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Background: Loss of appetite is a common nutrition symptom in patients with cancer. Understanding the trajectory of appetite could be of clinical use for prognostication in palliative cancer care. Our primary aim was to explore the association between self-assessed appetite and mortality in patients suffering from advanced cancer. Secondary aims included the relation between fatigue, albumin levels and CRP/albumin ratio and mortality. We also aimed to study potential sex-differences in the associations., Methods: Post-hoc analyses were performed using data from the Palliative D-study comprising 530 patients with cancer admitted to palliative care. Appetite and fatigue were assessed with the Edmonton Symptom Assessment System (ESAS). Cox proportional hazards models were used to calculate Hazard ratios (HR) with 95% confidence intervals (CI) for exposures of appetite, fatigue, albumin and CRP/albumin ratio, and time from study inclusion to death or censoring. Analyses were also performed stratified by sex., Results: The follow-up time ranged between 7 to 1420 days. Moderate and poor appetite were significantly associated with a higher mortality rate compared to reporting a good appetite; HR 1.44 (95%CI: 1.16-1.79) and HR 1.78 (95%CI: 1.39-2.29), respectively. A higher mortality rate was also seen among participants reporting severe fatigue compared to those reporting no fatigue; HR 1.84 (95%CI:1.43-2.36). Participants with low albumin levels (< 25 g/L) and those in the highest tertile of CRP/albumin ratio, had higher mortality rates, HR 5.35 (95%CI:3.75-7.63) and HR 2.66 (95%CI:212-3.35), compared to participants with high albumin levels (> 36 g/L) and those in lowest tertile of CRP/albumin ratio. These associations were more pronounced in men than in women., Conclusion: Poor appetite, severe fatigue, low albumin level and a high CRP/albumin ratio were associated with increased mortality rates among patients with advanced cancer. All these variables might be clinically useful for prognostication in palliative cancer care., Trial Registration: Clinicaltrial.gov. Identifier: NCT03038516;31, January 2017., (© 2023. BioMed Central Ltd., part of Springer Nature.)

There has been no validated digital tool for measuring appetite with a visual analog scale (VAS) through a mobile app using participants' smart phones for data collection in virtual settings. To fill the gap, we developed a digital VAS and conducted a digital cross-over clinical trial by comparing appetite responses measured by this digital tool versus paper-based VAS in 102 participants in a free-living environment. Participants consumed either a 230 or 460 kcal breakfast in randomized order in two virtual sessions, and their appetite was measured over the next 4 h using both tools. The results revealed no significant difference in hunger, fullness, satiety, or desire to eat measured by digital and paper VAS. Paper VAS resulted in a higher prospective consumption score than digital VAS; the difference (1.1 out of 100 points) was statistically significant but not practically relevant. Bland and Altman analysis also indicated consistency in the results from the two methods. In conclusion, digital VAS on a smart phone is a validated tool for appetite measurement in the real world; it provides a new way for researchers to leverage participants' mobile devices for appetite data collection in digital trials. [ABSTRACT FROM AUTHOR]

This study determined the validity, reproducibility and usability of a smartphone app – APPetite – for the measure of free-living, subjective appetite. Validity was assessed compared with the criterion tool of pen-and-paper visual analogue scale (VAS) (n 22). Appetite was recorded using APPetite and VAS, one immediately after the other, upon waking and every hour thereafter for 12 h. This was repeated the next day with the order of tool reversed. Agreement between tools was assessed using Bland–Altman analysis. Reproducibility and usability were assessed in a separate experiment (n 22) of two trials (APPetite v. VAS), separated by 7 d. Appetite was recorded in duplicate upon waking and every hour for 12 h using APPetite or VAS. Agreement between duplicate measures was assessed using Bland–Altman analysis and CV was compared between tools. Usability was assessed by comparing compliance and by qualitative evaluation. APPetite demonstrated good criterion validity with trivial bias of 1·65 units/mm·h–1 between APPetite- and VAS-derived AUC appetite scores. Limits of agreement were within a maximum allowed difference of 10 %. However, proportional bias was observed. APPetite demonstrated high reproducibility, with minimal bias (–0·578 units·h–1) and no difference in CV between APPetite and VAS (1·29 ± 1·42 % v. 1·54 ± 2·36 %, P = 0·64). Compliance was high with APPetite (92·7 ± 8·0 %) and VAS (91·6 ± 20·4 %, P = 0·81). Ninety percent of participants preferred APPetite, citing greater accessibility, simplified process and easier/quicker use. While proportional bias precludes using APPetite and VAS interchangeably, APPetite appears a valid, reproducible and highly usable tool for measuring free-living appetite in young-to-middle-aged adults. [ABSTRACT FROM AUTHOR]

Widowhood, in Indian society, is a dreaded condition of a woman after the death of her husband. It is an imposed performance that entails a set of ritualized practices and behavior to mark her transition to the state of a woman without. On many occasions, this state is ensured and maintained through multifarious rituals and practices, which range from restrictions on mobility, choices, and desires to injunctions on clothes, bodily demeanor, and food. This physio-social exercise of control and restraint alludes to a framework of religio-cultural discourse that renders widows as social and sexual non-beings. The present paper attempts to understand the state of widowhood through the analysis of two short stories in the collection, The Anger of Aubergines (1997) by Bulbul Sharma from the perspective of food. Food and eating, being the elementary aspects of everyday life, become important signifiers in studying the deprived state of widowhood. The paper intends to unpack the politics behind the imposition of a curriculum of gastronomic injunctions and food taboos on Hindu upper-caste widows. Further, the paper conceptualizes the appetite of widows as a subversive category not only in challenging the gender discourses behind their oppression but also in exonerating their status as desireless beings. [ABSTRACT FROM AUTHOR]

The survival of microorganisms inhabiting the intestinal tract depends on the nutrients provided by the host, with the latter obtaining them through food intake. It is hence not surprising that the co-evolution of gut bacteria and their hosts, including humans, shaped intrinsic interactions between their respective metabolisms with an impact on host feeding behavior. Understanding molecular pathways underlying such interactions may aid in the development of new therapeutic approaches for several pathological conditions accompanied by altered feeding behavior. A Special Issue titled "Gut Microbiota–Brain Axis in Regulation of Feeding Behavior" contributes to this topic of research, with eight papers covering its various aspects such as autoprobiotics, metabolic diseases and anorexia. [ABSTRACT FROM AUTHOR]

Sodium plays a key role in the regulation of water balance and is also important in food formulation due to its contribution to the taste and use in the preservation of many foods. Excessive intake of any essential nutrient is problematic and this seems to be particularly the case for sodium since a high intake makes it the nutrient most strongly associated with mortality. Sodium intake has been the object of recommendations by public health agencies such as the WHO and this has resulted in efforts by the food industry to reduce the sodium content of packaged foods, although there is still room for improvement. The recent literature also emphasizes the need for other strategies, e.g., regulations and education, to promote adequate sodium intake. In the present paper, we also describe the potential benefits of a global healthy lifestyle that considers healthy eating but also physical activity habits that improve body functionality and may help to attenuate the detrimental effects of high sodium intake on body composition and cardiometabolic health. In conclusion, a reduction in sodium intake, an improvement in body functioning, and educational interventions promoting healthy eating behaviours seem to be essential for the optimal regulation of sodium balance. [ABSTRACT FROM AUTHOR]

A well-balanced metabolism means a lower risk for metabolism-related neuropsychiatric disorders. Leptin is a secretory adipokine involved in the central control of appetite that appears to play a role in the etiology of feeding-related disorders. Additionally, the influence of exercise on feeding behaviors potentially modulates the circulation of metabolites that signal through the central nervous system. In this systematic review, we collected the recent clinical evidence on the effect of exercise on leptin concentrations in health individuals published from 2000 to 20 September 2022, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA 2020 statement). Six hundred and thirty-eight papers were retrieved and forty-eight papers were included in the qualitative synthesis. Data supports that exercise positively influences appetite via enhancing peripheral and central leptin signaling (reuptake), especially during weight loss. Exercise modulation of leptin signaling through leptin receptors helps to stabilize increases in food intake during periods of negative energy balance, prior to a decrease in the body fat tissue content. At a high intensity, exercise appears to counteract leptin resistance. [ABSTRACT FROM AUTHOR]

Urbanization and globalization are changing the conventional constraints of seasonality and geography on food consumption, such as that of fresh cherries. The rising demand for year-round cherry consumption in China is currently satisfied by open-field, greenhouse-produced, and imported products. This study conducted a spatial-temporal life cycle evaluation of the environmental performance of cherry consumption behaviors during different seasons of the year. Moreover, based on the definitions of global and local seasonality, the additional environmental costs of out-of-season cherry consumption were estimated. Results show that seasonality was an important factor affecting the environmental burdens of cherry consumption. Eating cherries imported from Chile by air in October resulted in the highest greenhouse gas (GHG) emissions of 6.38 kg CO 2 -eq/kg, while eating domestic open-field cherries during May to July (the natural harvest season) was a relatively environmentally beneficial option. The total cherry consumption in China in 2019 generated GHG emissions of 126.99 × 10 4  t CO 2 -eq. Under the definitions of global and local seasonality, the out-of-season consumption led to additional environmental costs of 57.59 × 10 4 and 85.67 × 10 4  t CO 2 -eq, accounting for 45.35% and 67.46% of total emissions, respectively. Furthermore, the time-environment trade-off effect of cherry consumption illustrates the higher environmental costs are exchanged for satisfying the appetite for out-of-season fresh foods. Our findings emphasize the meaningful implications for developing a sustainable consumption pattern for all stakeholders involved in the entire food chain., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

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

Variants of the melanocortin-4 receptor (MC4R) gene are the most common cause of monogenic obesity. It has been shown that, while obesity cannot be controlled with diet and exercise, glucagon-like-peptide-1 receptor agonists (GLP-1 RA) provide weight loss in the short term. In this paper, our experience with liraglutide treatment in an adolescent patient carrying a MC4R gene variant is presented. A female patient was admitted first at the age of 12.5 years with a complaint of progressive weight gain. She had marked excess of appetite since infancy. On physical examination of the pubertal female patient with a body mass index (BMI) of 36.1 kg/m2 (3.48 standard deviation score), there was no pathological finding except diffuse acanthosis nigricans. Laboratory examinations revealed only insulin resistance. Weight loss was not achieved with lifestyle changes, metformin and orlistat treatments. On genetic examination, a sporadic heterozygous c.206T>G(p.I69R) variant that had been reported previously, was found in MC4R gene. Treatment with the GLP-1 RA, liraglutide, was initiated and a 19.2% reduction was achieved in the body weight and BMI at the end of 32 weeks. However, the patient, whose treatment compliance was disrupted due to significant gastrointestinal complaints, returned to her former weight within a few months (13 weeks) after treatment was stopped. In this case with a known pathogenic variant in MC4R gene, decrease of appetite and weight loss were achieved with liraglutide treatment, but side-effects of this treatment led to discontinuation of therapy. In such cases, there is need for effective and tolerable treatment options. [ABSTRACT FROM AUTHOR]

Animals maintain physiological and behavioural systems that allow them to detect and consume specific macro‐ and micronutrients to maximize their fitness. One common physiological system is the nutrient‐state‐dependent or demand‐driven appetite. These systems are well described for macronutrient regulation, but not for micronutrients.Sterols are essential micronutrients that all animals need to survive. They are the backbone of many hormones, important in cell signalling and an integral component of cell membranes.Lady beetles are globally distributed predators of insect herbivores. Adult sevenspotted lady beetles maintain a state‐dependent sterol appetite and consume plant tissues to obtain sterols, which improves their fitness. Additionally, sevenspotted lady beetles can detect sterols pre‐ingestion.We used lady beetle species distributed across the three clades of the Coccinellini to determine (a) whether other beetle species maintain a state‐dependent sterol appetite, (b) if sterol structure affects beetles' state‐dependent sterol appetite and (c) whether lady beetles consume foliage in a sterol‐state dependent manner. Additionally, we determined (a) what sensory organ beetles use to detect sterols, (b) their limit of detection and (c) when during development their appetite manifests.All six beetle species we tested maintained a state‐dependent appetite for sterols. Sterol structure affected beetles' propensity to feed on sterol‐treated disks, indicating that the number and position of double bonds in sterol molecules affects beetles' ability to detect or desire to feed on them. Only beetles in clade III fed on plant foliage in response to sterol limitation. Few beetles in any clade that were supplemented with sterols consumed plant tissue.Beetles' appetite for sterols first appeared during the second larval stadium, and the rate of sterol consumption increased with age. Ablations of sensory organs revealed that beetles use their labial palps to detect sterols, and that they detect them at concentrations as low as 1ppm.These data demonstrate that lady beetles across the Coccinellini maintain a state‐dependent appetite for an essential class of micronutrients. They also provide very strong evidence that lady beetles can taste sterols, raising the possibility that they maintain novel as‐yet undescribed gustatory receptors for an essential class of lipids. A free Plain Language Summary can be found within the Supporting Information of this article. [ABSTRACT FROM AUTHOR]

Melanocortin 3 receptor (MC3R) is a G-protein coupled receptor which has been defined mostly as a regulator of the appetite/hunger balance mechanisms to date. In addition to its function regarding the weight gain and appetite control mechanisms of MC3R, recent studies have shown that MC3R controls growth, puberty, and circadian rhythms as well. Despite the drastic effects of MC3R deficiency in humans and other mammals, its cellular mechanisms are still under investigation. In this review paper, we aimed to point out the importance of MC3R regulations in three main areas: 1) its impact on weight and appetite control, 2) its role in the control of growth, puberty, and the circadian rhythm, and, 3) its protein-protein interactions and cellular mechanisms. [ABSTRACT FROM AUTHOR]

Several studies have found an association between eating behaviours and weight status and obesity risk in childhood. Children's eating behaviours arise from a combination of genetic and environmental factors. Parents appear to play a central role in their development as the main responsible for shaping children's feeding environment and eating experiences. The purpose of this paper is to review the literature on parental influences on eating behaviours across childhood, mainly focusing on parental feeding practices. The associations between parental feeding practices and children's eating behaviours have been extensively studied. However, most of the findings come from cross-sectional studies, so the possibility of reverse causality cannot be ruled out (i.e., children's behaviours influencing parents). Most recently, a few longitudinal studies with a cross-lagged design have shown that the relationship between children's eating behaviours and parental feeding practices seems to be bidirectional, where it is not straightforward whether parental feeding practices are a predictor or a consequence of children's eating behaviours. Children's eating behaviours influence parents to adopt certain feeding practices, but these practices also influence children's behaviours over time. Parental feeding practices may have the potential to shape children's eating behaviours and should be targeted to promote the development of non-obesogenic traits. However, parent–child interactions are complex and therefore both parent and child characteristics and the family dynamics should be considered. [ABSTRACT FROM AUTHOR]

Background and Objectives: The prevalence of cachexia has increased across all of the cancer types and accounts for up to 20% of cancer-related deaths. This paper is a systematic review of nutritional interventions aiming to improve cachexia outcomes in cancer, focusing on weight gain. Materials and Methods: A search in Medline and Elsevier databases for articles up until the 23 January 2022, was conducted. Results: Out of 5732 screened records, 26 publications were included in the final analysis. Four randomized clinical trials showed a significant body weight (BW) increase in patients treated with eicosapentaenoic acid (EPA), β-hydroxy-beta-methyl butyrate (β-HMB), arginine, and glutamine or marine phospholipids (MPL). An upward BW trend was observed in patients treated with L-carnitine, an Ethanwell/Ethanzyme (EE) regimen enriched with ω-3 fatty acids, micronutrients, probiotics, fish oil, a leucine-rich supplement, or total parental nutrition (TPN) with a high dose of a branched-chain amino acid (BCAA). Conclusions: Although clinical trials relating to large numbers of nutritional supplements present promising data, many trials provided negative results. Further studies investigating the underlying mechanisms of action of these nutritional supplements in cancer cachexia are needed. Early screening for cancer cachexia risk and nutritional intervention in cancer patients before aggravating weight loss may stabilize their weight, preventing cachexia syndrome. According to the GRADE methodology, no positive recommendation for these nutritional supplements may be expressed. [ABSTRACT FROM AUTHOR]

Widowhood, in Indian society, is a dreaded condition of a woman after the death of her husband. It is an imposed performance that entails a set of ritualized practices and behavior to mark her transition to the state of a woman without. On many occasions, this state is ensured and maintained through multifarious rituals and practices, which range from restrictions on mobility, choices, and desires to injunctions on clothes, bodily demeanor, and food. This physio-social exercise of control and restraint alludes to a framework of religio-cultural discourse that renders widows as social and sexual non-beings. The present paper attempts to understand the state of widowhood through the analysis of two short stories in the collection, The Anger of Aubergines (1997) by Bulbul Sharma from the perspective of food. Food and eating, being the elementary aspects of everyday life, become important signifiers in studying the deprived state of widowhood. The paper intends to unpack the politics behind the imposition of a curriculum of gastronomic injunctions and food taboos on Hindu upper-caste widows. Further, the paper conceptualizes the appetite of widows as a subversive category not only in challenging the gender discourses behind their oppression but also in exonerating their status as desireless beings.

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Candy provides little nutritional value and contributes to children's energy intake from added sugars. Factors influencing children's candy intake remain largely unknown. This study describes children's total candy intake (kcal) before and after a meal and examines associations of candy intake in both conditions with children's temperament and appetite among a predominantly White, highly educated sample. Children (n = 38, age 5–8 years) were given free access to 11 candies (5 chocolate, 6 non-chocolate) and non-food alternatives during a pre-meal and a post-meal condition. Parents completed the Child Behavior Questionnaire and the Child Eating Behavior Questionnaire. Total candy intake was less when offered after a meal (209.3 kcal; SD = 111.25) than before a meal when still hungry (283.6 kcal; SD = 167.3), but not statistically different. Individual differences in candy intake between conditions was calculated to categorize children into three groups: "Better Regulators" consumed more candy before a meal (39%), "Consistent/Poorer Regulators" consumed similar amounts before and after a meal regardless of hunger (32%), and "Most Disinhibited" children consumed more candy after a meal when not hungry (29%). The "Better Regulators" group was lowest in negative affect and the "Consistent/Poorer Regulators" group was highest in food responsiveness. Children's candy intake was high relative to daily energy needs both before and after a meal. Child negative affect and food responsiveness appear to be child characteristics that predispose children to poor self-regulation of candy intake before and after a meal. [ABSTRACT FROM AUTHOR]

Background/Objective: Obesity, clinically defined as a body mass index (BMI) of 30 kg/m2 or higher, is a medical condition characterized by the excessive accumulation of body fat, which can lead to adverse health consequences. As a global public health issue with an escalating prevalence, controlling appetite and satiety is essential for regulating energy balance and managing body weight. Dietary proteins and peptides have gained interest in their potential to prevent and treat obesity by modulating satiety signals. This narrative review analyzes scientific evidence highlighting the role of dietary proteins and peptides in regulating satiety signals and investigates their therapeutic potential in preventing and treating obesity. Methods: A comprehensive literature search was conducted in multiple electronic databases, including PubMed, Scopus, and Web of Science. The search focused on articles examining the impact of dietary proteins and peptides on satiety and obesity, encompassing both preclinical and clinical trials. Results: Several studies have demonstrated a correlation between the intake of specific proteins or peptides from plant and animal sources and satiety regulation. These investigations identified mechanisms where amino acids and peptides interact with enteroendocrine cell receptors, activating intracellular signaling cascades that promote the release of anorexigenic gut hormones such as cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1), and peptide YY (PYY). Both in vitro and in vivo assays have shown that these interactions contribute to appetite regulation and the sensation of satiety. Conclusions: Using proteins and peptides in the diet may be an effective strategy for regulating appetite and controlling body weight. However, more research—including clinical trials—is needed to understand the underlying mechanisms better and optimize the application of these bioactive compounds in preventing and treating obesity. [ABSTRACT FROM AUTHOR]

Sucralose stands as the most common non-nutritive sweetener; however, its metabolic effects have sparked significant controversy over the years. We aim to examine the effects of sucralose daily intake on glycemia, subjective appetite, and gut microbiota (GM) changes in subjects with overweight or obesity. In this randomized, crossover, and controlled trial, 23 participants with a body mass index between 25 kg/m2 and 39.9 kg/m2 will be assigned to one of two interventions to receive either sucralose (2 mg/kg/day equivalent to 40% of the acceptable daily intake) or glucose (control) for 4 weeks, each phase separated by a 4-week washout period. The glycemic response will be determined during a meal tolerance test, subjective appetite will be evaluated using a visual analog scale, and GM changes will be analyzed by next-generation sequencing of the bacterial rRNA 16S gene from fecal samples. All measures will be performed before and after intervention periods. We hypothesize that sucralose supplementation induces changes in glycemic response, subjective appetite, and gut microbiota in overweight and obese participants. This protocol was approved by the Ethics Committee of the UJAT (No. 0721) and was registered in the Australian New Zealand Clinical Trials Registry (ACTRN12621001531808). [ABSTRACT FROM AUTHOR]

The psychological states of hunger and satiety play an important role in regulating human food intake. Several lines of evidence suggest that these states rely upon declarative learning and memory processes, which are based primarily in the medial temporal lobes (MTL). The MTL, and particularly the hippocampus, is unusual in that it is especially vulnerable to insult. Consequently, we examine here the impact on hunger and satiety of conditions that: (1) are central to ingestive behaviour and where there is evidence of MTL pathology (i.e., habitual consumption of a Western-style diet, obesity, and anorexia nervosa); and (2) where there is overwhelming evidence of MTL pathology, but where ingestive behaviour is not thought central (i.e., temporal lobe epilepsy and post-traumatic stress disorder). While for some of these conditions the evidence base is currently limited, the general conclusion is that MTL impairment is linked, sometimes strongly, to dysfunctional hunger and satiety. This focus on the MTL, and declarative learning and memory processes, has implications for the development of alternative treatment approaches for the regulation of appetite. [ABSTRACT FROM AUTHOR]

The prevalence of obesity globally has tripled over the last half century, and currently affects around 650 million adults and 340 million children and adolescents (ages 5–19 years). Obesity contributes towards >50 co-morbidities and premature mortality. Obesity is a highly stigmatised condition that is associated with much mental and emotional distress and dysfunction. Thus, obesity is a major contributor to healthcare expenditure globally. Traditionally, the management of obesity stratifies into three major groups that include metabolic (bariatric) surgery, pharmacotherapies, and lifestyle (primarily dietary) strategies. Although listed as a separate category, dietary strategies for obesity remain a central component of any management plan, and often complement other surgical and pharmacotherapeutic options. Indeed, the effectiveness of any management approach for obesity relies upon successful behavioural changes, particularly relating to eating behaviours. In this concise review, we explore the foundational pillars of dietary strategies for obesity: sleep, listening, routine, de-stressing and optimisation of social conditions. We then discuss the importance of balancing dietary macronutrients (including dietary fibre, carbohydrates, protein and ultra-processed foods [UPFs]) as a key dietary strategy for obesity. Although we focus on general principles, we should provide bespoke dietary strategies for our patients, tailored to their individual needs. Rather than judging the utility of a diet based simply on its associated magnitude of weight loss, we should adopt a more holistic perspective in which a dietary strategy is valued for its overall health benefits, including the nurturing of our gut microbiota, to enable them to nurture and protect us. [ABSTRACT FROM AUTHOR]

Obesity is a chronic disease caused primarily by the imbalance between the amount of calories supplied to the body and energy expenditure. Not only does it deteriorate the quality of life, but most importantly it increases the risk of cardiovascular diseases and the development of type 2 diabetes mellitus, leading to reduced life expectancy. In this review, we would like to present the molecular pathomechanisms underlying obesity, which constitute the target points for the action of anti-obesity medications. These include the central nervous system, brain–gut–microbiome axis, gastrointestinal motility, and energy expenditure. A significant part of this article is dedicated to incretin-based drugs such as GLP-1 receptor agonists (e.g., liraglutide and semaglutide), as well as the brand new dual GLP-1 and GIP receptor agonist tirzepatide, all of which have become "block-buster" drugs due to their effectiveness in reducing body weight and beneficial effects on the patient's metabolic profile. Finally, this review article highlights newly designed molecules with the potential for future obesity management that are the subject of ongoing clinical trials. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the association between internet addiction and dietary habits among Omani junior college students. Methods: This cross-sectional study was conducted at Sultan Qaboos University, Muscat, Oman, among junior college students surveyed in November 2020. The Compulsive Internet Use Scale and a dietary habits questionnaire were used. Chi-square cross-tabulation analyses were used to explore the relationship between internet addiction and dietary habits. Results: A total of 377 students were included in this study. Overall, 59.9% of the junior college students were identified as having an internet addiction. Within this group, 62.8% reported reduced meal sizes and 54.4% reported a decrease in appetite. There was a statistically significant difference in both meal size (X2 = 30.528; P <0.001) and appetite changes (X2 = 28.731; P <0.001) among students with different levels of internet addiction. Conclusion: The results of this study suggest a possible link between internet addiction and altered dietary habits among this population. This study highlights the need for strategies that encourage healthy living behaviours and raise awareness about the adverse effects of internet addiction. [ABSTRACT FROM AUTHOR]

Effects of acute thermal exposures on appetite appear hypothetical in reason of very heterogeneous methodologies. The aim of this study was therefore to clearly define the effects of passive 24-h cold (16°C) and heat (32°C) exposures on appetitive responses compared with a thermoneutral condition (24°C). Twenty-three healthy, young and active male participants realised three sessions (from 13.00) in a laboratory conceived like an apartment dressed with the same outfit (Clo = 1). Three meals composed of three or four cold or warm dishes were served ad libitum to assess energy intake (EI). Leeds Food Preference Questionnaires were used before each meal to assess food reward. Subjective appetite was regularly assessed, and levels of appetitive hormones (acylated ghrelin, glucagon-like peptite-1, leptin and peptide YY) were assessed before and after the last meal (lunch). Contrary to the literature, total EI was not modified by cold or heat exposure (P = 0·120). Accordingly, hunger scores (P = 0·554) were not altered. Levels of acylated ghrelin and leptin were marginally higher during the 16 (P = 0·032) and 32°C (P < 0·023) sessions, respectively. Interestingly, implicit wanting for cold and low-fat foods at 32°C and for warm and high-fat foods at 16°C were increased during the whole exposure (P < 0·024). Moreover, cold entrées were more consumed at 32°C (P < 0·062) and warm main dishes more consumed at 16°C (P < 0·025). Thus, passive cold and hot exposures had limited effects on appetite, and it seems that offering some choice based on food temperature may help individuals to express their specific food preferences and maintain EI. [ABSTRACT FROM AUTHOR]

Background: The differential effects of pecans versus other popular snack foods on appetite and blood markers of metabolism and satiety have not been well studied. This study investigated the effects of a single mid-morning snack of pecans or tortilla chips on subjective appetite, food intake, blood measures of hormones and metabolites, and resting energy expenditure. Methods: Twenty participants with overweight and obesity were enrolled in a within-participants, randomized crossover trial. Participants had indwelling catheters placed for blood sampling and were fed a standardized breakfast, followed two hours later by a 250 kcal snack of either pecans or tortilla chips, and then by a self-selected lunch. Visual analog scale (VAS) appetite measures, blood markers, and energy expenditure were taken at intervals after food consumption. Results: VAS ratings, energy, food intake and macronutrient composition did not differ between treatment conditions, but glucose and insulin were significantly more elevated after tortilla chips. Free fatty acids (FFA), triglycerides (TG), peptide YY (PYY), and glucagon-like peptide-1 (GLP-1) were higher after consuming pecans compared to tortilla chips. Conclusions: Pecan consumption improves postprandial glucose and insulin profiles which would be beneficial to individuals at risk of developing type 2 diabetes. Further studies are needed to investigate whether increased relative secretion of PYY and GLP-1 after eating pecans versus tortilla chips may affect subjective appetite and energy intake if consumed chronically. [ABSTRACT FROM AUTHOR]

The development of new dishes in the catering services market requires an understanding of consumers' needs, expectations, and motivations for their choices. The effect of the serving method of a dessert on customers' perceptions of its visual appeal, portion size, energy value, and expected price was evaluated. The study involved the presentation of desserts on plates of various sizes, shapes, and colors. The study was carried out among 1005 respondents using the CAWI method. Our findings revealed that along with an increasing plate size from a diameter of ϕ24–27 cm to ϕ31 cm, the ratings of the dish's perceived appearance (p ≤ 0.001), portion size (p ≤ 0.001), and energy value (p ≤ 0.01) decreased. Plate shape influenced the perceived appearance of the dessert. When placed on a square platter, round desserts were considerably (p ≤ 0.05) less appealing. The color of the plate had a significant influence (p ≤ 0.001) on the dish's perceived appearance and estimated monetary value, and it evoked more sensory–hedonic impressions. Red-plate and white-plate desserts were liked less than black-plate desserts, but color-plated desserts were perceived as more expensive than those served on white dishes. Consumers perceived bright desserts on white plates as traditional, natural, and boring; those on black plates as modern, appetizing, and aesthetic; and those served on red plates as artificial, unsightly, and unappetizing. Higher consumer food neophobia led to a lower rating related to appearance and price perceptions, but elevated perceptions of portion size and energy value appraisal. Our results may be used in the marketing of gastronomic dishes. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is a clinical condition of the gastrointestinal tract that has significant incidence in childhood. Major symptoms include abdominal pain, dyspepsia, delayed gastric emptying, anorexia, diarrhea and weight loss. IBD etiopathogenesis is multifactorial, with a proven involvement of cytokines. In this regard, cytokines like resistin and adiponectin produced by adipose tissue play a crucial role in inflammation. Particularly, resistin seems related to IBD severity and is considered a promising marker of disease occurrence and progression. Unraveling its mechanism of action and downstream effectors is mandatory when designing novel therapies. This preclinical study aims to further elucidate the action of resistin in causing functional gastrointestinal alterations, comparing it with the well-defined effect of adiponectin. To this end, we carried out electrophysiological analysis on murine gastric fundus. We found that resistin, similarly to adiponectin, increases smooth muscle cell (SMC) capacitance, indicative of cell surface remodeling, which is consistent with relaxation. However, contrary to adiponectin, resistin unalters membrane potential and inward Ca2+ entry and scarcely affects outward current, suggesting its inefficacy in markedly modifying electrical phenomena on the SMC membrane. This outcome, supporting the role of resistin in gastrointestinal distention, as observed in IBD, rules out a strikingly direct effect on SMCs. [ABSTRACT FROM AUTHOR]

Hunger is a set of internal experiences that lead a human or animal to seek food. Satiety is a desire to limit further food intake or the state of being gratified after completing a meal. The objective of this review article is to discuss the influence of ghrelin and leptin in hunger, appetite, satiety, and long-term energy homeostasis. The data for this review were collected through an extensive journal search. Electronic databases (Medline and PubMed) were thoroughly consulted, and few articles were obtained from the website: Google Scholars (http://scholar.google.com). Ghrelin and leptin are concerned with food intake and energy homeostasis. Ghrelin increases food intake and affects food patterns, whereas leptin induces satiety. Circulating leptin levels are directly proportion to the amount of body fat, thereby reflecting the status of long-term energy stores. Recent work suggests that leptin plays a more important role in the maintenance of weight loss than weight loss per se and ghrelin increases appetite, adjusts energy balance, and enhances the release of growth hormone from the pituitary gland. [ABSTRACT FROM AUTHOR]

There has been no validated digital tool for measuring appetite with a visual analog scale (VAS) through a mobile app using participants’ smart phones for data collection in virtual settings. To fill the gap, we developed a digital VAS and conducted a digital cross-over clinical trial by comparing appetite responses measured by this digital tool versus paper-based VAS in 102 participants in a free-living environment. Participants consumed either a 230 or 460 kcal breakfast in randomized order in two virtual sessions, and their appetite was measured over the next 4 h using both tools. The results revealed no significant difference in hunger, fullness, satiety, or desire to eat measured by digital and paper VAS. Paper VAS resulted in a higher prospective consumption score than digital VAS; the difference (1.1 out of 100 points) was statistically significant but not practically relevant. Bland and Altman analysis also indicated consistency in the results from the two methods. In conclusion, digital VAS on a smart phone is a validated tool for appetite measurement in the real world; it provides a new way for researchers to leverage participants’ mobile devices for appetite data collection in digital trials.

The aim of this study was to assess whether adding Ca2+ to aggregate or native forms of β -lactoglobulin alters gut hormone secretion, gastric emptying rates and energy intake in healthy men and women. Fifteen healthy adults (mean ± sd: 9M/6F, age: 24 ± 5 years) completed four trials in a randomised, double-blind, crossover design. Participants consumed test drinks consisting of 30 g of β -lactoglobulin in a native form with (NATIVE + MINERALS) and without (NATIVE) a Ca2+-rich mineral supplement and in an aggregated form both with (AGGREG + MINERALS) and without the mineral supplement (AGGREG). Arterialised blood was sampled for 120 min postprandially to determine gut hormone concentrations. Gastric emptying was determined using 13C-acetate and 13C-octanoate, and energy intake was assessed with an ad libitum meal at 120 min. A protein × mineral interaction effect was observed for total glucagon-like peptide-1 (GLP-1TOTAL) incremental AUC (iAUC; P < 0·01), whereby MINERALS + AGGREG increased GLP-1TOTAL iAUC to a greater extent than AGGREG (1882 ± 603 v. 1550 ± 456 pmol·l−1·120 min, P < 0·01), but MINERALS + NATIVE did not meaningfully alter the GLP-1 iAUC compared with NATIVE (1669 ± 547 v. 1844 ± 550 pmol·l−1·120 min, P = 0·09). A protein × minerals interaction effect was also observed for gastric emptying half-life (P < 0·01) whereby MINERALS + NATIVE increased gastric emptying half-life compared with NATIVE (83 ± 14 v. 71 ± 8 min, P < 0·01), whereas no meaningful differences were observed between MINERALS + AGGREG v. AGGREG (P = 0·70). These did not result in any meaningful changes in energy intake (protein × minerals interaction, P = 0·06). These data suggest that the potential for Ca2+ to stimulate GLP-1 secretion at moderate protein doses may depend on protein form. This study was registered at clinicaltrials.gov (NCT04659902). [ABSTRACT FROM AUTHOR]

There has been growing interest in exploring factors that influence the success or otherwise of welfare policies in democratic countries, such as the interrelationships between the proposed policy and the context it will be introduced into, such as the sociodemographic characteristics of the population and the population's previous experience with welfare policies. However, there has been little exploration of factors that could influence general population support for long-term care for older people. The aim of this study was to investigate the general population's attitudes for determinants of high-quality aged care and different mechanisms for funding and any impact of individual characteristics on these. A representative sample of the Australian general population aged 18 years and over (N = 10,315, 52% female, 22% aged 65 years and over) drawn via quota sampling participated in the survey online. Participants were asked to rate the importance of a list of 10 determinants of quality care and their support for four models of funding, both using a five-point Likert scale. We identified consistently high expectations for long-term care services across the general population, especially among older people, females, those with a family member in care, and those living in rural or regional areas. In terms of how governments practically fund a high-quality long-term care system, we also identified broad support among the general population for both payment of a co-contribution towards the cost of care by older people using services and increased government funding for the system. Over 40% of participants said they would be willing to pay additional tax to improve access and quality of aged care services. While often neglected by governments in the past who assumed voter apathy on the topic, by comparison, our findings indicate that there is currently a strong appetite among the general population for improvements to the quality of care provided and that they are willing to consider changes to the funding model. [ABSTRACT FROM AUTHOR]

Simple Summary: Symptom management is a key goal of palliative cancer care. There is growing interest in the use of cannabis-based medicines or products for the management of physical and psychosocial symptoms associated with cancer or cancer treatment, including pain, nausea and vomiting, insomnia, and mood disorders. However, research on medical uses of cannabis has been limited because of legal restrictions and stigma. The goal of this review is to explore the potential role of cannabis and cannabinoids in the management of cancer-related symptoms. Limited evidence suggests that cannabis may improve cancer-related pain, chemotherapy-induced nausea and vomiting, appetite and chemosensory changes, insomnia, and mood disorders; however, cannabis is associated with several neuropsychiatric and systemic adverse effects and drug interactions. In this review, we discuss the potential role of cannabis and cannabinoids in the management of cancer-related symptoms. There is limited evidence demonstrating the effectiveness of cannabis-based products in treating cancer-related pain and gastrointestinal symptoms such as nausea, vomiting, and loss of appetite. Regarding the role of cannabis-based products in the treatment of insomnia and mood disorders, most studies looked at these symptoms as secondary outcomes with mixed results. Cannabis-based products have adverse effects, ranging from neuropsychiatric to systemic effects to potential drug interactions. [ABSTRACT FROM AUTHOR]

Sheep pain is an animal welfare issue monitored based on behavioral responses, including appetite. Dominant (alpha) males have priority for accessing limited feed resources, however, the effects of pain on feed interest in members of a group with defined social hierarchy are unknown. Our objective was to investigate effects of acute post-orchiectomy pain on alpha rams' interest in accessing a limited feed resource. Eighteen rams were randomly housed in pens of 3 rams. After acclimation, the first 5-d (consecutive) battery of a behavior test was performed. In this test, 180 g of the regular diet concentrate was placed in a portable trough in the center of the pen; this feed was supplemental to the diet and represented a limited, albeit strongly preferable feed resource. Rams were filmed for 5 min after the feed introduction. Hierarchical levels (alpha, beta, and gamma) were defined based on the social hierarchical index according to higher initiator and lower receptor agonistic behaviors from the social network analyses. After 15 d, a second 5-d behavioral test battery was repeated. On the following day, alpha rams were castrated. Flunixin meglumine was given immediately before surgery and a final behavioral test was performed 8 h postorchiectomy, concurrent with an expected peak in postoperative pain. For all recordings, the latency, frequency, and duration of time that each ram had its mouth inside the feed trough were recorded, and the Unesp-Botucatu sheep acute pain scale pain scale (USAPS) was applied. The social hierarchical index was highest in alpha rams, followed by beta and gamma. The pain scores were statistically equivalent across the 11 evaluation days for beta and gamma rams, whereas there was an increase in the final evaluation for alpha. There was no difference in latency, frequency, and duration between alpha, beta, and gamma rams across evaluations. We concluded that acute post-orchiectomy pain did not decrease alpha rams' interest in accessing limited feed. Routine feeding offers a valuable chance to detect pain-related behavior using the USAPS in rams. However, dominance may confound appetite-related behaviors in assessing acute pain, as alpha rams' interest in limited feed remained unaffected by the pain. [ABSTRACT FROM AUTHOR]

Background: Microalgae like Phaeodactylum tricornutum (PT) contain the carotenoid, fucoxanthin, which has been purported to promote fat loss, lower blood lipids, and improve glucose management. This study examined whether dietary supplementation with microalgae extracts from PT containing 4.4 mg/d of fucoxanthin affects changes in body composition or health markers in overweight women during an exercise and diet intervention. Materials and Methods: A total of 37 females (28.6 ± 7.9 years, 80.2 ± 14.9 kg, 29.6 ± 3.8 kg/m², 41.4 ± 4.2% fat) fasted for 12 h, donated a fasting blood sample, completed health and mood state inventories, and undertook body composition, health, and exercise assessments. In a counterbalanced, randomized, and double-blind manner, participants ingested a placebo (PL), or microalgae extract of Phaeodactylum tricornutum standardized to 4.4 mg of fucoxanthin (FX) for 12 weeks while participating in a supervised exercise program that included resistance-training and walking (3 days/week) with encouragement to accumulate 10,000 steps/day on remaining days of the week. The diet intervention involved reducing energy intake by about −300 kcal/d (i.e., ≈1400–1600 kcals/d, 55% carbohydrate, 30% fat, 15% protein) to promote a −500 kcal/d energy deficit with exercise. Follow-up testing was performed at 6 and 12 weeks. A general linear model (GLM) with repeated measures statistical analysis was used to analyze group responses and changes from baseline with 95% confidence intervals. Results: Dietary supplementation with microalgae extract from PT containing fucoxanthin for 12 weeks did not promote additional weight loss or fat loss in overweight but otherwise healthy females initiating an exercise and diet intervention designed to promote modest weight loss. However, fucoxanthin supplementation preserved bone mass, increased bone density, and saw greater improvements in walking steps/day, resting heart rate, aerobic capacity, blood lipid profiles, adherence to diet goals, functional activity tolerance, and measures of quality of life. Consequently, there appears to be some benefit to supplementing microalgae extract from PT containing fucoxanthin during a diet and exercise program. Registered clinical trial #NCT04761406. [ABSTRACT FROM AUTHOR]

Objectives: Sudden smell loss is one of the early symptoms of COVID‐19. Although it is stated that the loss of smell and taste following COVID‐19 improves within a few weeks, there are also cases that do not improve for a long time. The aim of this study is to reveal long‐term smell loss experiences after COVID‐19. Methods: A qualitative approach was adopted. We conducted semistructured interviews with 11 participants who had smell loss for at least 3 months. Interviews were recorded, transcribed and evaluated using a thematic analysis for qualitative data. Results: Nutrition and appetite, personal hygiene, threats to safety and emotional changes were the main themes created by the authors and were the areas where participant expressions focused. The participants used oral/nasal corticosteroid therapy for smell loss and received short‐term olfactory training, but could not find a solution. Conclusions: Long‐term smell loss problems, which were neglected during the pandemic period, should be carefully evaluated due to their negative effects. Understanding and focusing on the negative effects of loss of smell may contribute to the solution of long‐term smell loss problems. Patient and Public Contribution: Eleven participants who experienced long‐term loss of smell following COVID‐19 contributed to the study. They enriched the study by describing the effects of their experiences. There was no other participation or contribution from the public to the research. [ABSTRACT FROM AUTHOR]

The physical characteristics of chyme during gastrointestinal digestion are considered to significantly affect nutrient digestion and absorption (such as glucose diffusion), which has an impact on postprandial satiety. The present study aims to analyze the hydration rate (HR) and rheological properties of deacetylated konjac glucomannan (DKGM) at different degrees and then explore their effects on rice texture, digestive properties, and the subjects' post-meal appetite. The present results show that, as the deacetylation degree (DD) of KGM increased, the intersection point of the viscoelastic modulus shifted to a high shear rate frequency, and as the swelling time of the DKGM was prolonged, its HR decreased significantly. The results of the in vitro gastrointestinal digestion tests show that the hardness and chewability of the rice in the fast-hydration group (MK1) were remarkably reduced. In contrast, the slow-hydration group (MK5) exhibited an outstanding ability to resist digestion. The kinetics of starch hydrolysis revealed that the HR of the rice in the fast-hydration group was 1.8 times faster than that of the slow-hydration group. Moreover, it was found that the subjects' appetite after the meal was highly related to the HR of the MK. Their hunger (p < 0.001), desire to eat (p < 0.001), and prospective food consumption (p < 0.001) were significantly inhibited in the slow-hydration group (MK5) compared to the control. This study explored the nutritional effects of the hydration properties derived from the DKGM, which may contribute to modifying the high glycemic index food and provide ideas for the fabrication of food with enhanced satiating capacity. [ABSTRACT FROM AUTHOR]

Background: Insufficient data are available on the effects of long-term whey protein (WP) consumption on patients with type 2 diabetes mellitus (T2DM). So, in this study, we aimed to examine the effects of WP combined with individualized diet on anthropometric parameters, resting energy expenditure (REE), oxidative stress markers, and appetite among overweight/obese women with T2DM. Methods: In this 3-month double-blind placebo-controlled randomized clinical trial, 48 women with T2DM were randomly allocated into either WP group (one bread fortified by 20 g whey protein concentrates (WPC)) or placebo group (one unfortified bread) along with their individualized diets. At both pre- and post-intervention phases, physical activity, anthropometric parameters, REE, appetite, and serum levels of total antioxidant capacity (TAC) and malondialdehyde (MDA) as well as diet were assessed. Results: Thirty-five patients completed the trial. At the endpoint, there were no significant between-group differences for anthropometric parameters (p > 0.05), except for waist circumference (WC), which was lower in the WP group after adjusting for the confounders (p = 0.040). Serum level of MDA was significantly decreased in the WP group (p = 0.022). There were no significant within- or between-group changes for serum levels of TAC, REE, and appetite sensations (p > 0.05), except for the "hunger", which was lower in the WP group after adjusting for the confounders (p = 0.045). Conclusion: Regarding significant reduction in WC, serum levels of MDA, and feeling of hunger, consumption of the WPC fortified bread could be beneficial in women with T2DM. Registration Number: IRCT20110123005670N26; Registration date: 2019/01/07. [ABSTRACT FROM AUTHOR]

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]

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]