Nutritional implications of the cephalic-phase salivary response

Application of Artificial Neural Networks (ANN) to Elucidate the Connections among Smell, Obesity with Related Metabolic Alterations, and Eating Habit in Patients with Weight Excess

Obesity is a severe health problem linked to an increased risk of comorbidity and mortality and its etiopathogenesis includes genetic, epigenetic, microbiota composition, and environmental factors, such as dietary habits. The olfactory system plays an important role in controlling food intake and meal size, influencing body weight and energy balance. This study aims to identify the connection between olfactory function and clinical and nutritional aspects related to weight excess in a group of 68 patients with overweight or obesity. All participants underwent the evaluation of olfactory function, anthropometric data (weight, height, BMI, waist circumference), clinical data (hypertension, disglycemia, dyslipidemia, metabolic syndrome), and adherence to the Mediterranean diet (Mediterranean Diet Score). A fourth-generation artificial neural network data mining approach was used to uncover trends and subtle associations between variables. Olfactory tests showed that 65% of patients presented hyposmia. A negative correlation was found between olfactory scores and systolic blood pressure, fasting plasma glucose, and triglycerides levels, but a positive correlation was found between olfactory scores and the Mediterranean diet score. The methodology of artificial neural networks and the semantic connectivity map "Auto-Contractive Map" highlighted the underlying scheme of the connections between the variables considered. In particular, hyposmia was linked to obesity and related metabolic alterations and the male sex. The female sex was connected with normosmia, higher adherence to the Mediterranean diet, and normal values of blood pressure, lipids, and glucose levels. These results highlight an inverse correlation between olfactory skills and BMI and show that a normosmic condition, probably because of greater adherence to the Mediterranean diet, seems to protect not only from an excessive increase in body weight but also from associated pathological conditions such as hypertension and metabolic syndrome.

Cephalic phase insulin release: A review of its mechanistic basis and variability in humans

Cephalic phase insulin release (CPIR) is a transient pulse of insulin that occurs within minutes of stimulation from foods or food-related stimuli. Despite decades of research on CPIR in humans, the body of literature surrounding this phenomenon is controversial due in part to contradictory findings . This has slowed progress towards understanding the sensory and neural basis of CPIR, as well as its overall relevance to health. This review examines up-to-date knowledge in CPIR research and identifies sources of CPIR variability in humans in an effort to guide future research. The review starts by defining CPIR and discussing its presumed functional roles in glucose homeostasis and feeding behavior. Next, the types of stimuli that have been reported to elicit CPIR, as well as the sensory and neural mechanisms underlying the response in rodents and humans are discussed, and areas where knowledge is limited are identified. Finally, factors that may contribute to the observed variability of CPIR in humans are examined, including experimental design, test procedure, and individual characteristics. Overall, oral stimulation appears to be important for eliciting CPIR, especially when combined with other sensory modalities (vision, olfaction, somatosensation). While differences in experimental design and testing procedure likely explain some of the observed inter- and intra-study variability, individual differences also appear to play an important role. Understanding sources of these individual differences in CPIR will be key for establishing its health relevance.

An alternative pathway for sweet sensation: possible mechanisms and physiological relevance

Sweet substances are detected by taste-bud cells upon binding to the sweet-taste receptor, a T1R2/T1R3 heterodimeric G protein-coupled receptor. In addition, experiments with mouse models lacking the sweet-taste receptor or its downstream signaling components led to the proposal of a parallel "alternative pathway" that may serve as metabolic sensor and energy regulator. Indeed, these mice showed residual nerve responses and behavioral attraction to sugars and oligosaccharides but not to artificial sweeteners. In analogy to pancreatic β cells, such alternative mechanism, to sense glucose in sweet-sensitive taste cells, might involve glucose transporters and K_ATP channels. Their activation may induce depolarization-dependent Ca²⁺ signals and release of GLP-1, which binds to its receptors on intragemmal nerve fibers. Via unknown neuronal and/or endocrine mechanisms, this pathway may contribute to both, behavioral attraction and/or induction of cephalic-phase insulin release upon oral sweet stimulation. Here, we critically review the evidence for a parallel sweet-sensitive pathway, involved signaling mechanisms, neural processing, interactions with endocrine hormonal mechanisms, and its sensitivity to different stimuli. Finally, we propose its physiological role in detecting the energy content of food and preparing for digestion.

A stepwise approach investigating salivary responses upon multisensory food cues

Exposure to sensory food cues such as smell, vision, taste and/or texture may trigger anticipatory physiological responses such as salivation, participating on adequate metabolism of the signaled food. However, the individual contribution of each sensory modality as well as the impact of particular food products on salivation and salivary composition remains unclear. Therefore, by systematically varying sensory modalities and nutrient content of food stimuli, we investigated their effect on saliva secretion, α-amylase activity and other salivary characteristics (pH level, buffering capacity, MUC5B concentration, and total protein content). Over 3 sessions, 46 normal-weight healthy participants were exposed to 12 conditions, consisting of 4 levels of sensory stimulation (odor, odor + vision, odor + vision + taste, and odor + vision + taste + mastication) and 3 types of stimuli (bread, high-in-starch; cucumber, low-in-starch; and parafilm as non-food control) during which saliva was collected. Linear mixed models showed a significant increase in salivation with increasing levels of sensory stimulation. α-amylase secretion rate increased upon the highest level of stimulation, which involved mastication, compared to odor and odor + visual level of stimulation. Other salivary characteristics varied with the level of sensory stimulation, which might be related to the total volume of salivation. The type of stimuli did not influence the saliva composition (α-amylase concentration nor other salivary components). Our findings indicate that cumulative sensory information, rather than specific (food) product, play a vital role in anticipatory salivary responses.

Exacting Responses: Lack of Endocrine Cephalic Phase Responses Upon Oro-Sensory Exposure

Oro-sensory exposure (OSE) to food plays an important role in the regulation of food intake. One proposed underlying mechanism is the occurrence of cephalic phase responses (CPRs). CPRs include the pre-digestive endocrine responses induced by food-related sensory input. Yet, whether OSE duration or sweetness intensity affects CPRs is unknown. The objective of this study was to determine the independent and interactive effects of oro-sensory duration (chewing) and stimulation intensity (sweetness) on endocrine CPRs and satiation. Eighteen males (22 ± 2 years, BMI 22 ± 2 kg/m2) participated in a 2 × 2 randomized study with a control condition. Each session participants performed modified sham feeding (MSF) with one of the four gel-based model foods. During the control session no MSF was performed. Model foods differed in chewing duration (hard or soft texture) and sweetness (low or high intensity). During each session, eight blood samples were collected up till 25 min after MSF onset. Subsequently, food intake from an ad libitum lunch was measured. No typical CPR was found for insulin, pancreatic polypeptide (PP), and ghrelin. However, the overall PP response was 1.1 times greater for the hard sweet MSF condition compared to control (p = 0.02). Overall ghrelin responses were 1.1 times greater for the hard model food compared to the soft model food conditions (p = 0.003). These differences in endocrine response were not associated with differences in food intake at the subsequent meal. Exploratory sub-analysis of the responsive insulin curves showed that after 2.5 min of MSF the hard texture model foods insulin concentrations were 1.2 greater compared to the soft texture. These findings indicate that texture hardness and sweetness increase the overall PP response and that MSF on hard texture increases the overall ghrelin response compared to soft texture model foods. However, MSF on model foods does not lead to a typical CPR. This study, among others, shows that there are major dissimilarities in the endocrine responses to food stimulation between individuals. This emphasizes the importance of considering cephalic responders and non-responders. More research is needed to understand CPRs in relation to food texture and taste properties.

Conditioning of human salivary flow using a visual cue for sour candy

OBJECTIVE

Although the "mouthwatering" to sight, smell, or thought of food is commonly accepted in food and nutrition research, the concept of mouthwatering and human salivary flow conditioning is not well accepted in salivary research. The objective of this study was to revisit whether human salivary flow could be classically conditioned to a previously neutral stimulus.

DESIGN

Sour candy or a non-food control in opaque containers were presented to healthy participants (n = 8). Simple images were consistently paired with container contents. Participants viewed the images for 15 s, then opened the containers and ate (candy) or did not eat (non-food control) the contents. This was repeated 14 times (7 of each stimulus). Order was semi-randomized to ensure one candy and one non-food were presented as the first two and last two stimuli. Saliva was collected with cotton dental rolls during these presentations (first two and last two) after viewing the image for 15 s, but before opening the container.

RESULTS

Participants were successfully conditioned to increase salivary flow in response to the image that predicted candy, as demonstrated by greater weight of saliva in response to 1) the candy-paired image than the non-food-paired image, and 2) the candy-paired image at the end of the first visit compared with the beginning (when the image had no meaning). However, the effect was attenuated during the second visit.

CONCLUSIONS

We demonstrate classical conditioning of human salivary flow is achievable, but the effect may not persist to a second visit.

Nutrition and taste and smell dysfunction

Food selection plays a pivotal role in maintaining adequate nutrient intake, thus elucidating drivers of food choice is a meaningful strategy to maintain health and manage disease. Taste and smell are key determinants of food choice and warrant careful consideration. In this review, we first discuss how sensory stimulation influences food selection and metabolism. We then review the evidence regarding the relationship between taste and smell dysfunction and food preferences and selection, with attention given to contexts of certain chronic diseases. We conclude with brief recommendations for the management of chemosensory disorders. While sensory abilities influence food selection, the effect of taste and smell dysfunction on long-term consumption patterns and health status must be considered in light of environment, exposure, and culture.

Explicit wanting and liking for palatable snacks are differentially affected by change in physiological state, and differentially related to salivation and hunger

Incentive salience theory (IST) suggests that 'wanting' and liking are dissociable processes. We argue that explicit measures of wanting in humans can reflect the impact of implicit 'wanting' as envisaged by IST, suggesting that dissociations should also be evident for explicit judgments of wanting and liking. To test this, participants were asked to make ratings of these variables for 8 palatable snack foods - and in a related test salivation rate was also assessed. Participants viewed and sniffed each snack food and rated wanting, and then sampled it and rated liking and whether they wanted more of it. Following a lunch eaten to satiety, and composed in part of half of the palatable snack foods, participants repeated their evaluations of the snack foods (and salivation rate). Liking changed less across lunch than wanting and want more ratings, the last-mentioned changing the most. Change in liking was associated with change in salivation rate, independent of wanting, and change in wanting was associated with change in hunger independent of liking. We argue these dissociations are consistent with 'wanting' influencing explicit wanting, and that want more ratings may represent a 'purer' measure of IST 'wanting'.

Salivary secretion and disgust: A pilot study

Although a direct link has been established between self-experienced disgust and salivary secretion, it is unclear whether this physiological index is modulated by the social experience of disgust (i.e., exposure to the facial expression of disgust). We tested this issue in a pilot study by collecting salivary samples in a group of 20 healthy humans watching pictures of faces expressing disgust. Moreover, we tried to replicate previous evidence by testing saliva secretion in response to pictures of unpalatable (i.e., rotten) food and non-gustatory disgusting stimuli (i.e., disgusting insects). Overall, our analysis shows a general reduction of saliva secretion in response to disgust stimuli, compared to their positive counterparts, although further analyses for specific stimulus categories indicated that this difference was statistically significant only for food pictures. The non-significance of the face and insect categories might be due to insufficient power of our small sample. Overall, a general reduction of saliva secretion for different disgust-related stimuli suggests a shared mechanism of encoding, in line with theories of neural reuse.

Modification of a traditional breakfast leads to increased satiety along with attenuated plasma increments of glucose, C-peptide, insulin, and glucose-dependent insulinotropic polypeptide in humans

Our hypothesis was that carbohydrate, fat, and protein contents of meals affect satiety, glucose homeostasis, and hormone secretion. The objectives of this crossover trial were to examine satiety, glycemic-insulinemic response, and plasma peptide levels in response to 2 different recommended diabetes diets with equivalent energy content. One traditional reference breakfast and one test breakfast, with lower carbohydrate and higher fat and protein content, were randomly administered to healthy volunteers (8 men, 12 women). Blood samples were collected, and satiety was scored on a visual analog scale before and 3 hours after meals. Plasma glucose was measured, and levels of C-peptide, ghrelin, glucagon, glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide (GIP), insulin, plasminogen activator inhibitor-1, and adipokines were analyzed by Luminex. Greater satiety, visual analog scale, and total and delta area under the curve (P < .001), and lower glucose postprandial peak (max) and change from baseline (dmax; P < .001) were observed after test meal compared with reference meal. Postprandial increments of C-peptide, insulin, and GIP were suppressed after test meal compared with reference meal (total delta area under the curve [P = .03, .006, and .004], delta area under the curve [P = .006, .003, and .02], max [P = .01, .007, and .002], and dmax [P = .004, .008, and .007], respectively). Concentrations of other peptides were similar between meals. A lower carbohydrate and higher fat and protein content provides greater satiety and attenuation of C-peptide, glucose, insulin, and GIP responses compared with the reference breakfast but does not affect adipokines, ghrelin, glucagon, glucagon-like peptide-1, and plasminogen activator inhibitor-1.

Sensory-specific appetite is affected by actively smelled food odors and remains stable over time in normal-weight women

Understanding overconsumption starts with knowledge of how separate factors influence our eating behavior. Food cues such as food odors are known for their effect on general appetite and sensory-specific appetite (SSA). Active sniffing rather than passive exposure may induce satiation over time. The objective of this study was to investigate how actively sniffing banana odors affects general appetite, SSA, and subsequent food intake. In a crossover study, 61 women actively smelled cups containing natural banana, artificial banana odor, or water (no odor) for 10 min. Treatment order was randomly assigned as much as possible. General appetite and SSA were monitored by using 100-mm visual analog scales during the 10 min of active sniffing, followed by ad libitum intake of banana milkshake. Results showed that SSA was consistently high (+12 mm) during actively sniffing natural or artificial banana odors, with no decrease in SSA over time. Sniffing both banana odors increased the appetite for banana (+11 mm) and other sweet products (+4 mm), whereas the appetite for savory products decreased by 7 mm (all P < 0.01) compared with no odor. Actively sniffing banana odor did not significantly influence food intake (P = 0.68) or general appetite scores (P = 0.06). In conclusion, SSA scores during active sniffing were identical to the SSA found in a similar study that used passive smelling, suggesting that SSA is independent of the manner of sniffing and exposure time. Moreover, sweet/savory categorization may suggest that food odors communicate information about the nutrient composition of their associated foods. These data clearly show the appetizing effects of food odors.

Oral processing effort, appetite and acute energy intake in lean and obese adults

Chewing reportedly contributes to satiation and satiety signals. Attempts to document and quantify this have led to small and inconsistent effects. The present trial manipulated oral processing effort though required chewing of gums of different hardness and measured appetitive sensations, energy intake, gastric emptying, GI transit time, and concentrations of glucose, insulin, GLP-1, ghrelin and pancreatic polypeptide. Sixty adults classified by sex and BMI (15 each of lean females, obese females, lean males and obese males) were tested in a randomized, controlled, cross-over trial with three arms. They chewed nothing, soft gum or hard gum for 15 min while sipping grape juice (10% of individual energy needs) containing acetaminophen and lactulose on one day each separated by 7 days. Electromyographic recordings and self-reports were obtained during and after chewing to quantify oral processing effort. Blood was sampled through an indwelling catheter and appetite ratings were obtained at baseline and at 0, 15, 30, 45, 60, 90, 120, 180 and 240 min after chewing initiation. Breath samples were collected at 10 min intervals for the first 2h and at 30 min intervals for the next 2h. No effects of chewing were observed for appetitive sensations or gut peptide concentrations. Energy intake tended to decline in lean and increase in obese participants so that daily energy intake differed significantly between the two groups when chewing either gum, while no difference was observed on the non-chewing day. Serum glucose and insulin were significantly lower at selected time points 90-240 min after chewing compared to baseline and the non-chewing day. These data indicate chewing effort does not affect appetitive sensations or gut peptide secretion, but may exert a small differential effect on acute energy intake in lean and obese individuals and lead to greater post-prandial declines of serum glucose and insulin. The efficacy of gum chewing as a substitute for eating for weight management remains uncertain.

Increasing the number of masticatory cycles is associated with reduced appetite and altered postprandial plasma concentrations of gut hormones, insulin and glucose

To determine the influence of masticatory efficiency on postprandial satiety and glycaemic response, twenty-one healthy males were recruited for this randomised cross-over trial. The participants consumed a fixed amount of pizza provided in equal-sized portions by chewing each portion either fifteen or forty times before swallowing. Subjective appetite was measured by appetite questionnaires at regular intervals for 3 h after the meal and plasma samples were collected for the measurement of selected satiety-related hormones, glucose, insulin and glucose-dependent insulinotropic peptide (GIP) concentrations. An ad libitum meal was provided shortly after the last blood sample was drawn and the amount eaten recorded. Compared with fifteen chews, chewing forty times per portion resulted in lower hunger (P= 0·009), preoccupation with food (P= 0·005) and desire to eat (P= 0·002). Meanwhile, plasma concentrations of glucose (P= 0·024), insulin (P< 0·001) and GIP (P< 0·001) were higher following the forty-chews meal. Chewing forty times before swallowing also resulted in a higher plasma cholecystokinin concentration (P= 0·045) and a trend towards a lower ghrelin concentration (P= 0·051). However, food intake at the subsequent test meal did not differ (P= 0·851). The results suggest that a higher number of masticatory cycles before swallowing may provide beneficial effects on satiety and facilitate glucose absorption.

Microbial communities in the human small intestine: coupling diversity to metagenomics

The gastrointestinal tract is the main site where the conversion and absorption of food components takes place. The host-derived physiological processes and the residing microorganisms, especially in the small intestine, contribute to this nutrient supply. To circumvent sampling problems of the small intestine, several model systems have been developed to study microbial diversity and functionality in the small intestine. In addition, metagenomics offers novel possibilities to gain insight into the genetic potential and functional properties of these microbial communities. Here, an overview is presented of the most recent insights into the diversity and functionality of the microorganisms in the human gastrointestinal tract, with a focus on the small intestine.

Chemosensory dysfunction is a primary factor in the evolution of declining nutritional status and quality of life in patients with advanced cancer

Alterations in taste and smell functions have been reported in cancer patients. Although these senses are known to be particularly affected by chemotherapy, many features of chemosensory perception in cancer patients remain obscure. The relative importance of chemosensory changes in the etiology of malnutrition and wasting is not known. To assess this relationship, self-perceived taste and smell function were evaluated using a validated questionnaire in 66 patients with advanced cancer receiving palliative care (median survival 7.4 months). Participants also completed 3-day food records to assess dietary intake, and the Functional Assessment of Anorexia/Cachexia Therapy questionnaire to assess quality of life (QOL). Total chemosensory complaint scores ranged from 0 to 14 on a 16-point scale. Only 14% of the subjects reported no chemosensory complaints of any kind, whereas 86% reported some degree of chemosensory abnormality. The most common complaints were persistent bad taste in the mouth, taste distortion, and heightened sensitivity to odors. Subjects with severe chemosensory complaints showed substantially lower energy intakes (by 900-1,100 kcal/day), higher rates of weight loss, and lower QOL scores than subjects with mild or moderate chemosensory complaints. Severe chemosensory dysfunction is persistent well beyond the window of active therapy in patients with advanced cancer and represents a primary factor relating to malnutrition, wasting, and poor QOL. Further research is required to identify appropriate strategies to alleviate this important group of symptoms, to determine whether intervention will improve QOL, and to match foods and diet to the unique chemosensory profile of advanced cancer patients.

Food perception and postprandial lipid metabolism

The postprandial response to macronutrients in the diet, particularly carbohydrates and fats, underpins the detrimental changes in metabolism (impaired glucose tolerance or postprandial hyperlipaemia) and later pathology (insulin resistance, type 2 diabetes or atherosclerosis) associated with Westernised diets. Research has shown that in addition to what and how much we eat, eating behaviour in itself may be implicated in postprandial regulation. The process of ingestion stimulates cholinergic-vagal activity, irrespective of what is eaten, important in determining both the absorption and subsequent utilisation of nutrients but also potentially food intake through effects on hunger and satiety. Modifications in this aspect of physiology have the potential to influence all aspects of postprandial metabolism and subsequent disease risk in humans.

Orosensory considerations

The chemical senses (taste, smell, and chemical irritation) convey information from the external to the internal environment. This information influences an organism's quality of life, safety, reproductive function, and, to the present point, nutritional status. To illustrate this role, the effects of chemosensory stimulation on food choice, gastrointestinal function, and energy balance will be briefly reviewed. Each role is achieved, in part, by the chemosensory cue initiating anticipatory responses for an impending homeostatic challenge, a meal.

Consistent relationships between sensory properties of savory snack foods and calories influence food intake in rats

OBJECTIVE

Determine the influence of experience with consistent or inconsistent relationships between the sensory properties of snack foods and their caloric consequences on the control of food intake or body weight in rats.

DESIGN

Rats received plain and BBQ flavored potato chips as a dietary supplement, along with ad lib rat chow. For some rats the potato chips were a consistent source of high fat and high calories (regular potato chips). For other rats, the chips provided high fat and high calories on some occasions (regular potato chips) and provided no digestible fat and fewer calories at other times (light potato chips manufactured with a fat substitute). Thus, animals in the first group were given experiences that the sensory properties of potato chips were strong predictors of high calories, while animals in the second group were given experiences that the sensory properties of potato chips were not predictors of high calories.

SUBJECTS

Juvenile and adult male Sprague-Dawley rats.

MEASUREMENTS

Following exposure to varying potato chip-calorie contingencies, intake of a novel, high-fat snack food and subsequent chow intake were assessed. Body weight gain and body composition as measured by DEXA were also measured.

RESULTS

In juvenile animals, exposure to a consistent relationship between potato chips and calories resulted in reduced chow intake, both when no chips were provided and following consumption of a novel high-fat, high-calorie snack chip. Long-term experience with these contingencies did not affect body weight gain or body composition in juveniles. In adult rats, exposure to an inconsistent relationship between potato chips and calories resulted in increased consumption of a novel high-fat, high-calorie snack chip premeal along with impaired compensation for the calories contained in the premeal.

CONCLUSION

Consumption of foods in which the sensory properties are poor predictors of caloric consequences may alter subsequent food intake.

Appetite: measurement and manipulation misgivings

Humans appear to have a genotype that permits, or even encourages, an energy intake that is greater than energy expenditure when food is available. This was functional throughout most of human evolution but is less so in the current environment of inexpensive, palatable, and readily available foods. To achieve dietary goals of weight loss or maintenance, attempts have been made to influence appetitive sensations through the manipulation of the physical properties of foods, their composition, or their pattern of consumption. This has led to limited success, in part, because measurement of appetitive sensations is difficult but, more fundamentally, because the association between appetite and food choice or intake is not robust. This article critically reviews the most common methods for assessment of appetite and the effects of selected food constituents on appetitive sensations. Translation of current knowledge to dietetic practice must be made cautiously.

Dietary restraint and heightened reactivity to food

Previously, studies have explored the relationship between dietary behavior and salivary reactivity to food. Despite this, it remains unclear which behaviors are associated with enhanced reactivity. One problem is that measures of behavior have not been compared directly. In particular, it is unclear whether elevated reactivity is associated with measures of dietary restraint or with measures of failed dietary control and a tendency to overeat. To address this problem, we compared the association between salivary reactivity and scores on the subscales of the Three-Factor Eating Questionnaire (restraint, disinhibition, and hunger). Estimates of reactivity were derived from the difference between a baseline saliva measure and a similar measure taken in close proximity to hot pizza. Our second aim was to explore how salivary reactivity changes after a meal. Female participants (N=40) were tested before and after a lunch (cheese sandwiches). All tended to show reactivity to pizza before but not after lunch. No significant differences were associated with the disinhibition or hunger subscales. However, prelunch reactivity was significantly greater in those participants with high scores on the restraint scale. This does not appear to be related to reported levels of hunger before lunch. Rather, it may reveal an intrinsic difference between the reaction of restrained and unrestrained eaters to food.

The physiological-psychological dichotomy in the study of food intake

Human food intake is driven by necessity. We eat to live, but as Brillat-Savarin and others have noted throughout history, in affluent societies eating is a pleasure and becomes more than a means to an end. Eating signifies lifestyle choice and it has considerable meaning in our society beyond the acquisition of essential energy and nutrients. Thus, it is that the study of human food intake, particularly food choice, in contrast to food intake in other animals, tends to be skewed towards measures of behavioural, social and environmental influences rather than on precise physiological processes reflecting metabolism and nutrient partitioning. The dichotomy between physiological and psychological measures is a false one, since all behaviours are necessarily expressed through physiological systems. However, in the field of human food intake research the dichotomy refers to the divergent strands of interest in either psychological or physiological processes underlying intake and appetite. The present review considers both psychological and physiological measures in promoting our understanding of the human appetite system. The overall conclusion is that the burgeoning interest in identifying appetite suppressant drugs to combat obesity and in genotyping alongside behavioural phenotyping will close the gap between psychological and physiological perspectives on human food intake.