Viés da Escalada, Daemons de Otimização, e a Influência da Narrativa Social Aceleracionista / Hill-Climbing Bias, Optimization Daemons, and the Influence of Accelerated Social Narratives

O fenômeno de aceleração social, intimamente ligado a nossa modernização tecnológica e os sistemas políticos e sociais que adotamos, vem sendo alvo de questionamentos por parte da teoria crítica por diversos filósofos e sociólogos, principalmente em relação a se tal "aceleração" seja algo que, possa ser justificável pelo bem comum da sociedade. De fato, as rápidas mudanças que ocorreram no último século causaram uma tremenda mudança em nossos estilos-de-vida, e na maneira como experienciamos o mundo. Que a nossa sociedade mudou e continua a mudar é um fato evidente quando olhamos criticamente para o passado e presente, e comparamos diferentes épocas da história humana. Neste ensaio tentaremos explorar algumas possíveis hipóteses que fundamentem o comportamento aceleracionista em certos fatores e mecanismo biológicos que caracterizam os sistemas de motivação e saciação humanos. Também tentaremos mostrar como certos fenômenos sociais podem auxiliar em fortalecer este tipo de comportamento, e suas possíveis origens evolutivas. Este estudo tem como objetivo principal fundamentar a Tese Aceleracionista em evidências neurofisiológicas, cognitivo-comportamentais, evolutivas e sociais.

The phenomenon of social acceleration is closely linked to our technological modernization and the political and social systems we have adopted, and it has been questioned by several philosophers and sociologists, especially in relation to whether such acceleration is something that can be justified for the common good of society. In fact, the rapid changes that have occurred in the last century have caused a tremendous change in our lifestyles, and in the way we experience the world. That society have changed and continues to change is an evident fact when we look critically to the past and our present and compare different times in human history. In this essay we will try to explore some possible hypotheses that underpin accelerated behavior, in certain biological factors and mechanisms that characterize human motivation and satiation systems. We will also try to show how certain social phenomena can help to strengthen this type of behavior, and its possible evolutionary origins. The main objective of this study is to base the Accelerationist Thesis on neurophysiological, cognitive-behavioral, evolutionary and also social evidence.

Efecto sobre la saciedad y glucemia postprandial de un yogur hiperproteico vs otro normoproteico en mujeres adultas / Effect on post-prandial saciety and glucemia of a hyperproteic vs another normoproteic yogurt in adult women

Introducción: las proteínas presentes en los alimentos juegan un rol saciógeno y pueden actuar sobre la respuesta insulínica y la glucemia plasmática postprandial. Objetivos: evaluar saciedad y glucemia postprandial luego del consumo de yogur hiperproteico vs normoproteico en mujeres adultas aparentemente sanas, residentes de la Ciudad Autóno-ma Buenos Aires y el Gran Buenos Aires. Materiales y métodos: ensayo clínico cruzado simple ciego, sobre una muestra de 79 mujeres adultas (25-65 años), no diabéticas ni intolerantes a la glucosa. Se comparó saciedad, impacto glucémico y agradabilidad de dos yogures ofrecidos como merienda, con diferente aporte proteico, controlados en grasas y carbohidratos, con relación proteínas/carbohidratos: 0,56 en yogur hiperproteico y 0,33 en normoproteico. Se va-loró estado nutricional mediante índice de masa corporal (bajo peso <18,5 kg/m2, normopeso: 18,5 a 24,9 kg/m2, sobrepeso u obesidad: ≥25 kg/m2) y riesgo cardiometabólico mediante índice cintura/talla (≥0,50). Estadística mediante software SPSS 22.0, aplicando prueba de Wilcoxon y chi cuadrado o prueba exacta de Fisher, con nivel de significación estadística <0,05. Resultados: edad promedio: 34,4±11 años. El 65,8% con ade-cuado estado nutricional según IMC y 26,6% con riesgo cardio-metabólico aumentado, ambas variables asociadas en forma di-recta con la edad (p=0,0000 y p=0,001 respectivamente).El yogur hiperproteico fue más aceptado (p=0,03) con mejor res-puesta sobre saciedad post ingesta que el yogur normoproteico, a la hora y a las dos horas de ingerido (p=0,001 y p=0,000 res-pectivamente). A su vez, impactó significativamente más sobre la respuesta glucémica postprandial sólo a los 30 minutos de consu-mido (p=0,02), pero no a los 60 minutos (p=0,59). Conclusiones: el yogur hiperproteico alcanzó mayor agra-dabilidad y otorgó, a igual porción estándar, mayor saciedad postprandial que un yogur similar normoproteico, sin afectar la glucemia postprandial.

Acute Strength Exercise Decreases Satiety by Modifying Blood Cytokines Levels in Physically Active Men

Abstract Aim: Exercise elicits adaptations in several physiological systems, such as the gastrointestinal tract. We evaluated the effects of an acute strength exercise (acute-SE) on gastric satiety and its correlation with creatinine kinase (CK), lactate, and plasma cytokine levels in humans. Methods: Anthropometric parameters, body composition, muscular strength, and satiety (drink test protocol) at rest and exercise were assessed. Results: In the squat, bench press, and T-bar row exercises, we observed a significant decrease (p<0.05) in muscular strength in the second, third, and fourth sets compared with that in the first set. Compared with rest, we observed a significant increase (p<0.05) in CK and lactate levels after acute-SE. In the drink test, acute-SE significantly increased (p <0.05) the total intake, calories ingested, and a total time of ingestion. Concerning cytokines, there was a significant increase (p<0.05) after acute-SE of IL-1β and IL-6 levels at the beginning of the test and a decrease in IL-6, -10, -13, and TNF-α levels after acute-SE at the end of the test (p<0.05). There was a correlation between CK, lactate, and total intake after acute-SE (p<0.05) as well as between IL-6, 13, TNF-α, and volume ingested in the last score of the drink test after acute-SE (p<0.05). Conclusion: Acute-SE decreases satiety associated with changes in lactate, CK, and plasma cytokine levels in healthy humans.

Eosinofilia duodenal en pacientes Colombianos con dispepsia funcional: un estudio de casos y controles / Duodenal eosinophilia in functional dyspepsia in a Colombian sample: a case-control study

Introducción: La dispepsia funcional (DPF) es una entidad compleja cuya fisiopatología no está claramente definida. Existen alteraciones motoras gastroduodenales y recientemente se ha dado importancia a la eosinofilia duodenal. Objetivo: El objetivo de este estudio fuedeterminar si existe asociación entre eosinofilia duodenal y DPF. Materiales y métodos: Estudio de casos y controles. Pacientes mayores de 18 años con dispepsia según ROMA IV, a quienes se descartó DP orgánica con endoscopia alta (EVDA). Los controles fueron pacientes con anemia ferropénica y diarrea crónica a quienes de rutina se toman biopsias tanto del estómago como del duodeno. Se calcularon 70 pacientes en cada grupo. La información se recolectó en un formulario específico. Resultados: Hubo 243 pacientes elegibles. Se incluyeron 84 pacientes en grupo. El 80% eran mujeres. Edad promedio 53,6 años. Se encontró eosinofilia duodenal con diferencia significativa en los pacientes con saciedad precoz (p=0,01). No hubo diferencia significativa en los pacientes con llenura posprandial (p=0,63), dolor o ardor epigástrico (p=0,26), síntomas de reflujo gastroesofágico (p=0,13), alergia e intolerancia a alimentos (p=0,42) y tabaquismo (p=0,28). Asimismo, no se encontró relación entre mastocitosis duodenal y saciedad precoz (p=0,98), llenura posprandial (p=0,78) y dolor o ardor epigástrico (p=0,82). Conclusiones: La eosinofilia duodenal fue más frecuente en pacientes con DPF que tenían saciedad precoz.

Introduction: Functional dyspepsia (FD) is a complex symptom. Currently there are multiple therapeutic options that are used for the management of these patients; however, FD therapies are based on symptomatic control and do not address the pathophysiological pathways involved in its development. The duodenum has been proposed as a key site to understand the complex pathophysiology involved in FD. Objective: The aim of the study is to determine duodenal eosinophilia in patients with FD and establish the clinical-pathological correlation with the cardinal symptoms of dyspepsia. Material and methods: Case-control study. Patients older than 18 years with dyspepsia according to the Rome IV criteria, and upper gastrointestinal endoscopy normal (FD group).Patients with iron deficiency anemia and chronic diarrhea (control group). Biopsies were taken in the stomach, duodenal bulb and second portion of duodenum. A sample size of 140 patients (70 patients in the FD group and 70 patients in the control group) was calculated. The collected information was described and analyzed by conventional statistical techniques. Results: 243 patients were recruited. 84 patients were included in the FD group and 84 patients in the control group. 135 patients were women (80.3%). The mean age was 53.6 years (SD 14.9). Duodenal eosinophilia was found with significant difference in patients with early satiety (p=0.01). There was no difference in patients with postprandial fullness (p=0.63), epigastric pain or burning (p=0.26), gastroesophageal reflux symptoms (p=0.13), allergy and food intolerance (p=0.42) and smoking (p=0.28). There was no relationship between duodenal mastocytosis and early satiety (p=0.98), postprandial fullness (p=0.78), and epigastric pain or burning (p=0.82). Conclusions: Duodenal eosinophilia was similar in FD and controls. In subgroup analysis, duodenal eosinophilia occurs in patients with early satiety.

Efectos de la ingesta de los edulcorantes estevia y D-tagatosa sobre el metabolismo de la glucosa, ácido úrico y apetito-saciedad / Effects of stevia and D-tagatose sweeteners intake om glucose, uric acid metabolism and appetite-satiety

INTRODUCCIÓN: Si bien, los edulcorantes no nutritivos (ENN) estevia y D-tagatosa han sido reportados como seguros, han demostrado tener algunos efectos metabólicos tras su ingesta. OBJETIVO: Describir los efectos de la ingesta de estevia y D-tagatosa sobre el metabolismo de la glucosa y ácido úrico, y del apetito-saciedad, a partir de la evidencia disponible. MÉTODOS: Revisión descriptiva. Se realizó búsqueda en PubMed utilizando los siguientes términos y palabras clave: "stevia rebaudiana", "tagatose", "D-tagatose", "blood glucose", "insulin", "metabolic processes", "uric acid", "hyperuricemia", "appetite" o "satiety". El análisis de los estudios seleccionados fue discrecional. RESULTADOS: Existen estudios que demuestran efectos beneficiosos tras el consumo de estevia o D-tagatosa sobre el control glicémico, apetito y saciedad tanto en sujetos sanos como con alteraciones en el metabolismo de la glucosa. Por otra parte, un número importante de estudios que evalúan la ingesta de estevia reportan efectos nulos sobre dichos parámetros. En relación al ácido úrico, solo un estudio en sujetos con enfermedad renal crónica reporta aumento en la concentración de ácido úrico plasmático tras la ingesta de 500 mg/día de estevia. Pocos estudios han evaluado el efecto de la ingesta de D-tagatosa sobre uricemia, en sujetos sanos y diabéticos, reportando un aumento transitorio y significativo en los niveles de ácido úrico sérico, sin embargo, no se ha logrado demostrar un efecto hiperuricémico asociado. Es importante destacar que la metodología de los estudios revisados es heterogénea, especialmente en relación al tamaño muestral, tiempo, dosis y vía de adminitración del edulcorante. CONCLUSIÓN: La ingesta de estevia y D-tagatosa ha demostrado efectos beneficiosos sobre el metabolismo de la glucosa, el apetito y la saciedad. El efecto del consumo de D-tagatosa sobre ácido úrico sérico requiere mayor evidencia para demostrar su significancia clínica.

INTRODUCTION: No-nutritive sweeteners stevia and D-tagatose have been reported as safe according to their acceptable daily intake, however, they have been shown to have metabolic effects after their ingestion. OBJECTIVE: To describe the effects of stevia and D-tagatose intake on parameters associated to glucose, uric acid metabolism and on appetite-satiety, considering the available evidence. METHODS: Descriptive review. PubMed search was carried out to identify the totality of the published articles. The following terms and key words were used: "stevia rebaudiana", "tagatose", "D-tagatose", "blood glucose", "insulin", "metabolic processes", "uric acid", "hyperuricemia", "appetite" o "satiety". The analysis of the selected studies was discretionary. RESULTS: studies have shown beneficial effects of stevia and D-tagatose consumption on glycemic control, appetite and satiety in healthy subjects as well as subjects with impairment glucose metabolism. On the other hand, a significant number of studies evaluating estevia intake report null effects on these parameters. In relation to uric acid, only one study in subjects with chronic kidney disease reported an increase in plasmatic uric acid concentration after the intake of 500 mg/day of stevia. Several studies have evaluated the effect of D-tagatose intake on plasmatic uric acid, in healthy and diabetic subjects, reporting a transient and significant increase in serum uric acid levels, however, has not been able to demonstrate an associated hyperuricemic effect. It is important to highlight that the methodology of the studies reviewed is heterogeneous, especially in relation to sample size, dose administered, time and route of exposure to the sweetener. CONCLUSION: Stevia and D-tagatose intake has shown beneficial effects on glucose metabolism, appetite and satiety. The effects of the consumption of both sweeteners on uric acid require further study to demonstrate their clinic significance.

Effects of a high-fat diet on behavioral eating patterns / Efeitos de uma dieta com alto conteúdo de gordura sobre padrões comportamentais alimentares / Efectos de una dieta con alto contenido de grasas sobre patrones conductuales alimentarios

Abstract Excessive consumption of high-fat food has been associated with increased prevalence of obesity. The physiological and metabolic effects of high-fat diets have been extensively studied. Nevertheless, the behavioral mechanisms associated with the development of obesity induced by consumption of these diets has been less explored. Therefore, the aim of the present study was to characterize the changes in the behavioral feeding patterns produced by the consumption of a high-fat diet during 10 days. Male Wistar rats with free access to food were assigned to one of two groups, and for 10 days, they had access to a high-fat diet (45 % calories from fat) or to a standard diet. Detailed analysis of feeding behavior was performed on days 1, 5 and 10 at the beginning of the dark period. The results showed that subjects exposed to the high-fat diet accumulated more body fat and showed increased feeding efficiency, in absence of excessive body weight increase or alterations in the behavioral satiety sequence pattern. These findings suggest that exposure to high-fat diets may produce behavioral changes before excessive gain of body weight occurs, primarily affecting control mechanisms of feeding efficiency.

Resumo O consumo excessivo de alimentos com alto conteúdo de gordura tem sido associado com o aumento da obesidade. Os efeitos fisiológicos e metabólicos do consumo de dietas altas em gordura têm sido estudados extensamente, contudo os mecanismos comportamentais relacionados com o desenvolvimento da obesidade pelo consumo dessas dietas têm-se explorado em menor medida. Portanto, o objetivo deste estudo foi caracterizar as mudanças nos padrões comportamentais da alimentação produzidas pelo consumo de uma dieta alta em gordura durante dez dias. Utilizaram-se ratos de laboratório macho Wistar, com acesso livre ao alimento, designados a um de dois grupos, e durante dez dias estiveram sob uma dieta alta em gordura (45 % de calorias provenientes de gorduras) ou uma dieta padrão de laboratório. Nos dias 1, 5 e 10, realizou-se uma análise detalhada do comportamento alimentar ao início do período de escuridão. Os resultados mostraram que os sujeitos expostos à dieta alta em gordura acumularam mais gordura corporal e tiveram maior eficiência da alimentação do que o outro grupo, sem aumento do peso corporal nem alterações do padrão da sequência de saciedade comportamental. Isso sugere que a exposição a dietas com alto conteúdo de gordura pode produzir mudanças comportamentais antes de apresentar um ganho de peso excessivo, o que afeta principalmente os mecanismos de controle de eficiência alimentar.

Resumen El consumo excesivo de alimentos con alto contenido de grasas se ha asociado con el incremento de la obesidad. Los efectos fisiológicos y metabólicos del consumo de dietas altas en grasa han sido estudiados extensamente; sin embargo, los mecanismos conductuales asociados al desarrollo de la obesidad por el consumo de estas dietas se han explorado en menor medida. Por tanto, el objetivo del presente estudio fue caracterizar los cambios en los patrones conductuales de la alimentación producidos por el consumo de una dieta alta en grasas durante diez días. Se utilizaron ratas macho Wistar con acceso libre al alimento, asignadas a uno de dos grupos, y durante diez días estuvieron bajo una dieta alta en grasa (45 % de calorías provenientes de grasas) o una dieta estándar de laboratorio. En los días 1, 5 y 10 se realizó un análisis detallado de la conducta alimentaria al inicio del periodo de oscuridad. Los resultados mostraron que los sujetos expuestos a la dieta alta en grasa acumularon más grasa corporal y tuvieron mayor eficiencia de la alimentación que el otro grupo, sin incremento del peso corporal ni alteraciones del patrón típico de la secuencia de saciedad conductual. Esto sugiere que la exposición a dietas con alto contenido de grasas puede producir cambios conductuales antes de que se presente una ganancia de peso excesivo, lo que afecta principalmente los mecanismos de control de eficiencia alimentaria.

Effects of Maternal and Post-Weaning High-Fat Diet on Leptin Resistance and Hypothalamic Appetite Genes in Sprague Dawley Rat Offspring

The defective satiation signaling may contribute to the etiology of obesity. We investigated how dietary modification during maternal (pregnancy and lactation) and post-weaning affects obesity, insulin resistance (IR) and hypothalamic appetite responses in offspring in adulthood. Pregnant female SD rats were randomly allocated to either maternal high-fat diet (43% energy from fat) or control diet (12% energy from fat) until the end of suckling. After weaning for additional 4 weeks, half of the offsprings were continuously fed the same diet as the dam (C-C and H-H groups); the remainder received the counterpart diet (C-H and H-C groups). The long-term high-fat diet during maternal and post-weaning period (H-H group) led to susceptibility to obesity and IR through the significant increases of hypothalamic orexigenic genes compared to the maternal and post-weaning control diet group (C-C group). In contrast, the hypothalamic expression levels of anorexigenic genes, apolipoprotein E, leptin receptor, and activated signal transducer and activator of transcription protein 3 were significantly lower in H-H group with elevations in circulating insulin and leptin and body fat mass. However, dietary changes after weaning (H-C and C-H groups) partially modified these conditions. These results suggest that maternal and post-weaning diet conditions can potentially disrupt hypothalamic neuronal signal irrelevantly, which is essential for leptin's regulation of energy homeostasis and induce the risk of offspring to future metabolic disorders.

Effect of Pre-meal Water Consumption on Energy Intake and Satiety in Non-obese Young Adults

I determined whether water consumption reduces energy intake and affects satiety in non-obese young adults. The final subjects consisted of 15 individuals (8 women and 7 men) with average ages of 26.4 and 23.5 years for women and men, respectively. When subjects drank water before eating a test meal, they ate a lower amount of the test meal compared to eating test meals under waterless and postload water conditions (preload water: 123.3 g vs. waterless: 161.7 g or postload water: 163.3 g, p < 0.05). Water consumption after eating a test meal did not affect energy intake. When the subjects drank water before eating a test meal, despite consuming a lower amount, the subjects did not feel significantly less satiety than eating meals under waterless or postload water conditions. The finding that pre-meal water consumption led to a significant reduction in meal energy intake in young adults suggests that pre-meal water consumption may be an effective weight control strategy, although the mechanism of action is unknown.

Guideline Recommendation for Endpoints Used in Clinical Trials for Functional Dyspepsia / 대한소화기학회지

Functional dyspepsia is a disease, in which there is no organic lesion but chronic and repetitive postprandial fullness, early satiation, epigastric pain, and epigastric burning. Functional dyspepsia is not life-threatening but its symptoms are relapsing and remitting and persist over a lifetime, limiting the social life and reducing the quality of life. Therefore, the treatment for acute relapsing period may help improve the short-term symptoms. Continuous medication may be needed to improve the long-term symptoms. Research designs to demonstrate the short-term efficacy of therapeutic agents may differ from clinical trials to demonstrate long-term efficacy. There are many difficulties in clinical trial design, implementation, and screening because there are no international standards of clinical trials for functional dyspepsia. The purpose of this guideline recommendation is to develop a standard for clinical trials, such as clinical trial subjects and evaluation methods, in the development of therapeutic agents for functional dyspepsia. The ultimate aim is to enhance the safety and efficacy of therapeutic agents for functional dyspepsia and promote the development of new therapeutic agents.

Obesity and Brain Positron Emission Tomography / 대한핵의학회잡지

Obesity, an increasingly common problem in modern societies, results from energy intake chronically exceeding energy expenditure. This imbalance of energy can be triggered by the internal state of the caloric equation (homeostasis) and non-homeostatic factors, such as social, cultural, psychological, environmental factors or food itself. Nowadays, positron emission tomography (PET) radiopharmaceuticals have been examined to understand the cerebral control of food intake in humans. Using ¹⁵O–H₂ PET, changes in regional cerebral blood flow (rCBF) coupled to neuronal activity were reported in states of fasting, satiation after feeding, and sensory stimulation. In addition, rCBF in obese subjects showed a greater increase in insula, the primary gustatory cortex. ¹⁸F–fluorodeoxyglucose PET showed higher metabolic activity in postcentral gyrus of the parietal cortex and lower in prefrontal cortex and anterior cingulate cortex in obese subjects. In addition, dopamine receptor (DR) PET demonstrated lower DR availability in obese subjects, which might lead to overeating to compensate. Brain PET has been utilized to reveal the connectivity between obesity and brain. This could improve understanding of obesity and help develop a new treatment for obesity.

Are people who have a better smell sense, more affected from satiation? / As pessoas que têm melhor olfato são mais afetadas pela saciedade?

Abstract Introduction: The olfactory system is affected by the nutritional balance and chemical state of the body, serving as an internal sensor. All bodily functions are affected by energy loss, including olfaction; hunger can alter odour perception. Objective: In this study, we investigated the effect of fasting on olfactory perception in humans, and also assessed perceptual changes during satiation. Methods: The "Sniffin' Sticks" olfactory test was applied after 16 h of fasting, and again at least 1 h after Ramadan supper during periods of satiation. All participants were informed about the study procedure and provided informed consent. The study protocol was approved by the local Ethics Committee of Gaziosmanpaşa Taksim Education and Research Hospital (09/07/2014 no: 60). The study was conducted in accordance with the basic principles of the Declaration of Helsinki. Results: This prospective study included 48 subjects (20 males, 28 females) with a mean age of 33.6 ± 9.7 (range 20-72) years; their mean height was 169.1 ± 7.6 (range 150.0-185.0) cm, mean weight was 71.2 ± 17.6 (range 50.0-85.0) kg, and average BMI was 24.8 ± 5.3 (range 19.5-55.9). Scores were higher on all items pertaining to olfactory identification, thresholds and discrimination during fasting vs. satiation (p < 0.05). Identification (I) results: Identification scores were significantly higher during the fasting (median = 14.0) vs. satiation period (median = 13.0). Threshold (T) results: Threshold scores were significantly higher during the fasting (median = 7.3) vs. satiation period (median = 6.2). Discrimination (D) results: Discrimination scores were significantly higher during the fasting (median = 14.0) vs. satiation period (median = 13.0). The total TDI scores were 35.2 (fasting) vs. 32.6 (satiation). When we compared fasting threshold value of >9 and ≤9, the gap between the fasting and satiety thresholds was significantly greater in >9 (p < 0.05). Conclusion: Olfactory function improved during fasting and declined during satiation. The olfactory system is more sensitive, and more reactive to odours, under starvation conditions, and is characterised by reduced activity during satiation. This situation was more pronounced in patients with a better sense of smell. Olfaction-related neurotransmitters should be the target of further study.

Resumo Introdução: O sistema olfatório é afetado pelo equilíbrio nutricional e estado químico do corpo, que serve como um sensor interno. Todas as funções corporais são afetadas pela perda de energia, inclusive o olfato; a fome pode alterar a percepção do odor. Objetivo: Neste estudo, investigamos o efeito do jejum sobre a percepção olfativa em seres humanos, e também avaliamos as mudanças de percepção durante a saciedade. Método: O teste olfatório Sniffin Sticks foi aplicado após 16 horas de jejum e novamente pelo menos 1 hora após a ceia do Ramadã durante os períodos de saciedade. Todos os participantes foram informados sobre os procedimentos do estudo e forneceram o consentimento informado. O protocolo do estudo foi aprovado pelo Comitê de Ética do Gaziosmanpaşa Taksim Education e Research Hospital (2014/09/07 n° 60). O estudo foi conduzido de acordo com os princípios básicos da Declaração de Helsinki. Resultados: Foram incluídos 48 pacientes (20 homens, 28 mulheres) com média de 33,6 ± 9,7 aos (variação 20-72); a altura média deles era de 169,1 ± 7,6 cm (variação 150-185), o peso médio era de 71,2 ± 17,6 kg (variação de 50-85) e o IMC médio era de 24,8 ± 5,3 (variação de 19,5-55,9). Os escores foram maiores em todos os itens correspondentes à identificação olfativa, limiares e discriminação durante jejum vs. saciedade (p < 0,05). Resultados da identificação (I): os escores de identificação foram significativamente maiores durante o jejum (mediana = 14) vs. período de saciedade (mediana = 13). Resultados limiares (T): os escores limiares foram significativamente maiores durante o jejum (mediana = 7,3) vs. período de saciedade (mediana = 6,2). Resultados de discriminação (D): os escores de discriminação foram significativamente maiores durante o jejum (mediana = 14) vs. período de saciedade (mediana = 13). Os escores totais de TDI foram de 35,2 (jejum) vs. 32,6 (saciedade). Quando comparamos o valor do limiar de jejum de > 9 e ≤ 9, a diferença entre os limiares de jejum e de saciedade foi significativamente maior em > 9 (p < 0,05). Conclusão: A função olfatória melhorou durante o jejum e diminuiu durante a saciedade. O sistema olfatório é mais sensível e mais reativo aos odores em condições de fome e é caracterizado por atividade reduzida durante a saciedade. Essa situação foi mais pronunciada em pacientes com um melhor sentido olfativo. Os neurotransmissores relacionados com o olfato devem ser alvo de um estudo mais aprofundado.

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.

Influencia en el balance energético de los factores que regulan el control del apetito y la saciedad a corto plazo / Influence of the regulating factors of short-term control of appetite and satiety on energy balance

Introducción: el mantenimiento de un nivel constante de energía almacenada es gracias a los factores que regulan el apetito y la saciedad, los cuales influyen en el estado del balance energético. Objetivo: describir la influencia en el balance energético de los factores que regulan el control del apetito y la saciedad a corto plazo. Métodos: se realizó una búsqueda en Medline/PubMed, Bireme, ediciones DOYMA y Elsevier, de artículos publicados en inglés y español en el período comprendido entre enero de 1973 y junio de 2016. Los términos de búsqueda fueron food intake, energy balance, regulation, nutritional homeostasis. Desarrollo: la ingesta de alimentos es una conducta humana que resulta de la compleja interacción entre múltiples factores, en que los más importantes son los fisiológicos y, en el plano humoral, está bien establecido el papel de la ghrelina en la iniciación de la ingesta. Al unísono se ponen en marcha diferentes órganos desde este mismo momento para establecer el momento en el que se debe dejar de comer, mecanismo en el cual intervienen hormonas como colecistoquinina, péptido similar al glucagón tipo 1, oxintomodulina, péptido YY, bombesina, enterostatina, amilina y polipéptido pancreático. Consideraciones finales: existen diferentes mecanismos implicados en la regulación del control a corto plazo del apetito y la saciedad, los cuales se encuentran íntimamente relacionados, e influyen y determinan el estado del balance energético(AU)

Introduction: steady level of stored energy is kept thanks to regulating factors of appetite and satiety which also influence on the state of energy balance. Objective: to describe the influence of regulating factors of appetite and satiety at short-term on the energy balance. Methods: a literature search was made in Medline/PubMed, Bireme, DOYMA editions and Elsevier to find English and Spanish articles in the period of January 1973 to June 2016. The search terms were food intake, energy balance, regulation, nutritional homeostasis. Development: food intake is human behavior resulting from the complex interaction of multiple factors, being the most important the physiological ones and at the humoral level, the role of ghrelina in the onset of intake is well-established. At the same time, various organs set in motion to fix the moment when one should stop eating, a mechanism in which several hormones are involved such as cholecystokinin, a peptide similar to type 1 glycagon, oxyntomodulin, peptide YY, bombesin, enterostatin, amyline and pancreatic polypeptide. Final thoughts: there are several mechanisms involved in the regulation of the short-term control of appetite and satiety which are closely related, have an effect on and determine the state of the energy balance(AU)

The Application of the Rome IV Criteria to Functional Esophagogastroduodenal Disorders in Asia

The Rome criteria were amended as Rome IV. For functional esophageal disorders, the exclusion criteria have been more specifically revised based on further understanding of other esophageal disorders, including eosinophilic esophagitis and spastic and hypercontractile motor disorders. Another revised point is the more restrictive definition of gastroesophageal reflux disease, indicating that sensitivity to a physiological reflux burden may be placed more firmly within the functional group. For functional dyspepsia (FD), only minor changes were introduced, mainly to improve specificity. Among the major symptoms of FD, not only postprandial fullness, but also epigastric pain, epigastric burning, and early satiation should be “bothersome.” Investigation on the effect of meal ingestion on symptom generation has indicated that not only postprandial fullness and early satiety, but also epigastric pain, epigastric burning sensation and nausea (not vomiting) may increase after meals. Helicobacter pylori infection is considered a possible cause of dyspepsia if successful eradication leads to sustained resolution of symptoms for more than 6 months, and such status can be termed as “H. pylori–associated dyspepsia.” Prompt esophagogastroduodenoscopy and H. pylori testing and treatment would be more beneficial, especially in Asia, which has a high prevalence of gastric cancer. Acotiamide, tandospirone, and rikkunshito are the newly listed as treatment options for FD. For further therapeutic development, clinical studies based on the strict Rome IV criteria should be performed.

Somatic Complaints Are Significantly Associated with Chronic Uninvestigated Dyspepsia and Its Symptoms: A Large Cross-sectional Population Based Study

BACKGROUND/AIMS: Somatization may influence persistence and severity of symptoms in gastrointestinal diseases. Some studies suggest that somatization is associated with chronic uninvestigated dyspepsia (CUD); however, the association is unclear. We aimed to determine the association between the profiles of somatic complaints with CUD and its symptoms. METHODS: In a cross-sectional study conducted on 4763 Iranian adults, somatic complaints were assessed using a comprehensive 31-items questionnaire. Patients with CUD were identified by the Rome III diagnostic criteria. Profiles of somatic complaints were derived from factor analysis. Logistic regression analysis was used to assess the relationship between extracted profiles with CUD and its symptoms. RESULTS: CUD, bothersome postprandial fullness, early satiation, and epigastric pain or burning was identified in 723 (15.2%), 384 (8.1%), 302 (6.3%), and 371 (7.8%) of the study population. The frequency of all 31 somatic complaints was significantly higher in patients with CUD compared with controls (P < 0.001), and the most frequent was severe fatigue (45.1%). The profiles of somatic complaints were extracted in 4 domains, including “psychological”, “gastrointestinal”, “neuro-skeletal”, and “pharyngeal-respiratory”. The psychological (OR, 1.49; 95% CI, 1.44–1.54), gastrointestinal (OR, 2.22; 95% CI, 2.09–2.37), neuro-skeletal (OR, 1.52; 95% CI, 1.44–1.59), and pharyngeal-respiratory (OR, 2.09; 95% CI, 1.94–2.25) profiles were significantly associated with greater odds of CUD. CONCLUSIONS: CUD and its symptoms are strongly associated with higher levels of somatic complaints and their related extracted profiles. This perhaps explains that why it can be difficult to treat, however further prospective investigations are required to confirm these associations.

Distinct breakfast patterns on satiety perception in individuals with weight excess

ABSTRACT Objectives Western dietary pattern predisposes to weight gain, insulin resistance and cardiometabolic diseases. Promoting satiety via modifications in diet composition could be useful to fight weight gain. Mediterranean diet which is recognized to be cardioprotective contains high fiber and unsaturated fat contents. We compared the effects of distinct breakfast patterns on satiety of individuals at cardiometabolic risk, and examined the correlation of satiety level after each breakfast intervention period with glucose parameters. Materials and methods In this 10-week cross-over clinical trial, 54 individuals with weight excess were submitted to 2 types of 4-week isocaloric breakfasts (2-week washout), one typically Brazilian and a modified one, differing concerning fiber and types of fatty acids contents. Clinical data were collected before and after each breakfast. A satiety scale was applied at fasting and 10, 30 and 120’ after breakfast consumption. Repeated measures ANOVA, Student t test or non-parametric correspondents were used; correlations were tested by Pearson or Spearman coefficients. Results Anthropometric variations after breakfasts were not significant. Only after the modified breakfast, reduction in blood pressure levels was observed. The satiety level did not show significant variation across each period or between the breakfasts. Non-significant correlation between satiety and glucose, insulin and HOMA-IR values after each intervention period was observed. Conclusion We conclude that different breakfast compositions do not alter satiety level, which is not correlated to glucose parameters in overweight individuals. Stronger modifications of daily meals might be necessary to differentiate satiety levels under distinct dietary patterns.

Estudio de aceptabilidad y saciedad de barritas de cereal altas en fibra dietética en escolares de una escuela rural de Chile / Acceptability and saciety study of cereal bars high in dietetic fiber in schoolage children of a Chilean rural school

Cereal bars for infant collation in two flavors were developed: apple and red fruits. The bars were made with oatmeal and dried fruit, low in saturated fat, total sugars and sodium. The effect of the addition of 2.5% of β-glucan in the bars on the sensory acceptability, satiety and digestive tolerance in primary school children were evaluated. The results showed high sensory acceptability to all bars (both flavors, with and without β-glucan), being higher in children from 1st to 4th grade and in men (p <0.05). Consumption of the bars produced satiety in children without stumbling significant differences due to thepresence of β-glucan. Regarding the digestive tolerance, no cases of discomfort were presented, indicating that all cereal bars were well tolerated. The addition of β-glucan in the bars does not affect the sensory acceptability of these and does not affect satiety compared to bars without β-glucan.

RESUMEN Se desarrollaron barritas de cereal destinadas a la colación infantil en dos sabores: manzana y frutos rojos. Las barritas se elaboraron con avena y frutos deshidratados, con bajo contenido de grasas saturadas, azúcares totales y sodio. Se evaluó el efecto de la incorporación de 2.5% de β-glucano en las barritas sobre la aceptabilidad sensorial, saciedad y tolerancia digestiva en escolares de educación básica. Los resultados obtenidos demostraron alta aceptabilidad sensorial para todas las barritas (ambos sabores, con y sin β-glucano), siendo mayor en niños de 1° a 4° básico y en hombres (p<0.05). El consumo de las barritas produjo saciedad en los niños, sin encontrase diferencias significativas por efecto de la presencia de β-glucano. Respecto a la tolerancia digestiva, no se presentaron casos de malestar, lo que indica que todas las barritas de cereal fueron bien toleradas. La incorporación de β-glucano en las barritas no afecta la aceptabilidad sensorial de éstas y tampoco afecta la saciedad respecto a barritas sin β-glucano.

Functional Dyspepsia / 정신신체의학

Functional dyspepsia is one of the most common bowel disorders as prevalent of 7.7% Korean population. The cardinal manifestations include bothersome postprandial fullness, early satiation, epigastric burning or pain. These features are chronic and should be presented recurrently with no other compatible organic disease to explain the symptoms. Even though it is not life-shortening, functional dyspepsia usually make the health-related quality of life worse especially if other functional bowel disorder coexist. The coexistence of functional bowel disorders is called as 'overlap syndrome'. Anxiety, somatization and insomnia is more prevalent in overlap syndrome compared with sole functional bowel disorder. Therefore, it is worthwhile that physician interviews and elucidates whether the dyspeptic patient had other kinds of functional bowel disorders, and manages the underlying psychotic pathology. Placebo effect is large in functional dyspepsia, and there is only four kinds of prokinetics that is proven to be superior to placebo. Adverse events relating prolonged administration of prokinetics sometimes fatal or irreversible, physician willing to describe prokinetics should be familiar to the possible adverse effects and the relating risk factors. Pathologic acid reflux is not uncommon in functional dyspepsia, and acid-suppressant is equivalent to the prokientics in most of dyspeptic patients.

Dietary Intervention Strategies to Reduce Energy Intake in Diabetes / 임상당뇨병

Weight loss is physiologically beneficial in treating type 2 diabetes. Losing weight occurs when the body has a negative energy balance. However, many people have trouble in restricting their caloric intake. Strategies such as changing portion sizes, energy density and meal frequency can be useful for weight loss. Further research is needed on controlling food intake in the obese/overweight because of the complexity of eating behaviors.

Effects of CB1 cannabinoid receptor activation in the nucleus accumbens shell on feeding behavior / Efectos de la activación del receptor cannabinoide CB1 en el núcleo accumbens shell sobre la conducta alimentaria / Efeitos da ativação do receptor cannabinóide CB1 no núcleo accumbens shell sobre a conduta alimentar

Obesity and its related pathologies are well- known health hazards. Although obesity and overweight have multifactorial causes, overeating is common in both of these conditions. According to animal models, endocannabinoids and their receptors in the brain play a key role in the genesis and development of obesity. It has been proposed that the cannabinoid receptors CB1 (RCB1) expressed in the nucleus accumbens shell (NAC) are involved in the increase of the hedonic properties of food. To test this hypothesis, this study aimed to assess the effects of activating the NACs RCB1 on standard food intake during the light phase of the light-dark cycle. The effects of activating the RCB1 with CP 55,940 and WIN 55-212-2 (0.125, 0.25 and 0.5 nmol) in the NACS on feeding behavior and the behavioral satiety sequence of rats were assessed. It was found that both agonists increased food intake and delayed expression of satiety during the light phase. These results suggest that cannabinoid agonists encourage food intake when motivation is low and palatability is normal.

La obesidad y sus patologías relacionadas son riesgos de salud muy conocidos. Aunque la obesidad y el sobrepeso tienen causas multifactoriales, la sobreingesta de alimento es frecuente en estas condiciones. De acuerdo con modelos animales, los endocanabinoides y sus receptores en el cerebro juegan un papel clave en la génesis y desarrollo de la obesidad. Se ha propuesto que los receptores a canabinoides CB1 (RCB1) expresados en el núcleo accumbens shell (NAcS) están involucrados en el incremento de las propiedades hedónicas del alimento. Para probar esta hipótesis, este estudio tuvo como objetivo evaluar los efectos de la activación de los RCB1 en el NAcS sobre la ingesta de alimento estándar durante la fase de luz del ciclo luz-oscuridad. Se evaluaron los efectos de la activación de los RCB1 con WIN 55-212-2 y CP 55,940 (0.125, 0.25, y 0.5 nmol) en el NAcS sobre la conducta alimentaria y la secuencia de saciedad conductual en ratas. Se encontró que ambos agonistas aumentaron la ingesta de alimento y demoraron la expresión de la saciedad durante la fase de luz. Lo anterior sugiere que los agonistas canabinoides estimulan el consumo de alimento cuando la motivación por el mismo es baja y la palatabilidad es normal.

A obesidade e suas patologias relacionadas são riscos de saúde muito conhecidos. Ainda que a obesidade e o sobrepeso possuam causas multifatoriais, a sobre ingestão de alimento é frequente nestas condições. De acordo com modelos animais, os endocanabinóides e seus receptores no cérebro jogam um papel chave na gênese e desenvolvimento da obesidade. Foi proposto que os receptores a canabinóides CB1 (RCB1) expressos no núcleo accumbens shell (NAcS) estão envolvidos no aumento das propriedades hedônicas do alimento. Para testar esta hipótese, este estudo teve como objetivo avaliar os efeitos da ativação dos RCB1 nos NAcS sobre a ingestão de alimento padrão durante a fase de luz do ciclo luz-escuridão. Avaliaram-se os efeitos da ativação dos RCB1 com WIN 55-212-2 e CP 55,940 (0.125, 0.25, e 0.5 nmol) no NAcS sobre a conduta alimentar e a sequência de saciedade condutual em ratos. Encontrou-se que ambos agonistas aumentaram a ingestão de alimento e demoraram a expressão da saciedade durante a fase de luz. Isso sugere que os agonistas canabinóides estimulam o consumo de alimento quando a motivação pelo mesmo é baixa e a palatabilidade é normal.