Systemic Factors in the Control of Food Intake

The Timing of Meals

In most individuals, food intake occurs as discrete bouts or meals, and little attention has been paid to the factors that normally determine when meals will occur when food is freely available. On the basis of experiments using rats, the authors suggest that when there are no constraints on obtaining food and few competing activities, 3 levels of interacting controls normally dictate when meals will start. The first is the genetically determined circadian activity pattern on which nocturnal animals tend to initiate most meals in the dark. The second is the regularly occurring changing of the light cycle: These changes provide temporal anchors. The third relates to the size of the preceding meal, such that larger meals cause a longer delay until the onset of the next meal. Superimposed on these 3 are factors related to learning, convenience, and opportunity.

Blood glucose dynamics and control of meal initiation: a pattern detection and recognition theory

A new framework for understanding the control of feeding behavior, with special emphasis on the evolution of hunger, the initiation of feeding, and its dependence on patterns of blood glucose, is the subject of this review. A perspective on the current status and future directions of this search for a more complete understanding of the regulation of feeding behavior in laboratory rats and humans is presented including theoretical and experimental components. First, a historical perspective on the role of blood glucose in the control of feeding is presented. Next, the theoretical approaches that have been applied to the control of feeding and had a strong influence on experimental feeding research are summarized. This is followed by a statement and overview of a current theory that has emerged from studies of the role of transient declines in blood glucose in the control of meal initiation. The current working hypothesis that transient declines in blood glucose are endogenous metabolic patterns that are detected and recognized by the central nervous system and are mapped into meal initiation in rats and are correlated with meal requests in humans are then presented. Then, the experimental studies on meal initiation and its dependence on patterns of blood glucose, first in rats and then in humans, are reviewed in detail. Finally, the future directions of the work, limitations, and the implications for the understanding of the control of feeding behavior and the regulation of energy balance are discussed.

Habitual meal frequency and energy intake regulation in partially temporally isolated men

OBJECTIVE

Assessment of a possible relationship between habitual as well as manipulated meal frequency, blood glucose pattern, macronutrient- and energy intake (EI), and energy intake regulation in partially temporally isolated men.

DESIGN

A partially temporally isolated within-subject design assessing energy intake regulation in spite of intervention. Intervention consisted of manipulating meal frequency by offering iso-energetic (1 MJ) preloads high in fat or carbohydrate (CHO), with the same energy density. We have previously shown that after a high-CHO preload, inter-meal-interval was 1 h, while after a high-fat preload intermeal-interval was 2 h.

SUBJECTS

Twenty healthy young (18-31 y) normal weight (body mass index (BMI): 22.8+/-1.9 kg/m(2)) men.

MEASUREMENTS

On two separate days, each after a different preload: subsequent subjects' responses to the preload, eg manipulated meal frequency; continuous blood glucose levels and blood glucose patterns: macronutrient composition of food intake; EI; appetite ratings; and taste perception. From controlled 3-day food intake diaries: habitual meal frequency; EI; and macronutrient-intake.

RESULTS

Accuracy of energy intake regulation is expressed as minimizing the difference in energy intake, despite intervention. The difference in 24 h EI on the two test days after the preloads (r(2)=0.56; P<0.001) was a function of habitual meal frequency. Variation in energy intake was primarily explained by habitual meal frequency (r(2)=0.76; P<0.0001). Adding macronutrient composition and number of blood glucose declines to this increased the explained variation to 86 and 96%, respectively. Percentage energy from CHO or from fat explained the variation in habitual meal frequency (r(2)=0.84; P<0.0001). Adding the total number of blood-glucose declines to this increased the explained variation to 88%, and adding average baseline blood glucose levels, sweetness perception and hunger suppression during preload consumption increased the explained variation to 91%. Manipulated meal frequency was related to habitual meal frequency (r(2)=0.86; P<0.0001) and was a function of the number of transient and dynamic blood glucose declines (r(2)=0.74; P<0.0001).

CONCLUSION

Habitual meal frequency is of greater significance in energy intake regulation in healthy young men than manipulated meal frequency. Healthy young men with a high habitual meal frequency showed lower 24 h EI, and a smaller difference in EI after macronutrient specific preloads, compared to those with a low habitual meal frequency, thus showing a more accurate energy intake regulation. Habitual meal frequency is based upon a cluster of related factors including macronutrient composition of the food, sweetness perception, hunger suppression, blood glucose declines and average baseline blood glucose levels.

Associations between spontaneous meal initiations and blood glucose dynamics in overweight men in negative energy balance

The aim of the present study was to investigate associations between spontaneous meal initiations and blood glucose dynamics in overweight male subjects in negative energy balance. In a randomized crossover design, fifteen overweight male subjects (BMI 28.6 (SD 1.8 kg/m2) participated in three treatments, each of which consisted of 2 weeks consuming a low-energy diet followed by a test of voluntary food ingestion in the absence of time-related cues. The low-energy diet consisted of three daily meals (947 kJ) which were either semi-solid with or without 2.5 g guar gum, or solid, and a dinner of subject's own choice. During the time-blinded test, on the first, second, and third meal initiation subjects ingested a low-energy meal corresponding to that used during the preceding weeks. Changes in blood glucose were monitored on-line. Associations between spontaneous meal initiations and blood glucose dynamics were determined using the chi2 test. No difference was found between treatments in the occurrence of postabsorptive and postprandial declines in blood glucose or in associations between meal initiations and blood glucose dynamics. Postprandial dynamic blood glucose declines were associated with meal initiation (chi2 26 8, P<0.00 1), but postabsorptive and postprandial transient declines were not. In overweight subjects, the usual association between transient declines and spontaneous meal initiation was completely absent in negative energy balance.

Food intake and the regulation of body weight

This chapter reviews the recent literature on hormonal and neural signals critical to the regulation of individual meals and body fat. Rather than eating in response to acute energy deficits, animals eat when environmental conditions (social and learned factors, food availability, opportunity, etc.) are optimal. Hence, eating patterns are idiosyncratic. Energy homeostasis, the long-term matching of food intake to energy expenditure, is accomplished via controls over the size of meals. Individuals who have not eaten sufficient food to maintain their normal weight have lower levels of adiposity signals (leptin and insulin) in the blood and brain, and one consequence is that meal-generated signals (such as CCK) are less efficacious at reducing meal size. The converse is true if individuals are above their normal weight, when they tend to eat smaller meals. The final section reviews how these signals are received and integrated by the CNS, as well as the neural circuits and transmitters involved.

Refeeding signal in fasting-incubating king penguins: changes in behavior and egg temperature

This study is directed toward understanding the process of feeding stimulation ("refeeding signal") that has been suggested to operate below a body mass threshold or critical metabolic status in spontaneously fasting birds. Behavior and egg temperature (T(egg)) were continuously monitored by video monitoring and biotelemetry, respectively, in fasting-incubating king penguins kept in a pen to prevent relief by the partner until spontaneous egg abandonment. Penned birds fasted 10 days more and lost 1.2 kg more than birds relieved normally by their partner, abandoning the egg about 1 wk after reaching a critical body mass. Definitive egg abandonment was preceded by transitory abandonments of progressively increasing duration during which time the birds went further and further away from their egg. There were marked interindividual differences but on average transitory abandonments began 36 +/- 5 h before the definitive abandonment and were paralleled by resumption of display songs signaling the readiness of the bird to depart for feeding. T(egg) was maintained at around 35.7 degrees C during normal incubation but significantly decreased the last 2 days before egg abandonment. These changes are interpreted as reflecting a stimulation to refeed at a threshold body mass corresponding to a critical fat store depletion. Thus the fasting-incubating king penguin appears to be an interesting animal model for understanding the long-term metabolic control of feeding behavior in relation to energy status.

Metabolic and behavioral consequences of a snack consumed in a satiety state

BACKGROUND

In view of the influence of dietary habits on obesity, human eating patterns merit study.

OBJECTIVE

We investigated the behavioral and biological consequences of consumption of a 1-MJ snack by subjects in a satiety state.

DESIGN

Eleven lean young men were deprived of time cues and subjected to continuous blood withdrawal over each of 4 sessions scheduled 2 wk apart. The first session was a basal session designed to determine the following in each subject: 1) the amount eaten in an ad libitum lunch; 2) the temporal patterns of plasma concentrations of glucose, insulin, fatty acids, and triacylglycerols between lunch and the spontaneous dinner request; and 3) the latency of the dinner request. In the 3 other sessions, each subject ingested the same lunch as in the basal session and a nutritionally well-balanced snack either 5 min before his individual peak of hyperglycemia observed in the first session, 40 min after this peak, or 120 min before the time he had requested his dinner in the first session.

RESULTS

There was no significant difference in latency of the dinner request or the energy intake at dinner between sessions. Insulin secretion increased but glucose profiles did not change significantly regardless of the time of snack intake.

CONCLUSION

A snack consumed in a satiety state fails to prolong the intermeal interval and would thus tend to favor storage.

Control of food intake by fatty acid oxidation and ketogenesis

Fatty acid oxidation seems to provide an important stimulus for metabolic control of food intake, because various inhibitors of fatty acid oxidation (mercaptoacetate, methyl palmoxirate, R-3-amino-4-trimethylaminobutyric acid) stimulated feeding in rats and/or mice, in particular when fed a fat-enriched diet, and long-term intravascular infusion of lipids reduced voluntary food intake in various species, including humans. The feeding response to decreased fatty acid oxidation was due to a shortening of the intermeal interval with meal size remaining unaffected. Thus, energy derived from fatty acid oxidation seems to contribute to control of the duration of postmeal satiety and meal onset. Since inhibition of glucose metabolism by 2-deoxy-D-glucose affects feeding pattern similarly, and spontaneous meals were shown to be preceded by a transient decline in blood glucose in rats and humans, a decrease in energy availability from glucose and fatty acid oxidation seems to be instrumental in eliciting eating. Since the feeding response of rats to inhibition of fatty acid oxidation was abolished by total abdominal vagotomy and pretreatment with capsaicin destroying non-myelinated afferents and attenuated by hepatic branch vagotomy, fatty acid oxidation in abdominal tissues, especially in the liver, apparently is signalled to the brain by vagal afferents to affect eating. Brain lesions and Fos immunohistochemistry were employed to identify pathways within the brain mediating eating in response to decreased fatty acid oxidation. According to these studies, the nucleus tractus solitarii (NTS) of the medulla oblongata represents the gate for central processing of vagally mediated afferent information related to fatty acid oxidation. The lateral parabrachial nucleus of the pons seems to be a major relay for pertinent ascending input from the NTS. In particular the central nucleus of the amygdala, a projection area of the parabrachial nucleus, appears to be crucial for eating in response to decreased fatty acid oxidation. As ketones are products of hepatic fatty acid oxidation that are released into the circulation and peripheral (and central) administration of 3-hydroxybutyrate reduced voluntary food intake in rats, ketones being utilized as fuels by the peripheral and central nervous system might contribute to control of eating by fatty acid oxidation, especially when high levels of circulating ketones occur. Whether a modulation of the hepatic membrane potential resulting from changes in the rate of fatty acid oxidation and/or ketogenesis represent a signal for control of eating transmitted to the brain by vagal afferents remains to be established. Recent in vivo studies investigating the effects of mercaptoacetate on the hepatic membrane potential and on afferent activity of the hepatic vagus branch are consistent with this notion. Further investigations are necessary to delineate the coding mechanisms by which fatty acid oxidation and/or ketogenesis modulate vagal afferent activity.

Blood glucose patterns and appetite in time-blinded humans: carbohydrate versus fat

We assessed the extent to which a possible synchronization between transient blood glucose declines and spontaneous meal initiation would lend support to the interpretation of a preload study with isoenergetic (1 MJ) isovolumetric high-fat or simple carbohydrate (CHO) preload drinks. Ten men (18-30 yr) fasted overnight and then were time blinded and made aware that they could request meals anytime. At first meal requests, volunteers consumed a preload; ad libitum meals were offered at subsequent requests. Postabsorptively, transient declines in blood glucose were associated with meal requests (chi(2) = 8.29). Subsequent meal requests occurred during "dynamic declines" in blood glucose after the peak induced by drink consumption (100%). These meal requests took twice as long to occur after high-fat than after CHO preloads (fat = 126 +/- 21, CHO = 65 +/- 15 min), consistent with differences in interpolated 65-min satiety scores (fat = 38 +/- 8.2, CHO = 16 +/- 4). Postprandially, transient blood glucose declines were associated with meal requests (chi(2) = 4.30). Spontaneous meal initiations were synchronized with transient and dynamic blood glucose declines. Synchronization of intermeal interval and dynamic declines related to higher satiating efficiency from high-fat preloads than from simple CHO preloads.

Regulation of body weight in humans

The mechanisms involved in body weight regulation in humans include genetic, physiological, and behavioral factors. Stability of body weight and body composition requires that energy intake matches energy expenditure and that nutrient balance is achieved. Human obesity is usually associated with high rates of energy expenditure. In adult individuals, protein and carbohydrate stores vary relatively little, whereas adipose tissue mass may change markedly. A feedback regulatory loop with three distinct steps has been recently identified in rodents: 1) a sensor that monitors the size of adipose tissue mass is represented by the amount of leptin synthesized by adipose cells (a protein encoded by the ob gene) which determines the plasma leptin levels; 2) hypothalamic centers, with specific leptin receptors, which receive and integrate the intensity of the signal; and 3) effector systems that influence the two determinants of energy balance, i.e., energy intake and energy expenditure. With the exception of a few very rare cases, the majority of obese human subjects have high plasma leptin levels that are related to the size of their adipose tissue mass. However, the expected regulatory responses (reduction in food intake and increase in energy expenditure) are not observed in obese individuals. Thus obese humans are resistant to the effect of endogenous leptin, despite unaltered hypothalamic leptin receptors. Whether defects in the leptin signaling cascade play a role in the development of human obesity is a field of great actual interest that needs further research. Present evidences suggest that genetic and environmental factors influence eating behavior of people prone to obesity and that diets that are high in fat or energy dense undermine body weight regulation by promoting an overconsumption of energy relative to need.

Brain administration of OB protein (leptin) inhibits neuropeptide-Y-induced feeding in ob/ob mice

OB protein (or leptin) administration causes a long-lasting reduction in food intake and body weight in obese ob/ob mice. Neuropeptide Y, a stimulator of feeding, has been proposed to be a major mediator of the biological actions of OB protein. To test this hypothesis, the interaction of brain administration of exogenous OB protein and NPY on the feeding behavior of ob/ob mice was examined. Human OB protein, in a dose-dependent manner, partially or completely blocked feeding induced by exogenous NPY. These results demonstrate that OB protein can functionally antagonize and dominate the actions of exogenous NPY on feeding.

Chronic administration of OB protein decreases food intake by selectively reducing meal size in female rats

The mechanisms by which OB protein controls food intake and energy balance are unknown. Therefore, we investigated the effects of a novel modified human recombinant OB protein (Mod-OB) on spontaneous feeding patterns, body weight, running wheel activity, and ovarian cycling in female rats. Mod-OB or vehicle was injected (4 mg . kg-1 . day-1 sc) for 2 ovarian cycles (8 days) using a within-subjects design. Observations were continued for five ovarian cycles after injections; treatments were then reversed. Mod-OB reduced food intake approximately 20% from injection day 1 to postinjection day 2. Body weight was reduced from injection day 3 to postinjection day 15 (maximum decrease, 25 +/- 4 g, postinjection days 3 and 4). Food intake was reduced due to decreases in nocturnal meal size, which appeared to be superimposed on the normal pattern of spontaneous feeding (i.e., reductions in meal size at estrus). Mod-OB did not significantly affect diurnal food intake or meal patterns, failed to alter wheel running, and did not disrupt the rats' ovarian cycles. We conclude that chronically administered Mod-OB reduces food intake in female rats by selectively affecting the mechanisms controlling meal size.

Meal pattern analysis to investigate the satiating potential of fat, carbohydrate, and protein in rats

We examined meal patterns after isocaloric duodenal infusions of fat, carbohydrate (CHO), and protein by measuring meal size, intermeal interval (IMI) and total food intake (TFI). Wistar rats were adapted to normal feeding 6 h/day, with continuous computer monitoring of feeding patterns. One of five solutions (10 ml of 1 kcal/ml at 0.45 ml/min; 0, 20, 50, 80, or 100% of energy from fat) or saline (control) was infused 10 min after initiation of eating. Separate rats received casein or casein hydrolysate at 18.5 or 37% energy. Equivalent energy loads varying in fat, CHO, and protein content compared with saline resulted in similar reductions in first meal intakes. The second meal did not differ among fat and CHO treatments including saline; however, infusion with a protein-containing solution increased the size of meal 2. The IMI was doubled by protein infusion independently of dose or source but extended dose dependently by fat. TFI was lower after high fat and higher after protein than after saline infusion. The results indicate that the concentrations of fat, CHO, and protein differentially affect the qualitative and quantitative aspects of feeding in rats.

Metabolic and hormonal controls of food intake: highlights of the last 25 years--1972-1997

The six major research advances in metabolic and hormonal controls of food intake that have altered the direction or have broadened the scope of the field in the last 25 years are discussed. The advances selected are: (1) GI processes and meal termination-the CCK pathway; (2) Brain insulin hypothesis; (3) Glucose-dependent processes in periphery, plasma, and brain including the transient declines in blood glucose signaling meal initiation; (4) Fatty acid oxidation in the liver; (5) Behavioral and metabolic patterns; and (6) New pathways from molecular genetics and molecular biology-the OB protein pathway.

An energy sensor for control of energy intake

Control of energy intake, either in response to changes in the energy content of food or in energy expenditures and storage, is based on the detection of a feedback signal generated in the processing of metabolic fuels for energy. Evidence from studies of the fructose analogue, 2,5-AM, indicates a sensor in liver responds to changes in intracellular ATP or some closely associated event and communicates this information to the brain via vagal afferent neurons. Such a mechanism could serve as the energy sensor which controls energy intake.

Breakfasts with different fiber and macronutrient contents do not differentially affect timing, size or microstructure of the subsequent lunch

The effects of four equienergetic breakfasts with varying fiber and macronutrient contents on hunger and satiety ratings, on subsequent lunch intake, and on postprandial carbohydrate and fat metabolism were investigated in normal weight male subjects in two experiments, in which lunch was offered at a predetermined time (Experiment 1) or in which the subjects were free to choose when to eat lunch (Experiment 2). Consumption of either a commercially available high fiber cereal (HFC, 10% fiber), a medium fiber cereal (MFC, 7% fiber), a low fiber cereal (LFC, 3% fiber), or a standard continental breakfast (0% fiber) on nonconsecutive days did not differentially affect hunger and satiety ratings, the size or microstructure of the subsequent lunch, and the breakfast to lunch intermeal interval (in Experiment 2). Plasma concentrations of glucose, lactate, and insulin increased more after the LFC breakfast than after the other breakfast varieties. A reactive postprandial hypoglycaemia occurred after the LFC breakfast, shortly before lunch. The plasma concentrations of fat metabolites (triglycerides, free fatty acids, beta-hydroxybutyrate) and of glucagon were not differentially affected by the breakfast varieties. The results are consistent with the assumption that energy content of a meal is the major determinant of subsequent energy intake in man and the fiber content and macronutrient composition have only a modulating effect.

Substitution and caloric regulation in a closed economy

Three experiments were conducted to study the effect of an imperfect substitute for food on demand for food in a closed economy. In Experiments 1 and 2, rats pressed a lever for their entire daily food ration, and a fixed ratio of presses was required for each food pellet. In both experiments, the fixed ratio was held constant during a daily session but was increased between sessions. The fixed ratio was increased over a series of daily sessions once in the absence of concurrently available sucrose and again when sucrose pellets were freely available. For both series, increases in the fixed ratio reduced food intake, but body weight was reduced only in the no-sucrose condition. In the sucrose condition, body weight and total caloric intake (sucrose plus food) were relatively unaffected by increases in the fixed ratio. At all fixed ratios, food intake was proportionally reduced by the intake of sucrose. In Experiment 3, monkeys obtained food or saccharin by pressing keys; the fixed ratio of presses per food pellet was increased once when tap water was each monkey's only source of fluid, again when each monkey's water was sweetened with saccharin, and a third time when each monkey had concurrent access to the saccharin solution and plain water. Increases in the fixed ratio, but not the intake of the saccharin solution, reduced each monkey's food intake. Because neither rats' sucrose nor monkeys' saccharin intakes affected the slope of the respective demand curves for food, monkeys and rats increased their daily output of presses and thereby defended their daily intake of those complementary elements of food. However, sucrose reduced rats' food intake. The relative constancy of body weight and total caloric intake in the sucrose condition is consistent with the possibility that rats tended to regulate caloric intake.