Effect of glucose and fructose on food intake via malonyl-CoA signaling in the brain.

In the brain malonyl-CoA serves the important function of monitoring and modulating energy balance. Because of its central role in the metabolism of higher animals, glucose acts as the principal indicator of global energy status. Specialized neuronal nuclei within the hypothalamus sense blood glucose and signal higher brain centers to adjust feeding behavior and energy expenditure accordingly. As the level of glucose entering the brain rises, food intake is suppressed. Energy status information triggered by glucose is transmitted via hypothalamic signaling intermediaries, i.e. AMPK and malonyl-CoA, to the orexigenic/anorexigenic neuropeptide system that determines hunger and energy expenditure. The central metabolism of glucose by the glycolytic pathway generates ATP which produces a compensatory decrease in AMP level and AMPK activity. Since acetyl-CoA carboxylase (ACC) is a substrate of AMPK, lowering AMP increases the catalytic activity of ACC and thereby, the level of its reaction product, malonyl-CoA. Malonyl-CoA signals the anorexigenic-orexigenic neuropeptide system to suppress food intake. Unlike glucose, however, centrally metabolized fructose increases food intake. This paradox results because fructose bypasses the rate-limiting step of glycolysis and uses a rapid ATP-requiring reaction that abruptly depletes ATP and provokes a compensatory rise in AMP. Thus, fructose has the opposite effect of glucose on the AMPK/malonyl-CoA signaling system and thereby, feeding behavior. The fact that fructose metabolism by the brain increases food intake and obesity risk raises health concerns in view of the large and increasing per capita consumption of high fructose sweeteners, especially by youth.