Neural circuits mediating food cue-reactivity: Toward a new model shaping the interplay of internal and external factors

Practical strategies to manage obesity in type 2 diabetes

The rising phenomenon of obesity, a major risk factor for the development and progression of type 2 diabetes, is a complex and multifaceted issue that requires a comprehensive and coordinated approach to be prevented and managed. Although novel pharmacological measures to combat obesity have achieved unprecedented efficacy, a healthy lifestyle remains essential for the long-term success of any therapeutic intervention. However, this requires a high level of intrinsic motivation and continued behavioural changes in the face of multiple metabolic, psychological and environmental factors promoting weight gain, particularly in the context of type 2 diabetes. This review is intended to provide practical recommendations in the context of a holistic, person-centred approach to weight management, including evidence-based and expert recommendations addressing supportive communication, shared decision-making, as well as nutritional and pharmacological therapeutic approaches to achieve sustained weight loss.

Trait food craving predicts functional connectivity between dopaminergic midbrain and the fusiform food area during eating imagery

Neurofunctional coupling between the dopaminergic midbrain (i.e., ventral tegmental area, VTA) and higher-order visual regions may contribute to food craving, leading to the onset or maintenance of obesity. We recently showed that the VTA resting-state functional connectivity with the occipitotemporal cortex, at the level of the fusiform gyrus (FFG), was specifically associated with trait food craving and the implicit bias for food images, suggesting that VTA-FFG connectivity may reflect the association between the visual representations of food and its motivational properties. To further test this hypothesis, this time we studied task-based functional connectivity in twenty-eight healthy-weight participants while imagining eating their most liked high-calorie (HC) or least liked low-calorie food (LC) or drinking water (control condition). Trait food craving scores were used to predict changes in task-based functional connectivity of the VTA during imagery of HC compared to LC foods (relative to the control condition). Trait food craving was positively associated with the functional connectivity of the VTA with the left FFG: people with higher trait food craving scores show stronger VTA-FFG connectivity, specifically for the imagery of the liked HC foods. This association was not linked to the quality of imagery nor to state measures of craving, appetite, or thirst. These findings emphasize the contribution of the functional coupling between dopaminergic midbrain and higher-order visual regions to food craving, suggesting a neurofunctional mechanism by which the mental representations of the HC food we like can become much more salient if not irresistible.

How images of food become cravingly salient in obesity

OBJECTIVE

This case-control study was aimed at testing two main hypotheses: (i) obesity is characterized by neurofunctional alterations within the mesocorticolimbic reward system, a brain network originating from the midbrain ventral tegmental area (VTA); and (ii) these alterations are associated with a bias for food-related stimuli and craving.

METHODS

Normal-weight individuals and individuals with obesity underwent a resting-state functional magnetic resonance imaging scan and the assessment of impulsivity, food craving, appetite, and implicit bias for food and non-food stimuli. The VTA was used as a seed to map, for each participant, the strength of its functional connections with the rest of the brain. The between-group difference in functional connectivity was then computed, and brain-behavior correlations were performed.

RESULTS

Individuals with obesity showed hyper-connectivity of the VTA with part of the ventral occipitotemporal cortex, recently found to be specialized for food images, and hypo-connectivity with the left inferior frontal gyrus, devoted to cognitive control. VTA-ventral occipitotemporal cortex connectivity was positively associated with food craving and food-related bias; the reverse correlation was observed for VTA-inferior frontal gyrus connectivity.

CONCLUSIONS

These findings reveal that, in obesity, food-related visual stimuli become cravingly salient through an imbalanced connectivity of the reward system with sensory-specific regions and the frontal cortex involved in cognitive control.

The development of an immersive mixed-reality application to improve the ecological validity of eating and sensory behavior research

Introduction

The modern eating environment has been implicated as a driving force of the obesity epidemic. Mixed reality applications may improve traditional methodological assessments of eating behavior by improving the ecological validity of the laboratory setting.

Methods

Research experts evaluated the utility and ecological validity of a mixed reality application that allowed immersion within virtual environments through utilizing the passthrough cameras of the head mounted display to view and interact with real foods. An initial evaluation was conducted that involved three virtual environments: a traditional laboratory booth, a non-textured restaurant, and a full-textured restaurant. The feedback from the initial evaluation was used to create a new virtual restaurant environment and a subsequent evaluation was conducted.

Results

Nearly all research experts suggested adding social cues such as people and background noise to create a more authentic and ecologically valid experience. The experts scored the new virtual restaurant environment to be more acceptable than eating or conducting research in a sensory booth but scored lower when compared to conducting research in a real-world restaurant setting.

Discussion

The results of this evaluation suggest that mixed reality applications may be a new methodology to assess environmental influences of eating behavior and may be a promising direction for eating behavior and sensory science research.

[Structural and functional characteristics of the brain and their role in the development of eating behaviour in obesity: A review]

Obesity is a major public health problem that requires new approaches. Despite all interventions, the behavioural and therapeutic interventions developed have demonstrated limited effectiveness in curbing the obesity epidemic. Findings from imaging studies of the brain suggest the existence of neural vulnerabilities and structural changes that are associated with the development of obesity and eating disorders. This review highlights the clinical relevance of brain neuroimaging research in obese individuals to prevent risky behaviour, early diagnosis, and the development of new safer and more effective treatments.

Changes in food cue reactivity through affective and nonaffective touch: An event-related potential study

Affective touch (gentle/slow brushing of the skin) can facilitate the allocation of processing resources to simultaneously present stimuli from different modalities. The present event-related potential (ERP) study investigated whether affective touch can enhance attention to visual cues of healthy food. Female participants (n = 117) were randomly assigned to three different groups that either received affective touch, nonaffective touch (fast brushing of the skin), or no touch during the presentation of pictures of healthy food (fruits and vegetables) and non-food. Electrocortical markers of motivated attention (frontal/parietal P300, late positive potential: LPP) and reported appetite for the depicted food items were compared between the three groups. Nonaffective touch was associated with reduced amplitudes of the frontal P300/LPP (300-1000 ms) for food pictures indexing reduced motivated attention. Affective touch did not influence food cue reactivity (P300/LPP, appetite). Effects of affective touch may be restricted to specific stimuli, e.g. those with social relevance.

Maternal Over- and Malnutrition and Increased Risk for Addictive and Eating Disorders in the Offspring

Evidence from human and animal studies has shown that maternal overnutrition and/or obesity are linked with neurobehavioral changes in the offspring. This fetal programming is characterized by adaptive responses to changes in the nutritional state during early life. In the past decade, an association has been made between overconsumption of highly-palatable food by the mother during fetal development and abnormal behaviors resembling addiction in the offspring. Maternal overnutrition can lead to alterations in the offspring's brain reward circuitry leading to hyperresponsiveness of this circuit following exposure to calorie-dense foods later in life. Given the accumulating evidence indicating that the central nervous system plays a pivotal role in regulating food intake, energy balance, and the motivation to seek food, a dysfunction in the reward circuitry may contribute to the addiction-like behaviors observed in the offspring. However, the underlying mechanisms leading to these alterations in the reward circuitry during fetal development and their relevance to the increased risk for the offspring to later develop addictive-like behaviors is still unclear. Here, we review the most relevant scientific reports about the impact of food overconsumption during fetal development and its effect on addictive-like behaviors of the offspring in the context of eating disorders and obesity.