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Serious infection elicits inflammatory processes that act through a range of molecular pathways, including cytokine signaling. It is not established however that noradrenaline (NA), a widely distributed neurotransmitter in the brain that is also a principal output molecule of the sympathetic nervous system, can produce psychological effects associated with infection. This paper puts forth the hypothesis that through neural-immune crosstalk, serious infection increases noradrenergic signaling, both in the central nervous system and in peripheral organs. In this manner, elevated noradrenergic transmission may help produce basic symptoms of infection such as fever, fatigue, aches and pains (including headache), nausea, and loss of appetite. NA may also promote cognitive impairment, major depression, unipolar mania, and even epileptic seizures in some cases. The paper focuses on three major types of infection: influenza (viral), tuberculosis (bacterial), malaria (parasitic), while also summarizing the potential relationship between NA and human immunodeficiency virus (HIV) infection. Four lines of evidence are used to test association between NA and influenza, tuberculosis, and malaria: direct measures of NA and its metabolites; and incidence of hypertension, bipolar mania, and epileptic seizures, since the latter three conditions may be associated with elevated NA. In addition, heart rate variability data are examined with respect to a number of infectious diseases, since those data provide information on sympathetic nervous system activity. While the data do not unequivocally support elevated noradrenergic signaling promoting psychological symptomatology with infection, many studies are consistent with this view.

Aim: To conduct a systematic review of the effects of chewing on appetite, food intake and gut hormones, and a meta-analysis of the effects of chewing on self-reported hunger. Objectives: To seek insights into the relationship between chewing, appetite, food intake and gut hormones, and to consider potentially useful recommendations to promote benefits of chewing for weight management. Materials and methods: Papers were obtained from two electronic databases (Medline and Cochrane), from searches of reference lists, and from raw data collected from the figures in the articles. A total of 15 papers were identified that detailed 17 trials. All 15 papers were included in the systematic review; however, a further five studies were excluded from the meta-analysis because appropriate information on hunger ratings was not available. The meta-analysis was conducted on a total of 10 papers that detailed 13 trials. Results: Five of 16 experiments found a significant effect of chewing on satiation or satiety using self-report measures (visual analogue scales, VASs). Ten of 16 experiments found that chewing reduced food intake. Three of five studies showed that increasing the number of chews per bite increased relevant gut hormones and two linked this to subjective satiety. The meta-analysis found evidence of both publication bias and between study heterogeneity (IA2=93.4%, tau2=6.52, p

People often crave for high-caloric sweet foods when facing stress and this 'emotional eating' is a most important cause for weight gain and obesity. Eating under stress contrasts with the normally expected response of a loss of appetite, yet in spite of intensive research from neurobiological and cognitive disciplines we still do not know why stress or negative affect triggers overeating in so many of us. Since the prevalence of overweight and obesity still rises, the discovery of crucial risk factors is a most desirable goal of today's research on sub-optimal eating habits. This paper summarizes the most relevant current knowledge from the (human) literature regarding cognitive and biological vulnerabilities for stress-induced emotional eating. A (non-systematic) review of the most relevant studies reveals that most studies contemplate a rather one-directional way of focusing on either cognitive or biological factors, showing inconsistent results. The current paper elaborates and/or integrates these findings into a biological-cognitive interaction model in which a specific combination of genetic and cognitive vulnerabilities are thought to increase our bio-behavioral response to stress, critically increasing the rewarding value of pleasant foods and, hence, emotional eating.

Punktem wyjścia artykułu jest rozważanie i konfrontowanie ze sobą różnych znaczeń terminu "wola", formułowanych i dyskutowanych w XII-wiecznej antropologii. Znaczna część tych historycznych dociekań poświęcona jest takim zagadnieniom, jak charakterystyka i specyfika działania ludzkiej woli, jej odniesienie do całej dziedziny pragnienia (w szczególności do pożądania zmysłowego), zwłaszcza zaś wzajemne funkcjonalne i hierarchiczne relacje między wolą a rozumem jako władzą poznawczą. Na podstawie porównawczej i krytycznej analizy tekstów źródłowych z epoki (w tym dzieł Anzelma z Canterbury, Bernarda z Clairvaux, Hugona ze św. Wiktora oraz ważniejszych zbiorów sentencji znanych i nieznanych autorów) autor artykułu bada poglądy tych i innych ówczesnych myślicieli na temat przynależności woli do sfery racjonalności w człowieku, udziału intelektu w jej wyborach i decyzjach z jednej strony, a zarazem jej autonomii i samoczynności z drugiej. Swoje badania koncentruje na tym, w jaki sposób XII-wieczni myśliciele próbują wyjaśnić fenomen wolnego wyboru czy też wolnej decyzji i odpowiedzieć na pytania dotyczące właściwego podmiotu, źródła, przyczyny sprawczej bądź koniecznego i wystarczającego warunku ludzkiej wolności. Czyni to w kontekście średniowiecznych dyskusji i sporów między woluntaryzmem i intelektualizmem antropologicznym. A starting point of this paper is a consideration and confrontation of the various meanings of the term "will" formulated and discussed in twelfth century anthropology. A significant part of this historical research is devoted to such issues as the characteristics and specific activity of the human will, its relation to the whole domain of the desire, particularly that of the sensual desire, and especially the mutual - functional and hierarchical - relationship between will and reason as the cognitive faculty. On the ground of the critical and comparative analysis of the text-sources (including the works of Anselm of Canterbury, Bernard of Clairvaux, Hugh of Saint-Victor, as well as the collections of sentences of known and unknown authors), author of the paper explores the views of just mentionned and others thinkers of this time on the belonging of the will to the domain of human rationality, on the participation of the intellect in the will's decisions and choices, one the one hand, and on will's autonomy and its possibility of self-moving, on the other. He focuses his scrutiny on how the twelfth century thinkers try to explicate a phenomenon of free choice or free decision and to answer to a questions concerning a proper subject, source, efficient cause or necessary and sufficient condition of the human freedom in the context of the medieval disputes between voluntarism and intellectualism in the domain of anthropology.

The prevalence of metabolic diseases such as type 2 diabetes mellitus (T2DM) is rapidly increasing all over the world. Frequent episodes of elevated postprandial blood glucose have been associated with oxidative stress and subclinical inflammation, and the importance of a tight glycaemic control has been identified as an important factor to maintain health and prevent T2DM, obesity and cardiovascular disease (CVD).The aim was to investigate possibilities to tailor the course of postprandial glycaemia to bread in healthy adults in favour of reduced glycaemic index (GI) and increased glycaemic profile (GP) by inclusion of guar gum or β-glucans. GP is defined as the duration of the glucose curve above the fasting concentration divided by the incremental glucose peak. Effects on second meal glucose tolerance and appetite were also investigated. Furthermore, the potential use of in vitro measurements of starch hydrolysis rate (HI) and fluidity (FI) to predict course of postprandial glycaemia (GI and/or GP) was evaluated.In paper I, white wheat-based bread was supplemented with whole grain maize flour and different types and amounts of guar gum. Supplementation with medium weight guar gum (mwGG) resulted in lower postprandial glycaemia and insulinaemia and improved acute appetite compared to the white wheat reference bread (WWB).In paper II, three commercially available β-glucans from barley and oats were baked into yeast leavened bread products. Even a low level of high molecular weight (MW) β-glucan elicited a lowering effect on postprandial glycaemia, indicating that the β-glucan quality is of importance.In paper III, mwGG and whole grain rye flour or high amylose maize starch (HAM) were combined in an effort to design bread products in favour of low but sustained glycaemia. The combination of mwGG and rye was superior, with improvements in subjective appetite. Additionally both mwGG in combination with whole grain rye flour and HAM led to improvements in biomarkers of appetite compared to the WWB.In paper IV, pasta or WWB were provided for breakfast and a standardised lunch meal was given 4 h later. The pasta breakfast resulted in reduced glycaemic excursions, both acute and after a second meal, which demonstrates the importance of considering not only the ingredients but also the food processing conditions.An indexed glycaemic profile (GPI) was introduced, allowing comparisons between studies. GPI was defined as GP for WWB divided by the GP for the test product taken by the same subject, multiplied by 100 and then presented as a mean of all individual values. GPI was better correlated to subjective appetite ratings compared to both GP and GI for the present studies. Both the measures of HI and FI were related to GI, GPI, glucose iPeak, II and insulin iPeak (Spearman’s partial correlation, papers I-III). HI seems to better predict the glycaemic response, defined as GI or GPI, compared to FI.For the future, the importance of the course of glycaemia for long-term metabolic outcome should be evaluated, also including effects on weight regulation.

Short-term dietary adjustments used as a detox health tonics in this study with which helps to eliminate excess toxins from the body while simultaneously increasing vitamin and mineral absorption through the consumption of natural juices, fruits, and vegetables. The aimed of the study was to formulate a detox health tonic diets for toxin elimination and observe its efficacy on health and nutrition. A total 45 people were recruited for this preliminary study and randomly divided into two groups in a randomized, single-blind, placebo-controlled trial (30 individual included in case group and 15 individuals were in control group). All of the subjects in the case group consumed a curcumin-based diet for 12 weeks, while none of the subjects in the control group consumed any curcumin-based food mixes. It was clear that 100% opined that good taste and 93.3% of the subjects reported that it increased their appetite and interested to intake again. Following intervention, no patients in the case group were determined to be in severe pain, and nearly 93% reported either no discomfort or mild pain. After a three-month control trial, however, there was no discernible reduction in pain in the control group. The intervention group showed substantial declines in weight (p=0.013), body mass index (p=0.011) compared to baseline after consuming the detox diet for three months. Keywords: Detox diet, Toxin, Curcumin, Single blind placebo-controlled, appetite, Body mass index. Title: Formulation of a Detox Health Tonic Diet for Toxin Elimination Author: Samrina Afrose, S. S. Saliheen Sultana, Sonia Zebsyn, Mubashira Binta, Alam, A. K. Obidul Huq International Journal of Life Sciences Research ISSN 2348-313X (Print), ISSN 2348-3148 (online) Vol. 11, Issue 2, April 2023 - June 2023 Page No: 58-62 Research Publish Journals Website: www.researchpublish.com Published Date: 20-June-2023 DOI: https://doi.org/10.5281/zenodo.8058436 Paper Download Link (Source) https://www.researchpublish.com/papers/formulation-of-a-detox-health-tonic-diet-for-toxin-elimination, International Journal of Life Sciences Research, ISSN 2348-313X (Print), ISSN 2348-3148 (online), Research Publish Journals, Website: www.researchpublish.com

Summary 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.

This paper was published in the journal Appetite and the definitive published version is available at https://doi.org/10.1016/j.appet.2016.08.095. This paper was also presented at the British Feeding and Drinking Group, London, UK, 7th-8th April 2016.

This paper presents an individual-based model for gastrointestinal nematode parasites of sheep and includes the effect of these parasites on the liveweight performance of young sheep. Parasitism is known to affect the host animal in at least two ways. The first induces a loss of appetite in the host, which reduces pasture consumption compared with the parasite-free animal. This effect is examined in the first part of the study. The second major effect of parasitism is a reduction in the metabolic efficiency of the host which decreases nutrients available for maintenance and growth. The latter part of the paper examines the consequences of incorporating this effect on the liveweight changes in individuals in a group of sheep. Previous models addressing this issue have only given mean liveweight and worm burden changes.

Louis Dahl’s famous graph in 1960 showing a positive linear relationship between prevalence of hypertension and mean salt intake across five population groups caught the imagination of the blood pressure research community, and it remains influential to this day. It led to an intensification of research on the role of salt in hypertension spanning anthropology, epidemiology, animal studies, studies of mechanisms and clinical trials. In his 1960 paper, Dahl encompasses much of the basic thinking underpinning current-day public health efforts to reduce sodium consumption in the population. First, he notes that daily intakes of salt among Americans and other populations were well in excess of physiological need ~1 g salt/day (17 mmol sodium) compared with the 10 g (170 mmol sodium) or more being consumed on average by a white American man, and.26 g (440 mmol sodium) by northern Japanese farmers (rates of hypertension and stroke were exceptionally high in northern Japan at that time). He remarks that an individual’s dietary salt intake is highly variable and difficult to measure (noting that 24 h urinary excretion was the preferred method); also that salt appetite in humans is induced rather than innate, such that people on a low sodium diet (in some cases as low as a few mmol sodium/day) could rapidly adapt, and furthermore suffered no ill effects. In addition, his animal experiments (and those of Meneely et al. 1 ) had shown that hypertension in rats could be induced by sodium ingestion, in a dose-dependent way over a prolonged period. Though not an epidemiologist by training, he understood and expounded the concept that an environmental risk factor (salt intake) could increase the risk of disease (high blood pressure) in a group, while acknowledging that the risk for any given individual also depended on other factors, including genetic susceptibility. Therefore, the experiment of choice was to examine disease occurrence (rates of hypertension) in different populations with wide variations in exposure (salt intake, measured by 24 h urinary sodium excretion), rather than to compare blood pressures and sodium intakes of individuals within a population. Later, through a series of breeding experiments Dahl expanded on the concept of gene–environment interaction with respect to an animal model of salt and hypertension; he in-bred a strain of rats (Dahl-S rats), which were ‘sensitive’ to salt intake—fed a diet high in salt, the rats would go on to develop hypertension and stroke. In contrast Dahl-R rats (‘resistant’) could tolerate high salt intake without developing hypertension. 2 In his 1960 paper, Dahl postulated that humans would show a range of responses to a high salt intake, but that at the group level, hypertension would be uncommon below an intake of 4–5 g salt/day (68–85 mmol sodium/day). Other authors subsequently extended Dahl’s observations on five populations to other population groups. These studies generally confirmed the Dahl relationship, but, to a greater or lesser extent, suffered from a number of uncertainties and potential biases. Often, the data were not derived from one source, but from a variety of studies in the published literature in which unstandardized and often unspecified methods were used, and few data on confounding variables were available. Perhaps the best known of these reports was by Gleibermann, an anthropologist, who examined the relationship between sodium intake and blood pressure across 27 populations. 3 In contrast to Dahl’s reliance on 24 h urinary data to estimate sodium intake, in six of Gleibermann’s populations, the author’s own estimates of sodium intake (6 g salt/day) were used, while in a further ten ‘a quantitative value for mean salt consumption was reported with or without indications as to how it was calculated’. 3

in this issue of the journal are published six papers that were submitted in response to the Call for Papers “Physiological Regulation of Appetite” ([7][1], [17][2], [25][3], [27][4], [66][5], [86][6]). In addition, four other papers in this series have been published in previous issues ([13][7

SUMMARY Effect of access to wood shavings on gizzard activity was examined for birds fed pelleted wheat and oat diets with or without whole cereal inclusion. Layers on litter floor fed wheat diets with access to coarse wood shavings showed up to 60% higher weight of the gizzard and its content than caged layers fed the same diets without access to wood shavings. No such effect was found by feeding oat diets. Thus, a significant interaction was found, indicating that the appetite for wood shavings may be dependent of fiber level of the diet. Appetite for wood shavings and paper was examined for birds fed wheat and oat diets in 2 other experiments. The intake of wood shavings and paper by birds fed a wheat-based diet was numerically twice as high as in birds fed an oatbased diet. However, the individual variation was remarkably high. Neutral detergent fiber (NDF) concentration in the gizzard of birds fed the oat diet was up to twice (P < 0.05) the fiber concentration in the gizzard of birds fed the wheat diet. Passage of structural fibers through the gizzard and the appetite for feathers in the absence of structural fibers were also studied in an experiment using diets based on rice and casein. Coarse fiber structures were observed to accumulate in the gizzard. In the absence of fiber, birds ate feathers, indicating that birds may eat feathers to compensate for the lack of structural components in the feed.

This paper reviews evidence demonstrating a bidirectional relationship between memory and eating in humans and rodents. In humans, amnesia is associated with impaired processing of hunger and satiety cues, disrupted memory of recent meals, and overconsumption. In healthy participants, meal-related memory limits subsequent ingestive behavior and obesity is associated with impaired memory and disturbances in the hippocampus. Evidence from rodents suggests that dorsal hippocampal neural activity contributes to the ability of meal-related memory to control future intake, that endocrine and neuropeptide systems act in the ventral hippocampus to provide cues regarding energy status and regulate learned aspects of eating, and that consumption of hypercaloric diets and obesity disrupt these processes. Collectively, this evidence indicates that diet-induced obesity may be caused and/or maintained, at least in part, by a vicious cycle wherein excess intake disrupts hippocampal functioning, which further increases intake. This perspective may advance our understanding of how the brain controls eating, the neural mechanisms that contribute to eating-related disorders, and identify how to treat diet-induced obesity.

Compared to the large numbers of studies on the diabetes, hyperlipidemia and cancer therpeutic effects of ginseng, the anti-obese effect and mechanisms of ginsengs have not been studied as much. To determine the effects of ginseng on obesity, 14 keywords (ginseng, ginsenoside, obesity, weight, fat, diet, overeat, appetite, lipid, 3T3-L1, adipocyte, food intake, adipogenesis and lipolysis) were combined in searching a database. Fifty-six articles published from 1983 to 2012 as well as 656 patents registered until Aug 17 th , 2012, were screened for anti-obese effects of ginseng. In the classification of experimental methods, 16 papers on 3T3-L1 cells, 38 papers on animals and three papers on human were reviewed. In terms of obese mechanisms of action, the most commonly used biomarkers were in order of lipid profiles ＞ weight change ＞ blood glucose ＞ adipocytokine. Most ginseng studies on obesity focused on AMPK, PPARγ, GLUT-4, PI3K and SREBP-1. Korean white ginseng extracts and Re repressed the lipogenesis genes such as PPARc2, SREBP-1c, LPL, FAS and DGAT1. However, ginseng or ginsenosides, PD (Rb1) and PT (Re), showed different or contradictory results. Water and ethanol extraction of ginseng showed contradictory effects on the secretion of inflammatory cytokines, wheras IL-6 was repressed by ethanol extracts and TNF-α repressed by Re in vitro. Based on the literature, further studies on anti-obese mechanisms of ginseng, such as the inflammation-related obesity or cross signals between the adipocytes and the environments, are needed, instead of more studies on its hypolipidemic and hypoglycemic effects.

This present paper reviews the reliability and validity of visual analogue scales (VAS) in terms of (1) their ability to predict feeding behaviour, (2) their sensitivity to experimental manipulations, and (3) their reproducibility. VAS correlate with, but do not reliably predict, energy intake to the extent that they could be used as a proxy of energy intake. They do predict meal initiation in subjects eating their normal diets in their normal environment. Under laboratory conditions, subjectively rated motivation to eat using VAS is sensitive to experimental manipulations and has been found to be reproducible in relation to those experimental regimens. Other work has found them not to be reproducible in relation to repeated protocols. On balance, it would appear, in as much as it is possible to quantify, that VAS exhibit a good degree of within-subject reliability and validity in that they predict with reasonable certainty, meal initiation and amount eaten, and are sensitive to experimental manipulations. This reliability and validity appears more pronounced under the controlled (but more artificial) conditions of the laboratory where the signal: noise ratio in experiments appears to be elevated relative to real life. It appears that VAS are best used in within-subject, repeated-measures designs where the effect of different treatments can be compared under similar circumstances. They are best used in conjunction with other measures (e.g. feeding behaviour, changes in plasma metabolites) rather than as proxies for these variables. New hand-held electronic appetite rating systems (EARS) have been developed to increase reliability of data capture and decrease investigator workload. Recent studies have compared these with traditional pen and paper (P&P) VAS. The EARS have been found to be sensitive to experimental manipulations and reproducible relative to P&P. However, subjects appear to exhibit a significantly more constrained use of the scale when using the EARS relative to the P&P. For this reason it is recommended that the two techniques are not used interchangeably.

Destruction processes are considered ‘time capsules of material culture’ (Driessen 2013) as they freeze a site at one moment of its history providing key evidence for interpreting the archaeological record and reconstructing social, political, cultural and ideological circumstances. By focusing on selected case-studies, this paper aims at briefly discussing existing evidence of destruction events in Bronze Age contexts in Cyprus, and at a preliminary presentation of new research data resulting from ongoing interdisciplinary analyses at Middle Bronze Age Erimi.

Introduction. The paper presents modern literature and clinical research data on the efficacy and safety of dietary therapeutic and prophylactic foods in the complex therapy of diseases associated with Helicobacter pylori. Aim. To assess the efficacy and safety of the use of dietary therapeutic and prophylactic food products in the complex therapy of diseases of the gastrointestinal tract associated with Helicobacter pylori. Materials and methods. To evaluate the efficacy of dietary therapeutic and prophylactic food products such as Vegetable Puree Soup with Herbs and Oatmeal, Oatmeal Porridge with Herbs and Flax Seed, Protein-Sea Buckthorn Cocktail (LEOVIT Nutrio LLC), the main group of patients with gastrointestinal diseases (n = 41) was formed, which was further divided into four subgroups. Each of three subgroups received one specialty food product, and the fourth subgroup received all three products. Changes in complete blood count were evaluated using Sysmex XT-2000i analyzer, those in proteinograms – using SAS1, SAS2 protein fraction analyser and those in metabolic liver disorders, lipid profile and glucose level – using Konelab PRIME 30i (Thermo Fisher Scientific) analyzer. All parameters were studied three times: before use, 14 and 60 days after use of the products. Results and discussion. After 14 days, complaints of lack of appetite decreased in the main group, discomfort in the epigastrium, feeling of heaviness and nausea decreased. After 60 days, 100% of patients reported no heartburn, belching, nausea, pain, rumbling in the abdomen, appetite and stool returned to normal. There was a marked significant (p < 0.05) decrease in the level of alpha-1 globulin against the background of an increase in albumin, a decrease in the concentration of CRP and ESR, the levels of leukocytes and neutrophils in all subgroups of the main group after 60 days. Conclusions. The investigated products are safe, no adverse reactions were noted, including the phenomena of intolerance and allergies, and are recommended for use in dis[1]eases of the gastrointestinal tract associated with Helicobacter pylori.

Cachexia means any general reduction in vitality and strength of body and mind resulting from any debilitating chronic disease. Cachexia is defined as loss of weight, muscle atrophy, fatigue, weakness, and loss of appetite in someone who is not actively trying to lose weight. These features markedly distinguish cachexia from starvation. Cachexia can be a sign of various underlying disorders. Physicians confronted with cachexia generally consider the possibility of cancer, certain infectious diseases such as tuberculosis or AIDS, parasitic diseases, autoimmune disorders, or chronic heart failure. Cachexia physically weakens patients to a state of immobility stemming from loss of appetite, asthenia, and anemia. The response to standard treatments is poor [1]. The above sounds straightforward enough. However, in PubMed, about 4,500 papers have been published on cachexia; interestingly, >1,000 of these papers are reviews. Such a relationship raises suspicion that little is known about the subject. Weber et al. [2], in this issue, introduce a novel inverse marker of clinical muscle wasting, namely, the measurement of plasma myoglobin concentration. Their report is immediately disconcerting, as the title of their paper ends in a question mark, implying a lack of self-confidence on behalf of the authors. However, the entire cachexia field is riddled with question marks. Weber et al. studied 17 cancer patients, the prototype patients exhibiting cachexia. The patients had lost >20% of their body mass without intending to do so. A suitable matched control group of 27 subjects was recruited who had lost no weight. Plasma myoglobin, creatine kinase, quadriceps muscle cross-sectional area (by magnetic resonance imaging), muscle morphology from biopsies of the Vastus lateralis, body cell mass by impedance, and maximal oxygen uptake (VO2 max) were all measured in these patients and control subjects. To no surprise, myoglobin, muscle cross-sectional area, body cell mass, and VO2 max were all lower in cachexic cancer patients than in healthy controls. However, in a multiple-regression analysis, myoglobin (hypomyoglobinemia) won out over other indicators (27 μg/dl vs 42 μg/dl); or did it? The authors found that myoglobin was directly correlated with cross-sectional muscle mass and was better than reduced creatine kinase in this regard, although the magnitude of the creatine kinase reduction was greater. The fact that creatine kinase and myoglobin were not elevated is of some mechanistic interest, since active muscle destruction would have featured elevation of both myoglobin and creatine kinase. Weber et al. [2] performed muscle biopsies on 11 patients and 15 control subjects. A marked size reduction in type 1 and 2 fibers occurred in the cachexic patients that corresponded to the reduction in cross-sectional area and correlated significantly with the reduced myoglobin levels. What causes cachexia anyway? Are the diverse chronic (or not so chronic) cachexia conditions related? The cachexic patients presented by Weber et al. [2] all had cancer. Skipworth et al. [3] recently reviewed cancer cachexia. They stressed the role of host–tumor interaction, particularly pro-inflammatory cytokines. Tumor cells release cytokines and other factors locally to promote inflammation and thereby activate a local response. For instance, proteolysis-inducing factor (PIF) is a sulphated glycoprotein that produces muscle wasting in tumor-free mice when injected. The material has been identified in patients with pancreatic, breast, ovarian, lung, colon, rectum, and liver J Mol Med (2007) 85:783–785 DOI 10.1007/s00109-007-0231-0

Summary 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.

Obesity is one of the greatest public health challenges of the 21st century. Obesity is currently responsible for ∼0.7-2.8% of a country's health costs worldwide. Treatment is often not effective because weight regulation is complex. Appetite and energy control are regulated in the brain. Melanocortin-4 receptor (MC4R) has a central role in this regulation. MC4R defects lead to a severe clinical phenotype with lack of satiety and early-onset severe obesity. Preclinical research has been carried out to understand the mechanism of MC4R regulation and possible effectors. The objective of this study is to systematically review the literature for emerging pharmacological obesity treatment options. A systematic literature search was performed in PubMed and Embase for articles published until June 2012. The search resulted in 664 papers matching the search terms, of which 15 papers remained after elimination, based on the specific inclusion and exclusion criteria. In these 15 papers, different MC4R agonists were studied in vivo in animal and human studies. Almost all studies are in the preclinical phase. There are currently no effective clinical treatments for MC4R-deficient obese patients, although MC4R agonists are being developed and are entering phase I and II trials.