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Kullmann S, Heni M, Hallschmid M, Fritsche A, Preissl H, Häring HU. Brain Insulin Resistance at the Crossroads of Metabolic and Cognitive Disorders in Humans. Physiol Rev 2016; 96:1169-209. [PMID: 27489306 DOI: 10.1152/physrev.00032.2015] [Citation(s) in RCA: 334] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Ever since the brain was identified as an insulin-sensitive organ, evidence has rapidly accumulated that insulin action in the brain produces multiple behavioral and metabolic effects, influencing eating behavior, peripheral metabolism, and cognition. Disturbances in brain insulin action can be observed in obesity and type 2 diabetes (T2D), as well as in aging and dementia. Decreases in insulin sensitivity of central nervous pathways, i.e., brain insulin resistance, may therefore constitute a joint pathological feature of metabolic and cognitive dysfunctions. Modern neuroimaging methods have provided new means of probing brain insulin action, revealing the influence of insulin on both global and regional brain function. In this review, we highlight recent findings on brain insulin action in humans and its impact on metabolism and cognition. Furthermore, we elaborate on the most prominent factors associated with brain insulin resistance, i.e., obesity, T2D, genes, maternal metabolism, normal aging, inflammation, and dementia, and on their roles regarding causes and consequences of brain insulin resistance. We also describe the beneficial effects of enhanced brain insulin signaling on human eating behavior and cognition and discuss potential applications in the treatment of metabolic and cognitive disorders.
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Affiliation(s)
- Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Manfred Hallschmid
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Hans-Ulrich Häring
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany; German Center for Diabetes Research (DZD e.V.), Tübingen, Germany; Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany; Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; and Department of Pharmacy and Biochemistry, Faculty of Science, Eberhard Karls Universität Tübingen, Tübingen, Germany
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Goldstone AP, Miras AD, Scholtz S, Jackson S, Neff KJ, Pénicaud L, Geoghegan J, Chhina N, Durighel G, Bell JD, Meillon S, le Roux CW. Link Between Increased Satiety Gut Hormones and Reduced Food Reward After Gastric Bypass Surgery for Obesity. J Clin Endocrinol Metab 2016; 101:599-609. [PMID: 26580235 PMCID: PMC4880130 DOI: 10.1210/jc.2015-2665] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CONTEXT Roux-en-Y gastric bypass (RYGB) surgery is an effective long-term intervention for weight loss maintenance, reducing appetite, and also food reward, via unclear mechanisms. OBJECTIVE To investigate the role of elevated satiety gut hormones after RYGB, we examined food hedonic-reward responses after their acute post-prandial suppression. DESIGN These were randomized, placebo-controlled, double-blind, crossover experimental medicine studies. PATIENTS Two groups, more than 5 months after RYGB for obesity (n = 7-11), compared with nonobese controls (n = 10), or patients after gastric banding (BAND) surgery (n = 9) participated in the studies. INTERVENTION Studies were performed after acute administration of the somatostatin analog octreotide or saline. In one study, patients after RYGB, and nonobese controls, performed a behavioral progressive ratio task for chocolate sweets. In another study, patients after RYGB, and controls after BAND surgery, performed a functional magnetic resonance imaging food picture evaluation task. MAIN OUTCOME MEASURES Octreotide increased both appetitive food reward (breakpoint) in the progressive ratio task (n = 9), and food appeal (n = 9) and reward system blood oxygen level-dependent signal (n = 7) in the functional magnetic resonance imaging task, in the RYGB group, but not in the control groups. RESULTS Octreotide suppressed postprandial plasma peptide YY, glucagon-like peptide-1, and fibroblast growth factor-19 after RYGB. The reduction in plasma peptide YY with octreotide positively correlated with the increase in brain reward system blood oxygen level-dependent signal in RYGB/BAND subjects, with a similar trend for glucagon-like peptide-1. CONCLUSIONS Enhanced satiety gut hormone responses after RYGB may be a causative mechanism by which anatomical alterations of the gut in obesity surgery modify behavioral and brain reward responses to food.
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Affiliation(s)
- Anthony P Goldstone
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Alexander D Miras
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Samantha Scholtz
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Sabrina Jackson
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Karl J Neff
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Luc Pénicaud
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Justin Geoghegan
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Navpreet Chhina
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Giuliana Durighel
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Jimmy D Bell
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Sophie Meillon
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
| | - Carel W le Roux
- Metabolic and Molecular Imaging Group (A.P.G., A.D.M., S.S., N.C., J.D.B.), Robert Steiner MRI Unit (G.D.), Medical Research Council Clinical Sciences Centre, and Centre for Neuropsychopharmacology (A.P.G.) and Computational, Cognitive, and Clinical Neuroimaging Laboratory (A.P.G., N.C.), Division of Brain Sciences, and Division of Diabetes, Endocrinology, and Metabolism (A.D.M., C.W.l.R.), Imperial College London, Hammersmith Hospital, London W12 0NN, United Kingdom; Diabetes Complications Research Centre (S.J., K.J.N., J.G., S.M., C.W.l.R.), Conway Institute, School of Medicine and Medical Science, University College Dublin, Belfield, Dublin 4, Ireland; Centre National de la Recherche Scientifique Unité Mixte de Recherche 6265 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Institut National de la Recherche Agronomique Unité Mixte de Recherche 1324 (L.P., S.M.), Centre des Sciences du Goût et de l'Alimentation, and Unité Mixte de Recherche Centre des Sciences du Goût et de l'Alimentation (L.P., S.M.), Université de Bourgogne, F-21000, Dijon, France; Research Centre for Optimal Health (J.D.B.), University of Westminster, London W1W 6UW, United Kingdom; and Department of Gastro Surgical Research and Education (C.W.l.R.), University of Gothenburg, 41345 Gothenburg, Sweden
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