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.

Comparison of 8-weeks of full versus split body resistance training on appetite and energy intake in non-obese untrained men.

To investigate the effects of 8-weeks of full versus split body resistance training (RT) on appetite and energy intake in non-obese untrained men. The participants were pair-matched based on their initial fat mass and then randomly allocated into one of two treatment groups: Full body (FB, n = 20), in which all muscle groups were trained in every session, or Split body (SB, n = 15), in which upper and lower muscle groups were trained alternated per session; both groups trained in non-consecutive days, three times per week with total number of sets performed equated between groups. Energy intake, body composition, and strength performance were evaluated at pre-training, and after 8-weeks of RT, as well as self-reported hunger, fullness, and desire to eat, that were assessed at fasted and feed states pre- and post-intervention. FB and SB resistance training increased fat-free mass (FFM) (p < 0.001); and FB induced greater maximal strength improvement (p = 0.027). At fasted state self-reported hunger increased, and fullness decreased, while in feed state desire to eat something fatty increased in both groups. Carbohydrate intake (p = 0.011) decreased in both groups. In conclusion, FB and SB training increased orexigenic drive (increasing hunger and decreasing fullness), however, total energy intake and fat mass did not change after 8-weeks of RT in non-obese untrained men.Registered under Brazilian Registry of Clinical Trials no. RBR-3wkcvyw.

Pre-prandial plasma liver-expressed antimicrobial peptide 2 (LEAP2) concentration in humans is inversely associated with hunger sensation in a ghrelin independent manner.

PURPOSE: The liver-expressed antimicrobial peptide 2 (LEAP2) is a newly recognized peptide hormone that acts via the growth hormone secretagogue receptor (GHSR) blunting the effects of ghrelin and displaying ghrelin-independent actions. Since the implications of LEAP2 are beginning to be elucidated, we investigated if plasma LEAP2 concentration varies with feeding status or sex and whether it is associated with glucose metabolism and appetite sensations. METHODS: We performed a single test meal study, in which plasma concentrations of LEAP2, ghrelin, insulin and glucose as well as visual analogue scales for hunger, desire to eat, prospective food consumption, fullness were assessed before and 60 min after breakfast in 44 participants (n = 21 females) with normal weight (NW) or overweight/obesity (OW/OB). RESULTS: Pre-prandial plasma LEAP2 concentration was ~ 1.6-fold higher whereas ghrelin was ~ 2.0-fold lower in individuals with OW/OB (p < 0.001) independently of sex. After adjusting for body mass index (BMI) and sex, pre-prandial plasma LEAP2 concentration displayed a direct relationship with BMI (ß: 0.09; 95%CI: 0.05, 0.13; p < 0.001), fat mass (ß: 0.05; 95%CI: 0.01, 0.09; p = 0.010) and glycemia (ß: 0.24; 95%CI: 0.05, 0.43; p = 0.021), whereas plasma ghrelin concentration displayed an inverse relationship with BMI and fat mass but not with glycemia. Postprandial plasma LEAP2 concentration increased ~ 58% in females with OW/OB (p = 0.045) but not in females with NW or in males. Pre-prandial plasma LEAP2 concentration displayed an inverse relationship with hunger score (ß: - 11.16; 95% CI: - 18.52, - 3.79; p = 0.004), in a BMI-, sex- and ghrelin-independent manner. CONCLUSIONS: LEAP2 emerges as a key hormone implicated in the regulation of metabolism and appetite in humans. TRIAL REGISTRATION: The study was retrospectively registered in clinicaltrials.gov (April 2023). CLINICALTRIALS: gov Identifier: NCT05815641.

Role of Leu72Met of GHRL and Gln223Arg of LEPR Variants on Food Intake, Subjective Appetite, and Hunger-Satiety Hormones.

Appetite regulation has been recognized as a promising target for the prevention of obesity, which has become a worldwide health issue. Polymorphisms in the genes of hormones or receptors including Leu72Met for ghrelin and Gln223Arg for the leptin receptor could play a role in dietary intake, hunger, and satiety process. The aim of this study was to analyze subjective appetite assessments, dietary intake, and appetite hormones in relationship to these polymorphisms. Subjects (n = 132) with normal BMIs were enrolled. Dietary intake was analyzed with 3-day diet records. Subjective appetite was measured by visual analogue scales. Biochemical parameters were measured after 12 h of fasting and 120' following ingestion of a test meal. Ghrelin and leptin levels were measured by ELISA assay (enzyme-linked immunosorbent assay) and insulin by chemiluminescence assay. The polymorphisms were determined by allelic discrimination using TaqMan® probes. Fasting ghrelin levels differed significantly between men and women. The consumption of fruit and bread/starch with added sugar servings, as indicated by dietary records, and measured ghrelin levels were higher in carriers of Leu72Met/Met72Met compared to Leu72Leu carriers; total sugar intake was higher in Gln223Gln carriers than in Gln223Arg/Arg223Arg carriers. In conclusion, the Leu72Met and Gln223Arg polymorphism in ghrelin and LEPR may contribute to differential responses to a standardized meal as evidenced by higher postprandial levels of ghrelin and may also contribute to a higher dietary sugar intake.

Impact of a prenatal education intervention in pregnant women to prevent overweight in infants.

INTRODUCTION: During the first 1000 days of life is the basis for a child's future health established. OBJECTIVE: To evaluate the impact of a prenatal educational intervention in pregnant women on the nutritional status of the child from birth to 4 months of age. METHODS: Quasi-experimental intervention design in women with at least 12 weeks of gestation, who were randomly assigned to an intervention group (IG) to participate in five group and three individual sessions on feeding practices and maternal perception of the child's weight and signals of hunger-satiety; the control group (CG) received routine care that included at least three prenatal consultations. RESULTS: Thirty women were included in each group. After the intervention, women in the CG practiced less exclusive breastfeeding, were more likely to underestimate or overestimate the children's weight, and perceived hunger-satiety signals with less intensity (p < 0.05). 80 % of the infants in the IG had normal weight, whereas 63 % of those in the CG had a combination of overweight and obesity (p < 0.05). CONCLUSIONS: The prenatal education program in pregnant women showed a significant effect on postnatal nutritional status of infants four months after birth.

INTRODUCCIÓN: Durante los primeros 1000 días de vida se establece la base para la salud futura de un niño. OBJETIVO: Evaluar el impacto de una intervención educativa prenatal en mujeres embarazadas sobre el estado nutricional del hijo desde el nacimiento hasta los cuatro meses de edad. MÉTODOS: Diseño cuasiexperimental de intervención con mujeres a partir de la semana 12 de gestación, asignadas aleatoriamente a un grupo de intervención (GI) para recibir cinco sesiones grupales y tres individuales sobre prácticas de alimentación y percepción materna del peso del hijo y de señales de hambre-saciedad; el grupo control (GC) recibió atención de rutina que incluía al menos tres consultas prenatales. RESULTADOS: 30 mujeres conformaron cada grupo. Después de la intervención, las mujeres del GC practicaron menos lactancia materna exclusiva, fueron propensas a subestimar o sobrestimar el peso del hijo y percibieron con menor intensidad las señales de hambre-saciedad (p < 0.05). El 80 % de los lactantes del GI presentaron peso normal y 63 % de los niños del GC, una combinación de sobrepeso y obesidad (p < 0.05). CONCLUSIONES: El programa de educación prenatal en mujeres embarazadas mostró un efecto significativo en el estado nutricional de los lactantes después de cuatro meses del nacimiento.

Impacto de una intervención de educación prenatal en mujeres embarazadas para prevenir el sobrepeso en lactantes / Impact of a prenatal education intervention in pregnant women to prevent overweight in infants

Resumen Introducción: Durante los primeros 1000 días de vida se establece la base para la salud futura de un niño. Objetivo: Evaluar el impacto de una intervención educativa prenatal en mujeres embarazadas sobre el estado nutricional del hijo desde el nacimiento hasta los cuatro meses de edad. Métodos: Diseño cuasiexperimental de intervención con mujeres a partir de la semana 12 de gestación, asignadas aleatoriamente a un grupo de intervención (GI) para recibir cinco sesiones grupales y tres individuales sobre prácticas de alimentación y percepción materna del peso del hijo y de señales de hambre-saciedad; el grupo control (GC) recibió atención de rutina que incluía al menos tres consultas prenatales. Resultados: 30 mujeres conformaron cada grupo. Después de la intervención, las mujeres del GC practicaron menos lactancia materna exclusiva, fueron propensas a subestimar o sobrestimar el peso del hijo y percibieron con menor intensidad las señales de hambre-saciedad (p < 0.05). El 80 % de los lactantes del GI presentaron peso normal y 63 % de los niños del GC, una combinación de sobrepeso y obesidad (p < 0.05). Conclusiones: El programa de educación prenatal en mujeres embarazadas mostró un efecto significativo en el estado nutricional de los lactantes después de cuatro meses del nacimiento.

Abstract Introduction: During the first 1000 days of life is the basis for a child‘s future health established. Objective: To evaluate the impact of a prenatal educational intervention in pregnant women on the nutritional status of the child from birth to 4 months of age. Methods: Quasi-experimental intervention design in women with at least 12 weeks of gestation, who were randomly assigned to an intervention group (IG) to participate in five group and three individual sessions on feeding practices and maternal perception of the child’s weight and signals of hunger-satiety; the control group (CG) received routine care that included at least three prenatal consultations. Results: Thirty women were included in each group. After the intervention, women in the CG practiced less exclusive breastfeeding, were more likely to underestimate and overestimate the children’s weight, and perceived hunger-satiety signals with less intensity (p < 0.05). 80 % of the infants in the IG had normal weight, whereas 63 % of those in the CG had a combination of overweight and obesity (p < 0.05). Conclusions: The prenatal education program in pregnant women showed a significant effect on postnatal nutritional status of infants four months after birth.

Gut-to-brain signals in feeding control.

Interoceptive signals from gut and adipose tissue and sensory cues from the environment are integrated by hubs in the brain to regulate feeding behavior and maintain homeostatic control of body weight. In vivo neural recordings have revealed that these signals control the activity of multiple layers of hunger neurons and eating is not only the result of feedback correction to a set point, but can also be under the influence of anticipatory regulations. A series of recent technical developments have revealed how peripheral and sensory signals, in particular, from the gut are conveyed to the brain to integrate neural circuits. Here, we describe the mechanisms involved in gastrointestinal stimulation by nutrients and how these signals act on the hindbrain to generate motivated behaviors. We also consider the organization of multidirectional intra- and extrahypothalamic circuits and how this has created a framework for understanding neural control of feeding.

Appetite control: hormones or diet strategies?

PURPOSE OF REVIEW: Appetite control results from metabolic, behavioral, and environmental factors that influence hunger and the desire to eat. We summarize the latest advances in the hormonal and nutritional strategies to control appetite and reduce hunger. RECENT FINDINGS: The fed-hunger-state is regulated by central and peripheric hormones, which modulate energy balance. Leptin, insulin, ghrelin, peptide YY (PYY), and other gut-derived peptides represent the main appetite controllers. The role of orexins, obestatin, and liver-expressed antimicrobial peptide 2 has been uncovered recently. New insights have demonstrated the role of hippocampal activity as a possible mechanism of action. Glucagon-like peptide 1 (GLP1) receptor agonists are well known agents controlling appetite. Association of GLP1 receptor agonist, PYY, or glucose-dependent insulinotropic polypeptide agonists have been tested as new approaches. Appetite-control hormones have also risen as factors involved in the efficacy of bariatric procedures. High-protein, ketogenic diet, and intermittent fasting have been described as nutritional strategies to reduce appetite, although the physiological mechanism and long-term safety remains unclear. SUMMARY: Appetite control has been an important target for the treatment of obesity and associated disorders. New studies have demonstrated promising adoption of dietary approaches, hormone-based drugs, and bariatric surgery to control energy intake. Further research will establish a significant association, benefits, and safety of these new therapies.

Perception of Hunger/Satiety and Nutrient Intake in Women Who Regain Weight in the Postoperative Period After Bariatric Surgery.

OBJECTIVE: To investigate the perception of hunger and satiety and its association with nutrient intake in women who regain weight in the postoperative period after bariatric surgery. METHODS: Cross-sectional study of adult women divided into three groups: weight regain (n = 20), stable weight (n = 20) (both at least 24 months after Roux-en-Y gastric bypass surgery), and non-operated obesity (n = 20). A visual analogue scale measured hunger/satiety perception while fasting, immediately after finishing a test meal, and 180 min after finishing the test meal. The incremental area above or under the curve was calculated. Food intake was analyzed by 3 days of food recall and adjusted for intraindividual variation. To make between-group comparisons, Mann-Whitney, ANOVA, Kruskal-Wallis, and independent-samples T tests and Pearson's correlation were used. RESULTS: There were no between-group differences in incremental areas of hunger/satiety, but protein intake was significantly lower among patients who regained weight compared with those who had stable body weight (0.99 ± 0.23 g/kg body weight vs. 1.17 ± 0.21 g/kg body weight, p = 0.047). In the group that regained weight, satiety was correlated positively with usual dietary protein density (r = 0.541; p = 0.017) and negatively with usual carbohydrate intake (r = - 0.663; p = 0.002). CONCLUSION: Women who regained weight presented similar perceptions of hunger/satiety to those of patients without weight regain and with non-operated obesity. In patients who regained weight postoperatively, satiety perception was correlated positively with usual dietary protein density and inversely with usual carbohydrate intake.

Eating in the Absence of Hunger and Obesity Among Adolescents in Santiago, Chile.

In reports among mostly, US, white, preschool and young school-age children eating in the absence of hunger (EAH) has been positively related to adiposity, with some support for a sex-specific relationship. There is considerable interest in EAH and obesity in populations at risk for obesity-like populations of countries that have undergone rapid development. We assessed adolescents (n = 679) after an overnight fast with anthropometry and an EAH paradigm beginning with an ad lib pre-load meal. Participants reported satisfaction and perceived ability to eat more food, and then proceeded to a room with freely available snacks where they were permitted to eat ad lib for 20 min. Adolescents were 16.8 years old, 52% male, and 14% with obesity. Median preload meal kcal consumption was 602 (IQR 474-746). Additional calories were consumed at the EAH snack by 47.6%. Among those who ate snack, 155 additional calories were consumed (IQR 78-283). Adolescents with obesity had 0.61 (95% CI 0.37-0.99) reduced odds of eating at the EAH snack adolescents without obesity. Adolescents with obesity were also less likely to eat above the median total calories compared to adolescents without obesity (OR = 0.59, 95% CI 0.36-0.96). A sex by obesity interaction term was not significant in any model. Obesity was related to eating behavior in our sample of Chilean adolescents, however not in the direction we hypothesized. Adolescents with obesity were less likely to eat additional calories in the EAH paradigm and ate fewer total calories compared to adolescents without obesity.

El plátano: indicador de hambre y escasez de alimentos en familias beneficiarias de programas alimentarios en Vigía del Fuerte, Colombia / Plantain: indicator of hunger and food shortage in families benefiting from food programs in Vigia del Fuerte, Colombia

RESUMEN Objetivo Interpretar la percepción de hambre y escasez de alimentos en familias beneficiarias de Programas alimentarios MANA (Mejoramiento Alimentario y Nutricional de Antioquia) en Vigía del Fuerte. Método La investigación se orientó desde el enfoque cualitativo, usando la Etnografía Focalizada como método, para la recolección de la información se utilizaron entrevistas individuales y grupos de discusión. Resultados Las comunidades de la cuenca del río Murrí están protegidas del hambre física por la disponibilidad permanente del plátano; el hambre está asociada a la ausencia de carne o "liga" y al hecho de comer "plátano vacío"; así mismo se refieren al hambre como la sensación de desasosiego, debido al dolor de cabeza y de estómago que experimentan de manera permanente e intensa. Conclusiones A pesar de que las comunidades vigieñas disponen durante todo el tiempo de plátano, protegiéndolas del hambre física; estas no lo aprecian así, como alimento que calma su hambre y los libera, de cierta manera, de la escasez, porque su presencia como único alimento disponible, les recuerda, precisamente, que tienen carencia y hambre.(AU)

ABSTRACT Objective To analyze the perception of hunger and food shortage in families benefiting from MANA (Food and Nutritional Improvement) food programs in Vigía del Fuerte, Colombia. Methods Qualitative research, using focused ethnography as a method for collecting information. Individual interviews and discussion groups were used. Results Even though the communities that live by the Murrí River basin are protected from physical hunger due to the constant availability of plantain or musa, hunger is associated with the absence of meat or liga and the fact that they feel forced to eat empty musa. They also refer to hunger as the feeling of uneasiness caused by headache and stomachache. Conclusions Despite the fact that the communities of Vigía del Fuerte have access to plantain throughout the year, thus protecting them from physical hunger, they do not consider it as food that could calm their hunger and free them from scarcity. This happens because its presence as the only food available reminds them, precisely, that they lack certain conditions and feel hunger.(AU)

Genes, emotions and gut microbiota: The next frontier for the gastroenterologist.

Most medical specialties including the field of gastroenterology are mainly aimed at treating diseases rather than preventing them. Genomic medicine studies the health/disease process based on the interaction of the human genes with the environment. The gastrointestinal (GI) system is an ideal model to analyze the interaction between our genes, emotions and the gut microbiota. Based on the current knowledge, this mini-review aims to provide an integrated synopsis of this interaction to achieve a better understanding of the GI disorders related to bad eating habits and stress-related disease. Since human beings are the result of an evolutionary process, many biological processes such as instincts, emotions and behavior are interconnected to guarantee survival. Nourishment is a physiological need triggered by the instinct of survival to satisfy the body's energy demands. The brain-gut axis comprises a tightly connected neural-neuroendocrine circuitry between the hunger-satiety center, the dopaminergic reward system involved in the pleasure of eating and the gut microbiota that regulates which food we eat and emotions. However, genetic variations and the consumption of high-sugar and high-fat diets have overridden this energy/pleasure neurocircuitry to the point of addiction of several foodstuffs. Consequently, a gut dysbiosis generates inflammation and a negative emotional state may lead to chronic diseases. Balancing this altered processes to regain health may involve personalized-medicine and genome-based strategies. Thus, an integrated approach based on the understanding of the gene-emotions-gut microbiota interaction is the next frontier that awaits the gastroenterologist to prevent and treat GI disorders associated with obesity and negative emotions.

GLP-1 and GLP-2 Levels are Correlated with Satiety Regulation After Roux-en-Y Gastric Bypass: Results of an Exploratory Prospective Study.

BACKGROUND: Changes in satiety regulation are known to play a pivotal role in the weight loss effects of Roux-en-Y gastric bypass (RYGB) and the mechanisms by which these changes occur are not entirely known. There are previous reports of the influence of GLP-1 to cause enhancement of satiation, but in regard to GLP-2, it remains unclear. This study aimed to determine whether there is a correlation between the levels of GLP-1 and GLP-2 and satiety regulation following RYGB. MATERIALS AND METHODS: An exploratory prospective cohort study was made which enrolled 11 individuals who underwent RYGB and were followed-up for 12 months. GLP-1 and GLP-2 levels were determined before and after surgery and correlated with visual analogue scale scores for satiety. RESULTS: GLP-2 AUC after standard meal tolerance test (MTT) was significantly higher following surgery (945.3 ± 449.1 versus 1787.9 ± 602.7; p = 0.0037). Postoperatively, GLP-1 AUC presented a significant negative correlation with the mean score obtained in the first question of the visual analogue scale ("how hungry do you feel?") (p = 0.008); GLP-2 AUC presented a significant positive correlation with the mean score of the third ("how full do you feel?") question, and a significant positive correlation with the mean score achieved in the fourth question ("how much do you think you can eat?"), (p = 0.005 and p = 0.042, respectively). CONCLUSION: GLP-1 and GLP-2 were significantly correlated with satiety assessment within this sample. Further research is necessary to confirm these findings.

Infralimbic cortex activation and motivated arousal induce histamine release.

Appetitive behaviours occur in a state of behavioural and physiological activation that allows the optimal performance of these goal-directed behaviours. Here, we tested the hypothesis that histamine neurons under the command of the infralimbic cortex are important to provide behavioural activation. Extracellular histamine and serotonin were measured by microdialysis of the medial prefrontal cortex in behaving rats in parallel with a picrotoxin microinjection into the infralimbic cortex. The injection aroused the rats behaviourally, increased histamine release and decreased serotonin levels. Inhibition of the infralimbic cortex with muscimol produced the opposite effects on neurotransmitter release. The behavioural activation induced by motivating hungry rats with caged food was paralleled by an immediate histamine release, whereas awakening induced by tapping their microdialysis bowl increased serotonin, but not histamine levels. In conclusion, picrotoxin injection into the infralimbic cortex produces behavioural activation together with histamine release; in a similar manner, induction of an appetitive state produced histamine release, likely related to increased behavioural activation characteristic of an appetitive behaviour.

Effect of aerobic exercise on hunger feelings and satiety regulating hormones in obese teenage girls.

Exercise is implicated in modifying subsequent energy intake (EI) through alterations in hunger and/or satiety hormones. Our aim was to examine the effects of aerobic exercise on hunger, satiety regulatory peptides, and EI in obese adolescents. Nine obese girls (age: 13-18 years old, BMI: 33.74 ± 4.04 kg/m2) participated in this randomized controlled crossover study. Each participant randomly underwent 2 experimental protocols: control (seated for 150 min) and exercise (exercised for 30 min on a treadmill performed at ventilatory threshold [VT] intensity and then remained seated for 120 min). Leptin, peptide YY(3-36) (PYY(3-36)), and subjective hunger were measured at baseline as well as 30 min and 150 min, followed by 24-hr EI measurement. Exercise session resulted in an acute increase in PYY(3-36) (p < .01) without changes in leptin and/or hunger scores. The control session increased hunger scores (p < .01) and decreased circulating leptin levels (p = .03). There was a strong effect size for carbohydrate intake (d = 2.14) and a modest effect size for protein intake (d = 0.61) after the exercise compared with the control session. Exercise performed at VT intensity in this study appears to provoke a state of transient anorexia in obese girls. These changes may be linked to an increase in circulating PYY3-36 and maintenance of leptin levels.

Maternal controlling feeding practices and girls' inhibitory control interact to predict changes in BMI and eating in the absence of hunger from 5 to 7 y.

BACKGROUND: Mothers use a range of feeding practices to limit children's intake of palatable snacks (eg, keeping snacks out of reach, not bringing snacks into the home), but less is known about the effects of these practices on children's eating and weight outcomes. OBJECTIVE: The objective was to identify distinct feeding practice profiles and evaluate the interactive effects of these profiles and girls' temperament (inhibitory control and approach) on girls' eating behaviors and weight outcomes at 5 and 7 y. DESIGN: Participants included 180 mother-daughter dyads; measures were mothers' reports of controlling feeding practices and girls' height and weight, eating in the absence of hunger (EAH) at 5 y, and inhibitory control (a measure of behavioral inhibition) and approach (a measure of appetitive motivation) at 7 y. RESULTS: Latent profile analysis of maternal feeding practices showed 4 feeding profiles based on maternal use of limit-setting practices and keeping snacks out of girls' physical reach, a restrictive practice: Unlimited Access to Snacks, Sets Limits+Does Not Restrict Snacks, Sets Limits+Restricts High Fat/Sugar Snacks, and Sets Limits+Restricts All Snacks. Girls whose mothers used Sets Limits+Restricts All Snacks had a higher approach and EAH at 5 y. Low inhibitory control girls whose mothers used Sets Limits+Restricts All Snacks or Unlimited Access to Snacks had greater increases in EAH and body mass index (BMI) from 5 to 7 y. CONCLUSIONS: Effects of maternal control on girls' EAH and BMI may differ by the type of practice used (eg, limit-setting or restrictive practices). Girls with low inhibitory control were more susceptible to the negative effects of low and high control.

Melanocortin-4 receptor polymorphism rs17782313: association with obesity and eating in the absence of hunger in Chilean children.

OBJECTIVE: The aim of this study was to assess the association between melanocortin-4 receptor (MC4R) rs17782313 alleles with obesity and eating behavior scores in Chilean children. METHODS: A case-control study was conducted with 139 normal-weight and 238 obese children (ages 6-12 y). MC4R rs17782313 genotypes were determined by quantitative-polymerase chain reaction allelic-discrimination assays. Eating behavior scores were evaluated in a subset of participants using the Chilean version of the Child Eating Behavior Questionnaire (CEBQ). Additionally, five normal-weight C-allele carriers of rs17782313 were matched by sex, age, and body mass index (BMI) to five TT homozygous children to carry out the Eating in the Absence of Hunger (EAH) test. RESULTS: The frequency of the C-allele of MC4R rs17782313 was higher in the obese group than in the control group, without achieving statistical significance (odds ratio, 1.4; 95% confidence interval, 0.8-2.4; P = 0.16). CEBQ scores of "enjoyment of food" were higher (P = 0.04) and "satiety responsiveness" were lower (P = 0.02) in children with CC genotype than in those with TT genotype matched by sex, age, and BMI. In the EAH test, all five non-obese carriers of the C-allele (three CC and two CT) showed increased sweet snack consumption compared with five matched (by sex-age-BMI) non-carriers after a preload meal, without achieving statistical significance (P = 0.06). CONCLUSION: MC4R polymorphism rs17782313 may contribute to childhood obesity, affecting enjoyment of food, satiety responsiveness, and possibly eating in the absence of hunger.

Validación factorial de un cuestionario para medir la conducta de comer en ausencia de hambre y su asociación con obesidad infantil / A questionnaire to measure eating behavior in the absence of hunger and its association with childhood obesity

Background: It has been observed that some psychological factors tend to stimulate food intake in the absence of hunger in obese children. objective: To evaluate whether obese children have a greater tendency to eat in the absence of hunger, in response to various emotional and environmental factors versus normal weight children. subjects and Methods: Obese patients were selected according to NCHS/CDC2000 (n = 49 and n = 99 for non-obese children), males and females in the age group of 6-12 years who consulted in the UC health network and also children that were evaluated in schools located in southeastern Santiago. The questionnaire "Eating in the absence of hunger" was used, which measures three subscales: external stimuli, fatigue/boredom and negative feelings. results: Factor analysis showed a significant degree of overlap between the "fatigue/boredom" and "negative feelings" subscales. Obese children had higher scores on "external stimuli" versus normal weight children (median 2.7 compared to 1.7, p < 0.001). In the "fatigue/boredom" subscale, scores of 2.5 versus 1.2 (p < 0.001) were obtained, while in "negative feelings", scores reported 2.0 versus 1.2 (p = 0.0013). Conclusions: Obese patients reported higher scores on the questionnaire "Eating in the absence of hunger" than non-obese children, identifying modifiable and educable stimuli that could prevent this eating behavior.

Introducción: Se ha observado que en los niños obesos, algunos factores psicológicos tienden a estimular la ingesta de alimentos en ausencia de hambre. objetivo: Evaluar si los niños obesos presentan mayor tendencia a comer en ausencia de hambre, en respuesta a distintos factores emocionales y ambientales, en comparación con niños normopeso. Pacientes y Método: Se seleccionaron pacientes obesos según NCHS/CDC2000 (n = 49) y normopeso (n = 99) de ambos sexos y con edades entre 6-12 años, que consultaron en forma espontánea en la Red de Salud UC y niños evaluados en colegios del sector suroriente de Santiago. Se aplicó el cuestionario "Comer en ausencia de hambre" que mide tres subescalas: Estímulos externos, cansancio/aburrimiento y sentimientos negativos. resultados: El análisis factorial reveló un importante grado de solapamiento entre las ponderaciones de las subescalas "cansancio/aburrimiento" y "sentimientos negativos". Los niños con obesidad presentaron mayores puntajes en la dimensión "estímulos externos" que los niños normopeso (mediana de 2,7 versus 1,7; p < 0,001). En "cansancio/aburrimiento" se obtuvieron puntajes de 2,5 versus 1,2 (p < 0,001) mientras que en "sentimientos negativos" los puntajes fueron 2,0 versus 1,2 (p = 0,0013). Conclusiones: Los pacientes obesos presentaron mayores puntajes en la encuesta alimentaria "Comer en ausencia de hambre" que los niños normopeso, pudiendo identificarse estímulos modificables y educables que podrían prevenir esta conducta alimentaria.