Hyperphagia Research Articles

Increased Feeding Speed Is Associated with Higher Subsequent Sympathetic Activity in Dogs.

Although the domestication process has altered the feeding behavior of dogs, some breeds still demonstrate a remarkable ability to gorge, and will eat exceptionally large quantities of food whenever it is available. Lesions in the ventromedial hypothalamus increase appetite and lead to obesity, suggesting that the autonomic nervous system plays an important role in feeding. Focusing on the autonomic activities closely involved in food intake, we investigated sympathetic activities before and after feeding in dogs. The subjects were 56 healthy dogs of 21 different breeds (29 males and 27 females). Based on feeding habits, the 56 dogs were divided into three groups: Fast (n = 19), Slow (n = 24) and Leftover (n = 13). The feeding speed and the amount of food per mouthful of the Fast dogs were significantly greater than those of the Slow and the Leftover dogs. The plasma norepinephrine level in dogs of the Fast group was significantly increased after feeding, while those in the Slow and Leftover groups were significantly decreased after feeding, compared with the pre-feeding concentrations. The low frequency/high frequency ratio of heart rate variability is a good indicator of sympathetic activity and was also significantly higher in the Fast group than in the other groups. Delayed feeding using automatic feeding equipment decreased the plasma norepinephrine concentration and low frequency/high frequency ratio observed after feeding in dogs of the Fast group. In conclusion, dogs eating rapidly with less chewing, which indicates increased sympathetic activity during feeding, may benefit from delayed feeding. The slow eating may activate the parasympathetic nervous system after feeding, which could enhance the activity of the digestive system.

Does a Larger Menu Increase Appetite? Collateral Eligibility and Bank Risk-Taking

We examine a change in the European Central Bank’s collateral framework, which significantly lowered the rating requirement for eligible residential mortgage-backed securities (RMBS), and its impact on bank lending and risk-taking in the Netherlands. Banks most affected by the policy increase loan supply and lower interest rates on new mortgage originations. These lower interest rate loans serve as collateral for newly issued RMBS with lower-rated tranches and subsequently experience worse repayment performance. The performance deterioration is pronounced among loans with state guarantees, which suggests looser collateral requirements may lead to undesired credit risk transfer to the sovereign.

A randomized controlled trial: the effect of inulin on weight management and ectopic fat in subjects with prediabetes.

BackgroundFat infiltration of the liver, muscle and pancreas is associated with insulin resistance and risk of diabetes. Weight loss reduces ectopic fat deposition and risk of diabetes, but is difficult to sustain to due to compensatory increases in appetite. Fermentable carbohydrates have been shown to decrease appetite and food intake, and promote weight loss in overweight subjects. In animal studies, fermentable carbohydrate reduces ectopic fat independent of weight loss. We aimed to investigate the effect of the fermentable carbohydrate inulin on weight maintenance, appetite and ectopic fat in subjects with prediabetes.MethodsForty-four subjects with prediabetes were randomized to 18 weeks’ inulin or cellulose supplementation. During weeks 1–9 (weight loss phase) all subjects had four visits with a dietitian to guide them towards a 5 % weight loss. During weeks 10–18 (weight maintenance phase) subjects continued taking their assigned supplementation and were asked to maintain the weight they had lost but were offered no further support. All subjects attended study sessions at baseline, 9 and 18 weeks for measurement of weight; assessment of adipose tissue and ectopic fat content by magnetic resonance imaging and magnetic resonance spectroscopy; glucose, insulin and GLP-1 levels following a meal tolerance test; and appetite by ad libitum meal test and visual analogue scales.ResultsBoth groups lost approximately 5 % of their body weight by week nine (−5.3 ± 0.1 % vs −4.3 ± 0.4 %, p = 0.13, but the inulin group lost significantly more weight between 9 and 18 weeks (−2.3 ± 0.5 % vs −0.6 ± 0.4 %, p = 0.012). Subjects taking inulin had lower hepatic (p = 0.02) and soleus muscle (p < 0.05) fat content at 18 weeks compared to control even after controlling for weight loss and consumed less at the ad libitum meal test (p = 0.027). Fasting glucose significantly decreased at week nine only (p = 0.005), insulin concentrations did not change, and there was a significant increase in GLP-1 in the cellulose group at 9 and 18 weeks (p < 0.03, p < 0.00001).ConclusionInulin may have a two-pronged effect on the risk of diabetes by 1) promoting weight loss 2) reducing intrahepatocellular and intramyocellular lipid in people with prediabetes independent of weight loss.Trial registrationClinical trial number: NCT01841073.Electronic supplementary materialThe online version of this article (doi:10.1186/s12986-015-0033-2) contains supplementary material, which is available to authorized users.

E40 - Clinical Outcome of Patients With Stage IV Colorectal Cancer Receiving Combination Chemotherapy Without Surgery As Initial Treatment

Background: At the time of diagnosis, 25% of patients (pts) with colorectal cancer (CRC) present synchronous unresectable metastases. The best therapeutic option for this pts is not yet defined: primary tumor resection (PTR) followed by chemotherapy or upfront chemotherapy without PTR? Methods: We conducted a prospective observation trial. Main study's objective was to describe the incidence of primary tumor–related complications in pts with stage IV CRC who received up-front oxaliplatin- or irinotecan-based combination chemotherapy with or without target therapies. Secondary objectives were: overall response rate (ORR- according to RECIST criteria), toxicity (CTCAE v4), progression free survival (PFS) and clinical benefit (defined as: increase in body weight and appetite, improvement of existing symptoms such as pain, bleeding, anorexia, asthenia). Results: From July 2013 to January 2015, 38 pts with median age of 65.8 years (range 44-83), were enrolled. Primary tumors were: right colon (cecum, ascending or transverse colon) in 26.3% of pts, left colon (descending or sigmoid) in 52.6% and rectum in 21.1%. The most common sites of metastasis were: liver (65.8%), retroperitoneal nodes (48.1%), lung (52.7%), peritoneum (21.1%), bone (21.1%) and brain (13.2%). Metastases involved one site or organ in 52.6% of pts, two sites in 26.3%, three sites in 13.2% and four sites in 7.9%. Of 38 pts, 97,4% never required surgical palliation of their primary tumor. One patients (2,6%) required medical therapy for primary tumor subobstruction. No bleeding or intestinal perforation were observed in the site of primary tumor. After 6 months, 94.7% of pts was evaluable for response: ORR was 25%, no complete response (CR), was observed, disease control rate (CR + partial response + stable disease) was 75% and progression was 25%; median PFS was 9.3 months (range 3-15). Grade 3/4 toxicities were as follows: neutropenia 19.2%; diarrhea 11.3%; nausea-vomiting 1.6%. Pain improved in 80% of pts, constipation in 60% of pts with less need for medical treatment (laxatives and enemas toileting), appetite improved in 64.8% of pts and an increase in body weight was observed in 48.3% of pts. Conclusions: These data showed that upfront chemotherapy, without routine prophylactic resection, could be an appropriate therapeutic option for pts with neither obstructed nor hemorrhaging primary colorectal tumors in the setting of metastatic disease.

AB156. Clinical and laboratory characteristics of Prader-Willi syndrome

Background Prader-Willi syndrome (PWS) is a complex multisystem genetic disorder due the lack of expression of paternally inherited imprinted genes on chromosome 15q11-13. Clinical presentation includes hypotonia, hyperphagia, obesity, hypogonadism, learning difficulty. The article aims to study clinical and laboratory of patient diagnosed and treated in National Hospital of Pediatrics, Hanoi (NHP).

Impact of localisation of deep brain stimulation electrodes on motor and neurobehavioural outcomes in Parkinson's disease

BackgroundDeep brain stimulation (DBS) of the subthalamic nucleus (STN) represents a well-established treatment in advanced Parkinson's disease (PD) for motor signs, but it is still debated concerning psychiatric effects.ObjectiveExploration of...

Association between circulating levels of galanin and pre-pregnancy body mass index in patients with gestational diabetes mellitus

Galanin is an important neuropeptide which induces an increase in obesity and appetite, improving insulin sensitivity and glucose tolerance in experimental animals. Although significantly higher levels of plasma galanin are found in pregnant women with gestational diabetes mellitus (GDM), there is a limited understanding of its precise mechanism underlying this variation. In the present study, concentrations of circulating galanin were determined at baseline in pregnant women with GDM and pregnant women with normal glucose tolerance (NGT). Correlation analyses were performed between galanin and pre-gestational body weight, pre-gestational BMI, and hormone involved in various homeostatic processes. Results showed that plasma galanin level was significantly higher in the patients with GDM than in the NGT subjects (p<0.001). Plasma galanin was positively correlated with pre-gestational body weight (r=0.42, p=0.037), pre-gestational BMI (r=0.643, p=0.001), and fasting blood glucose (r=0.840, p<0.001) in the GDM group. Moreover, a significant negative correlation was shown between galanin and sex hormone binding globulin (SHBG) (r=−0.901, p<0.001) in the GDM group. These data indicate that serum galanin concentration increases markedly in pregnant women with GDM, and this increase seems to be related to the increase of pre-gestational BMI and significantly lower SHBG in patients with GDM. Thus, circulating galanin is affected under conditions of altered pre-gestational BMI with highest levels in GDM patients. The increase of galanin under conditions of GDM may indicate a physiological function to improve glucose tolerance which is often impaired in GDM subjects.

Changes in macronutrient, micronutrient, and food group intakes throughout the menstrual cycle in healthy, premenopausal women.

It is thought that total energy intake in women is increased during the luteal versus follicular phase of the menstrual cycle; however, less is understood regarding changes in diet composition (i.e., macro- and micronutrient intakes) across the cycle. The aim of this study was to investigate changes in macronutrient, micronutrient, and food group intakes across phases of the menstrual cycle among healthy women, and to assess whether these patterns differ by ovulatory status. The BioCycle study (2005-2007) was a prospective cohort study of 259 healthy regularly menstruating women age 18-44 who were followed for up to two menstrual cycles. Dietary intake was measured using 24-h dietary recalls, and food cravings were assessed via questionnaire, up to four times per cycle, corresponding to menses, mid-follicular, expected ovulation, and luteal phases. Linear mixed models adjusting for total energy intake were used to evaluate changes across the cycle. Total protein (P = 0.03), animal protein (P = 0.05), and percent of caloric intake from protein (P = 0.02) were highest during the mid-luteal phase compared to the peri-ovulatory phase. There were also significant increases in appetite, craving for chocolate, craving for sweets in general, craving for salty flavor, and total craving score during the late luteal phase compared to the menstrual, follicular, and ovulatory phases (P < 0.001). Our findings suggest an increased intake of protein, and specifically animal protein, as well as an increase in reported food cravings, during the luteal phase of the menstrual cycle independent of ovulatory status. These results highlight a plausible link between macronutrient intake and menstrual cycle phase.

Grazing crops: implications for reproducing sheep

Integration of crops and livestock has been revitalised in Australia, initially as an opportunity to increase cropping within the high-rainfall grazing zones, and more recently, to improve enterprise diversification and profitability across the low-, medium- and high-rainfall, and mixed-farming zones. Young crops are highly digestible (&gt;80% dry matter digestibility, DMD) with a high energy density (&gt;12 MJ/kg DM) and, in much of southern Australia, fill a winter feed gap. The quality and time of feed availability also coincide with the high nutrient requirements of ewes in late pregnancy and lactation. In Western Australia and South Australia, young crops are available for lactating ewes and young growing lambs (autumn lambing). For the smaller proportion of growers who lamb later in winter, young crops are available for the last 1–2 months of pregnancy. In the later-lambing states of New South Wales and Victoria, crops may be grazed by ewes at any stage of pregnancy and lactation and/or by young lambs. In Tasmania, crops are more likely to be available during early–mid-gestation. Limited studies on feed budgeting with grazing crops have indicated that ewes can maintain or even increase liveweight, with a much lower level of feed on offer than would be required with traditional pastures (&lt;500 kg DM/ha). This has the potential to increase whole-farm stocking rates and/or reduce fetal mortality, increase lamb birthweight and survival and improve lifetime production. Maintaining or increasing ewe liveweight during pregnancy and lactation may also result in heavier ewes the following year and higher ovulation rates. Pregnancy and lactation are also periods of increased susceptibility to metabolic disturbances. The composition of young crops increases this susceptibility. Pregnancy toxaemia, hypocalcaemia and hypomagnesaemia can influence ewe health and fetal survival. Chronic acidosis and excessive ammonia absorption from rapid introduction of pregnant ewes onto young crops may risk appetite loss and increase susceptibility to pregnancy toxaemia. Low magnesium and sodium combined with high potassium increases the risk of grass tetany. Most young crops (except canola) also have a tetany index &gt;2.2, indicating a high risk of grass tetany. The elevated potassium also contributes to a high dietary cation–anion difference of approximately +49 mEq/100 g DM and this may cause metabolic alkalosis and hypocalcaemia. Pregnancy toxaemia, hypocalcaemia and grass tetany are all potential causes of increased ewe mortality. Pregnancy and/or lactation outcomes will also be influenced by a deficiency of trace elements. Grazing young crops in areas with a history of selenium, copper, iodine and cobalt deficiency will increase susceptibility to deficiency by increasing growth and feed intake. In conclusion, the grazing of young growing crops presents new opportunities for increased production and stocking rates in the mixed-farming zones. The value of this feed source is well recognised by some producers. While growing crops have a highly productive potential, they also come with an increased risk of a range metabolic disturbances and nutritional imbalances. These risks can be minimised by regular monitoring of livestock and crop biomass and the provision of mineral supplements.

A pharmacokinetic study of patchouli alcohol after a single oral administration of patchouli alcohol or patchouli oil in rats.

Pogostemonis herba is used in traditional Chinese medicine to remove dampness, relieve sunstroke, stop vomiting and increase appetite. Patchouli alcohol, an ingredient in pogostemonis herba, has the potential to treat inflammation as well as bacterial and fungal infections. The essential oil of pogostemonis herba (patchouli oil) is commonly given orally in clinical settings; however, no pharmacokinetic studies have examined its oral administration. The goal of this study was to investigate the pharmacokinetic behavior of patchouli alcohol following single-dose oral administration in rats; the influence of other patchouli oil components on the pharmacokinetic profile of patchouli alcohol was also examined. In this study, a simple and selective GC/MS method was developed and validated to measure the level of patchouli alcohol in rat plasma. The study revealed that the pharmacokinetics profile was linear in both the patchouli alcohol and patchouli oil groups. The C max and AUC0-t of patchouli alcohol were greater in all three doses of patchouli alcohol compared to corresponding patchouli oil doses. Additionally, the T max values were significantly greater in the patchouli oil group. These results suggest that the other ingredients in patchouli oil influence the pharmacokinetic behavior of patchouli alcohol during its absorption. The results provide a meaningful basis for evaluating the clinical application of patchouli oil and patchouli alcohol.

Medicinal use of cannabis in E urope

The beneficial medicinal properties of cannabis, especially for pain relief, are widely recognized. Yet its main active ingredient, tetrahydrocannabinol (THC), is listed as a schedule‐1 illicit drug in the United Nations' Single Convention on Narcotic Drugs. This status has hampered the medicinal use of marijuana, which has prompted patients and physicians to lobby governments to approve its use to treat chronic pain. This in turn has triggered an intense debate between governments, regulators and law enforcement on one side, and physicians and patients on the other side, about whether to legalize a drug, the production, possession and usage of which is still illegal in many countries. > … there is no unique list of pathologies that can be treated with cannabis‐based drugs, since it is not a cure, but rather a palliative treatment In recent years, a number of nations have introduced specific laws and programmes to allow patients to use cannabis preparations in various forms to relieve the symptoms of a range of severe, disabling diseases. As a result, cannabis has been used to effectively relieve chronic pain, muscular cramps and spasticity in patients with multiple sclerosis or spinal cord damage, as well as for patients affected by neurogenic pain caused by nerve damage and other causes [1]. Patients with terminal cancer and AIDS have also benefitted from the use of cannabis to alleviate nausea and vomiting, and to stimulate appetite and weight increase [2]. However, there is no unique list of pathologies that can be treated with cannabis‐based drugs, since it is not a cure, but rather a palliative treatment. It is up to physicians to decide under which circumstances cannabis should be prescribed and which patients could benefit from the treatment. In the USA, 23 states and the District of Columbia have already legalized …

Impact of breakfast skipping toward children health: a review

Breakfast skip is an activity that ignores the meal in the morning before start works, most previous studies assumed that it’s affect children health outcome. This study aim to inform the readers that how breakfast skip influence adolescent health status particularly weigh gain. This data was collected from published papers between January 2008 to 2014 used Google scholar databases. The articles were limited to English language only which focus on breakfast skip, obesity and children as keywords. Breakfast skipping has great influence to the children body particularly body mass index (BMI). Those who omit breakfast will less satiety, increase appetite and having large portion at subsequent meals, consequently total energy density higher than breakfast eaters. Breakfast skipping will lead children to the adverse health outcome especially weigh gain. Conversely, breakfast consumption is a way to ensure that they meet their daily nutrient and energy intakes.

Clinical trial for evaluation of a Human Immunodeficiency Virus nosode in the treatment for Human Immunodeficiency Virus-Infected individuals

Introduction: Identifying the need for strengthening of the immune system, the investigator has developed new Human Immunodeficiency Virus (HIV) nosode and evaluated its effect on HIV positive individuals through a clinical trial. Methods: Standardized and the scientific method of HIV nosode preparation has been described and documented. Thirty-seven HIV-infected persons were registered for the trial, and ten participants were dropped out from the study, so the effect of HIV nosode 30C and 50C, was concluded on 27 participants under the trial. Results: Out of 27 participants, 7 (25.93%) showed a sustained reduction in the viral load from 12 to 24 weeks. Similarly 9 participants (33.33%) showed an increase in the CD4+ count by 20% altogether in 12 th and 24 th week. Significant weight gain was observed at week 12 (P = 0.0206). 63% and 55% showed an overall increase in either appetite or weight. The viral load increased from baseline to 24 week through 12 week in which the increase was not statistically significant (P > 0.05). 52% (14 of 27) participants have shown either stability or improvement in CD4% at the end of 24 weeks, of which 37% participants have shown improvement (1.54-48.35%) in CD4+ count and 15% had stable CD4+ percentage count until week 24 week. 16 out of 27 participants had a decrease (1.8-46.43%) in CD8 count. None of the adverse events led to discontinuation of study. Conclusion: The study results revealed improvement in immunological parameters, treatment satisfaction, reported by an increase in weight, relief in symptoms, and an improvement in health status, which opens up possibilities for future studies.

Do ketogenic diets really suppress appetite? A systematic review and meta-analysis

Very-low-energy diets (VLEDs) and ketogenic low-carbohydrate diets (KLCDs) are two dietary strategies that have been associated with a suppression of appetite. However, the results of clinical trials investigating the effect of ketogenic diets on appetite are inconsistent. To evaluate quantitatively the effect of ketogenic diets on subjective appetite ratings, we conducted a systematic literature search and meta-analysis of studies that assessed appetite with visual analogue scales before (in energy balance) and during (while in ketosis) adherence to VLED or KLCD. Individuals were less hungry and exhibited greater fullness/satiety while adhering to VLED, and individuals adhering to KLCD were less hungry and had a reduced desire to eat. Although these absolute changes in appetite were small, they occurred within the context of energy restriction, which is known to increase appetite in obese people. Thus, the clinical benefit of a ketogenic diet is in preventing an increase in appetite, despite weight loss, although individuals may indeed feel slightly less hungry (or more full or satisfied). Ketosis appears to provide a plausible explanation for this suppression of appetite. Future studies should investigate the minimum level of ketosis required to achieve appetite suppression during ketogenic weight loss diets, as this could enable inclusion of a greater variety of healthy carbohydrate-containing foods into the diet.

Effects of risperidone treatment on the expression of hypothalamic neuropeptide in appetite regulation in Wistar rats

Although the use of atypical antipsychotic drugs has been successful in the treatment of schizophrenia, they can cause some complications in the long-term use, including weight gain. Patients using these drugs tend to disrupt treatment primarily due to side effects. The atypical antipsychotic mechanism of action regulates a number of highly disrupted neurotransmitter pathways in the brains of psychotic patients but may also cause impairment of neurohormonal pathways in different brain areas. In this study, we investigated the circulating levels of hypothalamic neurohormones, which are related to appetite regulation; neuropeptide Y (NPY); alpha melanocyte stimulating hormone (α-MSH); cocaine and amphetamine regulated transcript (CART); agouti-related peptide (AgRP); and leptin in male Wistar rats, which were treated with risperidone, a serotonin antagonist, for four weeks. Alterations in the mRNA expression levels of these candidate genes in the hypothalamus were also analyzed. We hypothesized that risperidone treatment might alter both hypothalamic and circulating levels of neuropeptides through serotonergic antagonism, resulting in weight gain. Gene expression studies revealed that the mRNA expression levels of proopiomelanocortin (POMC), AgRP, and NPY decreased as well as their plasma levels, except for NPY. Unexpectedly, CART mRNA levels increased when their plasma levels decreased. Because POMC neurons express the serotonin receptor (5HT2C), the serotonergic antagonism of risperidone on POMC neurons may cause an increase in appetite and thus increase food consumption even in a short-term trial in rats.

Do ketogenic diets really suppress appetite? A systematic review and meta-analysis.

Very-low-energy diets (VLEDs) and ketogenic low-carbohydrate diets (KLCDs) are two dietary strategies that have been associated with a suppression of appetite. However, the results of clinical trials investigating the effect of ketogenic diets on appetite are inconsistent. To evaluate quantitatively the effect of ketogenic diets on subjective appetite ratings, we conducted a systematic literature search and meta-analysis of studies that assessed appetite with visual analogue scales before (in energy balance) and during (while in ketosis) adherence to VLED or KLCD. Individuals were less hungry and exhibited greater fullness/satiety while adhering to VLED, and individuals adhering to KLCD were less hungry and had a reduced desire to eat. Although these absolute changes in appetite were small, they occurred within the context of energy restriction, which is known to increase appetite in obese people. Thus, the clinical benefit of a ketogenic diet is in preventing an increase in appetite, despite weight loss, although individuals may indeed feel slightly less hungry (or more full or satisfied). Ketosis appears to provide a plausible explanation for this suppression of appetite. Future studies should investigate the minimum level of ketosis required to achieve appetite suppression during ketogenic weight loss diets, as this could enable inclusion of a greater variety of healthy carbohydrate-containing foods into the diet.

Lactation litter size differentially affects satiety hormone concentrations and gut adaptations in Wistar rat dams

Introduction: Peptide-YY (PYY) is a satiety hormone secreted by the colon. We have previously shown that PYY significantly increases in early lactation in rats, despite hyperphagia. Increased PYY may be associated with significantly increased gut growth by late lactation in dams with average-sized litters. Our aim was to determine whether feeding different litter sizes influences postpartum changes occurring during the maternal adaptation to lactation. Materials and Methods: Wistar rats had litter sizes adjusted to 4, 8 (standard) or 12 pups by 1 day postpartum and were sacrificed at day 25 of lactation. Colonic PYY was quantified using radioimmunoassay. Gut tissue measurements were standardised by free-floating gut for length measurements and using nicardipine for circumference measurements. Results and Discussion: Dams feeding 4 pups had significantly shorter and lighter small and large intestines and lighter caecums compared with dams feeding 8 pups and we hypothesise that this is due to reduced suckling demand. Significantly increased descending colon PYY in dams with 8 pups was associated with increased gut size in these dams. Despite no increase in gut length or wet weight, dams feeding 12 pups had significantly increased gut circumferences, which may represent an adaptation to lactation that requires less energy. Energy insufficiency for structural modifications may be why dams feeding 12 pups showed different adaptations to dams feeding 8 pups. This study is the first time such differential adaptations have been shown in dams due to litter size; further work is being carried out to establish if pups from different sized litters have altered endocrine profiles or gut structure that influence feeding.

An innovative solid oral nutritional supplement to fight weight loss and anorexia: open, randomised controlled trial of efficacy in institutionalised, malnourished older adults.

To evaluate the impact of a solid nutritional supplement on the weight gain of institutionalised older adults>70 years with protein-energy malnutrition. The innovation of these high-protein and high-energy cookies was the texture adapted to edentulous patients (Protibis®, Solidages, France). An open, multicentre, randomised controlled trial. Seven nursing homes. One hundred and seventy-five malnourished older adults, aged 86±8 years. All participants received the standard institutional diet. In addition, Intervention group participants received eight cookies daily (11.5 g protein; 244 kcal) for 6 weeks (w0-w6). Five visits (w-4, w0, w6, w10 and w18). Percentage of weight gain from w0 to w6 (body mass in kg). Appetite, rated using a numerical scale (0: no appetite to 10: extremely good appetite); current episodes of pressure ulcers and diarrhea. Average weight increased in Intervention group (n=88) compared with Control group (n=87) without cookies supplementation (+1.6 versus -0.7%, P=0.038). Weight gain persisted 1 month (+3.0 versus -0.2%, P=0.025) and 3 months after the end of cookies consumption (+3.9 versus -0.9%, P=0.003), with diarrhea reduction (P=0.027). There was a synergistic effect with liquid/creamy dietary supplements. Subgroup analysis confirmed the positive impact of cookies supplementation alone on weight increase (P=0.024), appetite increase (P=0.009) and pressure ulcers reduction (P=0.031). The trial suggested that, to fight against anorexia, the stimulation of touch (finger food; chewing, even on edentulous gums) and hearing (intra-oral sounds) could be valuable alternatives to sight, smell and taste alterations.

Do low-calorie drinks 'cheat' the enteral-brain axis?

The consumption of low-calorie beverages has increased worldwide, mainly because of their combination of sweet taste without adding significant calories to the diet. However, some epidemiological studies have linked the higher consumption of low-calorie beverages with increased body weight gain. Although a matter of debate, this paradoxical association between low-calorie beverages and weight gain has been attributed to their effect on the enteral-brain axis. More specifically, artificial sweeteners present in low-calorie beverages could induce appetite increase, probably due to an ambiguous psychobiological signal (uncoupling sweet taste from calorie intake) that confounds the appetite's regulatory mechanisms, promoting overeating and, ultimately, leading to weight gain. However, many studies do not support this assumption, and the mechanisms underlying the interaction between low-calorie beverages and the enteral-brain axis remain to be defined. The understanding of the effects of low-calorie drinks on the enteral-brain axis still remains in its infancy and needs to be unveiled. The consumption of low-calorie beverages reduces the calories from that drink, but compensatory phenomena may increase energy intake, and if so must be recognized and avoided.

Effect of orexin-A (hypocretin-1) on hyperalgesic and cachectic manifestations of experimentally induced rheumatoid arthritis in rats

Orexin-A has been shown to modulate pain sensation and increase appetite. Rheumatoid arthritis (RA) is characterized by joint destruction, deformity, hyperalgesia, and weight reduction. Evaluate the possible effect of orexin-A on hyperalgesic and cachectic manifestations in an adjuvant-induced arthritis (AIA) rat model. Forty adult male Wistar rats were distributed among 4 groups; I, normal controls; II, rats with AIA induced by intradermal injection of Mycobacterium butyricum, but with no other treatment; III, AIA rats treated daily with an intravenous injection of orexin-A for 8 days; and IV, AIA rats treated orally with dexamethasone for 8 days. The parameters we assessed were pain-associated behavior, body mass, hind paw volume, serum levels of nerve growth factor (NGF) and neuropeptide Y (NPY). Orexin-A caused a significant reduction in pain sensation and NGF levels, and increased body mass and the levels of NPY, whereas treatment with dexamethasone led to significant reductions in paw swelling and pain sensation. Orexin-A has hypoalgesic properties and increases body mass, whereas dexamethasone has a potent anti-inflammatory effect. Therefore, the combination of orexin-A and dexamethasone should have a greater effect with respect to attenuating the manifestations and complications associated with RA.