Caregivers' Attention Toward, and Response to, Their Child's Interoceptive Hunger and Thirst Cues.

People can use their internal state to determine if they are hungry or thirsty. Although the meaning of some interoceptive cues may be innate (e.g., pain), it is possible that others-including those for hunger and thirst-are acquired. There has been little exploration of this idea in humans. Consequently, we conducted a survey among child caregivers to determine if the basic conditions necessary for interoceptive learning were present. Two-hundred and thirty-five caregivers of children aged 1-12 years were asked if they had recently noticed stomach rumbling, hunger-related irritability, and a dry mouth in their child. They were also asked how they would respond. The impact of several moderating variables, especially caregiver beliefs about the causes of hunger, fullness, and thirst, was also explored. Fifteen percent of caregivers had recently noticed stomach rumbling in their child, 28% hunger-related irritability, and 14% a dry mouth. Forty-four percent of caregivers had noticed at least one of these three cues. Noticing hunger cues was significantly moderated by caregiver beliefs about their cause, by child age, and in one case by temporal context (around vs. outside mealtimes). Key caregiver responses were providing the need (e.g., offer food) and/or asking the child if they had a need (e.g., hungry?). Each type of response could potentially support a different form of interoceptive learning. In conclusion, we suggest the necessary conditions for children to learn interoceptive hunger and thirst cues, are present in many caregiver-offspring dyads.

Effect of coffee intake on appetite parameters in woman with overweight or obesity: A pilot crossover randomized trial.

INTRODUCTION: Coffee consumption has demonstrated an effect on the regulation of appetite, causing less hunger and/or greater satiety; however, its effects are not well known in woman with overweight or obesity. Therefore, this study aimed to evaluate the effect of coffee consumption on hunger, satiety, sensory specific desire (SSD), and dietary intake in women with overweight or obesity. METHODOLOGY: A randomized crossover clinical trial was realized in 3 sessions: in the first session a clinical history, anthropometric measurements and body composition analysis were performed; in sessions 2 and 3 the participants randomly consumed 240mL of coffee with 6mg/caffeine/kg of weight or 240mL of water along with a standardized breakfast. At fasting and every 30min after breakfast for the next 3h, appetite sensations and SSD were recorded using visual analog scales. Blood samples were taken at fasting, 30 and 180min after breakfast. Dietary intake was recorded in the rest of the intervention days. RESULTS: In the coffee intervention there was an increased desire for sweet foods, higher fructose intake during the rest of the day, and higher triglyceride levels than with the water intervention. No differences were detected in ghrelin or cholecystokinin. CONCLUSIONS: Coffee consumption may lead to higher triglycerides and higher intake of simple sugars, mainly fructose, through changes in the SSD. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/NCT05774119.

Practicing Interoceptive Sensitivity as a Couple: A Mixed-Methods Acceptance Analysis of a Dyadic vs. Single Pilot Randomized Controlled Trial.

Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey (n = 68 couples) and focus groups (n = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.

Low-calorie diet-induced weight loss is associated with altered brain connectivity and food desire in obesity.

OBJECTIVE: The main objective of this study is to better understand the effects of diet-induced weight loss on brain connectivity in response to changes in glucose levels in individuals with obesity. METHODS: A total of 25 individuals with obesity, among whom 9 had a diagnosis of type 2 diabetes, underwent functional magnetic resonance imaging (fMRI) scans before and after an 8-week low-calorie diet. We used a two-step hypereuglycemia clamp approach to mimic the changes in glucose levels observed in the postprandial period in combination with task-mediated fMRI intrinsic connectivity distribution (ICD) analysis. RESULTS: After the diet, participants lost an average of 3.3% body weight. Diet-induced weight loss led to a decrease in leptin levels, an increase in hunger and food intake, and greater brain connectivity in the parahippocampus, right hippocampus, and temporal cortex (limbic-temporal network). Group differences (with vs. without type 2 diabetes) were noted in several brain networks. Connectivity in the limbic-temporal and frontal-parietal brain clusters inversely correlated with hunger. CONCLUSIONS: A short-term low-calorie diet led to a multifaceted body response in patients with obesity, with an increase in connectivity in the limbic-temporal network (emotion and memory) and hormone and eating behavior changes that may be important for recovering the weight lost.

An integrative sensor of body states: how the mushroom body modulates behavior depending on physiological context.

The brain constantly compares past and present experiences to predict the future, thereby enabling instantaneous and future behavioral adjustments. Integration of external information with the animal's current internal needs and behavioral state represents a key challenge of the nervous system. Recent advancements in dissecting the function of the Drosophila mushroom body (MB) at the single-cell level have uncovered its three-layered logic and parallel systems conveying positive and negative values during associative learning. This review explores a lesser-known role of the MB in detecting and integrating body states such as hunger, thirst, and sleep, ultimately modulating motivation and sensory-driven decisions based on the physiological state of the fly. State-dependent signals predominantly affect the activity of modulatory MB input neurons (dopaminergic, serotoninergic, and octopaminergic), but also induce plastic changes directly at the level of the MB intrinsic and output neurons. Thus, the MB emerges as a tightly regulated relay station in the insect brain, orchestrating neuroadaptations due to current internal and behavioral states leading to short- but also long-lasting changes in behavior. While these adaptations are crucial to ensure fitness and survival, recent findings also underscore how circuit motifs in the MB may reflect fundamental design principles that contribute to maladaptive behaviors such as addiction or depression-like symptoms.

Association between glucose dips and the feeling of hunger in a dietary intervention study among students with early and late chronotype-secondary analysis of a randomized cross-over nutrition trial.

Consumption of foods with high glycaemic index (GI) can cause hyperglycemia, thus increasing postprandial hunger. Since circadian rhythm differs inter-individually, we describe glucose dips after breakfast/dinner with high/medium estimated meal GI among students with early (n = 22) and late chronotype (n = 23) and examine their relation to the feeling of hunger in a secondary analysis of a randomized cross-over nutrition trial. Glucose dips reflect the difference between the lowest glucose value recorded 2-3 h postprandially and baseline, presented as percentage of average baseline level. Associations between glucose dips and the feeling of hunger were analyzed using multilevel linear models. Glucose dips were lower after medium GI meals than after high GI meals among both chronotype groups (p = 0.03). Among early chronotypes, but not among late chronotypes, glucose dip values were lower after breakfast than after dinner (-4.9 % vs. 5.5 %, p = 0.001). Hunger increased throughout the day among both chronotypes but glucose dips were not related to the feeling of hunger at the meal following breakfast. Interestingly, lower glucose dip values 2-3 h postprandially occurred particularly after medium GI meals and were seen after breakfast among early chronotypes. These glucose dips did not predict hunger at meals after breakfast.

Endogenous Opioids in the Homeostatic Regulation of Hunger, Satiety, and Hedonic Eating: Neurobiological Foundations.

This chapter (part one of a trilogy) summarizes the neurobiological foundations of endogenous opioids in the regulation of energy balance and eating behavior, dysregulation of which translates to maladaptive dietary responses in individuals with obesity and eating disorders, including anorexia, bulimia, and binge eating disorder. Knowledge of these neurobiological foundations is vital to researchers' and clinicians' understanding of pathophysiology as well as the science-based development of multidisciplinary diagnoses and treatments for obesity and eating disorders. We highlight mechanisms of endogenous opioids in both homeostatic and hedonic feeding behavior, review research on the dysregulation of food reward that plays a role in a wide array of obesity and disordered eating, and the clinical implications of neurobiological responses to food for current science-based treatments for obesity and eating disorders.

Food Insecurity Screening in High-Income Countries, Tool Validity, and Implementation: A Scoping Review.

Household food insecurity has significant negative implications across the lifespan. While routine screening is recommended, particularly in healthcare, guidelines are lacking on selection of screening tools and best-practice implementation across different contexts in non-stigmatizing ways. The objective of this scoping review was to synthesize evidence on household food insecurity screening tools, including psychometrics, implementation in a range of settings, and experiences of carrying out screening or being screened. Four electronic databases were searched for studies in English published from 1990 until June 2023. A total of 58 papers were included, 21 of which focused on tool development and validation, and 37 papers described implementation and perceptions of screening. Most papers were from the USA and described screening in healthcare settings. There was a lack of evidence regarding screening in settings utilized by Indigenous people. The two-item Hunger Vital Sign emerged as the most used and most valid tool across settings. While there is minimal discomfort associated with screening, screening rates in practice are still low. Barriers and facilitators of screening were identified at the setting, system, provider, and recipient level and were mapped onto the COM-B model of behavior change. This review identifies practical strategies to optimize screening and disclosure.

Dialogues between popular education and food and nutritional education: reflections from the trajectories of three university professors. / Diálogos entre educação popular e educação alimentar e nutricional: reflexões a partir das trajetórias de três docentes universitários.

This essay explores the convergences and singularities of popular education and Food and Nutrition Education based on biographical fragments of the undergraduate training program in Nutrition of three university professors who established their academic and professional trajectories at these crossroads of knowledge and actions mediated by popular education. Inspired by the autobiographical method, the narratives revealed that the initial indignations with social inequalities were mobilizing the routes in the formative path toward understanding hunger, suffering, and human care. To this end, seeking spaces and opportunities to learn about and experience social work in contexts of vulnerabilities was a decisive factor in their personal and professional constructions, revealing the contradictions of traditional training models and the starting point for the genesis of critical thinking. Thus, clues are offered to understand the interfaces of Popular Education (PE) and Food and Nutrition Education (FNE) in the converging actions around the fight against hunger and the right to food without, however, reducing one to the other when food and Nutrition are projected on the horizon of practices.

Este ensaio explora as convergências e singularidades do diálogo entre a educação popular (EP) e a educação alimentar e nutricional (EAN) a partir de fragmentos biográficos do percurso formativo da graduação em Nutrição de três docentes universitários que constituíram as suas trajetórias acadêmico-profissional mediados pela Educação Popular. Inspirando-se na autobiografia, as narrativas revelaram que as indignações iniciais com as desigualdades sociais foram mobilizadoras do percurso formativo, possibilitando a compreensão dos fenômenos da fome, do sofrimento e do cuidado humano. Assim, o exercício de buscarem espaços e oportunidades na qual pudessem conhecer e experienciar o trabalho social em contextos de vulnerabilidades mostrou-se decisivo nas construções pessoais e profissionais, revelando as contradições dos modelos tradicionais de formação e foram o ponto de partida para a gênese do pensamento crítico. Assim, pretende-se oferecer pistas para compreender as interfaces entre EP e EAN, na convergência de ações em torno da luta contra a fome e pelo Direito à Alimentação, sem, entretanto, reduzir-se uma à outra, quando a alimentação e nutrição se projetam no horizonte das práticas.

Speaking of Hunger: Food Shortages, Poverty and Community Assistance in Urban South Africa.

How people speak of hunger extends beyond statements about food adequacy; people's remarks may reflect experiences of poverty and feelings of vulnerability, and may be used to request help. In this article, we build on the idea of idioms of distress to conceptualize hunger talk as expressing more than an empty belly. We draw on ethnographic data gathered in two settings in South Africa: one a peri-urban area under traditional jurisdiction in the Eastern Cape Province; the other an inner-city suburb of the largest city, Johannesburg, in Gauteng. Hunger-related idioms of distress help illustrate the complex interplay of social, economic, and cultural factors, and allow people to speak of various affective and material aspects of their lives.

New Federal Program to Address Child Hunger Begins This Summer.

This JAMA Forum discusses a new summer nutrition program to address child hunger, the evidence on the effects of this and other summer programs, the role for health professionals, and the policy considerations for participation by individual states.

NPY-mediated synaptic plasticity in the extended amygdala prioritizes feeding during starvation.

Efficient control of feeding behavior requires the coordinated adjustment of complex motivational and affective neurocircuits. Neuropeptides from energy-sensing hypothalamic neurons are potent feeding modulators, but how these endogenous signals shape relevant circuits remains unclear. Here, we examine how the orexigenic neuropeptide Y (NPY) adapts GABAergic inputs to the bed nucleus of the stria terminalis (BNST). We find that fasting increases synaptic connectivity between agouti-related peptide (AgRP)-expressing 'hunger' and BNST neurons, a circuit that promotes feeding. In contrast, GABAergic input from the central amygdala (CeA), an extended amygdala circuit that decreases feeding, is reduced. Activating NPY-expressing AgRP neurons evokes these synaptic adaptations, which are absent in NPY-deficient mice. Moreover, fasting diminishes the ability of CeA projections in the BNST to suppress food intake, and NPY-deficient mice fail to decrease anxiety in order to promote feeding. Thus, AgRP neurons drive input-specific synaptic plasticity, enabling a selective shift in hunger and anxiety signaling during starvation through NPY.

AgRP neuron cis-regulatory analysis across hunger states reveals that IRF3 mediates leptin's acute effects.

AgRP neurons in the arcuate nucleus of the hypothalamus (ARC) coordinate homeostatic changes in appetite associated with fluctuations in food availability and leptin signaling. Identifying the relevant transcriptional regulatory pathways in these neurons has been a priority, yet such attempts have been stymied due to their low abundance and the rich cellular diversity of the ARC. Here we generated AgRP neuron-specific transcriptomic and chromatin accessibility profiles from male mice during three distinct hunger states of satiety, fasting-induced hunger, and leptin-induced hunger suppression. Cis-regulatory analysis of these integrated datasets enabled the identification of 18 putative hunger-promoting and 29 putative hunger-suppressing transcriptional regulators in AgRP neurons, 16 of which were predicted to be transcriptional effectors of leptin. Within our dataset, Interferon regulatory factor 3 (IRF3) emerged as a leading candidate mediator of leptin-induced hunger-suppression. Measures of IRF3 activation in vitro and in vivo reveal an increase in IRF3 nuclear occupancy following leptin administration. Finally, gain- and loss-of-function experiments in vivo confirm the role of IRF3 in mediating the acute satiety-evoking effects of leptin in AgRP neurons. Thus, our findings identify IRF3 as a key mediator of the acute hunger-suppressing effects of leptin in AgRP neurons.

Hunger and satiety: Neuronal dynamics in Hydra behavior.

Hormonal and neuronal inputs to the brain control how much animals eat. The origins of this behavior were unclear, but in this issue of Cell Reports, Giez et al.1 describe specific neurons inhibiting feeding in evolutionary ancient animals without brain.

The development and validation of the food insecurity physical activity concerns scale.

Food insecurity - defined as having limited access to nutritious foods - is linked with obesity. Previous research has also shown that food insecurity is associated with lower levels of leisure-time physical activity (physical activity performed outside of essential activities). This association may occur in part due to concerns about preserving levels of energy during times of food shortage. Currently, no scale exists which measures this construct. Therefore, we aimed to develop and validate such a scale - the food insecurity physical activity concerns scale (FIPACS). Participants (N = 603, individuals with food insecurity = 108) completed an online survey, consisting of the FIPACS, the International Physical Activity Questionnaire short-form (IPAQ), the restraint subscale of the Dutch Eating Behaviour Questionnaire (DEBQ), the amotivation subscale of the Behaviour Regulation In Exercise Questionnaire-2 (BREQ-2), and the Behavioural Inhibition System/Behavioural Approach System Reactivity scale (BIS/BAS) to assess convergent and divergent validity. An exploratory factor analysis revealed a four-factor model of the FIPACS - namely 'Concerns relating to hunger', 'Concerns of replenishment and calories', 'Concerns of physiological effects of exercise' and 'Compensatory behaviours' which was verified through a confirmatory factor analysis. To assess test-retest reliability, 100 participants completed the FIPACS again two weeks later. The FIPACS had good internal, test-retest reliability and divergent validity. However, there was limited evidence of convergent validity. Future studies could incorporate this scale when investigating the association between food insecurity and physical activity.

Ethical challenges in health care during collective hunger strikes in public or occupied spaces.

Public collective hunger strikes take place in complex social and political contexts, require medical attention and present ethical challenges to physicians. Empirical research, the ethical debate to date and existing guidelines by the World Medical Association focus almost exclusively on hunger strikes in detention. However, the public space differs substantially with regard to the conditions for the provision of health care and the diverse groups of healthcare providers or stakeholders involved. By reviewing empirical research on the experience of health professionals with public collective hunger strikes, we identified the following ethical challenges: (1) establishment of a trustful physician-striker relationship, (2) balancing of medico-ethical principles in medical decision-making, (3) handling of loyalty conflicts and (4) preservation of professional independence and the risk of political instrumentalization. Some of these challenges have already been described and discussed, yet not contextualized for public collective strikes, while others are novel. The presence of voluntary physicians may offer opportunities for a trustful relationship and, hence, for ethical treatment decisions. According to our findings, it requires more attention to how to realise autonomous medical decisions in the complex context of a dynamic, often unstructured and politically charged setting, which ethical norms should shape the professional role of voluntary physicians, and what is the influence of the hunger strikers' collective on individual healthcare decisions. Our article can serve as a starting point for further ethical discussion. It can also provide the basis for the development of potential guidelines to support health professionals involved in public collective hunger strikes.

Association between hedonic hunger and body mass index in adults: A systematic review and meta-analysis.

Hedonic hunger has been proposed as one of the important causes of obesity in recent years. In the present study, we systematically reviewed and meta-analyzed the relationship between hedonic hunger and body mass index (BMI) in healthy adults. PubMed, Web of Science, and Scopus were searched until January 19, 2023. All English-language original observational studies conducted on healthy adult subjects, which used the Power of Food Scale (PFS) to evaluate hedonic hunger were included. Quality assessment was done using the Joanna Briggs Institute checklist, and StataMP-17 software was used for the meta-analysis. After screening, 25 observational studies with a total of 14457 participants were included. Twenty-four studies were cross-sectional, and one was a cohort study. Twenty-two studies examined both sexes, two studies were conducted only on women, and one study conducted analysis separately on men and women. The results of the meta-analysis showed a positive and significant association between hedonic hunger and BMI with a small effect size (r = 0.13, 95% CI: 0.08, 0.18). In addition, a positive significant association was observed between subscales of PFS ("food available", "food present", and "food tasted") and BMI. The association between hedonic hunger and BMI was not affected by the results of meta-regression analysis of %female, mean age & BMI, and sample size. In conclusion, there was a positive significant association between hedonic hunger and BMI, but the effect size was weak. Considering the low quality of included studies, we need longitudinal design studies considering the association between these two variables as a primary outcome for a more accurate conclusion.

Compensatory enhancement of input maintains aversive dopaminergic reinforcement in hungry Drosophila.

Hungry animals need compensatory mechanisms to maintain flexible brain function, while modulation reconfigures circuits to prioritize resource seeking. In Drosophila, hunger inhibits aversively reinforcing dopaminergic neurons (DANs) to permit the expression of food-seeking memories. Multitasking the reinforcement system for motivation potentially undermines aversive learning. We find that chronic hunger mildly enhances aversive learning and that satiated-baseline and hunger-enhanced learning require endocrine adipokinetic hormone (AKH) signaling. Circulating AKH influences aversive learning via its receptor in four neurons in the ventral brain, two of which are octopaminergic. Connectomics revealed AKH receptor-expressing neurons to be upstream of several classes of ascending neurons, many of which are presynaptic to aversively reinforcing DANs. Octopaminergic modulation of and output from at least one of these ascending pathways is required for shock- and bitter-taste-reinforced aversive learning. We propose that coordinated enhancement of input compensates for hunger-directed inhibition of aversive DANs to preserve reinforcement when required.

Hedonic hunger, ultra-processed food consumption, and the moderating effects of impulsivity in pregnant individuals with body mass index ≥ 25.

Evidence suggests higher hedonic hunger (preoccupation with/desire to consume food for pleasure) is associated with greater ultra-processed food (UPF) consumption in non-pregnant individuals with higher, but not lower, self-report impulsivity or delay discounting. The current study tested the association between hedonic hunger and UPF consumption, and the moderating effects of self-report impulsivity and delay discounting, during pregnancy. Individuals (N = 220) with body mass index (BMI)≥25 completed the Power of Food Scale, 24-h dietary recalls, and Barratt Impulsiveness Scale-Version 11 in early-mid pregnancy. A subset enrolled in an ancillary study (n = 143) completed a Delay Discounting Task. Linear regression and moderation models covaried for age, gestational age, pre-pregnancy BMI, and socioeconomic status. The association between hedonic hunger and UPF consumption was nonsignificant (p = 0.47). Self-report impulsivity was not a significant moderator (p = 0.11), but delay discounting was (p = 0.01). Simple slopes analysis revealed a one-unit increase in hedonic hunger was associated with 7% lower UPF intake among participants with lower (M+1SD) delay discounting (p = 0.01) and 1% higher UPF intake among those with higher (M-1SD) delay discounting (p = 0.57). Findings contrast those from research with non-pregnant samples and indicate lower delay discounting may serve as a protective factor, associated with reduced UPF consumption at higher levels of hedonic hunger, during pregnancy.