Kohlenhydrate in der Regulation von Hunger und Sättigung

Zusammenfassung

Die Regulation der Nahrungsaufnahme erfolgt im Zusammenspiel von Magen, Zentralnervensystem und Fettgewebe. Der Verzehr einer Mahlzeit führt zu einer Aktivierung von Sättigungssignalen, die innerhalb von 30 - 60 min ein Maximum erreichen und zur Unterbrechung der Nahrungsaufnahme führen. Während der anschließenden Stunden nimmt das Sättigungsgefühl ab, während das Hungergefühl wieder ansteigt. Die initiale Sättigung entsteht im Wesentlichen durch Füllung des Magens. Die daraus resultierenden Dehnungsreize werden über vagale Afferenzen in die übergeordneten Regulationszentren im Hypothalamus geleitet, wo sie zu einer Aktivierung anorektischer Neurotransmitter führen. Das Auftreten des Hungergefühls wird unter anderem durch den Wiederanstieg des gastralen Hormons Ghrelin aktiviert, das im Hypothalamus zur vermehrten Freisetzung orexigener Neurotransmitter beiträgt. Diese akute Regulation von Sättigung und Hunger wird durch das Volumen der Nahrung und ergänzend in geringem Maß durch den Nährstoffgehalt bestimmt. Der Energiegehalt der konsumierten Nahrung ist keine Regelgröße. Dementsprechend ist die Energieaufnahme stark abhängig von der Energiedichte der verzehrten Lebensmittel. Frühe Untersuchungen aus den 80er-Jahren haben Kohlenhydraten einen größeren Sättigungseffekt als Fett zugeschrieben, während Protein wiederum einen stärkeren Einfluss auf die Aktivierung von Sättigungssignalen als Kohlenhydrate haben soll. Diese Experimente haben die sättigende Wirkung der einzelnen Makronährstoffe auf der Basis isokalorischer Testmahlzeiten verglichen, was bedeutet, dass die Volumina kohlenhydrathaltiger Mahlzeiten im Vergleich zu fettreichen Mahlzeiten immer größer ausgefallen sind. Legt man als Endpunkt der Nahrungsaufnahme Sättigung zugrunde, so ist die verzehrte Nahrungsmenge unabhängig vom Makronährstoffgehalt identisch und die Energieaufnahme entspricht der Energiedichte. Insgesamt haben Kohlenhydrate keinen nährstoffspezifischen Effekt auf die akute Sättigung. Ausmaß und Dauer von Sättigung und Hunger sowie die nachfolgende Nahrungs- und Energieaufnahme werden durch Kohlenhydrate ebenfalls nicht nährstoffspezifisch beeinflusst. Die Daten über Zucker und Nahrungsaufnahme sind sehr kontrovers. Detailliertere Studien mit realistischen Zuckermengen sind dringend erforderlich.

Abstract

Food intake is regulated by a coordination of gastric, central nervous system and adipose tissue functions. Meal ingestion activates satiety signals within 30 - 60 minutes to a maximum which leads to an interruption of food intake. During the following hours satiety signals decrease while hunger sensations regain increasing activity. Initial activation of satiety is mainly due to the filling of the stomach with subsequent distension of the gastric wall. This leads to activation of afferent vagal fibers which in turn stimulate anorectic hypothalamic neurotransmitters. The recurrence of hunger sensations is at least in part due to the increase of the gastric hormone ghrelin which stimulates orexigenic hypothalamic neurotransmitters. This acute postprandial control of hunger and satiety is regulated primarly bei the ingested volume of the food with a minor contribution of the nutrient content. The energy content of ingested food has no acute effect on satiety wich means that energy intake is largely determined by the energy density of the food items. Studies in the 80ies have suggsted that carbohydrates are more satiating than fat, while protein is superior in this context compared to the other two macronutrients. These experiments have compared the individual macronutrients on an isocaloric basis, which means that ingested amounts of carbohydrates were greater than those of fat-rich food. Food intake on the basis of satiation and satiety has shown that consumption of the various macronutrients is related to volume so that a nutrient specific satiation does not exist for carbohydrates. The extent and duration of satiety as well as subsequent food and energy intake is regulated neither by nutrient-specific effects. The available data about the role of simple sugars in feeding regulation are a matter of debate and require more extensive studies considering more realistic amounts of sugar intake with adequate control experiments.

Schlüsselwörter

Sätigung - Hunger - Magen - Vagus - Fett - Eiweiß - Kohlenhydrate - Energiedichte - Hypothalamus

Key words

Satiety - hunger - stomach - vagus serve - fat - protein - carbohydrate - energy density - hypothalamus

Literatur

• 1 World Health Organisation .Obesity - preventing and managing the global epidemic. Report of a WHO consultation. WHO Technical Report Series 2000: 894
• 2 Deutsch J A, Young W G, Kalogern T J. The stomach signals satiety.  Science. 1978;  201 165-167
• 3 Janowitz H D, Grossmann M. Some factors affecting food intake of normal dogs and dogs with esophagostomy and gastric fistulas.  Am J Physiol. 1949;  159 143-148
• 4 Kraly F S, Smith G P. Combined pregastric and gastric stimulation by food is sufficient for normal meal size.  Physiol Behav. 1978;  21 405-408
• 5 Mook D. Oral and postingestional determinants of the intake of various solutions in rats with esophageal fistulas.  J Comp Physiol Psychol. 1963;  56 645-659
• 6 Young R C, Gibbs J, Antin J, Holt J, Smith G P. Absence of satiety during sham feeding in the rat.  J Comp Physiol Psychiol. 1974;  87 795-800
• 7 Gibbs J, Maddison S P, Rolls E T. Satiety role of the small intestine examined in sham-feeding rhesus monkeys.  J Comp Physiol Psychiol. 1981;  95 1003-1015
• 8 Schick R R, Schusdziarra V, Schröder B, Classen M. Effect of intraduodenal or intragastric nutrient infusion on food intake in humans.  Z Gastroenterol. 1991;  29 637-641
• 9 Geliebter A. Gastric distention and gastric capacity in relation to food intake in humans.  Physiol Behav. 1988;  44 665-668
• 10 Geliebter A. Effects of equicaloric loads of protein, fat, and carbohydrate on food intake in the rat and man.  Physiol Behav. 1979;  22 267-273
• 11 Welch I M, Saunders K, Read N W. Effect of ileal and intravenous infusions of fat emulsions on feeding and satiety in human volunteers.  Gastroenterology. 1985;  89 1293-1297
• 12 Welch I M, Sepple C P, Read N W. Comparsions of the effects on satiety and eating behaviour of infusion of lipid into the different regions of the small intestine.  Gut. 1988;  29 306-311
• 13 Hunt J N, Stubbs D F. The volume and energy content of meals as determinants of gastric emptying.  J Physiol (Lond.). 1975;  245 209-225
• 14 McHugh P R, Moran T H. Calories and gastric emptying: a regulatory capacity with implications for feeding.  Am J Physiol. 1979;  236 R254-R260
• 15 Schick R R, Schusdziarra V. Regulation of food intake. In: Ditschuneit H, Gries FA, Hauner H, Schusdziarra V, Wechsler JG (eds) Obesity in Europe 1993. London; John Libbey 1994: 335-348
• 16 Rolls B J, Castellanos V H, Halford J C, Kilara A, Panyam D, Pelkman C L, Smith G P, Thorwart M L. Volume of food consumed affects satiety in men.  Am J Clin Nutr. 1998;  67 1170-1177
• 17 Rolls B J, Bell E A. Intake of fat and carbohydrate: role of energy density.  Eur J Clin Nutr. 1999;  53, Suppl 1 S166-S173
• 18 Rolls B J, Hetherington M, Burley V J. The specificity of satiety: the influence of foods of different macronutrient content on the development of satiety.  Physiol Behav. 1988;  43 145-153
• 19 Rolls B J, Kim S, McNelis A L, Fischman M W, Foltin R W, Moran T H. Time course of effects of preloads high in fat or carbohydrate on food intake and hunger ratings in humans.  Am J Physiol. 1991;  260 R756-R763
• 20 Porikos K P, Booth G, Itallie T B Van. Effect of covert nutritive dilution on the spontaneous food intake of obese individuals: a pilot study.  Am J Clin Nutr. 1977;  30 1638-1644
• 21 Lissner L, Levitsky D A, Strupp B J, Kackwarf H, Roe D A. Dietary fat and the regulation of energy intake in human subjects.  Am J Clin Nutr. 1987;  46 886-892
• 22 Hill A J, Blundell J E. Macronutrients and satiety: the effects of a high-protein or high carbohydrate meal on subjective motivation to eat and food preferences.  Nutr Behaviour. 1986;  3 133-144
• 23 Booth D A, Chase A, Campbell A T. Relative effectiveness of protein in the late stages of appetite suppression in man.  Physiol Behav. 1970;  5 1299-1302
• 24 Cotton J R, Burley V J, Blundell J E. High fat foods and hyperphagia: no feedback for the control of appetite.  Appetite. 1993;  21 169
• 25 Blundell J E, Burley V J, Cotton J R, Lawton C L. Dietary fat and the control of energy intake: evaluating the effects of fat on meal size and post meal satiety.  Am J Clin Nutr. 1993;  57 772S-778S
• 26 Erdmann J, Töpsch R, Lippl F, Gussmann P, Schusdziarra V. Postprandial response of plasma ghrelin levels to various test meals in relation to food intake, plasma insulin and glucose.  J Clin Endocrinol Metab. 2004;  89 3048-3054
• 27 Holt S H, Miller J C, Petocz P, Farmakalidis E. A satiety index of common foods.  Eur J Clin Nutr. 1995;  49 675-690
• 28 Marmonier C, Chapelot D, Fantino M, Louis-Sylvestre J. Snacks consumed in a nonhungry state have poor satiating efficiency: influence of snack composition on substrate utilization and hunger.  Am J Clin Nutr. 2002;  76 518-528
• 29 Graaf C de, Hulshof T, Weststrate J A, Jas P. Short-term effects of different amounts of protein, fats, and carbohydrates on satiety.  Am J Clin Nutr. 1992;  55 33-38
• 30 Kral T V, Roe L S, Rolls B J. Combined effects of energy density and portion size on energy intake in women.  Am J Clin Nutr. 2004;  79 962-968
• 31 Spiegel T A. Caloric regulation of food intake in man.  J Comp Physiol Psychiol. 1973;  84, 1 24-37
• 32 Kral T VE, Rolls B J. Energy density and portion size: their independent and combined effects on energy intake.  Physiol Behav. 2004;  82 131-138
• 33 Gray R W, French S J, Robinson T M, Yeomans M R. Dissociation of the effects of preload volume and energy content on subjective appetite and food intake.  Physiol Behav. 2002;  76 57-64
• 34 Rolls B J, Roe L S, Meengs J S. Salad and Satiety: Energy density and portion size of a first-course salad affect energy intake at lunch.  J Am Diet Aoc. 2004;  104 1570-1576
• 35 Schick R R, Yaksh T L, Roddy D R, Go V LW. Release of hypothalamic cholecystokinin in cats: effects of nutrient and volume loading.  Am J Physiol. 1989;  256 R248-R254
• 36 Gonzalez M F, Deutsch J A. Vagotomy abolishes cues of satiety produced by gastric distension.  Science. 1981;  212 1283-1284
• 37 Davis J D, Gallagher R J, Ladove R F. Food intake controlled by a blood factor.  Science. 1967;  157 1247-1248
• 38 Davis J D, Gallagher R J, Ladove R F, Turausky A J. Inhibition of food intake by a humoral factor.  J Comp Physiol Psychol. 1969;  67 407-414
• 39 Koopmans H S. A stomach hormone that inhibits food intake.  J Auton Nerv System. 1983;  9 157-171
• 40 Schick R R, Schusdziarra V, Mössner J, Neuberger J, Schröder B, Segmüller R, Maier V, Classen M. Effect of CCK on food intake in man: physiological or pharmacological effect?.  Z Gastroenterol. 1991;  29 53-58
• 41 Schusdziarra V, Lawecki J, Ditschuneit H H, Lukas B, Maier V, Pfeiffer E F. Effect of low-dose somatostatin infusion on pancreatic and gastric endocrine function in lean and obese nondiabetic human subjects.  Diabetes. 1985;  34 595-601
• 42 Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K. Ghrelin is a growth-hormone-releasing acylated peptide from stomach.  Nature. 1999;  402 656-660
• 43 Tschop M, Smiley D L, Heiman M L. Ghrelin induces adiposity in rodents.  Nature. 2000;  407 908-913
• 44 Tschop M, Wawarta R, Riepl R L, Friedrich S, Bidlingmaier M, Landgraf R, Folwaczny C. Post-prandial decrease of circulating human ghrelin levels.  J Endocrinol Invest. 2001;  24 RC19-RC21
• 45 Cummings D E, Purnell J Q, Frayo R S, Schmidova K, Wisse B E, Weigle D S. A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans.  Diabetes. 2001;  50 1714-1719
• 46 Cummings D E, Frayo R S, Marmonier C, Aubert R, Chapelot D. Plasma ghrelin levels and hunger scores in humans initiating meals voluntarily without time- and food-related cues.  Am J Physiol Endocrinol Metab. 2004;  287 E297-E304
• 47 Blom W AM, Stafleu A, Graaf C de, Kok F J, Schaafsma G, Hendriks H F. Ghrelin reponses to carbohydrate-enriched breakfast is related to insulin.  Am J Clin Nutr. 2005;  81 367-375
• 48 Monteleone P, Bencivenga R, Longobardi N, Serritella C, Maj M. Differential responses of circulating ghrelin to high-fat or high-carbohydrate meal in healthy women.  J Clin Endocrinol Metab. 2003;  88 5510-5514
• 49 Flanagan D E, Evans M L, Monsod T P, Rife F, Heptulla R A, Tamborlane W V, Sherwin R S. The influence of insulin on circulating ghrelin.  Am J Physiol Endocrinol Metab. 2003;  284 E313-E316
• 50 Djurhuus C B, Hansen T K, Gravholt C, Orskov L, Hosoda H, Kangawa K, Jorgensen J O, Holst J J, Schmitz O. Circulating levels of ghrelin and GLP-1 are inversely related during glucose ingestion.  Horm Metab Res. 2002;  34 411-413
• 51 Lippl F, Kircher F, Erdmann J, Allescher H D, Schusdziarra V. Effect of GIP, GLP-1, insulin and gastrin on ghrelin release in the isolated rat stomach.  Regul Pept. 2004;  119 93-98
• 52 Mohlig M, Spranger J, Otto B, Ristow M, Tschop M, Pi-Sunyer F. Euglycemic hyperinsulinemia, but not lipid infusion decreases circulating ghrelin levels in humans.  J Endocrinol Invest. 2002;  25 RC36-RC38
• 53 Murdolo G, Lucidi P, Di L C, Parlanti N, De C A, Fatone C, Fanelli C G, Bolli G B, Santeusanio F, De F P. Insulin is required forprandial ghrelin suppression in humans.  Diabetes. 2003;  52 2923-2927
• 54 Saad M F, Bernaba B, Hwu C M, Jinagouda S, Fahmi S, Kogosov E, Boyadjian R. Insulin regulates plasma ghrelin concentration.  J Clin Endocrinol Metab. 2002;  87 3997-4000
• 55 Kamegai J, Tamura H, Shimizu S, Ishii S, Sugihara H, Oikawa S. Effects of insulin, leptin, and glucagon on ghrelin secretion from isolated perfused rat stomach.  Regul Pept. 2004;  119 77-81
• 56 Kalra S, Dube M G, Pu S, Xu B, Horvath T L, Kalra P S. Interacting appetite-regulating pathways in the hypothalamic regulation of body weight.  Endocrine Rev. 1999;  20 68-100
• 57 Schwartz M W, Woods S C, Porte Jr D, Seeley R J, Baskin D G. Central nervous system control of food intake.  Nature. 2000;  404 661-671
• 58 Morley J E. Neuropeptide regulations of appetite and weight.  Endocr Rev. 1987;  8 256-287
• 59 Schusdziarra V, Zimmermann J P, Schick R R. Importance of orexigenic counter-regulation for multiple targeted feeding inhibition.  Obesity Research. 2004;  12 627
• 60 Considine R V, Sinha M K, Heiman M L, Kriauciunas A, Stephens T W, Nyce M R, Ohannesian J P, Marco C C, McKee L J, Bauer T L. Serum immunoreactive leptin concentrations in normal weight and obese humans.  N Engl J Med. 1996;  334 292-295
• 61 Trayhurn P, Hoggard N, Mercer J G, Rayner D V. Leptin: fundamental aspects.  Int J Obes Relat Metab Disord. 1999;  23 (Suppl 1) 22-28
• 62 Lippl F, Erdmann J, Atmatzidis S, Schusdziarra V. Direct effect of leptin on gastric ghrelin secretion.  Horm Metab Res. 2005;  37 123-125
• 63 Erdmann J, Lippl F, Wagenpfeil S, Schusdziarra V. Differential association of basal and postprandial plasma ghrelin with leptin, insulin, and type 2 diabetes.  Diabetes. 2005;  54 1371-1378
• 64 Stratum P van, Lussenburg R N, Wezel L A van, Vergroesen A J, Cremer H D. The effect of dietary carbohydrate: fat ratio on energy intake by adult women.  Am J Clin Nutr. 1978;  31 206-212
• 65 Stubbs R J, Wyck M Van, Johnson A M, Harbron C G. Breakfast high in protein, fat or carbohydrate: effect on within-day appetite and energy balance.  Eur J Clin Nutr. 1996;  50 409-417
• 66 Porrini M, Crovetti R, Testolin G, Silva S. Evaluation of satiety sensations and food intake after different preloads.  Appetite. 1995;  25 17-30
• 67 Cecil J E, Castiglione K, French S, Francis S, Francis J, Read N W. Effects of intragastric infusions of fat and carbohydrate on appetite ratings and food intake from a test meal.  Appetite. 1998;  30 65-77
• 68 Shide D J, Caballero B, Reidelberger R, Rolls B J. Accurate energy compensation for intragastric and oral nutrients in lean males.  Am J Clin Nutr. 1995;  61 754-764
• 69 Himaya A, Fantino M, Antoine J M, Brondel L, Louis-Sylvestre J. Satiety power of dietary fat: a new appraisal.  Am J Clin Nutr. 1997;  65 1410-1418
• 70 Melanson K J, Westerterp M S, Saris W HM, Campfield A. Meal initiation in humans isolated from time cues: role of plasma glucose, macronutrient ingestion and dietary restraint.  Int J Obes. 1997;  21 S77
• 71 Vozzo R, Wittert G, Cocchiaro C, Tan W C, Mudge J, Fraser R, Chapman I. Similar effects of foods high in protein, carbohydrate and fat on subsequent spontaneous food intake in healthy individuals.  Appetite. 2003;  40 101-107
• 72 Latner J D, Schwartz M. The effects of a high-carbohydrate, high-protein or balanced lunch upon later food intake and hunger ratings.  Appetite. 1999;  33 119-128
• 73 Poppitt S D, McCormack D, Buffenstein R. Short-term effects of macronutrient preloads on appetite and energy intake in lean women.  Physiol Behav. 1998;  64 279-285
• 74 Schusdziarra V, Dangel G, Klier M, Henrichs I, Pfeiffer E F. Effect of solid and liquid carbohydrates upon postprandial pancreatic endocrine function.  J Clin Endocrinol Metab. 1981;  53 16-20
• 75 Spitzer L, Rodin J. Effects of fructose and glucose preloads on subsequent food intake.  Appetite. 1987;  8 135-145
• 76 Rayner C K, Park H S, Wishart J M, Kong M, Doran S M, Horowitz M. Effects of intraduodenal glucose and fructose on antropyloric motility and appetite in healthy humans.  Am J Physiol. 2000;  278 R360-R366
• 77 Anderson G H, Catherine N LA, Woodend D M, Wolever T MS. Inverse association between the effect of carbohydrates on blood glucose and subsequent short-term food intake in young men.  Am J Clin Nutr. 2002;  76 1023-1030
• 78 Kong M F, Chapman I, Goble E, Wishart J, Wittert G, Morris H, Horowitz M. Effects of oral fructose and glucose on plasma GLP-1 and appetite in normal subjects.  Peptide. 1999;  20 545-551
• 79 Rodin J. Effects of pure sugar vs. mixed starch fructose loads on food intake.  Appetite. 1991;  17 213-219
• 80 Rodin J, Reed D, Jamner L. Metabolic effects of fructose and glucose: implications for food intake.  Am J Clin Nutr. 1988;  47 683-689
• 81 Tordorff M G, Alleva A M. Effect of drinking soda sweetened with aspartame or high-fructose corn syrup on food intake and body weight.  Am J Clin Nutr. 1990;  51 963-969
• 82 Green S M, Burley V J, Blundell J E. Effect of fat- and sucrose-containing foods on the size of eating episodes and energy intake in lean males: potential for causing overconsumption.  Europ J Clin Nutr. 1994;  48 547-555
• 83 Ball S D, Keller K R, Moyer-Mileur L J, Ding Y W, Donaldson D, Jackson W D. Prolongation of satiety after low versus moderately high glycemic index meals in obese adolescent.  Pediatr. 2003;  3 Vol 111 488
• 84 Pasman W J, Blokdijk V M, Bertina F M, Hopman W PM, Hendriks H FJ. Effect of two breakfasts, different in carbohydrate composition, on hunger and satiety and mood in healthy men.  Int J Obesity. 2003;  27 663-668