Appetite Assessment Research Articles

Effect of weekly practice of Laghu Shankhaprakshalana Kriya (yogic bowel cleansing) on appetite in healthy adults: An exploratory study

ABSTRACT Introduction: Shankhaprakshalana (SP) kriya is one of the shatkarma (hatha yogic cleansing practices) used to cleanse the entire gastrointestinal tract with water. This technique involves the consumption of lukewarm saline water in conjunction with dynamic yoga asanas followed by a phase of deep relaxation. Past studies have reported the benefits of SP in managing digestive issues such as constipation, migraine-associated abdominal discomfort, and irritable bowel syndrome. However, there is a notable lack of literature investigating the impact of yoga-based cleansing practices on appetite status. Objective: This study aimed to investigate the effect of Laghu Shankhaprakshalana (LSP) kriya on the appetite status of healthy individuals. Materials and Methods: Sixty-five healthy male participants naïve to yoga with a mean age of 26.92 ± 5.35 years were recruited and randomly divided into an LSP group (n = 32) and a control group (n = 33). The LSP group engaged in LSP practice once a week for 8 weeks, while the control group received no intervention. Appetite status was assessed using the Council of Nutrition Appetite Questionnaire before and after completing eight sessions of LSP. The data were analyzed using the mixed model analysis of variance followed by post hoc Bonferroni correction for a total of 60 participants (five participants withdrew from the study). Results: Following eight sessions of LSP practice, a significant increase in appetite levels was observed (p < 0.001). No significant change was found in the control group. Conclusion: This study provides preliminary evidence suggesting that LSP practice tends to enhance appetite levels in apparently healthy individuals. Further research is needed with a larger sample and physiological assessment of appetite.

Appetite assessment in cognitively intact and impaired old patients – A novel tool to be implemented

Appetite assessment in cognitively intact and impaired old patients – A novel tool to be implemented

The Absence of Items Addressing Increased Appetite or Weight in Depressive-Symptom Questionnaires: Implications for Understanding the Link between Major Depressive Disorder, Antidepressants, and Obesity.

Major depressive disorder (MDD) and obesity have a complex bidirectional relationship. However, most studies do not assess increased appetite or weight as a depressive symptom due to limitations in rating scales. Here we aimed to analyze frequently employed depressive-symptom scales and discuss the relevance of weight and appetite assessment items. To elaborate this perspective, we searched for validated questionnaires and scales evaluating depressive symptoms in English. We analyzed appetite and weight items from 20 depressive-symptoms rating scales. Only 8 of 20 rating scales assessed for increased weight or appetite. The scales reported in the literature as the most employed in antidepressants efficacy trials do not assess increased appetite or weight. The current use of rating scales limits our understanding of the relationship between MDD, antidepressants, and obesity. It is necessary to improve our weight and appetite measurements in MDD to clarify the respective impact of depressive symptoms and antidepressants on weight change.

Nutritional Status of Patients Starting on Peritoneal Dialysis: A Comparison Between Planned and Unplanned Dialysis Initiation

A suboptimal dialysis initiation with insufficient or no planning before urgent start of dialysis remains a common problem associated with increased morbimortality. Whether nutritional markers differ between patients starting peritoneal dialysis (PD) in unplanned and planned modes has not yet been explored. Therefore, we aimed to evaluate whether the nutritional status at the start of dialysis differed between patients with unplanned and planned PD initiation. In this observational study comprising 47 adult patients starting PD (age 58±15 years, 51% female), 29 patients had unplanned (starting dialysis up to 72 hours after peritoneal catheter implantation) and 18 planned (follow-up pre-dialysis >90 days) dialysis initiation. Within 30 days of PD initiation, nutritional status was evaluated using anthropometric measurements, multifrequency bioelectrical impedance analysis, appetite assessment, handgrip strength, laboratory markers, and the malnutrition-inflammation score (MIS). Physical activity and performance were also evaluated. Patients with an unplanned PD initiation had a higher frequency of diabetes, higher blood glucose, urea, and glycated hemoglobin levels, and lower hemoglobin and albumin levels. Furthermore, they had a lower calf circumference, slower gait speed, higher protein intake, and greater MIS, while their physical activity level and appetite did not differ. Patients with an unplanned PD had unfavorable clinical and nutritional markers compared with those with planned PD. These findings indicate that a lack of follow-up prior to dialysis initiation can influence the clinical and nutritional statuses of patients, reinforcing the importance of conservative treatment prior to dialysis initiation.

#2900 Appetite changes as a predictor of mortality among end-stage renal disease patients (ESRD) on maintenance hemodialysis: one year survival analysis

Abstract Background and Aims End-stage renal disease (ESRD) has become a major health problem worldwide. Appetite loss is a dominant feature of the disease which plays an important role in protein energy wasting and malnutrition, with subsequent higher rates of mortality. The study aimed to examine appetite changes among patients with ESRD on maintenance hemodialysis and its association with one-year mortality. Method This is a prospective observational study that was conducted at Mansoura Nephrology and Dialysis Unit (MNDU), Mansoura University and Aga Hospital Dialysis Unit over a period of one-year Patients who fulfilled inclusion and exclusion criteria were included. The study was explained to all participants and informed consent was obtained. All demographic, clinical, and laboratory data were collected. Appetite was assessed using the following 4 scores: subjective assessment of appetite, the self-assessment of appetite changes for 30 days, The Visual Analog Scale (VAS), and The Functional Assessment of Anorexia/Cachexia Therapy (FAACT). All patients were followed up for one year to report the mortality events. Results The current study included 162 hemodialysis patients whose age (SD) was 48.72±12.64 years, and males constituted 57.4% of them. Around 44.4% of the cases reported having good appetite using the subjective assessment score, and 13% reported decreased appetite using the self-assessment of appetite score. The median VAS score was 80, and the FAACT score ranged from 7 to 32 with a mean value of 15.85. After one year of observation, death occurred in 24/162 (14.8%). There were statistically significant differences in mean values of three appetite scores among both dead and alive groups with lower values reported in the deceased one [self-assessment of appetite (p=0.019), VAS score (p=0.001), and FACCT (p=<0.001)]. The ROC analysis shows that FACCT & VAS scores were able to determine patients who destinated to mortality with area under curve (AUC) of (0.774 &0.704), at a cut-off point of (14.5%, and 75), with sensitivity of (83.3% &and 66.7%) and specificity of (61.6%, and 53.6%), respectively. Kaplan Meier survival analysis demonstrated that VAS & FACCT scores had a statistically significant effect on median survival time among studied cases. Lower median survival time was detected among cases with decreased appetite by self-assessment tool, VAS score less than 80, and FACCT score less than 15. Kaplan-Meier and hazard curves for the included sample showed lower Median survival time (95% CI) among patients with diminished appetite by the 4 scores: 311.67(265.98-357.36) by self-assessment score (p=0.008), 344.28 (329.57-358.9) days by subjective assessment of appetite (p=0.28), 342.33(330.46-354.19) days by VAS score (p=0.016), and 332.01(314.6-349.43) days by FAACT score (p<0.0001). Cox regression analysis demonstrated that VAS and FACCT scores were statistically significant predictors of median survival time among studied cases (p<0.001, <0.001) and hazard ratio (HR) of (0.968 & 0.734), respectively. Conclusion Diminished appetite is prevalent among hemodialysis patients. Poor appetite is associated with higher mortality. Lower appetite score values can predict mortality among such patients.

Does enteral nutrition require continuity of management: a randomized controlled study.

To explore a set of enteral nutrition therapy continuity management programs for intensive care unit patients based on the theoretical study of circadian rhythm mechanism. The control group followed routine nursing management. Patients in the experimental group were implemented with an enteral nutrition continuity management program, and their eating behavior was adjusted 3 days before the end of tube feeding. Food intake was intermittent at 2, 3, and 4h on the first day, the second day, and the third day of intervention, respectively, and all patients stopped eating at night. Abdominal distension assessment, appetite assessment, application of gastric motility drugs, and patient satisfaction were compared between the two groups after tube feeding. Three days after the end of tube feeding, abdominal distention assessment, bowel sound auscultation, and appetite assessment were statistically different (P<0.05) between the two groups. There were differences in the first day (15 vs. 6, P<0.05), the second day (9 vs. 3, P<0.05), and the cumulative number (17 vs. 7, P<0.05) of gastrointestinal drugs, but no differences in the third day (2 vs. 1, P>0.05). There was a statistical difference in nursing intervention (6.0 vs. 7.0, P<0.05) and psychological nursing (6.0 vs. 7.0, P<0.05), but no statistical difference in health education, medical environment, and nursing attitude (P>0.05). Enteral nutrition continuity management program has a good preventive effect on the gastrointestinal symptoms of intensive care unit patients after the end of tube feeding.

Taste assessment as a part of geriatric nutritional care: Potential implications for clinical practice

IntroductionAging is related to decrease in taste perception. As appetite is considered crucial for maintenance of proper nutritional status of older adults, its decrease during aging raises questions about its relation to gustatory functions and further prevention possibilities. Aim of the studyThe aim was to assess the characteristics and eating behaviors of the patients who reported a self-perceived reduction in taste perception in the context of appetite. Material and methodsThis semi-qualitative study was conducted between November 2021 and March 2022 in the Department of Internal Medicine and Geriatrics of the University Hospital in Krakow. Patients were assessed using an original appetite assessment scale, which allowed for an in-depth interview on areas related to the decline in gustatory function. Additionally, nutritional assessment was performed using Mini Nutritional Assessment and Council on Nutrition Appetite Questionnaire (CNAQ) and anthropometric measurements. ResultsThe most common characteristics of patients with gustatory dysfunction were early satiety, decreased appetite in the three months prior to the study and polypharmacy. A significant difference was observed in the CNAQ scores between the group of patients with and without gustatory dysfunction. ConclusionCareful identification of patients presenting with gustatory dysfunction can provide an important cue for an individualised approach aimed at preventing malnutrition. In our work, we suggest the areas that can be addressed during a nutritional interview to enable the selection of an optimal approach.

How Can We Improve the Appetite of Older Patients on Dialysis in Japan?

It is necessary to ensure adequate energy and protein intake in dialysis patients. However, in addition to the decline in dietary intake in older dialysis patients due to aging, the rate of anorexia is high in dialysis patients, which increases the risk of protein–energy wasting (PEW), sarcopenia, and frailty. There are many causes of anorexia in dialysis patients, including older dialysis patients, and approaches to improve the appetite of such patients have been reported; however, there has been no established approach to improve appetite adequately. Therefore, a key practical goal is to identify anorexia early and implement timely interventions before weight loss occurs. Appetite assessment tools and weight loss assessments are helpful for the screening and early identification of anorectic signs. Nutritional interventions include reducing dietary restrictions, using oral nutritional supplements, and intradialytic parenteral nutrition, as well as replenishing energy, protein, and zinc to prevent the development of nutritional disorders among older dialysis patients. Appetite assessments, early intervention, and dietary and nutritional counseling are key to improving appetite in these patients. The aging rate of dialysis patients in Japan is unprecedented globally, and I believe that this is a situation that will eventually occur in other countries as well. I discuss the factors that contribute to anorexia, especially in older dialysis patients, and Japan’s efforts to address this problem, such as the relaxation of dietary restrictions and the use of oral nutritional supplements.

Do we care about appetite?—an investigation into the recording of reduced appetite in older hospitalised adults

Key summary pointsAimThe aim of the study was to check the frequency of reporting of appetite status in hospitalized older adults and to analyze the terms documented by physicians when reporting reduced appetite.FindingsIn our setting appetite was not assessed using standardized questionnaires. Appetite was mentioned in 13.3% of medical notes.MessageThe lack of routinely performed appetite assessment procedures results in low rates of mention of appetite status in electronic medical records.

A fish appetite assessment method based on improved ByteTrack and spatiotemporal graph convolutional network

The appetite of fish significantly influences aquaculture efficiency and fish welfare. However, accurately assessing fish appetite has posed a challenging problem. Currently, the study of fish feeding behaviour relies primarily on the overall information obtained from images of fish schools, often overlooking the distinctive behavioural traits of individual fish. Analysing the behaviour of individual fish is hindered by challenges such as intraclass variation and cross-occlusion within real aquaculture environments. To address these challenges, this paper introduces a novel method for assessing appetite based on individual fish behaviour. The ByteTrack model was improved to enable stable tracking of each fish within a school under complex conditions. Additionally, this paper employs the spatiotemporal graph convolutional neural network (ST-GCN) to extract the movement characteristics of individual fish, facilitating accurate appetite assessment. The experimental results demonstrate that the proposed method achieves 98.47% accuracy in appetite assessment, surpassing the performance of other state-of-the-art methods. This paper provides a new opportunity and effective means for analysing fish behaviour and appetite in intricate environments.

Efficacy of Herbal Supplementation of Purslane Freeze-dried Juice for Weight Loss: An 8-week Randomized, Double-blind, Placebo-controlled Clinical Trial

Background: Obesity is a condition that has been linked to several ailments. The current investigation is a randomized, double-blind, placebo-controlled clinical experiment to examine how Portulaca oleracea L. tablets affect hunger and Body Mass Index (BMI). Methods: A total of 70 healthy people aged 18 - 65 years old with a BMI &gt;25.0 kg/m² were chosen for an 8-week study. They were randomized into two groups, herbal medicine and placebo. Anthropometry, laboratory tests, and appetite assessment by questionnaire were performed at baseline and the end of the study period. In the end, the data were analyzed. Results: There were significant differences in appetite and BMI (p&lt;0.05) between the two groups after 8 weeks. No serious adverse events occurred in the two groups, and herbal medicine was well tolerated. Purslane juice was found to be well tolerated and could be effective in the reduction of appetite and BMI, either in obese or overweight individuals, following 8 weeks of intervention. Conclusion: The trial indicated the effectiveness of this extract on appetite and BMI. However, long-term investigations with larger populations are needed to determine the tolerability and permanent effectiveness of this natural medicament.

Ուսանողների սննդային վարքագիծը և սպիտակուցային սննդատեսակների օգտագործումը

Food is a vital and indispensable component of a healthy lifestyle. Consumption of food is a basic necessity for ensuring the full vitality of a person. The aim of our research is to study the eating behaviour and nutrition culture of students, as well as the characteristics and preferences for the consumption of protein products. The research was conducted among students of current undergraduate education system of the Faculty of Food Technologies of ANAU for the 2019-2021 academic years. The survey was conducted using a specially designed "Lifestyle Research Card" before and after completing the "Nutrition" course. Out of 309 students of the faculty, 135 (43,7%) took part in the survey. The nature of nutrition and improvements were examined through initial feedback observations. Observations of manifestations of eating behaviour were carried out according to the following indicators: appetite assessment, frequency and regularity of food intake during the day, casual meals and time of the last meal. The use of nutritional culture elements allowed students to improve the character of nutrition: the rate of improvement in appetite increased by 9,1%, the proportion of students eating 4 times a day increased by 25,2% and the proportion of those eating regularly increased by 31,9%. Significant positive changes were noted in preferences, consumption, as well as in regulating the frequency of intake of protein products, in particular, meat, dairy, fish and vegetables. The proportion of sausage lovers decreased by 18,5%, and 8,1% of students completely excluded them from the main diet. Analysis of the results of two-year observations showed that students not only gained knowledge, but also improved their diet, became more educated, literate in eating, realized the role and importance of nutrition as the main factor affecting health and life.

How images of food become cravingly salient in obesity.

This case-control study was aimed at testing two main hypotheses: (i) obesity is characterized by neurofunctional alterations within the mesocorticolimbic reward system, a brain network originating from the midbrain ventral tegmental area (VTA); and (ii) these alterations are associated with a bias for food-related stimuli and craving. Normal-weight individuals and individuals with obesity underwent a resting-state functional magnetic resonance imaging scan and the assessment of impulsivity, food craving, appetite, and implicit bias for food and non-food stimuli. The VTA was used as a seed to map, for each participant, the strength of its functional connections with the rest of the brain. The between-group difference in functional connectivity was then computed, and brain-behavior correlations were performed. Individuals with obesity showed hyper-connectivity of the VTA with part of the ventral occipitotemporal cortex, recently found to be specialized for food images, and hypo-connectivity with the left inferior frontal gyrus, devoted to cognitive control. VTA-ventral occipitotemporal cortex connectivity was positively associated with food craving and food-related bias; the reverse correlation was observed for VTA-inferior frontal gyrus connectivity. These findings reveal that, in obesity, food-related visual stimuli become cravingly salient through an imbalanced connectivity of the reward system with sensory-specific regions and the frontal cortex involved in cognitive control.

The metabolic interplay between dietary carbohydrate and exercise and its role in acute appetite regulation in males: a randomized controlled study.

An understanding of the metabolic determinants of postexercise appetite regulation would facilitate development of adjunctive therapeutics to suppress compensatory eating behaviours and improve the efficacy of exercise as a weight-loss treatment. Metabolic responses to acute exercise are, however, dependent on pre-exercise nutritional practices, including carbohydrate intake. We therefore aimed to determine the interactive effects of dietary carbohydrate and exercise on plasma hormonal and metabolite responses and explore mediators of exercise-induced changes in appetite regulation across nutritional states. In this randomized crossover study, participants completed four 120 min visits: (i) control (water) followed by rest; (ii) control followed by exercise (30 min at ∼75% of maximal oxygen uptake); (iii) carbohydrate (75 g maltodextrin) followed by rest; and (iv) carbohydrate followed by exercise. An ad libitum meal was provided at the end of each 120 min visit, with blood sample collection and appetite assessment performed at predefined intervals. We found that dietary carbohydrate and exercise exerted independent effects on the hormones glucagon-like peptide 1 (carbohydrate, 16.8 pmol/L; exercise, 7.4 pmol/L), ghrelin (carbohydrate, -48.8 pmol/L; exercise: -22.7 pmol/L) and glucagon (carbohydrate, 9.8 ng/L; exercise, 8.2 ng/L) that were linked to the generation of distinct plasma 1 H nuclear magnetic resonance metabolic phenotypes. These metabolic responses were associated with changes in appetite and energy intake, and plasma acetate and succinate were subsequently identified as potential novel mediators of exercise-induced appetite and energy intake responses. In summary, dietary carbohydrate and exercise independently influence gastrointestinal hormones associated with appetite regulation. Future work is warranted to probe the mechanistic importance of plasma acetate and succinate in postexercise appetite regulation. KEY POINTS: Carbohydrate and exercise independently influence key appetite-regulating hormones. Temporal changes in postexercise appetite are linked to acetate, lactate and peptide YY. Postexercise energy intake is associated with glucagon-like peptide 1 and succinate levels.

The Impact of the Gastric Pouch and Gastro-Jejunostomy Size after Laparoscopic Roux-En-Y Gastric Bypass - A Prospective, CT-Volumetry Based Study

Abstract Background Some patients who undergo laparoscopic Roux-en-Y gastric bypass (LRYGB) may present with insufficient weight loss or weight regain. Anatomical factors that may lead to failure of LRYGB include the size of the gastric pouch and the diameter of the gastro-jejunostomy. Aims This study explores the gastric pouch size and the size of the gastro-jejunostomy after LRYGB and investigates their impact on weight loss, appetite and quality of life (QoL). Methods Patients undergoing LRYGB in a single centre underwent computed tomography (CT) with oral contrast one day and one year after LRYGB. Volumetry of the gastric pouch and calculation of the size of the gastro-jejunostomy was performed. Appetite was assessed pre-operatively and one year after LRYGB using the Edmonton Appetite Assessment questionnaire. QoL was assessed pre-operatively one year after surgery using the GIQLI and BAROS questionnaires. Results 61 patients were included. Of those, 55 patients (90.2%) underwent CT one year after LRYGB. The mean preoperative Body Mass Index was 40.7±3.97kg/m2. The mean Excess weight loss (%EWL) one year after surgery was 82.1±21.5%. There was no significant change in mean gastric pouch size one day and one year after LYRGB (15.73±11.8cm3 and 14.4±11.5cm3, respectively, p=0.55). The mean size of the gastrojejunostomy increased significantly from 2.63cm2 to 3.60cm2 (p&amp;lt;0.0001). Mean GIQLI and BAROS values improved significantly one year after LRYGB, but no significant changes in the mean Edmonton Appetite Assessment values were found. %EWL and improvement in GIQLI and BAROS values one year after surgery did not correlate with the initial size of the gastric pouch and the increase of the size of the gastro-jejunostomy. Conclusions One year after LRYGB, the size of the gastro-jejunostomy increased significantly, but no difference in the gastric pouch volume was found. Both gastric pouch volume and dilatation of the gastro-jejunostomy did not correlate with weight loss and QoL outcomes.

No Evidence That Circulating GLP-1 or PYY Are Associated with Increased Satiety during Low Energy Diet-Induced Weight Loss: Modelling Biomarkers of Appetite.

Bariatric surgery and pharmacology treatments increase circulating glucagon-like peptide-1 (GLP-1) and peptide YY (PYY), in turn promoting satiety and body weight (BW) loss. However, the utility of GLP-1 and PYY in predicting appetite response during dietary interventions remains unsubstantiated. This study investigated whether the decrease in hunger observed following low energy diet (LED)-induced weight loss was associated with increased circulating 'satiety peptides', and/or associated changes in glucose, glucoregulatory peptides or amino acids (AAs). In total, 121 women with obesity underwent an 8-week LED intervention, of which 32 completed an appetite assessment via a preload challenge at both Week 0 and Week 8, and are reported here. Visual analogue scales (VAS) were administered to assess appetite-related responses, and blood samples were collected over 210 min post-preload. The area under the curve (AUC0-210), incremental AUC (iAUC0-210), and change from Week 0 to Week 8 (∆) were calculated. Multiple linear regression was used to test the association between VAS-appetite responses and blood biomarkers. Mean (±SEM) BW loss was 8.4 ± 0.5 kg (-8%). Unexpectedly, the decrease in ∆AUC0-210 hunger was best associated with decreased ∆AUC0-210 GLP-1, GIP, and valine (p < 0.05, all), and increased ∆AUC0-210 glycine and proline (p < 0.05, both). The majority of associations remained significant after adjusting for BW and fat-free mass loss. There was no evidence that changes in circulating GLP-1 or PYY were predictive of changes in appetite-related responses. The modelling suggested that other putative blood biomarkers of appetite, such as AAs, should be further investigated in future larger longitudinal dietary studies.

Post-operative Pain Assessment Following Tooth Extraction Using Liposomal Encapsulated Bupivacaine as a Local Anesthetic in Dogs.

The objective of this study was to evaluate owner assessment of appetite, demeanor, and mouth soreness following dental extractions in dogs receiving either bupivacaine hydrochloride (BH) or liposomal encapsulated bupivacaine (LEB) for dental blocks. Thirty healthy, adult dogs requiring dental extractions were enrolled in the study. All procedures were completed with dogs under general anesthesia. A non-steroidal anti-inflammatory drug was administered subcutaneously in the preoperative period. Dogs were randomly assigned to receive BH or LEB. An owner assessment to evaluate appetite, demeanor, and soreness of mouth was completed at the end of both the first and second day after discharge from the hospital. The total of the owner assessments for day 1 and both days combined was significantly lower for dogs receiving LEB (P = .007). There were no differences in the number of extractions (P = .21), time from block to evaluations (P = .07), in-hospital pain assessments (P = .99), or number of dogs requiring rescue analgesia (P = .99). This study concluded, dogs that received LEB for dental blocks had improved appetite and demeanor, and reduced soreness of mouth, as evaluated by the owner two days postoperatively, when compared to dogs who received BH.

The Influence Of Czech Herbal Medicine In Increasing Appetite On Toddlers

Difficulty eating in children is still a complaint from parents. Toddlers often experi ence a decrease in appetite which results in reduced nutritional intake resulting in decreased body weight. This can result in decreased immune system, impaired brain function which can cause disability and death. According to the World Health Or ganization, in 2013 there were 99 million children under five in the world suffering from malnutrition and 67% were in Asia. There are 17 thousand deaths every day due to nutritional problems and infectious diseases. In Indonesia, especially the Javanese, believe that herbal medicine has the property of increasing appetite in children. Research Objectives To determine the effect of herbal medicine in increas ing appetite in toddlers 12-36 months. Pre-experimental designs with one group pretest-posttest. The sampling technique was total sampling, namely 10 toddlers or all toddlers aged 12-36 months in the Panggarangan Health Center area with de creased appetite problems in November 2022. Appetite assessment results before being given herbal medicine to 10 respondents with a minimum score of 2 and a maximum of 5, and an average of 3.70 (SD 0.949). While the appetite after being given herbal medicine with a minimum value of 7 and a maximum of 10, and an average of 8.70 (SD 1.059). So, herbal medicine has the effect of increasing appetite in toddlers aged 12-36 months in the Penggarangan Health Center (p-value &lt;0.000). Herbal medicine has an effect on increasing appetite in toddlers 12-36 months. It is hoped that the public can be more selective in choosing ingredients and herbal medicine providers to increase toddlers' appetite.

Neurobehavioral Mechanisms of Sodium Appetite.

The objectives of this paper are to first present physiological and ecological aspects of the unique motivational state of sodium appetite, then to focus on systemic physiology and brain mechanisms. I describe how laboratory protocols have been developed to allow the study of sodium appetite under controlled conditions, and focus on two such conditions specifically. The first of these is the presentation a sodium-deficient diet (SDD) for at least one week, and the second is accelerated sodium loss using SDD for 1-2 days coupled with the diuretic furosemide. The modality of consumption is also considered, ranging from a free intake of high concentration of sodium solution, to sodium-rich food or gels, and to operant protocols. I describe the pivotal role of angiotensin and aldosterone in these appetites and discuss whether the intakes or appetite are matched to the physiological need state. Several brain systems have been identified, most recently and microscopically using molecular biological methods. These include clusters in both the hindbrain and the forebrain. Satiation of sodium appetite is often studied using concentrated sodium solutions, but these can be consumed in apparent excess, and I suggest that future studies of satiation might emulate natural conditions in which excess consumption does not occur, using either SDD only as a stimulus, offering a sodium-rich food for the assessment of appetite, or a simple operant task.

Association between Malnutrition Risk Factors and Physical Function in Community-Dwelling Adults ≥80 Years

Malnutrition is associated with accelerated loss of physical function in old adults, but the assessment of malnutrition in primary prevention is challenging. This study aimed to investigate if malnutrition risk factors; poor appetite, dysphagia, and poor dental state, were associated with reduced physical function in community-dwelling adults ≥80 years. The study is based on data from two cross-sectional studies. Physical function was assessed by the Short Physical Performance Battery (score ≤ 9 indicate reduced physical function) and poor appetite, dysphagia and poor dental status was assessed by single questions. A total of 900 participants were included (age 85.1 ± 3.7 years; 60.9% females; 62.8% had reduced physical function). Participants with reduced physical function were older, had a higher BMI, more polypharmacy, more falls, and lower quality of life. Poor appetite was reported by 10.8% and associated with reduced physical function (adjusted-OR 1.93, 95%CI 1.18–3.15). No association was identified between dysphagia, poor dental state and reduced physical function (adjusted-OR 0.96, 95%CI 0.53–1.75 and adjusted-OR 0.99, 95%CI 0.41–2.35, respectively). The assessment of appetite during primary preventive strategies was feasible and may offer an opportunity for identification of very old community-dwelling adults at risk of reduced physical function.