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Blum K, Baron D, McLaughlin T, Thanos PK, Dennen C, Ceccanti M, Braverman ER, Sharafshah A, Lewandrowski KU, Giordano J, Badgaiyan RD. Summary Document Research on RDS Anti-addiction Modeling: Annotated Bibliography. JOURNAL OF ADDICTION PSYCHIATRY 2024; 8:1-33. [PMID: 38765881 PMCID: PMC11100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Annotated bibliography of genetic addiction risk severity (GARS) publications, pro-dopamine regulation in nutraceuticals (KB220 nutraceutical variants), and policy documents. Further research is required to encourage the field to consider "Reward Deficiency Syndrome (RDS) Anti-addiction Modeling" which involves early risk identification by means of genetic assessment similar to GARS, followed by induction of dopamine homeostasis by means of genetically guided pro-dopamine regulation similar to KB220. These results suggest that genetically based treatments may be a missing piece in the treatment of substance use disorder (SUD).
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Affiliation(s)
- Kenneth Blum
- Center for Sports and Mental Health, Western University Health Sciences, Pomona, CA, USA
- The Kenneth Blum Behavioral and Neurogenetic Institute, LLC., Austin, TX, USA
| | - David Baron
- Center for Sports and Mental Health, Western University Health Sciences, Pomona, CA, USA
| | - Thomas McLaughlin
- The Kenneth Blum Behavioral and Neurogenetic Institute, LLC., Austin, TX, USA
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York, Buffalo, NY, USA
| | - Catherine Dennen
- Department of Family Medicine, Jefferson University School of Medicine, Philadelphia, PA, USA
| | - Mauro Ceccanti
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Eric R. Braverman
- The Kenneth Blum Behavioral and Neurogenetic Institute, LLC., Austin, TX, USA
| | - Alireza Sharafshah
- Division of Genetics, Department of Cell and Molecular Biology and Microbiology, School of Science and Biotechnology, University of Isfahan, Isfahan, Iran
| | - Kai-Uwe Lewandrowski
- Department of Orthopaedics, Fundación Universitaria Sanitas Bogotá D.C. Colombia
| | - John Giordano
- The Kenneth Blum Behavioral and Neurogenetic Institute, LLC., Austin, TX, USA
- Division of Recovery Science, JC’S Recovery Center, Hollywood, Florida, USA
| | - Rajendra D. Badgaiyan
- The Kenneth Blum Behavioral and Neurogenetic Institute, LLC., Austin, TX, USA
- Department of Psychiatry, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
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2
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Hidalgo Vira N, Oyarce K, Valladares Vega M, Goldfield GS, Guzmán-Gutiérrez E, Obregón AM. No association of the dopamine D2 receptor genetic bilocus score (rs1800497/rs1799732) on food addiction and food reinforcement in Chilean adults. Front Behav Neurosci 2023; 17:1067384. [PMID: 37064299 PMCID: PMC10102336 DOI: 10.3389/fnbeh.2023.1067384] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/08/2023] [Indexed: 04/03/2023] Open
Abstract
Purpose: Different systems regulate food intake. In the reward system, dopamine (DA) is the main neurotransmitter, and a variety of genetic variants (rs1799732 and rs1800497) are associated with addiction. Addiction is a highly polygenic disease, where each allelic variant adds a small amount of vulnerability. Polymorphisms rs1799732 and rs1800497 are associated with eating behavior and hedonic hunger, but links to food addiction remain unclear.Aim: To evaluate the association between the bilocus profile (rs1799732-rs1800497) of the dopaminergic pathway with food reinforcement and food addiction in Chilean adults.Methods: A cross-sectional study recruited a convenience sample of 97 obese, 25 overweight, and 99 normal-weight adults (18–35 years). Anthropometric measurements were performed by standard procedures and eating behavior was assessed using the: Food Reinforcement Value Questionnaire (FRVQ) and Yale Food Addiction scale (YFAS). The DRD2 genotypes were determined by TaqMan assays (rs1800497 and rs1799732). A bilocus composite score was calculated.Results: In the normal weight group, individuals who were heterozygous for the rs1977932 variant (G/del) showed higher body weight (p-value 0.01) and abdominal circumference (p-value 0.01) compared to those who were homozygous (G/G). When analyzing rs1800497, a significant difference in BMI was observed for the normal weight group (p-value 0.02) where heterozygous showed higher BMI. In the obese group, homozygous A1/A1 showed higher BMI in comparison to A1/A2 and A2/A2 (p-value 0.03). Also, a significant difference in food reinforcement was observed in the rs1800497, where homozygous for the variant (A1A1) show less reinforcement (p-value 0.01).In relation to the bilocus score in the total sample, 11% showed “very low dopaminergic signaling”, 24.4% were “under”, 49.7% showed “intermediate signaling”, 12.7% showed “high” and 1.4% showed “very high”. No significant genotypic differences were observed in food reinforcement and food addiction by bilocus score.Conclusions: The results indicate that the genetic variants rs1799732 and rs1800497 (Taq1A) were associated with anthropometric measurements but not with food addiction or food reinforcement in Chilean university students. These results suggest that other genotypes, such as rs4680 and rs6277, which affect DA signaling capacity through a multilocus composite score, should be studied. Level V: Evidence obtained from a cross-sectional descriptive study.
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Affiliation(s)
- Nicole Hidalgo Vira
- Escuela de Tecnología Médica, Facultad de Medicina y Ciencia, Universidad San Sebastián, Concepción, Chile
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Concepción, Chile
| | - Karina Oyarce
- Escuela de Tecnología Médica, Facultad de Medicina y Ciencia, Universidad San Sebastián, Concepción, Chile
| | - Macarena Valladares Vega
- Escuela de Terapia Ocupacional, Facultad de Salud y Ciencias Sociales, Universidad de las Ámericas, Santiago, Chile
| | - Gary S. Goldfield
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Enrique Guzmán-Gutiérrez
- Pregnancy Diseases Laboratory, Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Universidad de Concepción, Concepción, Chile
| | - Ana M. Obregón
- Escuela de Nutrición y Dietética, Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Concepción, Chile
- *Correspondence: Ana M. Obregón
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Madigan MA, Gupta A, Bowirrat A, Baron D, Badgaiyan RD, Elman I, Dennen CA, Braverman ER, Gold MS, Blum K. Precision Behavioral Management (PBM) and Cognitive Control as a Potential Therapeutic and Prophylactic Modality for Reward Deficiency Syndrome (RDS): Is There Enough Evidence? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116395. [PMID: 35681980 PMCID: PMC9180535 DOI: 10.3390/ijerph19116395] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 12/20/2022]
Abstract
This brief commentary aims to provide an overview of the available and relatively new precision management of reward deficiencies manifested as substance and behavioral disorders. Current and future advances, concepts, and the substantial evidential basis of this potential therapeutic and prophylactic treatment modality are presented. Precision Behavioral Management (PBM), conceptualized initially as Precision Addiction Management (PAM), certainly deserves consideration as an important modality for the treatment of impaired cognitive control in reward processing as manifested in people with neurobiologically expressed Reward Deficiency Syndrome (RDS).
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Affiliation(s)
- Margaret A. Madigan
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - David Baron
- Center for Psychiatry, Medicine, & Primary Care (Office of Provost), Division of Addiction Research & Education, Western University Health Sciences, Pomona, CA 91766, USA;
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA;
| | - Igor Elman
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Catherine A. Dennen
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Eric R. Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
- Center for Psychiatry, Medicine, & Primary Care (Office of Provost), Division of Addiction Research & Education, Western University Health Sciences, Pomona, CA 91766, USA;
- Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, 1053 Budapest, Hungary
- Department of Psychiatry, School of Medicine, University of Vermont, Burlington, VT 05405, USA
- Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton VA Medical Centre, Dayton, OH 45324, USA
- Correspondence:
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Blum K, Khalsa J, Cadet JL, Baron D, Bowirrat A, Boyett B, Lott L, Brewer R, Gondré-Lewis M, Bunt G, Kazmi S, Gold MS. Cannabis-Induced Hypodopaminergic Anhedonia and Cognitive Decline in Humans: Embracing Putative Induction of Dopamine Homeostasis. Front Psychiatry 2021; 12:623403. [PMID: 33868044 PMCID: PMC8044913 DOI: 10.3389/fpsyt.2021.623403] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/05/2021] [Indexed: 02/01/2023] Open
Abstract
Over years, the regular use of cannabis has substantially increased among young adults, as indicated by the rise in cannabis use disorder (CUD), with an estimated prevalence of 8. 3% in the United States. Research shows that exposure to cannabis is associated with hypodopaminergic anhedonia (depression), cognitive decline, poor memory, inattention, impaired learning performance, reduced dopamine brain response-associated emotionality, and increased addiction severity in young adults. The addiction medicine community is increasing concern because of the high content of delta-9-tetrahydrocannabinol (THC) currently found in oral and vaping cannabis products, the cognitive effects of cannabis may become more pronounced in young adults who use these cannabis products. Preliminary research suggests that it is possible to induce 'dopamine homeostasis,' that is, restore dopamine function with dopamine upregulation with the proposed compound and normalize behavior in chronic cannabis users with cannabis-induced hypodopaminergic anhedonia (depression) and cognitive decline. This psychological, neurobiological, anatomical, genetic, and epigenetic research also could provide evidence to use for the development of an appropriate policy regarding the decriminalization of cannabis for recreational use.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA, United States
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
- Department of Psychiatry, University of Vermont, Burlington, VT, United States
- Department of Psychiatry, Wright University Boonshoff School of Medicine, Dayton, OH, United States
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, School of Medicine, Washington, DC, United States
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - David Baron
- Western University Health Sciences, Pomona, CA, United States
| | - Abdalla Bowirrat
- Department of Neuroscience, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Brent Boyett
- Bradford Health Services, Madison, AL, United States
| | - Lisa Lott
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Raymond Brewer
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Marjorie Gondré-Lewis
- Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC, United States
| | - Gregory Bunt
- Good Samaritan/Day Top Treatment Center, and NYU School of Medicine, New York, NY, United States
| | - Shan Kazmi
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
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5
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DAT1 and Its Psychological Correlates in Children with Avoidant/Restrictive Food Intake Disorder: A Cross-Sectional Pilot Study. Behav Sci (Basel) 2021; 11:bs11010009. [PMID: 33466618 PMCID: PMC7828669 DOI: 10.3390/bs11010009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/03/2021] [Accepted: 01/09/2021] [Indexed: 12/02/2022] Open
Abstract
International research has underlined the role played by children’s and maternal psychopathological symptoms on the onset of avoidant/restrictive food intake disorder (ARFID) in early childhood. No study has considered the possible interplay between children’s dopamine transporter (DAT1) genotype and methylation, dysregulation problems and maternal psychopathological risk. This study aimed to investigate the complex relationship between these variables, considering the possible mediation role played by children’s DAT1 methylation on the relationship between mothers’ psychopathological risk and children’s dysregulation problems, moderated by children’s DAT1 genotype. Our sample consisted of 94 early children and their mothers, divided into four subgroups, based on children’s ARFID subtypes (irritable/impulsive (I/I), sensory food aversions (SFA), post-traumatic feeding disorders subtypes (PTFD), and a non-clinical group (NC)). We addressed children’s dysregulation problems and maternal psychopathological risk, and collected children’s DNA through buccal swabs. Results showed that children’s 9/x genotype was associated with PTFD and NC groups, whereas the 10/10 genotype was associated with the SFA group, with large effect size. There were significant large differences in the study groups on children’s DAT1 total methylation, children’s dysregulation problems, and maternal psychopathological risk. Children’s DAT1 methylation did not mediate the relationship between mother’s psychopathological risk and children’s dysregulation problems, but there was a significant large direct effect. Children’s 9/x genotype moderated the relationship between maternal psychopathological risk and children’s DAT1 methylation but, respectively, with a large and small effect. Our pilot study suggested that the relationship between children’s DAT1 genotype and methylation, dysregulation problems, and maternal psychopathological risk has a crucial contribution to ARFID.
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6
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Blum K, Baron D, Jalali R, Modestino EJ, Steinberg B, Elman I, Badgaiyan RD, Gold MS. Polygenic and multi locus heritability of alcoholism: Novel therapeutic targets to overcome psychological deficits. ACTA ACUST UNITED AC 2020; 7. [PMID: 34707891 PMCID: PMC8547332 DOI: 10.15761/jsin.1000240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA, USA.,Institute of Psychology, ELTE Eotvos Lorand University, Budapest, Hungary.,Division of Nutrigenomics, Genomic Testing Center Geneus Health, LLC, San Antonio, TX, USA.,Department of Psychiatry, University of Vermont, VT, USA.,Department of Psychiatry, Wright University Boonshoff School of Medicine, Dayton, OH., USA.,The Kenneth Blum Behavioral Neurogenetic Institute (Division of iVitalize Inc.), Austin, Tx, USA
| | - David Baron
- Western University Health Sciences, Pomona, CA, USA
| | - Rehan Jalali
- The Kenneth Blum Behavioral Neurogenetic Institute (Division of iVitalize Inc.), Austin, Tx, USA
| | | | | | - Igor Elman
- Department of Psychiatry, Harvard School of Medicine, Cambridge, MA, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy I Memorial VA Hospital, San Antonio, TX. and Long School of Medicine, University of Texas Medical Center, San Antonio TX, USA
| | - Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Mo. USA
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7
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Gupta A, Osadchiy V, Mayer EA. Brain-gut-microbiome interactions in obesity and food addiction. Nat Rev Gastroenterol Hepatol 2020; 17:655-672. [PMID: 32855515 PMCID: PMC7841622 DOI: 10.1038/s41575-020-0341-5] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/24/2020] [Indexed: 12/13/2022]
Abstract
Normal eating behaviour is coordinated by the tightly regulated balance between intestinal and extra-intestinal homeostatic and hedonic mechanisms. By contrast, food addiction is a complex, maladaptive eating behaviour that reflects alterations in brain-gut-microbiome (BGM) interactions and a shift of this balance towards hedonic mechanisms. Each component of the BGM axis has been implicated in the development of food addiction, with both brain to gut and gut to brain signalling playing a role. Early-life influences can prime the infant gut microbiome and brain for food addiction, which might be further reinforced by increased antibiotic usage and dietary patterns throughout adulthood. The ubiquitous availability and marketing of inexpensive, highly palatable and calorie-dense food can further shift this balance towards hedonic eating through both central (disruptions in dopaminergic signalling) and intestinal (vagal afferent function, metabolic endotoxaemia, systemic immune activation, changes to gut microbiome and metabolome) mechanisms. In this Review, we propose a systems biology model of BGM interactions, which incorporates published reports on food addiction, and provides novel insights into treatment targets aimed at each level of the BGM axis.
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Affiliation(s)
- Arpana Gupta
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, University of California Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, CA, USA
| | - Vadim Osadchiy
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, University of California Los Angeles, Los Angeles, CA, USA
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Emeran A Mayer
- G. Oppenheimer Family Center for Neurobiology of Stress and Resilience, Ingestive Behavior and Obesity Program, University of California Los Angeles, Los Angeles, CA, USA.
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
- Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles, Los Angeles, CA, USA.
- Ahmanson-Lovelace Brain Mapping Center at University of California Los Angeles, University of California Los Angeles, Los Angeles, CA, USA.
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Wiss DA, Avena N, Rada P. Sugar Addiction: From Evolution to Revolution. Front Psychiatry 2018; 9:545. [PMID: 30464748 PMCID: PMC6234835 DOI: 10.3389/fpsyt.2018.00545] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 10/12/2018] [Indexed: 12/12/2022] Open
Abstract
The obesity epidemic has been widely publicized in the media worldwide. Investigators at all levels have been looking for factors that have contributed to the development of this epidemic. Two major theories have been proposed: (1) sedentary lifestyle and (2) variety and ease of inexpensive palatable foods. In the present review, we analyze how nutrients like sugar that are often used to make foods more appealing could also lead to habituation and even in some cases addiction thereby uniquely contributing to the obesity epidemic. We review the evolutionary aspects of feeding and how they have shaped the human brain to function in "survival mode" signaling to "eat as much as you can while you can." This leads to our present understanding of how the dopaminergic system is involved in reward and its functions in hedonistic rewards, like eating of highly palatable foods, and drug addiction. We also review how other neurotransmitters, like acetylcholine, interact in the satiation processes to counteract the dopamine system. Lastly, we analyze the important question of whether there is sufficient empirical evidence of sugar addiction, discussed within the broader context of food addiction.
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Affiliation(s)
- David A. Wiss
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Nicole Avena
- Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Pedro Rada
- School of Medicine, University of Los Andes, Mérida, Venezuela
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Blum K, Modestino EJ, Gondré-Lewis MC, Neary J, Siwicki D, Hauser M, Barh D, Steinberg B, Badgaiyan RD. GLOBAL OPIOID EPIDEMIC: DOOMED TO FAIL WITHOUT GENETICALLY BASED PRECISION ADDICTION MEDICINE (PAM ™): LESSONS LEARNED FROM AMERICA. PRECISION MEDICINE 2017; 2:17-22. [PMID: 29372187 PMCID: PMC5778881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
It is a reality that globally opioid deaths have soared for men and women of all social, economic status and age from heroin and fentanyl overdoses. Specifically, in the United States, deaths from narcotic overdoses have reached alarming metrics since 2010. In fact, the Fentanyl rise is driven by drug dealers who sell it as heroin or who use it to lace cocaine or to make illegal counterfeit prescription opioids. The President's Commission on the crisis has linked the death toll as equivalent to "September 11th every three weeks." In fact, The U.S. Centre for Disease Control (CDC) released data showing that opioid-related overdoses were up 15% in the first three quarters of 2016 compared to 2015. Various governmental organizations including NIDA, are actively seeking solutions. However, we argue that unless the scientific community embraces genetic addiction risk coupled with potential precision or personalized medicine to induce "dopamine homeostasis" it will fail. We now have evidence that a ten-gene and eleven single nucleotide polymorphism (SNP) panel predicts Addiction Severity Index (ASI) for both alcohol and drugs of abuse (e.g., Opioids). In a large multi-addiction centre study involving seven diverse treatment programs, the genetic addiction risk score (GARS™) was shown to have a predictive relationship with ASI-MV derived alcohol (≥ seven alleles), and other drugs (≥ 4 alleles) severity risk scores. In a number of neuroimaging studies, we also display that in both animal (bench) and abstinent Chinese severe heroin-dependent patients (bedside), BOLD dopamine activation across the brain reward circuitry revealed increases in resting state functional connectivity as well volume connectivity. It is also known that published nutrigenomic (coupling gene polymorphisms with altered KB220z) studies reveal improved clinical outcomes related to obesity.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, University of Florida & McKnight Brain
Institute, College of Florida, Gainesville, FL, USA
- Department of Psychiatry, Human Integrated Services Unit University
of Vermont Center for Clinical & Translational Science, College of Medicine,
Burlington, VT, USA
- Department of Clinical Neurology, Path Research Foundation, NY, NY,
USA
- Dominion Diagnostics, LLC, North Kingstown, RI, USA
- Department of Psychiatry, Wright State University, Boonshoft School
of Medicine, Dayton, OH USA
- Division of Genetic Testing, Geneus Health LLC, San Antonio, Texas,
USA
- Center for Genomics and Applied Gene Technology, Institute of
Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, West
Bengal, India
- Institute of Psychology, Eötvös Loránd
University Budapest, Hungary
- Department of Psychiatry, University of Southern California, Keck
School of Medicine, Los Angeles, CA, USA
- Division of Neuroscience Based Addiction Research and Therapy, The
Shores Treatment & Recovery Center, Port t. Lucie, Fl. USA
| | | | - Marjorie C. Gondré-Lewis
- Departments of Anatomy, Psychiatry & Behavioral Sciences,
Howard University, Washington, DC, USA
| | - Jennifer Neary
- Division of Genetic Testing, Geneus Health LLC, San Antonio, Texas,
USA
| | - David Siwicki
- Division of Genetic Testing, Geneus Health LLC, San Antonio, Texas,
USA
| | - Mary Hauser
- Dominion Diagnostics, LLC, North Kingstown, RI, USA
| | - Debmalya Barh
- Center for Genomics and Applied Gene Technology, Institute of
Integrative Omics and Applied Biotechnology (IIOAB), Nonakuri, Purba Medinipur, West
Bengal, India
| | | | - Rajendra D. Badgaiyan
- Department of Psychiatry, Richmond University Hospital, Icahn
School of Medicine, New York, NY, USA
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Blum K, Madigan MA, Fried L, Braverman ER, Giordano J, Badgaiyan RD. Coupling Genetic Addiction Risk Score (GARS) and Pro Dopamine Regulation (KB220) to Combat Substance Use Disorder (SUD). ACTA ACUST UNITED AC 2017; 1. [PMID: 29399668 DOI: 10.19080/gjarm.2017.01.555556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, USA.,Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California, USA.,Division of Applied Clinical Research & Education, Dominion Diagnostics, USA.,Department of Neurogenetics, Igene, USA.,National Institute for Holistic Addiction Studies, USA.,Department of Clinical Neurology, Path Foundation NY, USA.,Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center, USA.,Eötvös Loránd University, Institute of Psychology, Europe.,Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, US.,Division of Reward Deficiency Syndrome, Nupathways, Inc., Innsbrook, MO, USA
| | | | - Lyle Fried
- Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center, USA
| | | | - John Giordano
- National Institute for Holistic Addiction Studies, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, US
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Jia X, Wang F, Han Y, Geng X, Li M, Shi Y, Lu L, Chen Y. miR-137 and miR-491 Negatively Regulate Dopamine Transporter Expression and Function in Neural Cells. Neurosci Bull 2016; 32:512-522. [PMID: 27628529 DOI: 10.1007/s12264-016-0061-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 07/13/2016] [Indexed: 12/14/2022] Open
Abstract
The dopamine transporter (DAT) is involved in the regulation of extracellular dopamine levels. A 40-bp variable-number tandem repeat (VNTR) polymorphism in the 3'-untranslated region (3'UTR) of the DAT has been reported to be associated with various phenotypes that are involved in the aberrant regulation of dopaminergic neurotransmission. In the present study, we found that miR-137 and miR-491 caused a marked reduction of DAT expression, thereby influencing neuronal dopamine transport. Moreover, the regulation of miR-137 and miR-491 on this transport disappeared after the DAT was silenced. The miR-491 seed region that is located on the VNTR sequence in the 3'UTR of the DAT and the regulatory effect of miR-491 on the DAT depended on the VNTR copy-number. These data indicate that miR-137 and miR-491 regulate DAT expression and dopamine transport at the post-transcriptional level, suggesting that microRNA may be targeted for the treatment of diseases associated with DAT dysfunction.
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Affiliation(s)
- Xiaojian Jia
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Peking University Shenzhen Hospital, Biomedical Research Institute, Shenzhen Peking University - The Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, China
| | - Feng Wang
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Peking University Shenzhen Hospital, Biomedical Research Institute, Shenzhen Peking University - The Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, China.,Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, 453000, China
| | - Ying Han
- Institute of Mental Health, Peking University Sixth Hospital and Key Laboratory of Mental Health, National Institute on Drug Dependence, Peking University, Beijing, 100191, China
| | - Xuewen Geng
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Peking University Shenzhen Hospital, Biomedical Research Institute, Shenzhen Peking University - The Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, China
| | - Minghua Li
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Peking University Shenzhen Hospital, Biomedical Research Institute, Shenzhen Peking University - The Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, China
| | - Yu Shi
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Peking University Shenzhen Hospital, Biomedical Research Institute, Shenzhen Peking University - The Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, China
| | - Lin Lu
- Institute of Mental Health, Peking University Sixth Hospital and Key Laboratory of Mental Health, National Institute on Drug Dependence, Peking University, Beijing, 100191, China.
| | - Yun Chen
- Shenzhen Key Laboratory for Drug Addiction and Medication Safety, Department of Ultrasound, Peking University Shenzhen Hospital, Biomedical Research Institute, Shenzhen Peking University - The Hong Kong University of Science and Technology Medical Center, Shenzhen, 518036, China.
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Vitali M, Napolitano C, Berman MO, Minuto SF, Battagliese G, Attilia ML, Braverman ER, Romeo M, Blum K, Ceccanti M. Neurophysiological Measures and Alcohol Use Disorder (AUD): Hypothesizing Links between Clinical Severity Index and Molecular Neurobiological Patterns. ACTA ACUST UNITED AC 2016; 5. [PMID: 28090374 PMCID: PMC5231399 DOI: 10.4172/2155-6105.1000181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background In 1987, Cloninger proposed a clinical description and classification of different personality traits genetically defined and independent from each other. Moreover, he elaborated a specific test the TCI to investigate these traits/states. The study of craving in Alcohol Use Disorder (AUD) assumed a greater significance, since ever more data seems to suggest a direct correlation between high levels of craving and a higher risk of relapse in alcoholics. Thus, our study aim is to explore the possible correlations among TCI linked molecular neurobiological pattern (s), craving and alcohol addiction severity measures in a sample of Italian alcoholics. Materials and Methods 191 alcoholics were recruited in a Day Hospital (DH) setting at the Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome. After 7 days detoxification treatment a psychodiagnostic protocol was administered, including TCI, VAS-C, ASI and SADQ. All patients signed an Institutional Review Board (IRB) approved informed consent. Results Principally, we detected a significant positive correlation between HA-scale scores and the VAS scale: increasing in HA-scale corresponds to an increase in craving perception for both intensity (r=0.310; p ≤ 0.001) and frequency (r=0.246; p ≤ 0.001). Moreover, perception of dependence severity, measured with SADQ was also found to be significantly associated positively to both HA-scale (r=0.246; p ≤ 0.001) and NS-scale (r=0.224; p ≤ 0.01). While, for character scales, Persistence (r=−0.195; p=.008) and Self-directedness (r=−0.294; p ≤ 0.001) was negatively associated with ASI linked to alcohol problems. Self-directedness was also negatively correlated with ASI linked to family and social problems (r=−0.349; p ≤ 0.001), employment and support problems (r=−0.220; p=0.003) and psychiatric problems (r=−0.358; p ≤ 0.001). Cooperativeness was a negative correlate with Legal Problems (r=−0.173; p=0.019). and Self-Transcendence was positive correlated with Medical Problems (r=0.276; p ≤ 0.001) Conclusions In view of recent addiction neurobiological theories, such as the “Reward Deficiency Syndrome (RDS)” and the Koob model, our data could suggest that our cohort of patients could possibly be in a particular stage of the course of their addiction history. Thus, if our hypothesis will be confirmed, the TCI-based assessment of alcoholics would allow an optimization of the treatment. Clinicians understanding these newer concepts will be able to translate this information to their patients and potentially enhance clinical outcome (s), because it could suggest a functional hypothesis of neurotransmitter circuits that helps to frame the patient in his/her history of addiction.
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Affiliation(s)
- Mario Vitali
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Carmen Napolitano
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Marlene Oscar Berman
- Department of Psychiatry and Neurology, Boston University School of Medicine and Veterans Administration System, Boston, Massachusetts, USA
| | | | - Gemma Battagliese
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Maria Luisa Attilia
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Eric R Braverman
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA; Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
| | - Marina Romeo
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA; Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA; Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA; Department of Psychiatry & Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA; Department of Nutrigenomics, RD Solutions, LLC, La Jolla, California, USA; Department of Personalized Medicine, IGENE, LLC, Austin, Texas, USA; Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA; Basic & Clinical Research Center, Victory Nutrition, LLC., Austin, Texas, USA
| | - Mauro Ceccanti
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
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Di Lorenzo R, Sberveglieri S, Marrama D, Landi G, Ferri P. Weight control and behavior rehabilitation in a patient suffering from Prader Willi syndrome. BMC Res Notes 2016; 9:199. [PMID: 27036220 PMCID: PMC4818533 DOI: 10.1186/s13104-016-1981-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 03/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study reports a case of Prader Willi syndrome (PWS), a genomic imprinting disease related to chromosome regions 15q11.2-q13 15, which includes hypothalamic dysfunction leading to hyperphagia, obesity, shortness, sleep abnormalities. Our case is extremely severe, in comparison to other PWS cases described in literature, due to the association with severe emotional and psychiatric symptoms: oppositional behaviour, rigidity of thought, skin picking and pathological hoarding. CASE PRESENTATION We described the case of a Caucasian male patient suffering from PWS, treated in outpatient care by local Mental Health Centre and supported by Social Service, who was admitted to a residential rehabilitative facility. After a 2-year follow-up, the patient showed a global improvement in symptoms and functioning, as registered by the rating scales administered. At the end of observation period, we also reported an important improvement in weight control, reducing the risk of obesity and related diseases, therefore improving the prognosis of life. CONCLUSION This case highlights the need for long-term, individualized and multi-professional treatment in patients suffering from a complex genetic syndrome with both organic and psychological alterations, for which medical care setting and pharmacological treatments are not sufficient. Clinical observation of this case leads us to compare PWS to drug addiction and indirectly endorse the neurophysiological hypothesis that food and drugs stimulate the same brain circuits in the limbic system.
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Affiliation(s)
- Rosaria Di Lorenzo
- />Psychiatrist, SPDC, Department of Mental Health, Az-USL-Modena, Via P. Giardini, 1355 Baggiovara, 41126 Modena, Italy
| | - Sara Sberveglieri
- />Registered Nurse, School of Nursing, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy
| | - Donatella Marrama
- />Psychiatrist, Outpatient Care Service, Department of Mental Health, Az-USL-Modena, Via I. Newton, 150, 41121 Modena, Italy
| | - Giulia Landi
- />Resident in Psychiatry, School of Psychiatry, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy
| | - Paola Ferri
- />Nurse Researcher, School of Nursing, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, Italy
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Love T, Laier C, Brand M, Hatch L, Hajela R. Neuroscience of Internet Pornography Addiction: A Review and Update. Behav Sci (Basel) 2015; 5:388-433. [PMID: 26393658 PMCID: PMC4600144 DOI: 10.3390/bs5030388] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/29/2015] [Accepted: 09/08/2015] [Indexed: 02/07/2023] Open
Abstract
Many recognize that several behaviors potentially affecting the reward circuitry in human brains lead to a loss of control and other symptoms of addiction in at least some individuals. Regarding Internet addiction, neuroscientific research supports the assumption that underlying neural processes are similar to substance addiction. The American Psychiatric Association (APA) has recognized one such Internet related behavior, Internet gaming, as a potential addictive disorder warranting further study, in the 2013 revision of their Diagnostic and Statistical Manual. Other Internet related behaviors, e.g., Internet pornography use, were not covered. Within this review, we give a summary of the concepts proposed underlying addiction and give an overview about neuroscientific studies on Internet addiction and Internet gaming disorder. Moreover, we reviewed available neuroscientific literature on Internet pornography addiction and connect the results to the addiction model. The review leads to the conclusion that Internet pornography addiction fits into the addiction framework and shares similar basic mechanisms with substance addiction. Together with studies on Internet addiction and Internet Gaming Disorder we see strong evidence for considering addictive Internet behaviors as behavioral addiction. Future research needs to address whether or not there are specific differences between substance and behavioral addiction.
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Affiliation(s)
- Todd Love
- Society for the Advancement of Sexual Health, Ardmore, PA 19003, USA.
| | - Christian Laier
- Department of General Psychology: Cognition, University of Duisburg-Essen, Duisburg 47057, Germany.
| | - Matthias Brand
- Department of General Psychology: Cognition, University of Duisburg-Essen, Duisburg 47057, Germany.
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen 45141, Germany.
| | - Linda Hatch
- Private Practice, Santa Barbara, CA 93103, USA.
| | - Raju Hajela
- Health Upwardly Mobile Inc., Calgary, AB T2S 0J2, Canada.
- Diagnostic and Descriptive Terminology Action Group (DDTAG), American Society of Addiction Medicine (ASAM), Chevy Chase, MD 93101, USA.
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Food addiction: an evolving nonlinear science. Nutrients 2014; 6:5370-91. [PMID: 25421535 PMCID: PMC4245594 DOI: 10.3390/nu6115370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 09/12/2014] [Accepted: 10/13/2014] [Indexed: 12/12/2022] Open
Abstract
The purpose of this review is to familiarize readers with the role that addiction plays in the formation and treatment of obesity, type 2 diabetes and disorders of eating. We will outline several useful models that integrate metabolism, addiction, and human relationship adaptations to eating. A special effort will be made to demonstrate how the use of simple and straightforward nonlinear models can and are being used to improve our knowledge and treatment of patients suffering from nutritional pathology. Moving forward, the reader should be able to incorporate some of the findings in this review into their own practice, research, teaching efforts or other interests in the fields of nutrition, diabetes, and/or bariatric (weight) management.
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Blum K, Thanos PK, Gold MS. Dopamine and glucose, obesity, and reward deficiency syndrome. Front Psychol 2014; 5:919. [PMID: 25278909 PMCID: PMC4166230 DOI: 10.3389/fpsyg.2014.00919] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/01/2014] [Indexed: 01/08/2023] Open
Abstract
Obesity as a result of overeating as well as a number of well described eating disorders has been accurately considered to be a world-wide epidemic. Recently a number of theories backed by a plethora of scientifically sound neurochemical and genetic studies provide strong evidence that food addiction is similar to psychoactive drug addiction. Our laboratory has published on the concept known as Reward Deficiency Syndrome (RDS) which is a genetic and epigenetic phenomena leading to impairment of the brain reward circuitry resulting in a hypo-dopaminergic function. RDS involves the interactions of powerful neurotransmitters and results in abnormal craving behavior. A number of important facts which could help translate to potential therapeutic targets espoused in this focused review include: (1) consumption of alcohol in large quantities or carbohydrates binging stimulates the brain’s production of and utilization of dopamine; (2) in the meso-limbic system the enkephalinergic neurons are in close proximity, to glucose receptors; (3) highly concentrated glucose activates the calcium channel to stimulate dopamine release from P12 cells; (4) a significant correlation between blood glucose and cerebrospinal fluid concentrations of homovanillic acid the dopamine metabolite; (5) 2-deoxyglucose (2DG), the glucose analog, in pharmacological doses is associated with enhanced dopamine turnover and causes acute glucoprivation. Evidence from animal studies and fMRI in humans support the hypothesis that multiple, but similar brain circuits are disrupted in obesity and drug dependence and for the most part, implicate the involvement of DA-modulated reward circuits in pathologic eating behaviors. Based on a consensus of neuroscience research treatment of both glucose and drug like cocaine, opiates should incorporate dopamine agonist therapy in contrast to current theories and practices that utilizes dopamine antagonistic therapy. Considering that up until now clinical utilization of powerful dopamine D2 agonists have failed due to chronic down regulation of D2 receptors newer targets based on novel less powerful D2 agonists that up-regulate D2 receptors seems prudent. We encourage new strategies targeted at improving DA function in the treatment and prevention of obesity a subtype of reward deficiency.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville FL, USA ; Department of Addiction Research & Therapy, Malibu Beach Recovery Center Malibu Beach, CA, USA
| | - Panayotis K Thanos
- Behavior Neuropharmacology and Neuroimaging Lab, Department of Psychology, State University of New York Stony Brook, NY, USA
| | - Mark S Gold
- Department of Psychiatry, McKnight Brain Institute, College of Medicine, University of Florida, Gainesville FL, USA ; Department of Addiction Research & Therapy, Malibu Beach Recovery Center Malibu Beach, CA, USA
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McGill AT. Causes of metabolic syndrome and obesity-related co-morbidities Part 1: A composite unifying theory review of human-specific co-adaptations to brain energy consumption. ACTA ACUST UNITED AC 2014; 72:30. [PMID: 25708524 PMCID: PMC4335398 DOI: 10.1186/2049-3258-72-30] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 04/26/2014] [Indexed: 12/30/2022]
Abstract
One line summary Metabolic syndrome and obesity-related co-morbidities are largely explained by co-adaptations to the energy use of the large human brain in the cortico-limbic-striatal and NRF2 systems. The medical, research and general community is unable to effect significantly decreased rates of central obesity and related type II diabetes mellitus (TIIDM), cardiovascular disease (CVD) and cancer. All conditions seem to be linked by the concept of the metabolic syndrome (MetS), but the underlying causes are not known. MetS markers may have been mistaken for causes, thus many treatments are destined to be suboptimal. The current paper aims to critique current paradigms, give explanations for their persistence, and to return to first principles in an attempt to determine and clarify likely causes of MetS and obesity related comorbidities. A wide literature has been mined, study concepts analysed and the basics of human evolution and new biochemistry reviewed. A plausible, multifaceted composite unifying theory is formulated. The basis of the theory is that the proportionately large, energy-demanding human brain may have driven co-adaptive mechanisms to provide, or conserve, energy for the brain. A ‘dual system’ is proposed. 1) The enlarged, complex cortico-limbic-striatal system increases dietary energy by developing strong neural self-reward/motivation pathways for the acquisition of energy dense food, and (2) the nuclear factor-erythroid 2-related factor 2 (NRF2) cellular protection system amplifies antioxidant, antitoxicant and repair activity by employing plant chemicals, becoming highly energy efficient in humans. The still-evolving, complex human cortico-limbic-striatal system generates strong behavioural drives for energy dense food procurement, including motivating agricultural technologies and social system development. Addiction to such foods, leading to neglect of nutritious but less appetizing ‘common or garden’ food, appears to have occurred. Insufficient consumption of food micronutrients prevents optimal human NRF2 function. Inefficient oxidation of excess energy forces central and non-adipose cells to store excess toxic lipid. Oxidative stress and metabolic inflammation, or metaflammation, allow susceptibility to infectious, degenerative atherosclerotic cardiovascular, autoimmune, neurodegenerative and dysplastic diseases. Other relevant human-specific co-adaptations are examined, and encompass the unusual ability to store fat, certain vitamin pathways, the generalised but flexible intestine and microbiota, and slow development and longevity. This theory has significant past and future corollaries, which are explored in a separate article by McGill, A-T, in Archives of Public Health, 72: 31.
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Affiliation(s)
- Anne-Thea McGill
- School of Population Health and Human Nutrition Unit, Faculty of Medicine and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand ; B-Med Weight Control Consultancy, Auckland, New Zealand
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Prevalence of obesity and overweight and associated nutritional factors in a population-based Swiss sample: an opportunity to analyze the impact of three different European cultural roots. Eur J Nutr 2013; 53:1281-90. [PMID: 24374796 DOI: 10.1007/s00394-013-0643-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 12/17/2013] [Indexed: 12/29/2022]
Abstract
PURPOSE Obesity represents a growing public health concern worldwide. The latest data in Switzerland rely on self-reported body mass index (BMI), leading to underestimation of prevalence. We reassessed the prevalence of obesity and overweight in a sample of the Swiss population using measured BMI and waist circumference (WC) and explored the association with nutritional factors and living in different linguistic-cultural regions. METHODS Data of 1,505 participants of a cross-sectional population-based survey in the three linguistic regions of Switzerland were analyzed. BMI and WC were measured, and a 24-h urine collection was performed to evaluate dietary sodium, potassium and protein intake. RESULTS The prevalence of overweight, obesity and abdominal obesity was 32.2, 14.2 and 33.6%, respectively. Significant differences were observed in the regional distribution, with a lower prevalence in the Italian-speaking population. Low educational level, current smoking, scarce physical activity and being migrant were associated with an higher prevalence of obesity. Sodium, potassium and protein intake increased significantly across BMI categories. CONCLUSIONS Obesity and overweight affect almost half of the Swiss adolescents and adults, and the prevalence appears to increase. Using BMI and WC to define obesity led to different prevalences. Differences were furthermore observed across Swiss linguistic-cultural regions, despite a common socio-economic and governmental framework. We found a positive association between obesity and salt intake, with a potential deleterious synergistic effect on cardiovascular risk.
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Borgermans L, Vrijhoef B, Vandevoorde J, De Maeseneer J, Vansintejan J, Devroey D. Relevance of hypersexual disorder to family medicine and primary care as a complex multidimensional chronic disease construct. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2013; 2013:519265. [PMID: 24066230 PMCID: PMC3771452 DOI: 10.1155/2013/519265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 07/25/2013] [Indexed: 05/17/2023]
Abstract
Hypersexual disorder (HD) is not defined in a uniform way in the psychiatric literature. In the absence of solid evidence on prevalence, causes, empirically validated diagnostic criteria, instruments for diagnosis, consistent guidelines on treatment options, medical and psychosocial consequences, and type of caregivers that need to be involved, HD remains a controversial and relatively poorly understood chronic disease construct. The role of family medicine in the detection, treatment, and followup of HD is not well studied. The purpose of this paper is to describe the complexity of HD as a multidimensional chronic disease construct and its relevance to family medicine and primary care.
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Affiliation(s)
- Liesbeth Borgermans
- Department of Family Medicine, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Bert Vrijhoef
- Scientific Center for Care and Welfare, Tilburg University, 5000 LE Tilburg, The Netherlands
| | - Jan Vandevoorde
- Department of Family Medicine, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Jan De Maeseneer
- Department of Family Medicine and Primary Care, University Ghent, 9000 Ghent, Belgium
| | - Johan Vansintejan
- Department of Family Medicine, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Dirk Devroey
- Department of Family Medicine, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
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Yarnell S, Oscar-Berman M, Avena N, Blum K, Gold M. Pharmacotherapies for Overeating and Obesity. ACTA ACUST UNITED AC 2013; 4:131. [PMID: 23826512 DOI: 10.4172/2157-7412.1000131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Obesity has become pandemic, and the annual cost in related illnesses and loss of productivity is already over $100 billion and rising. Research has shown that obesity can and does cause changes in behavior and in the brain itself that are very similar to changes caused by drugs of abuse. While food addiction is not the causal agent of all obesity, it is clear that many people no longer eat to survive, but instead survive to eat. This review considers the importance of the brain's reward system in food intake. The review also examines research developments and current treatments for obesity, including diet and exercise, psychotherapy, surgical interventions, and pharmacotherapies. Finally we discuss alterations in American society that are necessary for change to occur, and the diffculties therein.
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Affiliation(s)
- S Yarnell
- Department of Psychiatry and McKnight Brain Institute, University of Florida College of Medicine, Gainesville, Florida, USA
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