Jurriaan M. Born

Acute Stress-related Changes in Eating in the Absence of Hunger

Obesity results from chronic deregulation of energy balance, which may in part be caused by stress. Our objective was to investigate the effect of acute and psychological stress on food intake, using the eating in the absence of hunger paradigm, in normal and overweight men and women (while taking dietary restraint and disinhibition into account). In 129 subjects (BMI = 24.5 ± 3.4 kg/m2 and age = 27.6 ± 8.8 years), scores were determined on the Three Factor Eating Questionnaire (dietary restraint = 7.2 ± 4.4; disinhibition = 4.5 ± 2.6; feeling of hunger = 3.9 ± 2.6) and State‐Trait Anxiety Inventory (trait score = 31.7 ± 24.2). In a randomized crossover design, the “eating in absence of hunger” protocol was measured as a function of acute stress vs. a control task and of state anxiety scores. Energy intake from sweet foods (708.1 kJ vs. 599.4 kJ, P < 0.03) and total energy intake (965.2 kJ vs. 793.8 kJ, P < 0.01) were significantly higher in the stress condition compared to the control condition. Differences in energy intake between the stress and control condition were a function of increase in state anxiety scores during the stress task (Δ state anxiety scores) (R2 = 0.05, P < 0.01). This positive relationship was stronger in subjects with high disinhibition scores (R2 = 0.12, P < 0.05). Differences in state anxiety scores were a function of trait anxiety scores (R2 = 0.07, P < 0.05). We conclude that acute psychological stress is associated with eating in the absence of hunger, especially in vulnerable individuals characterized by disinhibited eating behavior and sensitivity to chronic stress.

Acute stress and food-related reward activation in the brain during food choice during eating in the absence of hunger.

Background:Stress results in eating in the absence of hunger, possibly related to food reward perception.Hypothesis:Stress decreases food reward perception.Aim:Determine the effect of acute stress on food choice and food choice reward-related brain activity.Subjects:Nine females (BMI=21.5±2.2 kg/m2, age=24.3±3.5 years).Procedure:Fasted subjects came twice to randomly complete either a rest or stress condition. Per session, two functional MRI scans were made, wherein the subjects chose the subsequent meal (food images). The rewarding value of the food was measured as liking and wanting. Food characteristics (for example, crispiness, fullness of taste and so on), energy intake, amount of each macronutrient chosen, plasma cortisol and Visual Analog Scale (VAS) hunger and satiety were measured.Results:Fasted state was confirmed by high hunger (80±5 mm VAS). Breakfast energy intake (3±1 MJ) and liking were similar in all conditions. Wanting was lower postprandially (Δ=−0.3 items/category, P<0.01). Breakfast decreased hunger (−42 mm VAS, P<0.01). Postprandially, energy intake (−1.1 MJ), protein intake (−14.7 g) and carbohydrate intake (−32.7 g all P<0.05) were lower. Fat intake was not different (−7.3, P=0.4). Putamen activity was not lower postprandially. Cortisol levels were increased in the stress condition (Area under the curve of cortisol: ΔAUC=+2.2 × 104 nmol min−1 l−1, P<0.05). Satiety was lower after breakfast (−8 mm VAS, P<0.01). Postprandial energy intake, protein intake and carbohydrate intake were relatively higher compared with the rest condition, resulting from more choice for crispiness and fullness of taste (P<0.05). Brain activation was reduced in reward areas: amygdala, hippocampus and cingulate cortex (AUC=−13.33, −1.34, −2.56% blood oxygen level dependent (BOLD) s for choosing breakfast and AUC=−9.31, −1.25, −2.34%BOLD s<0.05 for choosing the second meal). Putamen activation was decreased postprandially (AUC=−1.2%BOLD s, P<0.05).Conclusion:Reward signaling and reward sensitivity were significantly lower under stress, coinciding with increased energy intake from food choice for more crispiness and fullness of taste. The changes in putamen activation may reflect specifically decreased reward prediction sensitivity.

Differences between liking and wanting signals in the human brain and relations with cognitive dietary restraint and body mass index

BACKGROUND Eating behavior is determined, to a significant extent, by the rewarding value of food (ie, liking and wanting). OBJECTIVE We determined brain regions involved in liking and wanting and related brain signaling to body mass index (BMI; in kg/m(2)) and dietary restraint. DESIGN Fifteen normal-weight female subjects [mean ± SEM age: 21.5 ± 0.4 y; BMI: 22.2 ± 0.2] completed a food-choice paradigm by using visually displayed food items during functional magnetic resonance imaging scans. Two scans were made as follows: one scan was made in a fasted condition, and one scan was made in a satiated condition. The paradigm discriminated between liking and wanting, and subjects were offered items rated highly for wanting immediately after each scan. Imaging contrasts for high and low liking and wanting were made, and data for regions of interest were extracted. Activation related to liking and wanting, respectively, was determined. Outcomes were correlated to cognitive dietary restraint and BMI. RESULTS Dietary restraint predicted liking task-related signaling (TRS) in the amygdala, striatum, thalamus, and cingulate cortex (r = -0.5 ± 0.03, P < 0.00001). In the nucleus accumbens, the premeal liking and wanting TRS and premeal to postmeal liking TRS changes correlated positively with dietary restraint [bilateral average r = 0.6 ± 0.02, P < 0.04 (Bonferroni corrected)]. BMI and hunger predicted wanting TRS in the hypothalamus and striatum (P < 0.05). Postmeal liking TRS in the striatum, anterior insula, and cingulate cortex and wanting TRS in the striatum predicted the energy intake (liking: r = -0.3 ± 0.05, P < 0.0001; wanting: r = -0.3 ± 0.03, P < 0.00001). CONCLUSIONS Successful dietary restraint was supported by liking TRS from premeal to postmeal in the nucleus accumbens. Reward-related signaling was inversely related to BMI and energy intake, indicating reward deficiency.

Influence of Consumption of a High-Protein vs. High-Carbohydrate Meal on the Physiological Cortisol and Psychological Mood Response in Men and Women

Consumption of meals with different macronutrient contents, especially high in carbohydrates, may influence the stress-induced physiological and psychological response. The objective of this study was to investigate effects of consumption of a high-protein vs. high-carbohydrate meal on the physiological cortisol response and psychological mood response. Subjects (n = 38, 19m/19f, age = 25±9 yrs, BMI = 25.0±3.3 kg/m2) came to the university four times, fasted, for either condition: rest-protein, stress-protein, rest-carbohydrate, stress-carbohydrate (randomized cross-over design). Stress was induced by means of a psychological computer-test. The test-meal was either a high-protein meal (En% P/C/F 65/5/30) or a high-carbohydrate meal (En% P/C/F 6/64/30), both meals were matched for energy density (4 kJ/g) and daily energy requirements (30%). Per test-session salivary cortisol levels, appetite profile, mood state and level of anxiety were measured. High hunger, low satiety (81±16, 12±15 mmVAS) confirmed the fasted state. The stress condition was confirmed by increased feelings of depression, tension, anger, anxiety (AUC stress vs. rest p<0.02). Consumption of the high-protein vs. high-carbohydrate meal did not affect feelings of depression, tension, anger, anxiety. Cortisol levels did not differ between the four test-sessions in men and women (AUC nmol·min/L p>0.1). Consumption of the test-meals increased cortisol levels in men in all conditions (p<0.01), and in women in the rest-protein and stress-protein condition (p<0.03). Men showed higher cortisol levels than women (AUC nmol·min/L p<0.0001). Consumption of meals with different macronutrient contents, i.e. high-protein vs. high-carbohydrate, does not influence the physiological and psychological response differentially. Men show a higher meal-induced salivary cortisol response compared with women.

A solid high-protein meal evokes stronger hunger suppression than a liquefied high-protein meal.

Hunger is a potential problem for compliance with an energy‐restricted diet. Relatively high‐protein meal‐replacement products have been shown to diminish this problem; they are available as liquid and solid meals, yet their physical state can affect hunger suppression. The objective was to investigate the differences in appetite profile and physiological parameters after consumption of a single‐macronutrient, subject‐specific, high‐protein meal in liquefied vs. solid form, controlled for energy density, weight, and volume. Ten male subjects (age: 21.1 ± 3.9 years; BMI: 22.4 ± 1.2 kg/m2) were offered lunch subject‐specifically as 15% of daily energy requirement (DER), consisting of solid (steamed chicken breast + 750 ml water) or liquefied protein (steamed chicken breast blended in 500 ml water + 250 ml water). Appetite profiles, insulin, glucose, and ghrelin were measured over 3 h. Comparing the solid vs. liquefied condition, oral exposure time did not differ between conditions (19.2 ± 0.4 and 18.8 ± 0.6 min, respectively; P = 0.13). Area under the curve (AUC) effects were observed for thirst; statistically significant condition × time interactions and statistically significant differences at several time points were observed for desire to eat (condition × time P < 0.05; 31 ± 6 mm vs. 53 ± 8 mm; P < 0.04 at 115 min) and thirst (condition × time P < 0.01; 27 ± 8 mm vs. 41 ± 8 mm; P < 0.05 at 30 min and 23 ± 6 mm vs. 41 ± 8 mm; P < 0.02 at 70 min) to be lower, while hunger suppression (79 ± 3 mm and 52 ± 10 mm; P < 0.03 at 20 min and 61 ± 7 mm and 44 ± 8 mm; P < 0.03 at 115 min) was higher in the solid condition. Glucose, insulin, and ghrelin concentration curves were similar for both conditions. In conclusion, solid protein evokes a stronger suppression of hunger and desire to eat than liquefied protein.

Hypothalamic-pituitary-adrenal (HPA) axis functioning in relation to body fat distribution.

Objective  To relate hypothalamic–pituitary–adrenal (HPA) axis functioning and HPA feedback functioning to body fat distribution in normal weight to obese subjects.

Hyperactivity of the HPA axis is related to dietary restraint in normal weight women

The objective of our study was to investigate the relationship between hypothalamus/pituitary/adrenal (HPA) axis functioning and dietary restraint in normal weight (BMI between 20 and 25 kg/m(2)) men and women. We therefore assessed in 38 men and 38 women HPA axis functioning, through measuring 5-hour cortisol exposure and cortisol feedback functioning through a dexamethasone (4 mg) suppression test. Eating behavior was assessed through the Three Factor Eating Questionnaire and body composition through hydro densitometry and deuterium dilution method. No relationship between HPA axis functioning and dietary restraint was found in men. Normal weight women with a restraint score >/=9 showed increased cortisol concentrations over a 5-hour time period, increased cortisol concentrations after a dexamethasone (4 mg) suppression test, higher BMI, and higher body fat percentage, when compared to women with a restraint score <9. Moreover, a positive relationship was found between cortisol concentrations over a 5-hour time period and dietary restraint in combination with the disinhibition score (R(2)=0.23, p<0.001). We conclude that in normal weight women hyperactivity of the HPA-axis is related to dietary restraint especially in combination with disinhibition.

Dietary Restraint and Control Over “Wanting” Following Consumption of “Forbidden” Food

Eating behavior can be influenced by the rewarding value of food, i.e., “liking” and “wanting.” The objective of this study was to assess in normal‐weight dietary restrained (NR) vs. unrestrained (NU) eaters how rewarding value of food is affected by satiety, and by eating a nonhealthy perceived, dessert‐specific food vs. a healthy perceived, neutral food (chocolate mousse vs. cottage cheese). Subjects (24NR age = 25.0 ± 8.2 years, BMI = 22.3 ± 2.1 kg/m2; 26NU age = 24.8 ± 8.0 years, BMI = 22.1 ± 1.7 kg/m2) came to the university twice, fasted (randomized crossover design). Per test‐session “liking” and “wanting” for 72 items divided in six categories (bread, filling, drinks, dessert, sweets, stationery (placebo)) was measured, before and after consumption of chocolate mousse/cottage cheese, matched for energy content (5.6 kJ/g) and individual daily energy requirements (10%). Chocolate mousse was liked more than cottage cheese (P < 0.05). After consumption of chocolate mousse or cottage cheese, appetite and “liking” vs. placebo were decreased in NR and NU (P < 0.03), whereas “wanting” was only decreased in NR vs. NU (P ≤ 0.01). In NR vs. NU “wanting” was specifically decreased after chocolate mousse vs. cottage cheese; this decrease concerned especially “wanting” for bread and filling (P < 0.05). To conclude, despite similar decreases in appetite and “liking” after a meal in NR and NU, NR decrease “wanting” in contrast to NU. NR decrease “wanting” specifically for a nonhealthy perceived, “delicious,” dessert‐specific food vs. a nutritional identical, yet healthy perceived, slightly less “delicious,” “neutral” food. A healthy perceived food may thus impose greater risk for control of energy intake in NR.

Protein v. carbohydrate intake differentially affects liking- and wanting-related brain signalling

Extreme macronutrient intakes possibly lead to different brain signalling. The aim of the present study was to determine the effects of ingesting high-protein v. high-carbohydrate food on liking and wanting task-related brain signalling (TRS) and subsequent macronutrient intake. A total of thirty female subjects (21.6 (SD 2.2) years, BMI 25.0 (SD 3.7) kg/m²) completed four functional MRI scans: two fasted and two satiated on two different days. During the scans, subjects rated all food items for liking and wanting, thereby choosing the subsequent meal. The results show that high-protein (PROT) v. high-carbohydrate (CARB) conditions were generated using protein or carbohydrate drinks at the first meal. Energy intake and hunger were recorded. PROT (protein: 53.7 (SD 2.1) percentage of energy (En%); carbohydrate: 6.4 (SD 1.3) En%) and CARB conditions (protein: 11.8 (SD 0.6) En%; carbohydrate: 70.0 (SD 2.4) En%) were achieved during the first meal, while the second meals were not different between the conditions. Hunger, energy intake, and behavioural liking and wanting ratings were decreased after the first meal (P< 0.001). Comparing the first with the second meal, the macronutrient content changed: carbohydrate -26.9 En% in the CARB condition, protein -37.8 En% in the PROT condition. After the first meal in the CARB condition, wanting TRS was increased in the hypothalamus. After the first meal in the PROT condition, liking TRS was decreased in the putamen (P< 0.05). The change in energy intake from the first to the second meal was inversely related to the change in liking TRS in the striatum and hypothalamus in the CARB condition and positively related in the PROT condition (P< 0.05). In conclusion, wanting and liking TRS were affected differentially with a change in carbohydrate or protein intake, underscoring subsequent energy intake and shift in macronutrient composition.

Satiating Capacity and Post-Prandial Relationships between Appetite Parameters and Gut-Peptide Concentrations with Solid and Liquefied Carbohydrate

Background Differences in satiating capacity of liquid and solid meals are unclear. Objective Investigating appetite parameters, physiological measurements and within-subject relationships after consumption of a single macronutrient, subject-specific carbohydrate meal in liquefied versus solid form, controlled for energy density, weight and volume. Design In a cross-over design, ten male subjects (age = 21.1±3.9 y, BMI = 22.4±1.2 kg/m2) consumed a solid (CS, whole peaches +750 ml water) and liquefied carbohydrate (CL, peach blended in 500 ml water +250 ml water) lunch. Appetite profiles, insulin-, glucose- and ghrelin concentrations were measured over three hours. Post-prandial relationships between appetite and blood parameters were calculated using subject-specific regression analyses. Results Fullness ratings were higher in the CL (85±5 mm) compared to the CS condition (73±8 mm) at 20 min (p<0.03). Glucose concentrations peaked 20 to 30 min after the start of the lunch in the CL condition, and 30 to 40 min after start of the CS condition. Correspondingly, insulin concentrations were peaked at 20–30 min in the CL condition, and at 30–40 min in the CS condition. AUC or condition x time interactions were not different comparing the CL and the CS condition. Insulin was significantly higher in the CS compared to the CL condition 40 min after the start of the lunch (p<0.05). Fullness scores were significantly related to insulin concentrations but not to glucose concentrations; desire to eat scores were significantly associated with ghrelin concentrations in both, the CL and the CS condition. The relationship between fullness scores and glucose concentrations was not statistically significant. Conclusion Liquefied and solid carbohydrate meals do not differ in satiating capacity, supported by appetite profile and relevant blood parameters. Postprandially, fullness and desire to eat were associated with respectively insulin and ghrelin concentrations.