Os estudos demonstraram que os estilos parentais que apresentam maior controle e pressão para a criança comer interferem na autorregulação do seu apetite ou controle da saciedade e consequente ganho de peso. Concluiu-se que os comportamentos alimentares dos pais têm impacto na autorregulação alimentar, controle da saciedade e peso da criança. No entanto, pesquisas mais aprofundadas sobre abordagens alimentares dos pais são necessárias para elucidar o comportamento das crianças e sua influência na prevenção da obesidade infantil.

Childhood obesity is a global public health problem that affects approximately 41 million children under five years of age and can be caused by several factors. The aim of this study was to evaluate the effect of the early childhood responsive feeding approach on appetite self-regulation and prevention of childhood obesity. A systematic literature review was performed and data synthesis and extraction were conducted according to PRISMA guidelines. For the bibliographic research, four databases were used: PubMed, Scopus, Web of Science and EMBASE, with no language restriction, between the years 2012 and 2022. The selection of articles was carried out by pairs and in two stages: reading of abstracts (207) and reading the complete articles (60), with 14 articles selected. Inclusion criteria were: studies published in journals, between 2012 and 2022, without restriction by language, observational and interventional studies that evaluated the association between self-regulation of food intake, caregivers' responsiveness to children's feeding and weight status in children aged zero to five years. Articles with a population of children with comorbidity, studies of babies with conditions that affect feeding and growth, very premature babies, low birth weight (LBW) <2,500 kg were excluded. Most studies used feeding questionnaires to assess child and adult eating behaviors, parental eating practices, and appetite and satiety scales. Anthropometric measurements were assessed using standard procedures, self-reported or medical records. Studies have shown that parenting styles that have greater control and pressure for the child to eat interfere with the self-regulation of their appetite or control of satiety and consequent weight gain. It was concluded that parents' eating behaviors have an impact on food self regulation, satiety control and child weight.

Saciación vs saciedad: reguladores del consumo alimentario / Satiation and satiety in the regulation of energy intake

The study of the factors that regulate high energy food intake is especially relevant nowadays due to the high prevalence of overweight and obesity. Food intake regulation can be divided in two basic processes, namely satiation and satiety. Satiation is the process that determines the moment in which feeding stops and regulates the amount of ingested food during a single meal. Satiety is the interval between meals and regulates the time elapsed between two meals. The longer the interval, the lower energy intake. Each of these processes are regulated by different factors, which are here reviewed.

A new approach to feed frequency studies and protein intake regulation in juvenile pirarucu

ABSTRACT This study aimed to investigate pirarucu's (Arapaima gigas) ability to trigger a self-feeding system to regulate protein intake between two standard diets that contained 39% and 49% of crude protein. The same system allowed the evaluation of daily feeding and locomotor activity rhythms. Eighteen fish (654.44±26.85g) were distributed into six 250 L tanks (3 fish/tank). Fish had free access to both diets (39% vs. 49% protein) by feeders (2 per tank), adapted to be activated by fish themselves. This system was connected to a computer system. After an adaptation period, fish learned to activate feeders and the mean food intake recorded was 2.14% of their body weight on a daily basis. Fish showed feeding (72.48%) and locomotor (72.49%) activity predominantly during the daytime, and daily variations of choice between diets, but fixed a protein intake feeding target at 44.53%. These results should be considered when discussing feeding behavior, feeding schedules and diet intake regulations.

El papel del gen del transportador de serotonina en los trastornos de la conducta alimentaria / Role of Serotonin Transporter Gene in Eating Disorders

Introducción: Al sistema serotoninérgico se lo ha implicado en la regulación del estado de ánimo y en la conducta alimentaria, por lo que el gen del transportador de serotonina (SLC6A4) es un buen candidato para el desarrollo de los trastornos de la conducta alimentaria (TCA). La mayoría de los estudios genéticos en los TCA se han centrado principalmente en un polimorfismo, el denominado 5-HTTLPR del gen SLC6A4. Objetivo: Realizar una revisión de los estudios de asociación entre el 5-HTTLPR y los TCA, como anorexia nerviosa, bulimia nerviosa y trastornos alimentarios no especificados. Método: Se realizó una búsqueda en MEDLINE, ISI y PubMed de las palabras clave «transportador de serotonina¼ y «TCA¼. Conclusiones: Según la revisión de 37 artículos originales, la variante S del 5-HTTLPR es un factor de riesgo de anorexia nerviosa. Además, se encontró asociación entre el alelo S y el índice de masa corporal, impulsividad, ansiedad, depresión y el tiempo de evolución en TCA. Sin embargo, en bulimia nerviosa no se reporta asociación con las variantes del 5-HTTLPR.

Background: The serotoninergic system has been implicated in mood and appetite regulation, and the serotonin transporter gene (SLC6A4) is a commonly studied candidate gene for eating disorders. However, most studies have focused on a single polymorphism (5-HTTLPR) in SLC6A4. Objective: We present the studies published on the association between eating disorders (ED) and 5-HTTLPR polymorphism in anorexia nervosa (AN), bulimia nervosa (BN), and eating disorders not otherwise specified (EDNOS). Method: Search of databases: MEDLINE, ISI, and PubMed for SLC6A4 and ED. Conclusions: From a review of 37 original articles, it was suggested that carriers of S allele is a risk factor for eating disorders, especially for AN. However, BN did not show any association. Also, BMI, impulsivity, anxiety, depression, and age of onset have been associated with S allele in ED patients.

Change of peripheral blood appetite regulation factor of anorexia children and infect of child anorexia granule / 中国中药杂志

Study the infect of child anorexia granule on serum ghrelin and leptin of anorexia children and its clinical efficacy. Selected 81 cases of anorexia children aged 1-6 years old into treatment group (42 cases) and control group (39 cases), in addition, 30 case healthy children as healthy control group. The control group children were treated with domperidone suspension 0.3 mg x kg(-1) x d(-1), tid, orally 30 minutes before meals. Treatment group were treated with child anorexia granule, 1-3 years 1 package, bid; 4-6 years 1 package, tid; po, 4 weeks as a course of treatment. Study the change of serum ghrelin and leptin before and after therapy. The study demonstrates that before treatment, the serum ghrelin level of disease group was lower than healthy group (P < 0.01), and the serum leptin level was higher than healthy group (P < 0.01). After treatment, the serum ghrelin level both increase, and the serum leptin decline. And the change of treatment group was significantly different with control group (P < 0.01). And the clinical effective rate are 95.23% and 74.35% (P < 0.01). After 6 months of follow-up visit, the children weight significantly increase in treatment group (P < 0.01). Results indicate that child anorexia granule can facilitate secretion of ghrelin, and inhibit secretion of leptin, so as to work up an appetite. And the molecular mechanism is its infect on serum ghrelin, leptin.

Naringenin stimulates cholecystokinin secretion in STC-1 cells

BACKGROUND/OBJECTIVES: Cholecystokinin (CCK), a hormone or neuropeptide, is secreted in response to intraluminal nutrients by enteroendocrine I-cells of the intestine and has important physiological actions related to appetite regulation and satiety. The stimulation on CCK secretion from the intestine is of potential relevance for body weight management. Naringenin (4',5,7-trihydroxyflavanone) and its glycoside naringin (naringenin 7-rhamnoglucoside) have been reported to have many biological functions. In the current study, we investigated the question of whether naringenin and naringin could stimulate CCK secretion and then examined the mechanisms involved in CCK release. MATERIALS/METHODS: STC-1 cells were used as a model of enteroendocrine cells. CCK release and changes in intracellular Ca2+ ([Ca2+]i) were measured after incubation of cells with naringenin and naringin for 1 h. RESULTS: Naringenin caused significant (P < 0.05) stimulation of CCK secretion, but naringin did not. In addition, regarding the secretory mechanisms, naringenin-induced CCK secretion involved increases in [Ca2+]i, influx of extracellular Ca2+, at least in part, and activation of TRP channels, including TRPA1. CONCLUSION: Findings of this study suggest that naringenin could have a role in appetite regulation and satiety.

Leptina, péptido pleiotrópico: características y su relación con la enfermedad periodontal: revisión de la literatura / Leptin, pleiotropic peptide: general features and its relationship with periodontal disease: review of literature

La leptina es un péptido que inicialmente fue caracterizado como un factor regulador del apetito y se creía que era producido sólo por el tejido adiposo, sin embargo, actualmente se conoce que es sintetizado en diferentes tejidos y posee receptores a lo largo de toda la economía del organismo, mostrando así múltiples funciones, dentro de las que cabe destacar su participación en la regulación del metabolismo lipídico y de los carbohidratos, el crecimiento óseo y la respuesta inmunológica, siendo estos últimos, procesos involucrados en la génesis de la enfermedad periodontal. Por tal motivo, en la presente revisión, se esbozan las principales características tanto estructurales como funcionales de este péptido, y su participación en diferentes roles a nivel sistémico, haciendo énfasis en el moldeado óseo y la respuesta inmunológica, para luego adentrarse en diferentes hallazgos encontrados a nivel bucal, que pudiesen indicar su posible participación en la génesis y el desarrollo de la enfermedad periodontal

Leptin is a peptide that was initially characterized as an appetite regulatory factor and it was believed that it was only produced by adipose tissue, however, it ?s currently known that is synthesized in different tissues and posses receptors throughout the body economy, showing multiple functions, such as involvement in the regulation of lipid and carbohydrate metabolism, bone growth and immune response, being the latter processes, involved in the genesis of periodontal disease. Therefore, the present review outlines the main structural and functional characteristics of this peptide, and their participation in various capacities at the systemic level, with emphasis on bone shaping and the immune response, and then goes into different findings at the oral level that could indicate their possible role in the genesis and periodontal disease development

Role of Ghrelin in the Pathophysiology of Gastrointestinal Disease

Ghrelin is a 28-amino-acid peptide that plays multiple roles in humans and other mammals. The functions of ghrelin include food intake regulation, gastrointestinal (GI) motility, and acid secretion by the GI tract. Many GI disorders involving infection, inflammation, and malignancy are also correlated with altered ghrelin production and secretion. Although suppressed ghrelin responses have already been observed in various GI disorders, such as chronic gastritis, Helicobacter pylori infection, irritable bowel syndrome, functional dyspepsia, and cachexia, elevated ghrelin responses have also been reported in celiac disease and inflammatory bowel disease. Moreover, we recently reported that decreased fasting and postprandial ghrelin levels were observed in female patients with functional dyspepsia compared with healthy subjects. These alterations of ghrelin responses were significantly correlated with meal-related symptoms (bloating and early satiation) in female functional dyspepsia patients. We therefore support the notion that abnormal ghrelin responses may play important roles in various GI disorders. Furthermore, human clinical trials and animal studies involving the administration of ghrelin or its receptor agonists have shown promising improvements in gastroparesis, anorexia, and cancer. This review summarizes the impact of ghrelin, its family of peptides, and its receptors on GI diseases and proposes ghrelin modulation as a potential therapy.

The Effect of Sleep Loss on Energy and Metabolism / 수면정신생리

The release of hormones and the metabolism of human body are controlled by the circadian rhythm related to sleep-wake cycle. Growth hormone, prolactin, thyroid stimulating hormone, cortisol, glucose, and insulin-secretion rates fluctuate according to the sleep-wake cycle. In addition, sleep is related to the appetite regulation and carbohydrate and other energy metabolism. Hypocretin (orexin), an excitatory neuropeptide, regulates waking and diet intake, and the poor sleep increases diet intake. The short sleep duration increases one's body mass index and impairs the function of the endocrine and metabolism, causing increases in the risk of glucose intolerance and diabetes. The poor sleep quality and sleep disorders have similar impact on the metabolic function. In short, the sleep loss and the poor quality of sleep have a detrimental effect on the endocrine and energy metabolism. The improvement of sleep quality by the future research and appropriate clinical treatment would contribute to the decrease of the metabolic diseases such as diabetes.

Molecular Mechanisms of Appetite Regulation

The prevalence of obesity has been rapidly increasing worldwide over the last several decades and has become a major health problem in developed countries. The brain, especially the hypothalamus, plays a key role in the control of food intake by sensing metabolic signals from peripheral organs and modulating feeding behaviors. To accomplish these important roles, the hypothalamus communicates with other brain areas such as the brainstem and reward-related limbic pathways. The adipocyte-derived hormone leptin and pancreatic beta-cell-derived insulin inform adiposity to the hypothalamus. Gut hormones such as cholecystokinin, peptide YY, pancreatic polypeptide, glucagon-like peptide 1, and oxyntomodulin transfer satiety signals to the brain and ghrelin relays hunger signals. The endocannabinoid system and nutrients are also involved in the physiological regulation of food intake. In this article, we briefly review physiological mechanisms of appetite regulation.

Mecanismos neuro-hormonais envolvidos na regulação do apetite ao sódio: alguns aspectos / Neuro-hormonal mechanisms involved within sodium appetite: some aspects

O sódio é o principal íon do líquido extracelular e tem primordial importância para diversas funções fisiológicas. Manter a concentração plasmática do sódio dentro dos limites fisiológicos é vital para diversas espécies de animais, inclusive os humanos. Portanto, é fundamental que hajam mecanismos responsáveis pela monitorização e manutenção de níveis adequados de sódio no plasma. O apetite ao sódio, o comportamento que comanda a ingestão de sal, é estimulado por situações de deficiência sistêmica de sódio. Ao longo de décadas, diversos estudos foram desenvolvidos a fim de compreender os mecanismos neurais e hormonais envolvidos no controle desse comportamento. No entanto, muitas questões relacionadas a esse assunto ainda permanecem desconhecidas e a cada dia surgem novas evidências. Neste trabalho, foram revistos os fatos históricos, mecanismos neurais, hormonais e os achados mais recentes envolvendo apetite ao sódio.

Sodium is the most important ion of the extracellular fluid and plays an important role for many physiological functions. Maintain the sodium concentration in the plasma around of its physiological values is vital for many species of animals, including humans. Therefore, it is important that have responsible mechanisms for monitorization and maintenance of appropriated levels of plasmatic sodium. Sodium appetite, the behavioral drive to ingest salt, is stimulated by systemic sodium deficiency. Over the past decades, several studies have been performed in order to understand the neural and hormonal mechanisms involved in the control of this behavior. However, many questions related to this issue are still unknown and everyday new evidences arise. Here, we review historical facts, neural and hormonal mechanisms and recent findings involving sodium appetite.

Sinalização cerebral do apetite: [revisão] / Appetite brain sinalization: [review]

JUSTIFICATIVA E OBJETIVOS: Os mecanismos de controle do apetite têm sido estudados, focados principalmente nas funções hipotalâmicas, regulando o aspecto metabólico da alimentação. O objetivo deste estudo foi demonstrar alguns dos principais mecanismos reguladores centrais do apetite, incluindo suas conexões com centros corticais superiores. CONTEÚDO: Os sistemas de controle do apetite estão muito mais voltados para o armazenamento energético do que para a perda de peso. O desejo de comer, os estímulos olfatórios, visuais, de memória e de recompensa passam por centros superiores, em regiões de córtex órbitofrontal, núcleo accumbens, pálido ventral, dentre outras numerosas estruturas, modulando assim o apetite. CONCLUSÃO: A compreensão desses mecanismos não só hipotalâmicos, mas também corticais do apetite abrem novos alvos terapêuticos para o tratamento da obesidade.

BACKGROUND AND OBJECTIVES: The mechanisms that control the appetite have been studied mainly focusing on the hypothalamic functions, which regulates the metabolic aspects of feeding. We will describe others cerebral connections in foodintake regulation. CONTENTS: Systems appetite control is much more focused on the energy storage than for weight loss. The desire to eat, olfactorystimuli, visual, memory and reward go through highercenters in regions of orbitofrontal cortex, nucleus accumbens, ventral pallidum, among numerous other structures, thereby modulating the appetite. CONCLUSION: Understanding these mechanisms not only hypothalamic but also cortical, opens new therapeutic targets for the treatment of obesity.

Effect of Geranium Essential Oil on Food Intake via Olfactory Stimulus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Recently, obesity has become one of the major health problems in our society. To overcome this problem, keeping a balance between food intake and energy expenditure is very important. Many natural substances including essential oils have been suggested for their potential effect on reducing weight. This study was performed to evaluate whether aroma inhalation of essential oil has a role in appetite regulation and works on the central nervous system through the olfactory stimulus. MATERIALS AND METHOD: Food intake was measured after 30 minutes of treatment with essential oil in overnight fasted Sprague-Dawley rats. In the control group, saline was used instead of essential oil. Changes in pro-opiomelanocortin (POMC) and neuropeptide Y (NPY) mRNA expression levels in the hypothalamus were measured following 30 minutes of treatment with geranium essential oil using real-time polymerase chain reaction. RESULTS: Of the seven essential oils, geranium significantly decreased the amount of food intake compared to the control group. Geranium essential oil significantly increased POMC mRNA expression in the hypothalamus, but did not change the NPY mRNA expression. The increased POMC mRNA expression was reversed by treatment with xylocaine, which blocks the olfactory perception. CONCLUSION: These results suggest that geranium essential oil has anorexic effect through the activation of POMC neurons in the hypothalamus via olfactory stimulus.

Controle do apetite: mecanismos metabólicos e cognitivos: [revisão] / Appetite control: metabolic and cognitive mechanisms: [review]

Os mecanismos de controle do apetite têm sido estudados focando principalmente as funções hipotalâmicas, regulando o aspecto metabólico da alimentação. A principal preocupação do organismo é manter um equilíbrio energético e, dentro dessaproposta, genes foram selecionados que condicionavam um armazenamento energético, para fazer frente às situações de carência alimentar. Poucosestudos se dedicaram, nos últimos 10 anos, às integrações do hipotálamo com outros centros superiores. Quando os períodos de fome e de carência alimentar cessam em um estilo de vida moderna, este organismo se vê frente a sistemas poupadores, que passam a propiciar um grande armazenamentoenergético, sob a forma de depósitos de gordura, e explode uma verdadeira “pandemia” de obesidade. Os sistemas de controle do apetite estão muito maisvoltados para o armazenamento energético do que para a perda de peso. Todos sabemos das dificuldades de perder peso e como o “cérebro cognitivo” vence o “cérebro metabólico”. O desejo de comer, os estímulos olfatórios, visuais, de lembrança e de recompensa passam por centros superiores, em regiões de córtex órbito-frontal, núcleo acumbens, pálido ventral, dentre numerosas outrasestruturas. Um pouco desta integração será discutida nesta revisão.

The mechanisms that control the appetite have been studied mainly focusing on the hypothalamic functions,which regulates the metabolic aspects of feeding. The main goal of the organism is to keep the energeticbalance and, on this purpose, genes have been selected to allow storage of fuel to face food deprivation. In thelast 10 years, few studies have focused the integration between the hypothalamus and cortical centers. Ina modern era where food deprivation does not occur unless for economic reasons, the organism with its thrifty genes and phenotypes, accumulate energy in the form of fat and an explosion of obesity ensues. We allknow the difficulties to lose weight and how the “cognitive brain” surpasses the “metabolic brain”. The desire to eat, the olfactory, visual, and reward stimulus travel through superior regions of the central nervous system, such as accumbens, ventral pallidus nuclei, among others. A little bit of this integration will be discussed in this review.

Regulación del peso corporal y del apetito / Body weight and appetite regulation

Debido a que la epidemia mundial de obesidad no muestra signos de disminución, se ha hecho necesaria una mejor comprensión de los mecanismos fisiológicos subyacentes a la homeostasis energética, el proceso mediante el cual el consumo energético se iguala al gasto energético a lo largo del tiempo, de manera que los almacenes energéticos corporales, en la forma de tejido adiposo, se mantienen constantes a pesar de las variaciones diarias en la ingesta calórica. El sistema que controla el balance energético posee, a su vez, dos componentes: uno en el corto y otro en el largo plazo. El sistema, en el corto plazo, se encarga de regular el apetito o inicio y finalización de comidas individuales, y responde, fundamentalmente, a hormonas gastrointestinales o señales de saciedad que se acumulan durante la alimentación y contribuyen a terminar la ingesta. Los factores de adiposidad, como la leptina e insulina, son señales que se liberan en proporción a los depósitos energéticos del organismo, y su función involucra la regulación del balance energético por periodos prolongados, por lo que se encargan de la estabilidad del peso corporal. La vía central de las melanocortinas representa un punto crucial de integración de estas señales. Los ligandos de los receptores de melanocortina son sintetizados en poblaciones neuronales discretas dentro del núcleo arcuado del hipotálamo, y ejercen acciones en los dos componentes del balance energético. Sumado a su capacidad de respuesta frente a los niveles de hormonas circulantes, el cerebro también responde directamente a los niveles circulantes de nutrientes. Se han identificado dos proteincinasas que sensan los niveles de nutrientes y funcionan como reguladoras del peso corporal y consumo energético en el hipotálamo: mTOR y AMPK. Además de estos circuitos homeostáticos, los mecanismos hedónicos de alimentación son importantes en la regulación del consumo energético, superando la capacidad reguladora del sistema de balance...

Due to the fact that the obesity epidemic shows no signs of diminishing, a better understanding of the physiological mechanisms underlying energy homeostasis has become necessary. During this process energy intake is matched to energy expenditure over time, in such a way that body fuel stored in the form of adipose tissue is held constant despite daily fluctuations in caloric intake. The system that controls energy balance possesses 2 components: a short and a long-term.The short-term system is in charge of appetite regulation or the initiation and termination of individual meals. It responds basically to gut hormones or satiety signals that accumulate duringeating and ultimately contribute to meal termination. Adiposity factors are circulating signals generated in proportion to the body energy storages, such as insulin and leptin, levels of which are involved in the regulation of energy balance over long intervals thereby promoting body weight stability. The central melanocortin pathway represents a crucial integration point for these signals. Melanocortin receptor ligands are synthesized by discrete neuronal populations within the arcuate nucleus of the hypothalamus and exert actions in both components of the energybalance equation. In addition to hormones, the brain also responds directly to the nutrient circulating levels. Two fuel-sensing protein kinases functioning as main regulators of bodyweight and food intake in the hypothalamus have been identified: mTOR and AMPK. Besides these basic homeostatic circuits, the hedonic mechanisms of feeding are important in the regulation of energy intake since they can override the energy balance system regulatory capability. The aim of this article is to review recent advances in the comprehension of the mechanisms underlying body weight and appetite regulation. Those mechanisms not only allow a new understanding about obesity pathophysiology but also provide new perspectives for its treatment.

A restrição de água e de alimento e alguns de seus múltiplos efeitos / The water and food restriction and its multiples effects / La restricción de agua y alimentos y sus múltiples efectos

O estudo dos diversos impactos de operações estabelecedoras incondicionadas vem ganhando importância na análise do comportamento. Para investigar os efeitos das restrições hídrica e alimentar sobre o peso e o padrão de consumo, 24 ratos Wistar (12 fêmeas e 12 machos) foram divididos em dois grupos: 16 no grupo restrição (gradual ou abrupta), submetidos a episódios de restrição alimentar ou hídrica intercalados com episódios de liberação de alimento ou água, e 8 no grupo controle, que permaneceram em condição ad lib. Todos tiveram seus pesos e consumos medidos diariamente. Os resultados produzidos indicam que: restrições diferentes (hídrica ou alimentar) agem diferentemente sobre o peso e o consumo; há diferenças na relação entre a perda de peso e a intensidade da restrição, entre os sujeitos submetidos à restrição gradual e os submetidos à restrição abrupta; e a exposição aos episódios de restrição altera os padrões de consumo em condição ad lib.

The study of the various impacts of unconditioned establishing operations has become important in behavior analysis. To investigated the effects of food and water restrictions on the weight and the pattern of consumption of 24 Wistar rats (12 female and 12 male) divided into two groups: 16 in restriction group,( gradual or abrupt), which were submitted to episodes of food or water restriction combined with episodes of free food or water and 8 in the control group which remained in ab lib condition. All subjects had their weights and consumption measured daily. The results indicate that: different restrictions (food or water) operate differently on the weight and consumption; there are differences in the ratio of the weight loss and the intensity of restriction between the subject submitted to gradual restriction and subjected to abrupt restriction, and exposure to episodes of restriction modify consumption patterns in ab lib condition.

El estudio de los diversos efectos de las operaciones establecedoras incondicionadas ha cobrado importancia en el análisis de comportamiento. Para investigar los efectos de las restricciones de agua y alimento, 24 ratos Wistar (12 hembras y 12 machos) fueran divididos en dos grupos: 16 en el grupo de restricción (gradual o abrupta), sometidos a episodios de restricción alimentar o hídrica intercalados con episodios de liberación de alimento o agua, y 8 en el grupo control que permanecerán en condición ab lib. Todos tuvieran SUS pesos y consumos medidos diariamente. Los resultados producidos indican que: restricciones distintas (hídrica o alimentar) actúan diferentemente sobre el peso y el consumo; hay diferencias en la relación entre la pérdida de peso y la intensidad de restricción entre los sujetos sometidos a restricción gradual y los sometidos a restricción abrupta, y la exposición a los episodios de restricción altera los patrones de consumo en condición ab lib.

Hypothalamic regulation of food intake and clinical therapeutic applications: [review] / Regulação hipotalâmica da ingestão alimentar e suas aplicações terapêuticas clínicas: [revisão]

Current estimates suggest that over 1 billion people are overweight and over 300 million people are obese. Weight gain is due to an imbalance between energy expenditure and dietary intake. This review discusses the hypothalamic control of appetite and highlights key developments in research that have furthered our understanding of the complex pathways involved. Nuclei within the hypothalamus integrate peripheral signals such as adiposity and caloric intake to regulate important pathways within the central nervous system controlling food intake and energy expenditure. Firmly established pathways involve the orexigenic NPY/AgRP and the anorexigenic POMC/CART neurons in the arcuate nucleus (ARC) of the hypothalamus. These project from the ARC to other important hypothalamic nuclei, including the paraventricular, dorsomedial, ventromedial and lateral hypothalamic nuclei. In addition there are many projections to and from the brainstem, cortical areas and reward pathways, which modulate food intake.

As estimativas atuais sugerem que mais de 1 bilhão de pessoas apresentam sobrepeso e 300 milhões são obesas. O ganho de peso representa um desequilíbrio entre o gasto energético e o consumo alimentar. Esta revisão discute o controle hipotalâmico do apetite e destaca os pontos-chave no desenvolvimento de pesquisas para ampliar o nosso entendimento dos complexos mecanismos envolvidos nesta regulação. Núcleos situados no hipotálamo integram uma série de sinais com o sistema nervoso central controlando a ingestão alimentar e o gasto energético. As vias mais estabelecidas envolvem os neurônios orexigênicos NPY/AgRP e os neurônios anorexigênicos POMC/CART no núcleo arqueado (ARC) do hipotálamo. Esses neurônios se projetam do ARC para outros importantes núcleos hipotalâmicos, tais quais: paraventricular, dorsomedial, ventromedial e lateral. Além disso, existem várias projeções que vão e vem do tronco cerebral, das áreas corticais e das vias de retroalimentação que modulam o consumo alimentar.

Genetic variants influencing effectiveness of weight loss strategies: [review] / Variantes genéticos influenciando a efetividade das estratégias de perda de peso: [revisão]

Body weight excess has an increasingly high prevalence in the world. Obesity is a complex disease of multifactorial origin with a polygenic condition affected by environmental factors. Weight loss is a primary strategy to treat obesity and its morbidities. Weight changes through life depend on the interaction of environmental, behavioral and genetic factors. Interindividual variation of weight loss in response to different types of interventions (behavioral, caloric restriction, exercise, drug or surgery) has been observed. In this article, currently available data on the role of candidate gene polymorphisms in weight loss are reviewed. Even though control of weight loss by genotype was described in twin and family studies, it is premature to recommend use of genotyping in the design of therapeutic diets or drug treatment. Future studies will have to be large in order to assess the effects of multiple polymorphisms, and will have to control factors other than diet.

A prevalência do excesso de peso cresce no mundo todo. De origem multifatorial, a obesidade é uma doença complexa, com condição poligênica afetada por fatores ambientais. A perda de peso é a estratégia primária utilizada para prevenir e tratar a obesidade bem como suas comorbidades. Mudanças de peso durante a vida dependem da interação entre fatores ambientais, comportamentais e genéticos. Observa-se grande variação da perda de peso entre indivíduos em resposta a diferentes modelos de intervenções (comportamentais, restrições da ingesta cálorica, exercícios físicos, drogas antiobesidade ou cirurgias). Este artigo é uma revisão atual da literatura disponível, que busca abordar o papel dos polimorfismos dos genes candidatos à obesidade e sua influência na perda de peso. Apesar da interação do genótipo na perda de peso corporal, descrita nos estudos de gêmeos e familiares, é prematuro recomendar o uso da genotipagem para estratégias de perda de peso. É necessário ampliar as pesquisas sobre os efeitos sinérgicos dos polimorfismos genéticos com coorte maior e associá-los não somente à restrição alimentar mas também às outras intervenções que auxiliam na perda de peso.

Rol del estómago en la regulación del apetito: la ghrelina en condiciones fisiológicas y en patología digestiva / Role of the stomach in the regulation of the appetite: ghrelin in physiologic conditions and digestive disorders

El cerebro regula la homeostasis energética en respuesta a señales del tracto gastrointestinal y adiposo. La vía de ingesta y el gasto energético se ajustan constantemente, manteniéndose así el peso de manera estable. La ghrelina es una hormona peptídica que estimula el apetito actuando a nivel del núcleo arquato, región conocida por controlar la ingesta de alimento. Se secreta desde el estómago y circula en el plasma bajo condiciones de ayuno. Su regulación depende de varios mecanismos como son, hormonas, control autonómico, nutrientes sanguíneos y el ejercicio. Además la ghrelina juega un rol importante para mantener la secreción de la hormona de crecimiento. Se analizan cambios observados en varias patologías gastroduodenales.

The brain regulates energy homeostasis in response to signals from both adipose and the gastrointestinal tract. The drive to eat and energy expenditure are adjusted so that over time, body weight remains stable. Ghrelin is a peptide hormone that stimulates appetite by acting on the arquate nucleus, a region known to control food intake. It is secreted from the stomach and circulates in the bloodstream under fasting conditions. Its regulation depends on a variety of mechanisms such as, hormones, autonomic control, bloodstream nutrients and exercise. Ghrelin also play an important role in growth hormone release. Ghrelin changes observed in several gastro duodenal disorders are analyzed.