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1-Physiology of feedings,
appetite & hunger
Prepared
By;
Dr. Siham M.O. Gritly
1Dr. Siham Gritly
Pleasure of eating
2Dr. Siham Gritly
Hypothalamus and other glands
3Dr. Siham Gritly
glossary
• appetite: the integrated response to the sight,
smell, thought, or taste of food that initiates or
delays eating.
• hunger: the painful sensation caused by a lack
of food that initiates food-seeking behavior
• hypothalamus: a brain center that controls
activities such as maintenance of water balance,
regulation of body temperature, and control of
appetite.
4Dr. Siham Gritly
• satiation: the feeling of satisfaction; and
fullness that occurs during a meal and stop
eating. Satiation determines how much food is
consumed during a meal.
• satiety: the feeling of fullness and
satisfaction that occurs after a meal and
inhibits eating until the next meal. Satiety
determines how much time passes between
meals.
5Dr. Siham Gritly
• binge-eating disorder: an eating disorder with
criteria similar to those of bulimia nervosa,
excluding purging or other compensatory
behaviors.
• Bulimia nervosa: an eating disorder
characterized by repeated episodes of binge eating
usually followed by self induced vomiting, misuse
of laxatives or diuretics, fasting, or excessive
exercise.
6Dr. Siham Gritly
Physiology of feeding
• Feeding - the placement of food in the mouth,
and the treatment of food in the oral cavity
• mastication
• Swallowing –
• The swallowing process is commonly divided
into oral, pharyngeal, and esophageal stages
according to the location of the bolus.
• Deglutition - process of swallowing
Dr. Siham Gritly 7
8Dr. Siham Gritly
Physiology of appetite and hunger
Regulation of food intake
• Ingestion of food is determined by the intrinsic
desire of the person for food, this is called
hunger
• hunger is the physiological response to a need for
food caused by nerve signals and chemical
messengers originating and acting in the brain,
primarily in the hypothalamus.
• Hormones of hypothalamus promotes thoughts of
eating
• The type of food the person preferred is
determined by appetite
9Dr. Siham Gritly
• when there are no food for many hours, the
stomach undergo intense rhythmic contraction
called hunger contractions
• These contraction cause a tight feeling in the
stomach and cause pain known as hunger
pangs
• Hungry person also become more tense and
restless and often has a strange feeling in his
entire body
10Dr. Siham Gritly
• After a meal Satiety is developed; this
means the feeling of fullness and satisfaction
that occurs after a meal and inhibits eating
until the next meal. Satiety determines how
much time passes between meals
• the feeling of satiety continues to suppress
hunger and allows a person to not eat again for
a while.
11Dr. Siham Gritly
• During the course of a meal, as food enters the
GI tract and hunger diminishes, satiation
develops “stop eating,” .
• As receptors in the stomach stretch and
hormones such as cholecystokinin become
active, the person begins to feel full. The
response: satiation occurs and the person
stops eating
12Dr. Siham Gritly
Factors influences hunger
• 1-Physiological influences of hunger
• Empty stomach
• Gastric contractions
• Absence of nutrients in small intestine GI
• Hormones such as Ghrelin that produced by
fundus of the human stomach and cells of the
pancreas and Leptin release from adipose
tissue
13Dr. Siham Gritly
• Endorphins (the brain’s pleasure chemicals)
• Endorphins are neurotransmitters produced by
pituitary gland and hypothalamus
• enhancing the desire for food by the smell,
sight, or taste of foods,
• Dopamine is classified as a catecholamine (a
class of molecules that serve as
neurotransmitters and hormones).
14Dr. Siham Gritly
Ellie Whitney and Sharon Rady Rolfes; Ref; Under standing Nutrition, Twelfth Edition. 2011, 2008
Wadsworth, Cengage Learning
• 2-Sensory influences
• Seek food and start meal
• Thought, sight, smell,
sound, taste of food
Endorphins
15Dr. Siham Gritly
• 3-Cognitive influences
• Keep eating
• Presence of others,
social stimulation
• Perception of hunger,
awareness of fullness
• Favorite foods, foods with special meanings
• Time of day
• Abundance of available food
16Dr. Siham Gritly
• 4-Postingestive influences (after food enters the
digestive tract)
• Satiation: End meal
• Food in stomach activates stretch receptors
• Nutrients in small intestine draw out hormones (for
example, fat draw out cholecystokinin CCK, which
slows gastric emptying)
• cholecystokinin, receptor regulates satiety and the
release of beta-endorphin and dopamine.
17Dr. Siham Gritly
• 5-Postabsorptive influences (after nutrients
enter the blood)
• Satiety: Several hours later
• Nutrients in the blood signal the brain (via
nerves and hormones) about their availability,
use, and storage
• As nutrients decrease, satiety diminishes
• Hunger develops
18Dr. Siham Gritly
Neural Centers for regulation of food intake
hypothalamus.
• Most hormones are secreted from the glands that
produce them under the influence of stimulating
hormones from the hypothalamus.
• The hypothalamus is a part of the brain involved
in the control of involuntary activity in the body;
contains many centers of neural control such as
temperature, hunger, appetite and thirst
• These hormones in turn are activated by releasing
hormones from the pituitary gland.
19Dr. Siham Gritly
Hypothalamus The part of the brain that lies below the
thalamus. contains many centers of neural control such
as temperature, hunger, appetite and thirst
20Dr. Siham Gritly
Lateral hypothalamus & Ventromedial nuclei of
the hypothalamus
• Hunger and satiety centers; hypothalamus gland
responsible of the hunger and satiety
• Lateral hypothalamus stimulation cases a person
to eat greedily or hungrily (hunger or feeding
center neurotransmitters Endorphins )
• Ventromedial nuclei of the hypothalamus causes
the sensation of food rejection or complete satiety
(satiety center neurotransmitters )
21Dr. Siham Gritly
• Destructive lesions or trauma of the Lateral
hypothalamus causes complete lack of desire
for food
• While destructive lesions of the Ventromedial
nuclei of the hypothalamus cause; voracious
and the person continued eating until it
become extremely obese (overactive)
22Dr. Siham Gritly
Dr. Siham Gritly 23
Other Neural Center that enter into feeding
• Another area of the hypothalamus Mammillary
bodies activate feeding reflexes such as licking
the lips and swallowing
• another area higher centers than hypothalamus
control feeding mainly appetite include
amygdala and cortical areas of the limbic
system which is coupled with the
hypothalamus
24Dr. Siham Gritly
Human brain
amygdala
25Dr. Siham Gritly
• Destructive lesions in the amygdala increase
feeding while other inhibit feeding (choice of
food loses the mechanism of appetite control and
quality of food
• The cortical regions of the limbic system have
areas when stimulated can increase or decrease
feeding activities
• It is believed that theses centers with amygdala
and hypothalamus responsible of the quality of
food that is eaten
26Dr. Siham Gritly
Limbic system
27Dr. Siham Gritly
Factors that regulate food intake
• Regulation of food intake can be divided into;
• 1-nutritional regulation (metabolic
regulation); concerned with the maintenance
of normal quantities of nutrient stores in the
body
• Factors that control the degree of activity of
feeding center of the hypothalamus are;
28Dr. Siham Gritly
• A) Decrease in blood glucose concentration is
associated with the development of hunger
(the glucostatic regulation theory of hunger
and feeding regulation)
29Dr. Siham Gritly
• B) the effect of blood amino acid
concentration on feeding; increase
concentration of amino acid in the blood
reduces feeding activity
30Dr. Siham Gritly
• C) effect of fat metabolism on feeding (long
term feeding); as the quantity of adipose tissue
increases the rate of feeding decrease this is
caused by a negative feedback regulation
31Dr. Siham Gritly
• D) body temperature and food intake
interrelationship; cold person tends to overeat
• When exposed to heat tends to under eat
• This relationship is due to interaction within
the hypothalamus between the temperature
regulation system (hypothalamic thermostat)
and the food regulating system (Lateral
hypothalamus & Ventromedial nuclei of the
hypothalamus)
32Dr. Siham Gritly
• The temp of the body is regulated by nervous
feedback mechanisms these mechanisms
operate through temperature regulating centers
in the hypothalamus
33Dr. Siham Gritly
• 2-alimentray regulation, non-metabolic
regulation; Habit, Gastrointestinal filling
34Dr. Siham Gritly
Hormonal control of feeding, appetite and
hunger
• Hormones that play an important role in controlling
feeding pattern;
• leptin (identified in 1994), Leptin release from
adipose tissue is enhanced by insulin
• Obese persons are found with high circulating leptin
levels but without response to leptin in the arcuate
nucleus (aggregation of neurons in the hypothalamus)
• Neurons are nerve cells that receive and send
electrical signals over long distances within the body
35Dr. Siham Gritly
• Acts on hypothalamus to decrease food
intake and increase energy consumption
• Abnormalities in leptin signaling appear
to be correlated to overeating and obesity
36Dr. Siham Gritly
• ghrelin (identified in 1999), called "hunger
hormone," is produced in the stomach and brain,
induces food intake, and operates through a brain
region that controls cravings for food and other
energy sources
• ghrelin is peptide hormone secreted by gastric
mucosa, on an empty stomach and during fasting
this hormones increase, and level fall rapidly after
meal
• work together with leptin to balance the states of
hunger and satiety
37Dr. Siham Gritly
• Insulin release from pancreatic islets cells
follows intake of both carbohydrates and
proteins.
• Insulin increase appetite by inhibiting
stimulatory neurons and by activating
releasing neurons.
• Resistance to insulin is very often associated
with obesity and the loss of insulin's regulation
of metabolism as seen in diabetes type 2.
Dr. Siham Gritly 38
• Insulin increase appetite by inhibiting
stimulatory neurons and by activating
releasing neurons.
• Resistance to insulin is very often associated
with obesity and the loss of insulin's regulation
of metabolism as seen in diabetes type 2.
Dr. Siham Gritly 39
• orexin , Also called Hypocretins –
neurotransmitter hormones that increase food
intake,
• Synthesized in neurons located in the lateral
Hypothalamus
• orexin are inhibited by leptin and activated by
Ghrelin and Hypoglycemia
40Dr. Siham Gritly
The healthy eating cycle
41Dr. Siham Gritly
Eating disorder
• Both men and women are susceptible to eating
disorders, although a greater percent of eating
disorders are found in women.
• The three most common eating disorders found
are:
• 1-Anorexia Nervosa,
• 2-Bulimia,
• 3-Compulsive Exercise
42Dr. Siham Gritly
Warning Signs of an Eating Disorder
• Preoccupation (worry) with food and weight
• Repeatedly expressed concerns about being fat
• Increasing criticism of one's body
• Frequent eating alone
• Use of laxatives
• Trips to the bathroom during or following meals
• Continuous drinking of diet soda or water
• Compulsive, excessive exercise
• Complaining of always being cold
43Dr. Siham Gritly
Anorexia nervosa
• Anorexia nervosa: an eating disorder
characterized by a refusal to maintain a
minimally normal body weight and a distortion
in perception of body
shape and weight
( BMI ≤ 17.5)
Excessive concern
with weight or weight gain
44Dr. Siham Gritly
Health Complications from Anorexia
• Anorexia poses life-threatening complications
including:
• malnutrition
• Abnormal Heart Rhythms
• low blood pressure
• Dehydration
• electrolyte imbalance
• amenorrhea (interruption of the menstrual cycle)
• osteoporosis (decreased bone mass)
• sleep disorder
45Dr. Siham Gritly
Signs and Symptoms of Anorexia
• Excessive weight loss
• Always thinking about food, calories, and
body weight
• Wearing layered clothing
• Mood swings or depression
• Inappropriate use of laxatives, or diuretics in
order to lose weight
• Avoiding activities that involve food
46Dr. Siham Gritly
Diet Strategies for Anorexia nervosa
• Appropriate diet is vital to recovery and must
be according to each individual’s needs.
• initial food intake may be only 1200 kcalories
per day.
• A variety of foods and foods with a higher
energy density help to ensure greater success.
• As eating becomes more comfortable, a
person with aneroxia should gradually increase
energy intake.
47Dr. Siham Gritly
Bulimia
• Bulimia is one such eating disorder
that describes a cycle of binging
and purging.
• Bulimia can begin when restrictive diets fail, or
the feeling of hunger associated with reduced
calorie intake leads to reduce eating.
• Like the person with anorexia nervosa, the person
with bulimia nervosa spends much time thinking
about body weight and food
48Dr. Siham Gritly
• Bulimia are multi-factorial, with psycho-
developmental, socio-cultural, and genetic
contribution factors
49Dr. Siham Gritly
Bulimia is of Two types:
• 1-Purging type: The person
regularly engages in self-induced
vomiting or the misuse of laxatives,
diuretics.
• 2-Nonpurging type: The person uses other
compensatory behaviors, such as fasting or
excessive exercise, but does not regularly
engage in self-induced vomiting or the misuse
of laxatives, diuretics,
50Dr. Siham Gritly
The Binge-Purge Cycle has no beginning or end, Bulimia is
an addictive cycle on both physical and emotional levels.,
this sequence involves a self-sustaining series of events and
edictable response
51Dr. Siham Gritly
Signs and Symptoms of Bulimia
• Excessive weight loss
• Visiting the bathroom after meals
• Depression
• Excessive dieting, followed by binge eating
• Always criticizing one's body
52Dr. Siham Gritly
Diet Strategies for Combating
Bulimia Nervosa
• Nutrition Principles
• Eat a well-balanced diet and regularly timed
meals consisting of a variety of foods.
• Include raw vegetables, salad, or raw fruit at
meals to prolong eating times.
• Choose whole-grain, high-fiber breads, pasta,
rice, and cereals to increase bulk.
• Consume adequate fluid, particularly water
53Dr. Siham Gritly
Compulsive Exerciser
• Some athletes suffer from a slight form of
eating disorder that results in excessive and
addictive exercise in an attempt to control or
lose weight.
• Addictive exercisers may use extreme training
as one way to expend calories and maintain or
lose body weight in the attempt to improve
performance or achieve a desired body shape
or weight.
54Dr. Siham Gritly
Warning Signs of a Compulsive Exerciser
• suffer symptoms of overtraining syndrome.
• Force to exercise even if you don't feel well.
• almost never exercise for fun
• Every time you exercise, you go as fast or hard as
you can.
• experience severe stress and anxiety if he or she
miss a workout.
• You miss family obligations because you have to
exercise.
55Dr. Siham Gritly
• Compulsive exercise is as dangerous as food
restriction, binging and purging and the use of
diet pills and laxatives.
• Compulsive exercise can quickly lead to more
serious types of eating disorders including
anorexia and bulimia as well as a number of
serious physical dangers including kidney
failure, heart attack and death.
56Dr. Siham Gritly
Unspecified Eating Disorders,
Binge-Eating Disorder
• Binge-Eating Disorder
• People with binge eating disorder consume less
during a binge, rarely purge, and exert less
restraint (self control) during times of dieting
• Such an eating disorder does not meet the criteria
for either anorexia nervosa or bulimia nervosa
• such compulsive overeating is a problem and
occurs in people of normal weight as well as those
who are severely overweight.
57Dr. Siham Gritly
• Obesity alone is not an eating disorder
• There are also differences between obese binge
eaters and obese people who do not binge.
Those with the binge-eating disorder report
higher rates of, disgust about body size,
depression, and anxiety.
• Obese binge eaters tend to consume more
kcalories and more dessert
58Dr. Siham Gritly
• Sareen Gropper, Jack Smith and James Groff, Advanced Nutrition
and Human Metabolism, fifth ed. WADSWORTH
• Melvin H Williams 2010; Nutrition for Health, Fitness and Sport. 9th
ed, McGraw Hill
• Heymsfield, SB.; Baumgartner N.; Richard and Sheau-Fang P. 1999.
Modern Nutrition in Health and Disease; Shils E Maurice,
Olson A. James, Shike Moshe and Ross A. Catharine eds. 9th
edition
• Guyton, C. Arthur. 1985. Textbook of Medical Physiology. 6th
edition, W.B. Company
59Dr. Siham Gritly

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1 physiology of feedimg, appetite & hunger

  • 1. 1-Physiology of feedings, appetite & hunger Prepared By; Dr. Siham M.O. Gritly 1Dr. Siham Gritly
  • 2. Pleasure of eating 2Dr. Siham Gritly
  • 3. Hypothalamus and other glands 3Dr. Siham Gritly
  • 4. glossary • appetite: the integrated response to the sight, smell, thought, or taste of food that initiates or delays eating. • hunger: the painful sensation caused by a lack of food that initiates food-seeking behavior • hypothalamus: a brain center that controls activities such as maintenance of water balance, regulation of body temperature, and control of appetite. 4Dr. Siham Gritly
  • 5. • satiation: the feeling of satisfaction; and fullness that occurs during a meal and stop eating. Satiation determines how much food is consumed during a meal. • satiety: the feeling of fullness and satisfaction that occurs after a meal and inhibits eating until the next meal. Satiety determines how much time passes between meals. 5Dr. Siham Gritly
  • 6. • binge-eating disorder: an eating disorder with criteria similar to those of bulimia nervosa, excluding purging or other compensatory behaviors. • Bulimia nervosa: an eating disorder characterized by repeated episodes of binge eating usually followed by self induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise. 6Dr. Siham Gritly
  • 7. Physiology of feeding • Feeding - the placement of food in the mouth, and the treatment of food in the oral cavity • mastication • Swallowing – • The swallowing process is commonly divided into oral, pharyngeal, and esophageal stages according to the location of the bolus. • Deglutition - process of swallowing Dr. Siham Gritly 7
  • 9. Physiology of appetite and hunger Regulation of food intake • Ingestion of food is determined by the intrinsic desire of the person for food, this is called hunger • hunger is the physiological response to a need for food caused by nerve signals and chemical messengers originating and acting in the brain, primarily in the hypothalamus. • Hormones of hypothalamus promotes thoughts of eating • The type of food the person preferred is determined by appetite 9Dr. Siham Gritly
  • 10. • when there are no food for many hours, the stomach undergo intense rhythmic contraction called hunger contractions • These contraction cause a tight feeling in the stomach and cause pain known as hunger pangs • Hungry person also become more tense and restless and often has a strange feeling in his entire body 10Dr. Siham Gritly
  • 11. • After a meal Satiety is developed; this means the feeling of fullness and satisfaction that occurs after a meal and inhibits eating until the next meal. Satiety determines how much time passes between meals • the feeling of satiety continues to suppress hunger and allows a person to not eat again for a while. 11Dr. Siham Gritly
  • 12. • During the course of a meal, as food enters the GI tract and hunger diminishes, satiation develops “stop eating,” . • As receptors in the stomach stretch and hormones such as cholecystokinin become active, the person begins to feel full. The response: satiation occurs and the person stops eating 12Dr. Siham Gritly
  • 13. Factors influences hunger • 1-Physiological influences of hunger • Empty stomach • Gastric contractions • Absence of nutrients in small intestine GI • Hormones such as Ghrelin that produced by fundus of the human stomach and cells of the pancreas and Leptin release from adipose tissue 13Dr. Siham Gritly
  • 14. • Endorphins (the brain’s pleasure chemicals) • Endorphins are neurotransmitters produced by pituitary gland and hypothalamus • enhancing the desire for food by the smell, sight, or taste of foods, • Dopamine is classified as a catecholamine (a class of molecules that serve as neurotransmitters and hormones). 14Dr. Siham Gritly
  • 15. Ellie Whitney and Sharon Rady Rolfes; Ref; Under standing Nutrition, Twelfth Edition. 2011, 2008 Wadsworth, Cengage Learning • 2-Sensory influences • Seek food and start meal • Thought, sight, smell, sound, taste of food Endorphins 15Dr. Siham Gritly
  • 16. • 3-Cognitive influences • Keep eating • Presence of others, social stimulation • Perception of hunger, awareness of fullness • Favorite foods, foods with special meanings • Time of day • Abundance of available food 16Dr. Siham Gritly
  • 17. • 4-Postingestive influences (after food enters the digestive tract) • Satiation: End meal • Food in stomach activates stretch receptors • Nutrients in small intestine draw out hormones (for example, fat draw out cholecystokinin CCK, which slows gastric emptying) • cholecystokinin, receptor regulates satiety and the release of beta-endorphin and dopamine. 17Dr. Siham Gritly
  • 18. • 5-Postabsorptive influences (after nutrients enter the blood) • Satiety: Several hours later • Nutrients in the blood signal the brain (via nerves and hormones) about their availability, use, and storage • As nutrients decrease, satiety diminishes • Hunger develops 18Dr. Siham Gritly
  • 19. Neural Centers for regulation of food intake hypothalamus. • Most hormones are secreted from the glands that produce them under the influence of stimulating hormones from the hypothalamus. • The hypothalamus is a part of the brain involved in the control of involuntary activity in the body; contains many centers of neural control such as temperature, hunger, appetite and thirst • These hormones in turn are activated by releasing hormones from the pituitary gland. 19Dr. Siham Gritly
  • 20. Hypothalamus The part of the brain that lies below the thalamus. contains many centers of neural control such as temperature, hunger, appetite and thirst 20Dr. Siham Gritly
  • 21. Lateral hypothalamus & Ventromedial nuclei of the hypothalamus • Hunger and satiety centers; hypothalamus gland responsible of the hunger and satiety • Lateral hypothalamus stimulation cases a person to eat greedily or hungrily (hunger or feeding center neurotransmitters Endorphins ) • Ventromedial nuclei of the hypothalamus causes the sensation of food rejection or complete satiety (satiety center neurotransmitters ) 21Dr. Siham Gritly
  • 22. • Destructive lesions or trauma of the Lateral hypothalamus causes complete lack of desire for food • While destructive lesions of the Ventromedial nuclei of the hypothalamus cause; voracious and the person continued eating until it become extremely obese (overactive) 22Dr. Siham Gritly
  • 24. Other Neural Center that enter into feeding • Another area of the hypothalamus Mammillary bodies activate feeding reflexes such as licking the lips and swallowing • another area higher centers than hypothalamus control feeding mainly appetite include amygdala and cortical areas of the limbic system which is coupled with the hypothalamus 24Dr. Siham Gritly
  • 26. • Destructive lesions in the amygdala increase feeding while other inhibit feeding (choice of food loses the mechanism of appetite control and quality of food • The cortical regions of the limbic system have areas when stimulated can increase or decrease feeding activities • It is believed that theses centers with amygdala and hypothalamus responsible of the quality of food that is eaten 26Dr. Siham Gritly
  • 28. Factors that regulate food intake • Regulation of food intake can be divided into; • 1-nutritional regulation (metabolic regulation); concerned with the maintenance of normal quantities of nutrient stores in the body • Factors that control the degree of activity of feeding center of the hypothalamus are; 28Dr. Siham Gritly
  • 29. • A) Decrease in blood glucose concentration is associated with the development of hunger (the glucostatic regulation theory of hunger and feeding regulation) 29Dr. Siham Gritly
  • 30. • B) the effect of blood amino acid concentration on feeding; increase concentration of amino acid in the blood reduces feeding activity 30Dr. Siham Gritly
  • 31. • C) effect of fat metabolism on feeding (long term feeding); as the quantity of adipose tissue increases the rate of feeding decrease this is caused by a negative feedback regulation 31Dr. Siham Gritly
  • 32. • D) body temperature and food intake interrelationship; cold person tends to overeat • When exposed to heat tends to under eat • This relationship is due to interaction within the hypothalamus between the temperature regulation system (hypothalamic thermostat) and the food regulating system (Lateral hypothalamus & Ventromedial nuclei of the hypothalamus) 32Dr. Siham Gritly
  • 33. • The temp of the body is regulated by nervous feedback mechanisms these mechanisms operate through temperature regulating centers in the hypothalamus 33Dr. Siham Gritly
  • 34. • 2-alimentray regulation, non-metabolic regulation; Habit, Gastrointestinal filling 34Dr. Siham Gritly
  • 35. Hormonal control of feeding, appetite and hunger • Hormones that play an important role in controlling feeding pattern; • leptin (identified in 1994), Leptin release from adipose tissue is enhanced by insulin • Obese persons are found with high circulating leptin levels but without response to leptin in the arcuate nucleus (aggregation of neurons in the hypothalamus) • Neurons are nerve cells that receive and send electrical signals over long distances within the body 35Dr. Siham Gritly
  • 36. • Acts on hypothalamus to decrease food intake and increase energy consumption • Abnormalities in leptin signaling appear to be correlated to overeating and obesity 36Dr. Siham Gritly
  • 37. • ghrelin (identified in 1999), called "hunger hormone," is produced in the stomach and brain, induces food intake, and operates through a brain region that controls cravings for food and other energy sources • ghrelin is peptide hormone secreted by gastric mucosa, on an empty stomach and during fasting this hormones increase, and level fall rapidly after meal • work together with leptin to balance the states of hunger and satiety 37Dr. Siham Gritly
  • 38. • Insulin release from pancreatic islets cells follows intake of both carbohydrates and proteins. • Insulin increase appetite by inhibiting stimulatory neurons and by activating releasing neurons. • Resistance to insulin is very often associated with obesity and the loss of insulin's regulation of metabolism as seen in diabetes type 2. Dr. Siham Gritly 38
  • 39. • Insulin increase appetite by inhibiting stimulatory neurons and by activating releasing neurons. • Resistance to insulin is very often associated with obesity and the loss of insulin's regulation of metabolism as seen in diabetes type 2. Dr. Siham Gritly 39
  • 40. • orexin , Also called Hypocretins – neurotransmitter hormones that increase food intake, • Synthesized in neurons located in the lateral Hypothalamus • orexin are inhibited by leptin and activated by Ghrelin and Hypoglycemia 40Dr. Siham Gritly
  • 41. The healthy eating cycle 41Dr. Siham Gritly
  • 42. Eating disorder • Both men and women are susceptible to eating disorders, although a greater percent of eating disorders are found in women. • The three most common eating disorders found are: • 1-Anorexia Nervosa, • 2-Bulimia, • 3-Compulsive Exercise 42Dr. Siham Gritly
  • 43. Warning Signs of an Eating Disorder • Preoccupation (worry) with food and weight • Repeatedly expressed concerns about being fat • Increasing criticism of one's body • Frequent eating alone • Use of laxatives • Trips to the bathroom during or following meals • Continuous drinking of diet soda or water • Compulsive, excessive exercise • Complaining of always being cold 43Dr. Siham Gritly
  • 44. Anorexia nervosa • Anorexia nervosa: an eating disorder characterized by a refusal to maintain a minimally normal body weight and a distortion in perception of body shape and weight ( BMI ≤ 17.5) Excessive concern with weight or weight gain 44Dr. Siham Gritly
  • 45. Health Complications from Anorexia • Anorexia poses life-threatening complications including: • malnutrition • Abnormal Heart Rhythms • low blood pressure • Dehydration • electrolyte imbalance • amenorrhea (interruption of the menstrual cycle) • osteoporosis (decreased bone mass) • sleep disorder 45Dr. Siham Gritly
  • 46. Signs and Symptoms of Anorexia • Excessive weight loss • Always thinking about food, calories, and body weight • Wearing layered clothing • Mood swings or depression • Inappropriate use of laxatives, or diuretics in order to lose weight • Avoiding activities that involve food 46Dr. Siham Gritly
  • 47. Diet Strategies for Anorexia nervosa • Appropriate diet is vital to recovery and must be according to each individual’s needs. • initial food intake may be only 1200 kcalories per day. • A variety of foods and foods with a higher energy density help to ensure greater success. • As eating becomes more comfortable, a person with aneroxia should gradually increase energy intake. 47Dr. Siham Gritly
  • 48. Bulimia • Bulimia is one such eating disorder that describes a cycle of binging and purging. • Bulimia can begin when restrictive diets fail, or the feeling of hunger associated with reduced calorie intake leads to reduce eating. • Like the person with anorexia nervosa, the person with bulimia nervosa spends much time thinking about body weight and food 48Dr. Siham Gritly
  • 49. • Bulimia are multi-factorial, with psycho- developmental, socio-cultural, and genetic contribution factors 49Dr. Siham Gritly
  • 50. Bulimia is of Two types: • 1-Purging type: The person regularly engages in self-induced vomiting or the misuse of laxatives, diuretics. • 2-Nonpurging type: The person uses other compensatory behaviors, such as fasting or excessive exercise, but does not regularly engage in self-induced vomiting or the misuse of laxatives, diuretics, 50Dr. Siham Gritly
  • 51. The Binge-Purge Cycle has no beginning or end, Bulimia is an addictive cycle on both physical and emotional levels., this sequence involves a self-sustaining series of events and edictable response 51Dr. Siham Gritly
  • 52. Signs and Symptoms of Bulimia • Excessive weight loss • Visiting the bathroom after meals • Depression • Excessive dieting, followed by binge eating • Always criticizing one's body 52Dr. Siham Gritly
  • 53. Diet Strategies for Combating Bulimia Nervosa • Nutrition Principles • Eat a well-balanced diet and regularly timed meals consisting of a variety of foods. • Include raw vegetables, salad, or raw fruit at meals to prolong eating times. • Choose whole-grain, high-fiber breads, pasta, rice, and cereals to increase bulk. • Consume adequate fluid, particularly water 53Dr. Siham Gritly
  • 54. Compulsive Exerciser • Some athletes suffer from a slight form of eating disorder that results in excessive and addictive exercise in an attempt to control or lose weight. • Addictive exercisers may use extreme training as one way to expend calories and maintain or lose body weight in the attempt to improve performance or achieve a desired body shape or weight. 54Dr. Siham Gritly
  • 55. Warning Signs of a Compulsive Exerciser • suffer symptoms of overtraining syndrome. • Force to exercise even if you don't feel well. • almost never exercise for fun • Every time you exercise, you go as fast or hard as you can. • experience severe stress and anxiety if he or she miss a workout. • You miss family obligations because you have to exercise. 55Dr. Siham Gritly
  • 56. • Compulsive exercise is as dangerous as food restriction, binging and purging and the use of diet pills and laxatives. • Compulsive exercise can quickly lead to more serious types of eating disorders including anorexia and bulimia as well as a number of serious physical dangers including kidney failure, heart attack and death. 56Dr. Siham Gritly
  • 57. Unspecified Eating Disorders, Binge-Eating Disorder • Binge-Eating Disorder • People with binge eating disorder consume less during a binge, rarely purge, and exert less restraint (self control) during times of dieting • Such an eating disorder does not meet the criteria for either anorexia nervosa or bulimia nervosa • such compulsive overeating is a problem and occurs in people of normal weight as well as those who are severely overweight. 57Dr. Siham Gritly
  • 58. • Obesity alone is not an eating disorder • There are also differences between obese binge eaters and obese people who do not binge. Those with the binge-eating disorder report higher rates of, disgust about body size, depression, and anxiety. • Obese binge eaters tend to consume more kcalories and more dessert 58Dr. Siham Gritly
  • 59. • Sareen Gropper, Jack Smith and James Groff, Advanced Nutrition and Human Metabolism, fifth ed. WADSWORTH • Melvin H Williams 2010; Nutrition for Health, Fitness and Sport. 9th ed, McGraw Hill • Heymsfield, SB.; Baumgartner N.; Richard and Sheau-Fang P. 1999. Modern Nutrition in Health and Disease; Shils E Maurice, Olson A. James, Shike Moshe and Ross A. Catharine eds. 9th edition • Guyton, C. Arthur. 1985. Textbook of Medical Physiology. 6th edition, W.B. Company 59Dr. Siham Gritly

Notes de l'éditeur

  1. Sareen Gropper, Jack Smith and James Groff, Advanced Nutrition and Human Metabolism, fifth ed. WADSWORTH
  2. Ellie Whitney and Sharon RadyRolfes; Under standing Nutrition, Twelfth Edition. 2011, 2008 Wadsworth, Cengage Learning
  3. Ellie Whitney and Sharon RadyRolfes; Under standing Nutrition, Twelfth Edition. 2011, 2008 Wadsworth, Cengage Learning