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Purpose: Distress screening using measures of patient-reported outcomes (PRO) has been introduced in China and is increasingly recognized as contributing to whole-patient care. We carried out a multi-centered cross-sectional survey of Chinese cancer inpatients to explore the symptom burden, symptom clusters, and risk factors of distress.Method: Patients were recruited from five hospitals in four provinces. The Distress Assessment and Response Tool (DART) was used as the screening tool. Demographic and medical information was collected. Descriptive analysis, the chi-square test, logistics regression analysis, and hierarchical clustering analysis were used.Results: Totally 1045 valid questionnaires were collected (83.6% validity ratio). Low well-being (39.4%), lack of appetite (35.4%), tiredness (32.9%), pain (21.1%), and anxiety (19.8%) were the top five symptoms. Patients in Ci County had a heavier symptom burden than patients at other sites. Depression, anxiety, nausea, drowsiness, and pain were considered pain-illness symptoms; lack of appetite, low well-being, tiredness, and shortness of breath were considered fatigue-illness symptoms. Social difficulty was a risk factor for all symptoms. A high proportion of suicide ideation (38.8%) and suicide intention (10.5%) was identified among patients with potential depression.Conclusion: The high symptom burden of Chinese cancer inpatients indicates the necessity of distress screening; well-designed screening programs such as the multidimensional DART and its acceptability in China should be further explored. Social difficulty has a universal impact on patients' well-being, and psychosocial care should be integrated into holistic symptoms management. [ABSTRACT FROM AUTHOR]

This paper is partly a brief academic autobiography. It begins in 1942 when I volunteered for lifesaving research for the Royal Navy. This brought me to a Department headed by a very unusual Professor, R.A. McCance, an eccentric and a polymath. I have tried to say something about him and the Department. After the war, McCance gave me the Ph.D. project: The Effect of Ventromedial Lesions in the Hypothalamus in Rats in Parabiosis. It had recently been discovered that such lesions cause obesity, and energy balance was an active field. Parabiosis dates to the nineteenth century but had not previously been used in this context. The results were uniform and dramatic. I have briefly presented them, with a review of my own and others' subsequent work. This leads to a picture of a negative feedback system, which regulates food intake to maintain a near-constant proportion of fat in the body, and maintains energy balance with increasing precision as time progresses. The parabiotic effect strongly suggests that there must be a blood-borne link between body fat and the hypothalamus. I have tried to make the case as strongly as I can for further work to identify this link, which has obvious scientific and clinical importance., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

People eat meals rather than nutrients or food groups. Plate size may influence meal size, meal composition, and food type. To examine effects of plate size on meals, we developed a method we label plate mapping. A quasi-experimental study asked university students to accurately draw what they would like to eat for dinner on either a 9″ or 11″ paper plate. Coding plate drawings for total meal size revealed that students drew an average of 26% more food on larger plates. When plates were coded for meal composition we found that the biggest three food portions drawn by students were bigger on 11″ plates, with 70% of the overall difference in food area occurring in the biggest food. Participants drew bigger portions of vegetables on larger plates, while other food types showed little change in mean size. Gender moderated plate sensitivity for food types: women drew 36% bigger vegetable portions than men on larger plates. Smaller plates may lead to smaller meal sizes, but plate size may differentially influence composition of meals for men and women. These findings suggest plate mapping can be used to reflect meal conceptualizations and assess sensitivity to plate size., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Chocolate craving can be defined as an intense, intrusive and irrepressible desire for the consumption of chocolate. It is a fairly unknown clinical reality, for which it is important to raise awareness among health care professionals and other interested people. This paper reviews the pathophysiology, epidemiology, diagnosis, complications, treatment and prevention of chocolate craving, based on a systematic review and reading of 57 articles published in the last decades about the subject. This review shows that chocolate craving is associated with many health problems, such as obesity, depression, anxiety and substance misuse. Since there is no specific treatment for chocolate craving, its therapeutic approach is based on psychological strategies and on the therapeutic strategies for addition, obesity and other conditions related to chocolate craving.

The aim of this paper was to investigate the association between appetite and kidney-disease specific quality of life in maintenance hemodialysis patients. Quality of life (QoL) was measured using the kidney disease quality of life survey. Appetite was measured using self-reported categories and a visual analog scale. Other nutritional parameters included Patient-Generated Subjective Global Assessment (PGSGA), dietary intake, body mass index and biochemical markers C-reactive protein and albumin. Even in this well nourished sample (n=62) of hemodialysis patients, PGSGA score (r=-0.629), subjective hunger sensations (r=0.420) and body mass index (r=-0.409) were all significantly associated with the physical health domain of QoL. As self-reported appetite declined, QoL was significantly lower in nine domains which were mostly in the SF36 component and covered social functioning and physical domains. Appetite and other nutritional parameters were not as strongly associated with the Mental Health domain and Kidney Disease Component Summary Domains. Nutritional parameters, especially PGSGA score and appetite, appear to be important components of the physical health domain of QoL. As even small reductions in nutritional status were associated with significantly lower QoL scores, monitoring appetite and nutritional status is an important component of care for hemodialysis patients., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

A significant adjustment in eating practices is required before and after bariatric surgery, yet we know relatively little about how patients manage these changes. In this paper, we explored how members of an online bariatric support group constructed their appetite and weight loss. Two hundred and eighty four online posts were collected, covering a period of just over a year, and analysed using discursive psychology. We found that a lack of appetite post-surgery was oriented to as something that was positively evaluated yet a cause for concern. Indeed, members monitored their food intake and marked out food consumption as a necessary activity in line with notions of healthy eating. Through monitoring members also normalised periods of weight stabilisation and were inducted into a group philosophy which encouraged a more holistic approach to post-surgery 'success'. Our analysis also highlights how monitoring and policing work as social support mechanisms which help to maintain weight management. Thus we argue, in line with others, that weight management, typically depicted as an individual responsibility, is bound up with the social practices of the online support group. We suggest that clinical advice about a loss of appetite and periods of weight stabilisation post-surgery perhaps need further explanation to patients., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Anecdotal evidence suggests that a disliked food can act as a contaminant to liked food during childhood. While this has been investigated in an infant sample, the current paper presents the first study to investigate this phenomenon in a sample of young children (4 years 5 months-6 years 1 month old, N=30). Children were shown a liked food at different stages of being contaminated by a disliked food. At each stage, the children were asked to rate their willingness to consume the liked food on a 3-point hedonic scale. The data show that children reduce their rating of a liked food once it has been in contact with a disliked food, in comparison to a like-like combination control measure. The data also show that girls show greater sensitivity than boys to this form of contamination and that the younger children are more likely to show a prolonged response (rating of the liked food does not return to the unadulterated level) than the older children in the sample. Several possible reasons for these findings are discussed including disgust, inferred distaste and associational contamination., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Purpose: Altered food relationships in people receiving chemotherapy are prevalent and distressing. Whether, or to what extent, taste perception and food hedonics plays in altered food relationships is unknown among people receiving chemotherapy. This two-armed systematic review addressed the question "Does chemotherapy influence taste perception and hedonic experience of food?", Methods: A systematic review was undertaken of (1) taste perception and (2) food hedonics. Search phrases used in the taste arm were: "chemotherapy AND taste", and in the food hedonics arm, "chemotherapy AND (liking OR food OR appetite OR hedonic(∗))". Databases searched were PsycINFO, PubMed, Medline, CINAHL, EMBASE and the Cochrane Library. English language, peer-reviewed publications investigating adults (>18years) receiving chemotherapy as the only cancer treatment were eligible., Results: One hundred and sixty three papers were screened in the taste arm, of which eight (5%) met inclusion criteria. Nine hundred and seventy two papers were screened in the food hedonics arm of which 25 (3%) met inclusion criteria. Chemotherapy had variable influence on both taste sensitivity and perceived intensity of the taste qualities sweet, salty, sour and bitter. Liking of food and drink decreased after chemotherapy treatment commenced. Caffeinated foods and drinks, red meat and citrus fruits or juices were most frequently reported as aversive during chemotherapy. A reduction in appetite was reported between baseline (pre-chemotherapy) and cycles 1-3 of chemotherapy with no further worsening in latter chemotherapy cycles and an improvement after completion of chemotherapy treatment., Conclusions: There was a lack of consistency of results between studies due to differences in study design, chemotherapy regimen, tumor type and stage of treatment examined. These results provide insufficient evidence to suggest chemotherapy has a significant or consistent influence on taste. There is a consistent, albeit small, body of evidence indicating food liking and appetite are adversely affected by chemotherapy and some evidence that declines in liking and appetite are reversed over time. Overall, more longitudinal studies of specific classes of chemotherapy drugs are required to accurately define the nature, magnitude and time course of taste, food liking and appetite changes over the treatment trajectory., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Appetitive operant conditioning in Aplysia for feeding behavior via the electrical stimulation of the esophageal nerve contingently reinforces each spontaneous bite during the feeding process. This results in the acquisition of operant memory by the contingently reinforced animals. Analysis of the cellular and molecular mechanisms of the feeding motor circuitry revealed that activity-dependent neuronal modulation occurs at the interneurons that mediate feeding behaviors. This provides evidence that interneurons are possible loci of plasticity and constitute another mechanism for memory storage in addition to memory storage attributed to activity-dependent synaptic plasticity. In this paper, an associative ambiguity correction-based neuro-fuzzy network, called appetitive reward-based pseudo-outer-product-compositional rule of inference [ARPOP-CRI(S)], is trained based on an appetitive reward-based learning algorithm which is biologically inspired by the appetitive operant conditioning of the feeding behavior in Aplysia. A variant of the Hebbian learning rule called Hebbian concomitant learning is proposed as the building block in the neuro-fuzzy network learning algorithm. The proposed algorithm possesses the distinguishing features of the sequential learning algorithm. In addition, the proposed ARPOP-CRI(S) neuro-fuzzy system encodes fuzzy knowledge in the form of linguistic rules that satisfies the semantic criteria for low-level fuzzy model interpretability. ARPOP-CRI(S) is evaluated and compared against other modeling techniques using benchmark time-series datasets. Experimental results are encouraging and show that ARPOP-CRI(S) is a viable modeling technique for time-variant problem domains.

Studies that make use of separate measures to capture 'liking' and 'wanting' components of food reward signal a paradigm shift in research on hedonic (over)eating in man. In a recent review, Havermans (2011) highlighted some key methodological and theoretical challenges faced by those working on this issue. Unfortunately, this selective reading of the recent literature in the field presents a skewed picture; but it should not dampen the building momentum. On the other hand the paper is a timely call for researchers to clarify some of the neological confusion that has inevitably been generated along the way. In this response to Havermans (2011), we offer a more robust review of current progress in the assessment of 'liking' vs. 'wanting' food in human appetite. The evidence supports important theoretical and practical implications for a dual-process account of food reward; the developing nature of the research means the majority of these remain tantalisingly unexplored., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Consumption of spicy foods containing capsaicin, the major pungent principle in hot peppers, reportedly promotes negative energy balance. However, many individuals abstain from spicy foods due to the sensory burn and pain elicited by the capsaicin molecule. A potential alternative for nonusers of spicy foods who wish to exploit this energy balance property is consumption of nonpungent peppers rich in capsiate, a recently identified nonpungent capsaicin analog contained in CH-19 Sweet peppers. Capsiate activates transient receptor potential vanilloid subtype 1 (TRPV1) receptors in the gut but not in the oral cavity. This paper critically evaluates current knowledge on the thermogenic and appetitive effects of capsaicin and capsiate from foods and in supplemental form. Meta-analyses were performed on thermogenic outcomes, with a systematic review conducted for both thermogenic and appetitive outcomes. Evidence indicates that capsaicin and capsiate both augment energy expenditure and enhance fat oxidation, especially at high doses. Furthermore, the balance of the literature suggests that capsaicin and capsiate suppress orexigenic sensations. The magnitude of these effects is small. Purposeful inclusion of these compounds in the diet may aid weight management, albeit modestly.

Functional magnetic resonance imaging (fMRI) has provided the opportunity to safely investigate the workings of the human brain. This paper focuses on its use in the field of human appetitive behaviour and its impact in obesity research. In the present absence of any safe or effective centrally acting appetite suppressants, a better understanding of how appetite is controlled is vital for the development of new antiobesity pharmacotherapies. Early functional imaging techniques revealed an attenuation of brain reward area activity in response to visual food stimuli when humans are fed-in other words, the physiological state of hunger somehow increases the appeal value of food. Later studies have investigated the action of appetite modulating hormones on the fMRI signal, showing how the attenuation of brain reward region activity that follows feeding can be recreated in the fasted state by the administration of anorectic gut hormones. Furthermore, differences in brain activity between obese and lean individuals have provided clues about the possible aetiology of overeating. The hypothalamus acts as a central gateway modulating homeostatic and nonhomeostatic drives to eat. As fMRI techniques constantly improve, functional data regarding the role of this small but hugely important structure in appetite control is emerging.

Obestatin is a 23 amino acid peptide encoded by the same gene as ghrelin and synthetized in the gastrointestinal tract. The first results of the investigations on the physiological function of obestatin pointed to its role in the reduction of appetite, delay of stomach emptying and decrease of body weight gains which may testify the fact that this peptide is an endogenous antagonist for ghrelin. The results of the last 5 years investigations on the physiological role of obestatin presented in this paper contradict such a statement and prove that obestatin is an independent hormone, participating in many physiological processes in the organism which may include the development of the gastrointestinal tract in the early postnatal period.

Obesity is one of the major challenges to human health worldwide; however, there are currently no effective pharmacological interventions for obesity. Recent studies have improved our understanding of energy homeostasis by identifying sophisticated neurohumoral networks which convey signals between the brain and gut in order to control food intake. The hypothalamus is a key region which possesses reciprocal connections between the higher cortical centres such as reward-related limbic pathways, and the brainstem. Furthermore, the hypothalamus integrates a number of peripheral signals which modulate food intake and energy expenditure. Gut hormones, such as peptide YY, pancreatic polypeptide, glucagon-like peptide-1, oxyntomodulin, and ghrelin, are modulated by acute food ingestion. In contrast, adiposity signals such as leptin and insulin are implicated in both short- and long-term energy homeostasis. In this paper, we focus on the role of gut hormones and their related neuronal networks (the gut-brain axis) in appetite control, and their potentials as novel therapies for obesity.

Introduction: To maintain energetic homeostasis the energetic state of the individual needs to communicate with appetite regulatory mechanisms on a regular basis. Although hunger levels indicated by the energetic state and appetite levels, the desire for food intake, tend to be correlated, and on their own are well studied, how the two cross-talk and regulate one another is less known. Insects, in contrast to vertebrates, tend to have trehalose as the primary sugar found in the hemolymph, which could possibly serve as an alternative monitor of the energetic state in comparison to the glucose-insulin signaling pathway, found in vertebrates. Methods: We investigate how manipulating hemolymph sugar levels alter the biogenic amines in the honey bee brain, appetite levels, and insulin like peptide gene expression, across three age classes, to determine how the energetic state of the honey bee might be connected to appetite regulation. Results: We found that only in the forager bees, with a lowering of hemolymph trehalose levels, there was an increase in octopamine and a decrease in tyramine levels in the honey bee brain that corresponded with increased appetite levels, while there was no significant changes in Insulin Like Peptide-1 or 2 gene expression. Discussion: Our findings suggest that hemolymph trehalose levels aid in regulating appetite levels, in forager bees, via octopamine and tyramine, and this regulation appears to be functioning independent of the glucose insulin signaling pathway. Whether this potentially more direct and rapid appetite regulatory pathway can be generalized to other insects, which also undergo energy demanding activities, remains to be investigated. [ABSTRACT FROM AUTHOR]

Objectives: Eating while distracted has been associated with a higher body mass index (BMI), whereas mindful eating and episodic memory for recent eating have shown the opposite pattern. This pre‐registered, global study (https://osf.io/rdjzk) compared the relative association between these variables (and four "positive controls": restraint, disinhibition, emotional eating, plate clearing) and self‐reported BMI. The timing of data collection (April–May 2020) during the SARS‐CoV‐2 pandemic enabled an investigation of the impact of stay‐at‐home restrictions imposed on the UK population on the measures of eating behavior. Methods: An online survey was completed, including: (i) demographic data (e.g., self‐reported BMI), (ii) Likert ratings assessing episodic memory for recent eating, mindful eating, cognitive distraction, restrained eating, emotional eating, disinhibition and plate clearing over the last 12 months and the last 7 days (during the first UK COVID‐19 lockdown), and (iii) the Mindful Eating Questionnaire (MEQ). Results: A large adult sample participated (N = 846; mean (SD) age = 33.0 (14.3) years; mean (SD) BMI = 24.6 (5.6) kg/m2). Mindful eating (MEQ‐total score) was associated with a lower self‐reported BMI (β = −0.12; 95% CI = −0.20, −0.04; p = 0.004), whereas disinhibited eating was associated with a higher self‐reported BMI (β = 0.30; 95% CI = 0.21, 0.38; p < 0.001). In UK participants (n = 520), consistent changes in eating behavior during lockdown were not found. For those that did experience change, decreases were reported in; emotional eating, disinhibited eating, focusing on taste during a meal (a measure of mindful eating), and using a smart phone while eating. Conclusions: These findings provide evidence in a large global sample for associations between BMI and (i) mindful eating, and (ii) disinhibited eating. Future research should evaluate whether mindful eating demonstrates a prospective association with body weight and should consider mechanisms of action. [ABSTRACT FROM AUTHOR]

Background Fatigue is common in patients undergoing radiotherapy (RT) and can significantly impact quality of life. Melatonin, a safe inexpensive natural supplement, may improve symptoms and attenuate the side effects of RT. The purpose of this randomized double-blind placebo-controlled phase III trial was to assess the effects of melatonin for preventing fatigue and other symptoms in patients with breast cancer undergoing RT. Methods Female early stage or Ductal carcinoma in situ patients with breast cancer ≥18 years of age with Eastern Cooperative Oncology Group (ECOG) performance status <3, hemoglobin ≥9 g/dL, planned for outpatient RT treatment with curative intent, were randomized 1:1 to melatonin 20 mg or placebo, orally, starting the night before RT initiation until 2 weeks post-RT. Randomization was stratified according to treatment duration (<3 weeks, ≥3 weeks) and prior chemotherapy. The primary endpoint was the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue scale), and secondary endpoints were FACIT-F subscales, Edmonton Symptom Assessment Scale (ESAS), and Patient-Reported Outcomes Measurement Information System (PROMIS) scores obtained at baseline, and 2 and 8 weeks post-RT. A 2-sided ANOVA F -test at a 4.5% significance level for the primary endpoint was used. Secondary analyses were reported using an F -test at a 5% significance level. The goal was to recruit approximately 140 patients with interim analysis planned mid-recruitment. Results Eighty-five patients were screened for eligibility; 79 patients were randomized: 40 to melatonin and 39 to placebo; 78 patients were treated and included in the interim analysis at the mid-recruitment point. Baseline patient characteristics of age, race, and ECOG performance status were similar in both arms. The treatment effect was studied using a longitudinal mixed effects model with the effect of treatment over time (treatment × time) as the primary outcome parameter. The treatment × time for FACIT-Fatigue did not demonstrate statistical significance (P -value.83) in the melatonin group compared to placebo. In addition, secondary analyses of FACIT physical, social, emotional, and functional well-being scores did not demonstrate statistical significance (P -values of.35,.06,.62, and.71, respectively). Total PROMIS scores, collected as secondary outcome reported by patients, did not demonstrate statistically significant change over time either (P -value is.34). The other secondary scale, ESAS, was analyzed for each individual item and found to be nonsignificant, anxiety (P  = .56), well-being (.82), drowsiness (.83), lack of appetite (.35), nausea (.79), pain (.50), shortness of breath (.77), sleep (.45), and tiredness (.56). Depression was the only item demonstrating statistical significance with a decrease of 0.01 unit in the placebo group, a change not considered clinically significant. Melatonin was well-tolerated with no grade 3 or 4 adverse events reported. The most common side effects were headache, somnolence, and abdominal pain. No patients died while participating in this study. Two patients died within a year of study completion from breast cancer recurrence. Sixteen patients withdrew prior to study completion for various reasons including adverse events, hospitalizations unrelated to study drug, RT discontinuation, and COVID-19 precautions. Conclusions In this double-blind placebo-controlled phase III trial, melatonin did not prevent or significantly improve fatigue and other symptoms in patients with early stage breast cancer undergoing RT. The analysis, showing little evidence of an effect, at mid-recruitment, assured early termination of the trial. [ABSTRACT FROM AUTHOR]

Appropriate dietary intake has been found to positively impact athletes' performance, body composition and recovery from exercise. Strategies to optimise dietary intake often involve targeting one or more of the many factors that are known to influence dietary intake. This review aims to investigate the types and effectiveness of interventions used to impact modifiable factors of dietary intake in athletes. MEDLINE, CINAHL, SPORTDiscus and Web of Science were searched from inception to May 2022 for intervention studies that measured dietary intake with a quantitative tool and explored at least one factor thought to influence the dietary intake of adult athletes. Study quality was assessed using the ADA Quality Criteria Checklist: Primary Research. Twenty-four studies were included. The most common interventions focused on nutrition education (n 10), macronutrient adjustment (n 7) and physical activity (n 5). The three most common factors thought to influence dietary intake addressed were nutrition knowledge (n 12), hunger and appetite (n 8), and body composition (n 4). Significant changes in dietary intake were found in sixteen studies, with nutrition education interventions returning significant results in the largest proportion of studies (n 8). Study quality within this review was mostly average (n 4 < 50 %, n 19 50–80 %, n 1 > 80 %). As studies included were published between 1992 and 2021, interventions and factors explored in older studies may require up-to-date research to investigate possible differences in results due to time-related confounders. [ABSTRACT FROM AUTHOR]

Dietary recommendations to reduce the consumption of free sugars often group 100% fruit juice with other sugar-containing beverages. The objective of this study was to determine the effect of consuming 100% orange juice compared to an orange drink on next-meal food intake (FI), glycemic response, average appetite, emotions, and sensory characteristics in normal-weight adults. Thirty-six normal-weight adults (age: 26.8 ± 0.9 years) consumed, in random order and at least 5 days apart, three 240 mL test beverages as follows: (a) 100% orange juice, (b) orange drink, or (c) water. Subjective sweetness and pleasantness were determined immediately after test beverage consumption. Glycemic response, average appetite, and subjective emotions were measured every 15 min for 60 min. Food intake was determined at a pizza lunch 60 min later. Rest-of-day glycemic response and energy intake (EI) were determined using a continuous glucose monitor and food record, respectively. Lunch FI (p = 0.054) and total EI (p = 0.01) were both lower after 100% orange juice compared with the orange drink. Caloric compensation was 84% after 100% orange juice and −25% after the orange drink (p = 0.047). Average appetite was not significantly different between the test beverages (p > 0.05). Blood glucose iAUC adjusted for available carbohydrate was lower after 100% orange juice compared with the orange drink (p < 0.001). Rest-of-day blood glucose concentrations were lower after 100% orange juice compared with the orange drink (p = 0.03) and water control (p < 0.001). In conclusion, consumption of 100% orange juice as a preload resulted in higher caloric compensation, lower total daily EI, and lower blood glucose concentrations compared to the orange drink. [ABSTRACT FROM AUTHOR]

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Adipokines are proteins secreted by adipose tissue to regulate glucolipid metabolism and play vital roles in our body. Different adipokines have more than one endocrine function and be divided into several different categories according to their functions, including adipokines involved in glucolipid metabolism, the inflammatory response, insulin action, activation of brown adipose tissue (BAT) and appetite regulation. Multiple adipokines interact with each other to regulate metabolic processes. Based on the recent progress of adipokine research, this article discusses the role and mechanism of various adipokines in glucolipid metabolism, which may provide new ideas for understanding the pathogenesis and improving the treatment of various metabolic diseases. [ABSTRACT FROM AUTHOR]

Purpose: Research has drawn attention to the challenges that patients receiving treatment for head and neck cancers experience, including the physical and emotional impact of diagnosis and treatment, the effects of weight loss, challenges related to eating and strategies used by patients to address nutritional problems. There is limited research in head and neck cancer populations about the impact associated with the disruptions and daily experience related to eating problems and the meaning and significance of these changes., Methods: This article describes research that is part of a larger study about patients' experiences of receiving radiation for head and neck cancer. The article reports an in-depth analysis of one of the subthemes from 17 participants, the changed meaning of food that emerged within the overarching theme of disrupted expectations and changes in life routines in the original study. This paper highlights participants' perspectives about their experiences and the disruptions caused by treatment, with a specific focus on the losses associated with the changed meaning of food., Results & Conclusions: There are physical, emotional and social losses associated with a changed meaning of food for Head and Neck cancer patients. Acknowledging the significance of eating problems and the changed meaning of food is required in order to provide patients with the appropriate support, strategies and interventions to manage with the changes and losses., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Background: The loss of appetite, anorexia, is commonly observed in older persons and associated with adverse outcomes. It is becoming increasingly apparent that anorexia is the chief factor in producing weight loss in older adults. Although common and expected in acute illness, anorexia is also frequently associated with chronic diseases and leads to inadequate nutrient intake., Objective: The aim of this paper was to review clinical studies on the use of orexigenic drugs to stimulate appetite., Methods: Clinical trials were identified related to improving appetite and/or weight gain in older persons. Articles were identified by Ovid search using terms nutrition, anorexia, cachexia, weight loss, orexigenic drugs, and by searching references from retrieved papers., Results: Environmental and nutritional interventions to improve intake should be the first intervention. When these fail to produce adequate intake, orexigenic drugs should be considered. No drug has received approval from the US Food and Drug Administration for geriatric anorexia., Conclusions: In the presence of adequate food, weight loss most often is due to cytokine-associated cachexia and anorexia. Assessment of changes in appetite is essential to evaluating older persons with weight loss. When anorexia is identified, a search for reversible causes should be instituted. Intervention should first be aimed at the provision of adequate calories and protein, often in the form of high-density nutritional supplements. Failure to respond to adequate nutrition or supplements should trigger a concern for cachexia. Orexigenic drugs have been reported to improve appetite and produce weight gain. The mechanism is unknown, but it may relate to suppression of proinflammatory cytokines., (Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.)

The relationship between HIV (human immunodeficiency virus), food security and nutrition has become increasingly important to practitioners, policy makers and people living with HIV. In this paper we describe for the first time the connection between HIV and antiretroviral therapies, the extent of nutritional counselling for HIV-positive people and food security in Papua New Guinea (PNG). A total of 374 HIV-positive people who were over the age of 16 and who had been on antiretroviral therapy (ART) for more than two weeks were recruited from six provinces, using a non-probability, convenience sampling methodology. A subsample of 36 participants also completed an in-depth qualitative interview. Participants received nutritional advice when beginning ART which focused on three main domains, of which the first two were the most frequently mentioned: what foods to avoid; what foods to eat; and how frequently to eat. 72% of the sample reported that they had experienced an increase in their appetite. Of those who reported that their appetite had increased on ART 33% reported that they did not have enough food to satisfy hunger. People who lived in the capital city, Port Moresby, within the Southern Region of PNG, had significantly more difficulty with food security than those who lived in other regions of the country. Not having enough food was the third most commonly recorded reason for non-adherence to ART. Responses to the HIV epidemic in Papua New Guinea must also begin to address the phenomenon of food insecurity for people with HIV, in particular those who are receiving antiretroviral therapies and who live in the urban areas.

The article discusses research on several topics related to science. Topics discussed include development of Stimulus-Triggered Acquisition of Pluripotency (STAP) Stem Cells by scientists at the Japanese natural sciences research institute RIKEN Center for Developmental Biology in Kobe, treatment of infertility in human beings by a team from Cornell University and identification of neural circuits for appetite and choice of mates by a team from the University of Washington.

A water deprived animal that ingests only water efficiently corrects its intracellular dehydration, but remains hypovolemic, in negative sodium balance, and with high plasma renin activity and angiotensin II. Therefore, it is not surprising that it also ingests sodium. However, separation between thirst and sodium appetite is necessary to use water deprivation as a method to understand the mechanisms subserving sodium appetite. For this purpose, we may use the water deprivation-partial repletion protocol, or WD-PR. This protocol allows performing a sodium appetite test after the rat has quenched its thirst; thus, the sodium intake during this test cannot be confounded with a response to thirst. This is confirmed by hedonic shift and selective ingestion of sodium solutions in the sodium appetite test that follows a WD-PR. The separation between thirst and sodium appetite induced by water deprivation permits the identification of brain states associated with sodium intake in the appetite test. One of these states relates to the activation of angiotensin II AT1 receptors. Other states relate to cell activity in key areas, e.g. subfornical organ and central amygdala, as revealed by immediate early gene c-Fos immunoreactivity or focal lesions. Angiotensin II apparently sensitizes the brain of the water deprived rat to produce an enhanced sodium intake, as that expressed by spontaneously hypertensive and by young normotensive rat. The enhancement in sodium intake produced by history of water deprivation is perhaps a clue to understand the putative salt addiction in humans. The paper represents an invited review by a symposium, award winner or keynote speaker at the Society for the Study of Ingestive Behavior [SSIB] Annual Meeting in Portland, July 2009., (2010. Published by Elsevier Inc.)

Investigators of appetite for food have been tricked into the twin illusions that ratings of the disposition to eat are subjective and amounts eaten at meals are objective. The reality is the opposite. Making a mark on a continuous or broken line specified by two levels of what the rater uses as a single concept is the objective performance of a quantitative judgment. In contrast, the amount of a test meal that a person eats is a completely subjective outcome accumulated from many choices of another mouthful, each subject to several rapidly changing influences. Hence, rather than intake at test meals providing any validation for ratings of appetite, measurements of effects on the judged disposition to eat available food at each moment during a meal are needed to explain the amount consumed. This short paper is written in the hope of exorcising such self-deception from the research community and restoring systematic ratings of appetite to the uses for which they were introduced 35 years ago.

The 'obesogenic' environment has the potential to affect everyone, but nonetheless, individuals differ in body weight, suggesting variation in susceptibility to environmental influences. Behavioural studies indicate that obese children experience low responsiveness to internal satiety signals and high responsiveness to external food cues. In this paper we describe the results of new studies using behavioural tests and psychometric questionnaires in large samples to show that individual variation in these appetitive traits relates to body weight throughout the distribution. We also describe twin studies and genetic association studies supporting a strong genetic component to appetite. Implications include the early identification of 'at risk' children, and interventions to modify appetitive traits.

This paper describes the psychometric evaluation of a new measure called the Power of Food Scale (PFS). The PFS assesses the psychological impact of living in food-abundant environments. It measures appetite for, rather than consumption of, palatable foods, at three levels of food proximity (food available, food present, and food tasted). Participants were 466 healthy college students. A confirmatory factor analysis replicated the three-factor solution found previously by Capelleri et al. [Capelleri, J. C., Bushmakin, A. G., Gerber, R. A., Leidy, N. K., Sexton, C., Karlsson, J., et al. (in press). Discovering the structure of the Power of Food Scale (PFS) in obese patients. International Journal of Obesity, 11, A165]. The PFS was found to have adequate internal consistency and test-retest reliability. The PFS and the Restraint Scale were regressed on four self-report measures of overeating. The PFS was independently related to all four whereas the Restraint Scale was independently related to two. Expert ratings of items suggested that the items are an acceptable reflection of the construct that the PFS is designed to capture. The PFS may be useful as a measure of the hedonic impact of food environments replete with highly palatable foods.

Despite the overwhelming evidence linking alcohol to the development of disease, the contribution of alcohol toxicity to ill health remains controversial. One of the major problems facing researchers is the fact that alcoholic beverages, which contribute little to the nutritional requirements of the body, are often substituted for food and nutritional deficiency alone can promote cell damage. Long-term alcohol intake can decrease the total amount of food consumed when food is freely available and the alcoholic individual is often held accountable for their irregular eating behaviour. Assessment of meal composition has highlighted that appetite for food-containing carbohydrate (in particular) is altered in moderate-heavy drinkers but at present there is insufficient biochemical evidence to confirm or deny this observation. The biochemical processes associated with appetite are many and it would be impossible to address all of these events in a single paper. Therefore, the aim of this review will be to focus on one of the major biochemical markers of appetite for carbohydrate in order to put forward the suggestion that a decreased appetite for food could be a physiological consequence of consuming some forms of alcohol.

Child obesity is becoming a serious public health concern, and major research effort is being devoted both to understand its aetiology and to improve the effectiveness of prevention strategies. Early growth patterns, both prenatally and postnatally, are emerging as important markers of later obesity risk, with rapid neonatal weight gain a clear risk factor for later obesity and metabolic syndrome. Thus, in two distinct senses child obesity is a growing problem. The paper summarises current evidence on growth pattern and obesity, relating it to infant feeding practice and appetite regulation, and highlights the areas in which public health interventions are feasible. Of the conclusions drawn, one involves a futuristic solution to child obesity where neonates are given an infusion of the hormone leptin to reset their appetite regulation.

Appetite research frequently employs principles derived from behaviour analysis. However, it has yet to utilise the more recent theoretical advances in this field. This paper describes the concept of the motivating operation (MO)--a behaviour analytic formulation of motivation. An MO is an environmental event that (a) establishes or abolishes the reinforcing or punishing effect of another event and (b) evokes or abates behaviours associated with that event. The paper describes both unconditioned and conditioned MOs and the ways in which they may help account for a variety of eating behaviours. It then goes on to highlight the main ways in which the MO account differs from other theories of motivation employed in appetite research. These relate to (1) the ways in which they account for non-regulatory feeding, (2) the extent to which they address cognitive variables and (3) their underlying philosophical assumptions and subsequent relation to intervention.

This paper updates an early review on benzodiazepine-enhanced food intake, published in the first issue of Appetite, and describes the considerable advances since then in the pharmacology of benzodiazepines, their sites and mechanisms of action, and in understanding the psychological processes leading to the increase in food consumption. A great diversity of benzodiazepine receptor ligands have been developed, many of which affect food intake. Agonists can be divided into full agonists (which produce the full spectrum of benzodiazepine effects) and partial agonists (which are more selective in their effects). In addition, inverse agonists have been identified, with high affinity for benzodiazepine receptors but having negative efficacy: these drugs exhibit anorectic properties. Benzodiazepine receptors are part of GABA(A) receptor complexes, and ligands thereby modulate inhibitory neurotransmission in the brain. Molecular approaches have identified a palette of receptor subunits from which GABA(A) receptors are assembled. In all likelihood, benzodiazepine-induced hyperphagia is mediated by the alpha2/alpha3 subtype not the alpha1 subtype. Novel alpha2/alpha3 selective compounds will test this hypothesis. A probable site of action in the caudal brainstem for benzodiazepines is the parabrachial nucleus. Behavioural evidence strongly indicates that a primary action of benzodiazepines is to enhance the positive hedonic evaluation (palatability) of tastes and foodstuffs. This generates the increased food intake and instrumental responding for food rewards. Therapeutic applications may derive from the actions of benzodiazepine agonists and inverse agonists on food procurement and ingestion.

Decrease in food intake is one of the most documented non-specific symptoms of inflammatory processes. However, attention has been mainly focused on quantitative analysis. The present paper reports studies undertaken to test the possible contribution of changes in taste processes in inflammatory-induced alteration of feeding behavior. In a first experiment, the effects of lipopolysaccharide-induced sickness were assessed on preference for saccharin and aversion for quinine in rats using the two-bottle test paradigm. In a second experiment, effect of lipopolysaccharide (LPS) on the behavioral reactivity to palatable, unpalatable and mixed solutions was analyzed using the taste-reactivity paradigm. Our results show that LPS decreased total fluid intake but did not change taste responses to unpalatable or palatable substances. However, LPS increased aversive reactions and decreased hedonic responses to mixed taste. These LPS-induced changes are interpreted as an increase in finickiness and are discussed in regard to their potential role in the adaptation of individuals to sickness.

The main purpose of this study was to investigate whether dipsogenic stimuli influences the sodium appetite of rats with ibotenic acid lesion of the dorsal raphe nucleus (IBO-DRN). Compared to control, rats microinjected with phosphate buffer (PB-DRN), the ingestion of 0.3M NaCl was enhanced in IBO-DRN at 21 and 35 days after DRN lesion under a protocol of fluids and food deprivation. Despite of similar dipsogenic response observed both in IBO-DRN and PB-DRN treated with isoproterenol (ISO, 300 microg/kg, sc), the 0.3M NaCl intake was again significantly enhanced in IBO-DRN at 21 and 35 days post-lesion. Finally, treatment with polyethylene glycol (PEG, MW=20,000, 20%, w/v, 16.7 ml/kg, sc) induced higher dipsogenic response in IBO-DRN than PB-DRN at 21 day after lesion. In addition, IBO-DRN also expressed higher sodium appetite than PB-DRN, concomitantly with a drinking response. These results suggest that ibotenic lesion of DRN promote an increase of the brain angiotensinergic response, possibly settled within the subfornical organ, through paradigms which increase circulating ANG II levels. The current paper supports the hypothesis that the ibotenic lesion of DRN suppresses a serotonergic component implicated on the modulation of the sodium appetite and, therefore, furthering homeostatic restoration of extracellular fluid volume.

In a recent paper, Tasker and colleagues show that glucocorticoids (GCs) act rapidly, probably through membrane receptors, on corticotropin-releasing factor (CRF)-synthesizing cells to release endocannabinoids. These act locally at presynaptic axons via cannabinoid CB-1 receptors to reduce excitatory glutaminergic input, and therefore induce fast feedback inhibition of CRF by GCs. Similar findings in other hypothalamic neurons suggest that this action of GCs might be common in the brain, and could, in part, explain rapid GC effects on food intake.

As obesity has reached epidemic proportions, the management of this global disease is of clinical importance. The availability and popularity of natural dietary supplements for the treatment of obesity has risen dramatically in recent years. The purpose of this paper was to review the effect of commonly available over the counter plant-derived supplements used to suppress appetite for obesity control and management. The data were obtained from the electronic databases PubMed, SpringerLink, Google Scholar, ScienceDirect, and MEDLINE with full text (via EBSCOHost) and the databases were accessed during late 2012 - early January 2013. The botanical species discussed in this review include Camellia sinensis, Caralluma fimbriata, Citrus aurantium, Coleus forskohlii, Garcinia cambogia and Phaseolus vulgaris. This review found that many botanical species including crude extracts and isolated compounds from plants have been shown to provide potentially promising therapeutic effects including appetite control and weight loss. However, many of these crude extracts and compounds need to be further investigated to define the magnitude of the effects, optimal dosage, mechanisms of action, long term safety, and potential side effects. [ABSTRACT FROM AUTHOR]

Snacking, or the habit of eating little and often, has been postulated to have a range of health benefits in relation to appetite control, bodyweight management and improved blood glucose control in diabetics and pre-diabetics. However, there is widespread agreement that our current obesogenic environment is encouraging overeating in response to increased food portion sizes, palatability and/or energy-density of foods, alongside the many social and psychological cues to eat. In this context, and as findings on the health effects of snacking are conflicting, the question remains as to whether more frequent eating and snacking can be of benefit to health. Snacks, if added to habitual meal intake, with no compensation for snack energy contribution, are likely over time to lead to positive energy balance. Hence, snacking might be a contributing factor to the obesity epidemic, in addition to more established factors, such as food choice and physical activity. This paper explores the existing evidence concerning the impact of snacking on bodyweight and the behavioural and metabolic response to snacking. The impact of snacking on cognitive function is also discussed. The review highlights the need for further research as, despite many years of scientific interest in snacking, the lack of consistency in study design and snacking definitions and the array of potential confounding factors ( e.g. physical activity levels) makes interpretation of findings difficult and has led to little consensus about the optimum number and composition of meals and/or snacks for bodyweight control, health and wellbeing on a population-wide basis. [ABSTRACT FROM AUTHOR]

Overview: As obesity has reached epidemic proportions, the management of this global disease is of clinical importance. The availability and popularity of natural dietary supplements for the treatment of obesity has risen dramatically in recent years. Aims: The aim of this paper was to assess the current evidence of commonly available natural supplements used to suppress appetite for obesity control and management in humans using a systematic search of clinical trials meeting an acceptable standard of evidence. Methods: The electronic databases PubMed, Web of Science, Google Scholar, ScienceDirect, and MEDLINE with full text (via EBSCOHost) were accessed during late 2012 for randomized controlled clinical trials (RCTs) using natural plant extracts as interventions to treat obesity through appetite regulation. A quality analysis using a purpose-designed scale and an estimation of effect size, where data were available, was also calculated. The inclusion criteria included the following: sample participants classified as overweight or obese adults (aged 18-65 years), randomized, double blind, controlled design, suitable placebo/control intervention, sample size >20, duration of intervention >2 weeks, have measurable outcomes on appetite or food intake and anthropometry, and full paper in English. Results: There were 14 studies that met the inclusion criteria. The findings from published double blind RCTs revealed mostly inconclusive evidence that plant extracts are effective in reducing body weight through appetite suppression. Caralluma fimbriata extract and a combination supplement containing Garcinia cambogia plus Gymnema sylvestre were the only exceptions. Conclusion: According to the findings from this systematic review, the evidence is not convincing in demonstrating that most dietary supplements used as appetite suppressants for weight loss in the treatment of obesity are effective and safe. A balance between conclusive findings by double blind RCTs and advertisement is required to avoid safety concerns and dissatisfaction from consumers. [ABSTRACT FROM AUTHOR]

Objective: How much do the sensory properties of food influence the way people select their food and how much they eat? The objective of this paper is to review results from studies investigating the link between the sensory perception of food and human appetite regulation., Content of the Review: The influence of palatability on appetite and food intake in humans has been investigated in several studies. All reviewed studies have shown increased intake as palatability increased, whereas assessments of the effect of palatability using measures of subjective appetite sensations have shown diverging results, for example, subjects either feel more hungry and less full after a palatable meal compared to a less palatable meal, or they feel the opposite, or there is no difference. Whether palatability has an effect on appetite in the period following consumption of a test meal is unclear. Several studies have investigated which sensory properties of food are involved in sensory-specific satiety. Taste, smell, texture and appearance-specific satieties have been identified, whereas studies on the role of macronutrients and the energy content of the food in sensory-specific satiety have given equivocal results. Different studies have shown that macronutrients and energy content play a role in sensory-specific satiety or that macronutrients and energy content are not a factor in sensory-specific satiety. Sensory-specific satiety may have an important influence on the amount of food eaten. Studies have shown that increasing the food variety can increase food and energy intake and in the short to medium term alter energy balance. Further knowledge about the importance of flavour in appetite regulation is needed, for example, which flavour combinations improve satiety most, the possible connection between flavour intensity and satiety, the effect of persistence of chemesthetic sensation on palatability and satiety, and to what extent genetic variation in taste sensitivity and perception influences dietary habits and weight control.

In books 8 and 9 of Plato's Republic, Socrates provides a detailed account of the nature and origins of four main kinds of vice found in political constitutions and in the kinds of people that correspond to them. The third of the four corrupt kinds of person he describes is the 'democratic man'. In this paper, I ask what 'rules' in the democratic man's soul. It is com-monly thought that his soul is ruled in some way by its appetitive part, or by a particular class of appetitive desires. I reject this view, and argue instead that his soul is ruled by a succession of desires of a full range of different kinds. I show how this view helps us better understand Plato's depiction of corrupt souls in the Republic more generally, and with it his views on the rule of the soul, appetitive desire, and the nature of vice. [ABSTRACT FROM AUTHOR]

This paper traces the various manifestations of the hunger/ingestion motif in Beloved and its implications at the psychological and diegetic levels, mapping out the connection between hunger and storytelling as a form of resistance. At a deeper level, however, the novel also evinces how the hunger/ingestion dialectics inform not only African Americans' emotional and spiritual deprivation but also the diegetic in(di)gestion, disadjustments, and dis(re)memberment of their history and identity. By mapping out the fusion between the intra-diegetic and extradiegetic, this essay ultimately argues that Morrison's transgressive re-reading/rewriting of the imperial archive of black history and identity essentially requires both "a visceral reliving of [its] trauma[s]" (Young 9) and a parodic o/aural and narratological reinscription of its predatory patterns. [ABSTRACT FROM AUTHOR]

Abstract: This paper gives a definition of ‘nutrient profiling’ and outlines the scope ‘marketing of foods to children’ and it’s ‘regulation’ for the purposes of the paper. It then points out that nutrient profiling has many other purposes besides the regulation of marketing of foods to children. It briefly outlines the ideal process for developing a nutrient profile model and summarises how nutrient profiling models have been validated to date. It discusses how existing nutrient profiling models for the purpose of regulating the marketing of foods to children can be compared and it concludes that nutrient profiling has much potential but that there are several obstacles to overcome before an ideal model for regulating the marketing of foods can be agreed. [Copyright &y& Elsevier]

In 2004, two seminal papers focused on the role of AMP-activated protein kinase (AMPK) in the hypothalamus opened new avenues of research in the field of the central regulation of energy homeostasis. Over the following 8 years, hundreds of studies have firmly established hypothalamic AMPK as a key sensor and integrator of hormonal and nutritional signals with neurochemical and neurophysiological responses to regulate wholebody energy balance. In this review article we aim to discuss the most recent findings in this particular area of research, highlighting the function of hypothalamic AMPK in appetite, thermogenesis, and peripheral glucose metabolism.The diversity of mechanisms by which hypothalamic AMPK regulates energy homeostasis illustrates the importance of this evolutionary-conserved energy signaling cascade in the control of this complex and fundamental biological process [ABSTRACT FROM AUTHOR]

Activity-based anorexia refers to the self-starvation of rats exposed to experimental conditions that combine restricted access to food with access to an activity wheel. This paper compares previous studies of this phenomenon in relation to the ambient temperatures (AT) that were employed. On this basis, and from some more direct evidence, we argue that AT is an important, but neglected, factor in activity-based anorexia research. More attention to AT is needed in future research, since its neglect threatens the validity of conclusions drawn from those studies. Furthermore, direct examination of the effect of AT on activity-based anorexia will allow a better understanding of the mechanisms underlying this phenomenon and the possible clinical implications for the treatment of human anorexia nervosa.