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Effects of brown seaweeds on postprandial glucose, insulin and appetite in humans - A randomized, 3-way, blinded, cross-over meal study

Zaharudin N, Tullin M, Pekmez CT, Sloth JJ, Rasmussen RR, Dragsted LO

Clin Nutr, 2021 Mar;40(3):830-838.
PMID: 32917417 DOI: 10.1016/j.clnu.2020.08.027

BACKGROUND & AIMS: Seaweed including brown seaweeds with rich bioactive components may be efficacious for a glycaemic management strategy and appetite control. We investigated the effects of two brown edible seaweeds, Laminaria digitata (LD) and Undaria pinnatifida (UP), on postprandial glucose metabolism and appetite following a starch load in a human meal study.
METHODS: Twenty healthy subjects were enrolled in a randomized, 3-way, blinded cross-over trial. The study was registered under ClinicalTrials.gov Identifier no. NCT00123456. At each test day, the subjects received one of three meals comprising 30 g of starch with 5 g of LD or UP or an energy-adjusted control meal containing pea protein. Fasting and postprandial blood glucose, insulin, C-peptide and glucagon-like peptide-1 (GLP-1) concentrations were measured. Subjective appetite sensations were scored using visual analogue scales (VAS).
RESULTS: Linear mixed model (LMM) analysis showed a lower blood glucose, insulin and C-peptide response following the intake of LD and UP, after correction for body weight. Participants weighing ≤ 63 kg had a reduced glucose response compared to control meal between 40 and 90 min both following LD and UP meals. Furthermore, LMM analysis for C-peptide showed a significantly lower response after intake of LD. Compared to the control meal, GLP-1 response was higher after the LD meal, both before and after the body weight adjustment. The VAS scores showed a decreased appetite sensation after intake of the seaweeds. Ad-libitum food intake was not different three hours after the seaweed meals compared to control.
CONCLUSIONS: Concomitant ingestion of brown seaweeds may help improving postprandial glycaemic and appetite control in healthy and normal weight adults, depending on the dose per body weight.
CLINICAL TRIAL REGISTRY NUMBER: Clinicaltrials.gov (ID# NCT02608372).

Matched MeSH terms: Appetite*
Fulltext Proceedings of the NSM update series: sugar substitutes-understanding the basics, global regulatory approvals, safety assessment protocols and benefits

Yashna Harjani, Siong Tee, E., Garcia, Jimena

Malays J Nutr, 2016;22(1):91-102.
MyJurnal

A seminar titled "Sugar Substitutes: Understanding the Basics, Global Regulatory Approvals, Safety Assessment Protocols and Benefits" organised by the Nutrition Society of Malaysia was held on 1.5th Apri12015 for nutritionists and other health care professionals, to review and discuss the latest evidence on safety and efficacy of sugar substitutes. Highlights from lectures by local and international speakers about this topical subject are presented in this report. Sugar substitutes have been extensively evaluated for decades and regulatory agencies world-wide continue to review and confirm their safety. Furthermore, the effects of sugar substitutes on human health continue to be the subject of research studies. Many studies have shown that replacement of sugar with sugar substitutes may help in weight management, glucose control for people with diabetes, and in the prevention of tooth decay. It is important for health professionals to discern whether the available evidence is based on good science and adequate protocols in order to guide consumers with the responsible use of sugar substitutes following national and international dietary guidelines. The use of sugar substitutes for certain health outcomes was discussed, specifically in regard to appetite, energy balance, body weight and other cardio-metabolic risk factors. Overall, the seminar provided an understanding of the different types of commercially available sugar substitutes, their use in a range of food and beverages, and calorie contribution to the diet. The seminar also covered the approvals of different sugar substitutes and the protocols for assessing the safety of these sugar substitutes, especially in the case of children and pregnant women.

Matched MeSH terms: Appetite
Fulltext Changes in Metabolic Hormones in Malaysian Young Adults following Helicobacter pylori Eradication

Yap TW, Leow AH, Azmi AN, Francois F, Perez-Perez GI, Blaser MJ, et al.

PLoS One, 2015;10(8):e0135771.
PMID: 26291794 DOI: 10.1371/journal.pone.0135771

More than half of the world's adults carry Helicobacter pylori. The eradication of H. pylori may affect the regulation of human metabolic hormones. The aim of this study was to evaluate the effect of H. pylori eradication on meal-associated changes in appetite-controlled insulinotropic and digestive hormones, and to assess post-eradication changes in body mass index as part of a currently on-going multicentre ESSAY (Eradication Study in Stable Adults/Youths) study.

Matched MeSH terms: Appetite/physiology
Fulltext Beta-human Chorionic Gonadotropin-secreting Lung Adenocarcinoma

Wong YP, Tan GC, Aziz S, Pongprakyun S, Ismail F

Malays J Med Sci, 2015 Jul-Aug;22(4):76-80.
PMID: 26715912 MyJurnal

Overexpression of beta-human chorionic gonadotropin (β-hCG) is frequently associated with germ cell tumours, especially choriocarcinoma. Ectopic secretion of β-hCG by non-small cell lung cancer is exceptional. We present an exceedingly rare case of pulmonary adenocarcinoma that secretes β-hCG. Our patient is a 62-year-old postmenopausal woman, a nonsmoker, who presented with a six-month history of progressive dyspnoea, associated with decreased appetite and significant weight loss. Her serum β-hCG was very high (11211.9 mIU/ml), which prompted investigations to exclude germ cell tumour. Radiological imaging revealed a 10-cm right lung mass with adrenal metastasis. No other focal lesions were detected. Microscopy of the lung biopsy specimen showed replacement of normal lung tissue by sheets of malignant cells, forming vague glands in some areas. Immunohistochemically, the malignant cells showed focal immunopositivity for thyroid transcription factor 1 (TTF-1), napsin A, cytokeratin 7 (CK7) and β-hCG. A diagnosis of β-hCG-secreting pulmonary poorly differentiated adenocarcinoma was rendered. Serum β-hCG level decreased significantly to 168.6 mIU/ml after the first cycle of chemotherapy. In conclusion, β-hCG expression in lung cancer should be recognised to facilitate prompt diagnosis and initiation of appropriate intervention.

Matched MeSH terms: Appetite
Fulltext Prevalence and Predictors of Malnutrition Risk among Post-Stroke Patients in Outpatient Setting: A Cross-Sectional Study

Wong HJ, Harith S, Lua PL, Ibrahim KA

Malays J Med Sci, 2020 Jul;27(4):72-84.
PMID: 32863747 MyJurnal DOI: 10.21315/mjms2020.27.4.7

Background: The present study examined the prevalence and predictors of malnutrition risk among post-stroke patients.
Methods: Post-stroke patients who attended the outpatient clinics in three hospitals of Peninsular Malaysia were enrolled in the study. The risk of malnutrition was assessed using the Malnutrition Risk Screening Tool-Hospital. Data including demographic characteristics, clinical profiles, dietary nutrients intake, body mass index (BMI) and hand grip strength were collected during the survey. The crude odds ratio (OR) and adjusted odds ratio (AOR) were reported for univariate and multivariate logistic regression analyses, respectively.
Results: Among 398 patients included in the study, 40% were classified as high-risk for malnutrition. In the multivariable logistic regression, tube feeding (AOR: 13.16, 95% confidence interval [CI]: 3.22-53.77), loss of appetite (AOR: 8.15, 95% CI: 4.71-14.12), unemployment (AOR: 4.26, 95% CI: 1.64-11.12), wheelchair-bound (AOR: 2.23, 95% CI: 1.22-4.09) and BMI (AOR: 0.87, 95% CI: 0.82-0.93) were found to be significant predictors of malnutrition risk among stroke patients.
Conclusion: The risk of malnutrition is highly prevalent among post-stroke patients. Routine nutritional screening, identification of risk factors, and continuous monitoring of dietary intake and nutritional status are highly recommended even after the stroke patient is discharged.

Matched MeSH terms: Appetite
Putative Probiotic Strains Isolated from Kefir Improve Gastrointestinal Health Parameters in Adults: a Randomized, Single-Blind, Placebo-Controlled Study

Wang MC, Zaydi AI, Lin WH, Lin JS, Liong MT, Wu JJ

Probiotics Antimicrob Proteins, 2020 09;12(3):840-850.
PMID: 31749128 DOI: 10.1007/s12602-019-09615-9

The dairy products remain as the largest reservoir for isolation of probiotic microorganisms. While probiotics have been immensely reported to exert various health benefits, it is also a common notion that these health potentials are strain and host dependent, leading to the need of more human evidence based on specific strains, health targets, and populations. This randomized, single-blind, and placebo-controlled human study aimed to evaluate the potential benefits of putative probiotic strains isolated from kefir on gastrointestinal parameters in fifty-six healthy adults. The consumption of AB-kefir (Bifidobacterium longum, Lactobacillus acidophilus, L. fermentum, L. helveticus, L. paracasei, L. rhamnosus, and Streptococcus thermophiles; total 10 log CFU/sachet) daily for 3 week reduced symptoms of abdominal pain, bloating (P = 0.014), and appetite (P = 0.041) in male subjects as compared to the control. Gut microbiota distribution profiles were shifted upon consumption of AB-kefir compared to baseline, where the abundance of bifidobacteria was increased in male subjects and maintained upon cessation of AB-kefir consumption. The consumption of AB-kefir also increased gastrointestinal abundance of total anaerobes (P = 0.038) and total bacterial (P = 0.049) in female subjects compared to the control after 3 weeks. Our results indicated that AB-kefir could potentially be developed as a natural strategy to improve gastrointestinal functions in adults.

Matched MeSH terms: Appetite*
Fulltext Pathogenicity of leptospira icterohaemorrhagiae serovar lai strain Langkawi in guinea pigs (cavia porcellus)

Tyagita, H., Bahaman, A.R., Jasni, S., Ibrahim, T.A.T., Fuzina, N.H.

Jurnal Veterinar Malaysia, 2019;31(1):1-11.
MyJurnal

A tourist was infected with a new strain of leptospires namely, Leptospira icterohemorrhagiae serovar Lai strain Langkawi, when he was on vacation in Langkawi, Malaysia. The leptospiral strain was successfully isolated from the patient in the Netherland. In this study, the bacteria were retrieved from Holland and inoculated into fifteen guinea pigs in Universiti Putra Malaysia (UPM) to determine its pathogenicity. The main clinical symptoms in the guinea pigs were decreased appetite and jaundice. Blood profile showed high neutrophil, lymphocyte, PCV, RBC, haemoglobin, leukocyte and thrombocyte counts. Besides that, enhancement of electrolytes such as sodium (Na), chloride (Cl), and potassium (K) was also noted. Biochemical examination showed an increase alkaline phosphatase (ALP), aspartate transaminase (AST) and bilirubin levels. Albumin, alanine transaminase (ALT), blood urea, total protein and creatinine were low values. Histopathological examination under haematoxylin and eosin staining showed evidence of haemorrhages, congestion and oedema in all organs, with inflammatory cell infiltration characterized by neutrophils, lymphocytes and macrophages. Hydropic degeneration and cell necrosis were also common in the findings. Leptospires were detected from Day 2 p.i by silver staining and transmission electron microscopy (TEM). Rise in antibody titre was seen as early as Day 5 p.i and leptospiral DNA was detected by PCR in the kidneys and liver on Day 3 and Day 5, respectively. The findings were indicative of leptospirosis. This study demonstrated that guinea pigs are a suitable animal model to illustrate the clinical symptoms and pathological changes seen following infection with Leptospira icterohaemorrhagiae serovar Lai strain Langkawi. In general, the symptoms and changes seen in leptospirosis are similar to viral infections and the information and data from this present study would help differentiate infection due to leptospires from that of viral infection. Leptospiral infection has often been misdiagnosed to be viral infection such as influenza and dengue which have similar signs and symptoms as leptospirosis.

Matched MeSH terms: Appetite
Fulltext Psychological and physical impact of the haze amongst a Malaysian community

Teoh, Hsien-Jin, Tan, Kai Ling

Jurnal Sains Kesihatan Malaysia, 2008;6(2):23-34.
MyJurnal

A total of 306 Malaysian university students and staff were surveyed to ascertain the physical and emotional effects of the polluted haze on them. All subjects completed self-reported questionnaires. Analysis of the results indicated that the majority of subjects reduced their outdoor activities and sports, and also reported an increase in emotional and physical health problems. The results indicated that there was a general increase in emotional problems such as feeling depressed, lacking in energy, not feeling like doing anything, feeling anxious and afraid, difficulty sleeping, feeling agitated and irritable, and having no appetite. There was also an increase in physical symptoms such as itchy or red eyes, itchy or running nose, dry throat/cough, headaches, nausea, and fever. This study indicated that emotional and behavioural problems are just as common during the haze, when compared with physical health problems. The study also suggests that there are a broad range of problems which health care and human resource departments need to be aware of and take precautions to minimize during a haze.

Matched MeSH terms: Appetite
Fulltext Mechanisms for Combined Hypoxic Conditioning and Divergent Exercise Modes to Regulate Inflammation, Body Composition, Appetite, and Blood Glucose Homeostasis in Overweight and Obese Adults: A Narrative Review

Tee CCL, Cooke MB, Chong MC, Yeo WK, Camera DM

Sports Med, 2023 Feb;53(2):327-348.
PMID: 36441492 DOI: 10.1007/s40279-022-01782-0

Obesity is a major global health issue and a primary risk factor for metabolic-related disorders. While physical inactivity is one of the main contributors to obesity, it is a modifiable risk factor with exercise training as an established non-pharmacological treatment to prevent the onset of metabolic-related disorders, including obesity. Exposure to hypoxia via normobaric hypoxia (simulated altitude via reduced inspired oxygen fraction), termed hypoxic conditioning, in combination with exercise has been increasingly shown in the last decade to enhance blood glucose regulation and decrease the body mass index, providing a feasible strategy to treat obesity. However, there is no current consensus in the literature regarding the optimal combination of exercise variables such as the mode, duration, and intensity of exercise, as well as the level of hypoxia to maximize fat loss and overall body compositional changes with hypoxic conditioning. In this narrative review, we discuss the effects of such diverse exercise and hypoxic variables on the systematic and myocellular mechanisms, along with physiological responses, implicated in the development of obesity. These include markers of appetite regulation and inflammation, body conformational changes, and blood glucose regulation. As such, we consolidate findings from human studies to provide greater clarity for implementing hypoxic conditioning with exercise as a safe, practical, and effective treatment strategy for obesity.

Matched MeSH terms: Appetite
The Cobblestone Heart

Tan WJ, Suz CS, Azza O, Zuki M

Med J Malaysia, 2021 03;76(2):241-244.
PMID: 33742636

Sarcoidosis is a chronic, multisystem disorder. A 38 years old lady presented at Hospital Raja Perempuan Zainab II, Kota Bharu ,Malaysia with cough and breathless for 2 months and constitutional symptoms of weight loss and loss of appetite. She was initially treated as smear negative pulmonary tuberculosis for 5 months. However, her clinical condition deteriorated with worsening New York Heart Association (NYHA) class 1 to class 3. Subsequently, workout of computed tomography( CT) thorax showed multiple perilymphatic distribution of nodules and multiple mediastinal lymphadenopathy coupled with pleura biopsy showed non caseating granuloma and cardiac magnetic resonance imaging (MRI) with positive late gadolinium enhancement revised the diagnosis of pulmonary sarcoidosis with cardiac involvement. Patient's functional status and cough improved with immunosuppresant was given in tapering dose fashion.

Matched MeSH terms: Appetite
Fulltext Self-esteem and anorectic eating concerns among female university students in Malaysia

Talwar, P.

Malaysian Journal of Psychiatry, 2012;21(1):0-0.
MyJurnal

Background: Self-esteem is a person’s appraisal of his own worth, significance, attractiveness, and competence. Low self-esteem could also lead to social, health and psychological problems including eating disorders. Eating disorder is when a person uses measures such as dieting, restricting intake of food or purging to control his or her body weight. Objective: The current study explores the relationship between self-esteem and anorectic eating concerns among female university students in Malaysia. Method: 217 female university students were studied, using Rosenberg’s Self Esteem Scale (SE-10) and Eating Attitude Test (EAT-40). Results: Students with low self esteem had higher anorectic eating concerns. Race of the student had no significance in predicting eating disorder. Age plays an important role in eating disorder. Young students with low self-esteem are more vulnerable to anorectic eating concerns than older students. Conclusion: It was found that there exists an inverse but low correlation between the two variables self esteem and anorectic eating concerns.

Matched MeSH terms: Appetite Depressants
Fulltext Factors influencing appetite and depression among institutionalised Chinese elderly in Penang

Suzana Shahar, Yow, Bee Charn

Jurnal Sains Kesihatan Malaysia, 2009;7(2):73-88.
MyJurnal

Poor appetite and inadequate food intake together with depression are associated with malnutrition, that will increase risk of morbidity and mortality among elderly people. Identifying factors associated with these conditions are essential for formulation of preventive strategies. Therefore, a study was conducted to identify factors associated with poor appetite and depression among institutionalised Chinese elderly people in Butterworth, Penang. A total of 100 Chinese elderly (49 men and 51 women) aged 60 years and above, (mean age ± SD of 74.7 ± 9.2 years), with no known terminal and mental illnesses from two nursing homes participated in this study. Subjects were interviewed to gather information on appetite using Council of Nutrition Appetite Questionnaire (CNAQ), depression using Geriatric Depression Scale (GDS) and also socio demographic and health status. Food intake was assessed using a combination of one-day food weighing and 24 hour diet recall. Body weight and height were measured. Results showed that the mean energy and nutrients intake did not achieve the Recommended Nutrient Intake of Malaysia (RNI), with the exception for vitamin C. Only 4% of the subjects were underweight and obese, 65% normal and 31% overweight. A total of 70% and 73% of subjects had poor appetite and depression, respectively. Subjects who had depression (adjusted OR = 2.78, 95% CI = 0.95-8.03), energy intake below RNI (adjusted OR = 2.34, 95% CI = 0.68-6.95) and difficulty to fall asleep at night (insomnia) (adjusted OR = 2.22, 95% CI = 0.72-6.82) were more likely to have poor appetite. Subjects who had poor appetite (adjusted OR = 3.36, 95% CI = 1.19-9.47) and insomnia (adjusted OR = 2.58, 95% CI = 0.83-7.98) were more likely to have depression. In conclusion, although the majority of subjects had normal body weight but the nutrient intake was inadequate. Poor appetite and depression were prevalent and interrelated and also strongly associated with insomnia.
Device, Scales & Questionnaire: Council of Nutrition Appetite Questionnaire (CNAQ-8); Geriatric Depression Scale (GDS-15)

Matched MeSH terms: Appetite
Fulltext Malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement

Suzana S, Boon PC, Chan PP, Normah CD

Malays J Nutr, 2013 Apr;19(1):65-75.
PMID: 24800385 MyJurnal

INTRODUCTION: Malnutrition is a common phenomenon among the elderly and quite often related to psychosocial problems. The objective of this study was to determine malnutrition risk and its association with appetite, functional and psychosocial status among elderly Malays in an agricultural settlement, i.e. FELDA Sungai Tengi, Selangor.
METHODS: A cross-sectional study was conducted among 160 subjects (men = 36.2%), with a mean age of 65.0 +/- 3.9 years, who were interviewed to obtain information on malnutrition risk and appetite using Mini Nutritional Assessment Short Form and Simplified Nutritional Appetite Questionnaire, respectively. Functional status was determined using Instrumental Activities of Daily Living (IADL), Elderly Mobility Scale (EMS) and handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale and De Jong Gierveld Loneliness Scale were used to identify cognitive impairment, depressive symptoms and loneliness status of subjects respectively. A total of 42.5% of subjects were at risk of malnutrition and 61.2% had poor appetite. The mean scores of IADL and EMS were lower in subjects at risk of malnutrition, compared to those who were not at high risk (p < 0.05 for both parameters). Multiple linear regression showed that 19.8% of malnutrition risk was predicted by poor appetite, decreased functional status (IADL) and depression.
CONCLUSION: Malnutrition risk was prevalent and associated with poor appetite, functional status and psychosocial problems among the elderly subjects. The psychosocial aspect should also be incorporated in nutrition intervention programmes in order to improve mental well-being and functional independancy.
Study site; FELDA Sungai Tengi, Selangor, Malaysia
Device, Questionnaire & Scale: Mini Nutritional Assessment Short Form; Simplified Nutritional Appetite Questionnaire, Instrumental Activities of Daily Living (IADL); Elderly Mobility Scale (EMS); handgrip strength. Mini Mental Status Examination (MMSE), Geriatric Depression Scale (GDS-15); De Jong Gierveld Loneliness Scale

Matched MeSH terms: Appetite/physiology*
Fulltext Nutrition and ecosystems in Sarawak: The role of the areca nut

Strickland SS, Duffield AE

Asia Pac J Clin Nutr, 1998 Dec;7(3/4):300-6.
PMID: 24393688

The effects of population pressure on agricultural sustainability in the delicate tropical and subtropical ecosystems have often been thought to explain high prevalence rates of malnutrition in rural South-East Asia. However, recent studies in rural Sarawak suggest that processes of modernisation have resulted in increased variations in energy nutritional status in adults. A contributory factor may be consumption of the areca nut (Malay pinang, of the palm Areca catechu). This is thought to influence energy balance through effects on appetite and resting metabolic rate. Body mass index (BMI, kg/m2) data for 325 Iban men and 438 non-pregnant Iban women, measured in 1990 and again in 1996, have been analysed in relation to areca use, smoking behaviour, socio-economic status, and reported morbidity. Body composition derived from skinfold thickness measurements for 313 men and 382 women was also analysed. The results suggest that use of areca nut is associated with significantly lower age-related increments in BMI and percentage body fat in women after allowing for age, smoking, reported morbidity, and confounding socio-economic factors. Therefore, the impact of recent economic and social development seen in rising prevalences of 'over-nutrition' may be modulated by use of the areca nut.

Matched MeSH terms: Appetite
Anthropometric status and resting metabolic rate in users of the areca nut and smokers of tobacco in rural Sarawak

Strickland SS, Duffield AE

Ann Hum Biol, 1997 Sep-Oct;24(5):453-74.
PMID: 9300122

The areca nut is chewed by many of the world's population, mainly in South and Southeast Asia. Anthropometric data for 458 Sarawaki adults aged over 24 years, measured both in 1990 and in 1996, were examined in relation to use of tobacco and areca nut. Compared to non-smokers, smoking men were significantly taller and slightly (not significantly) thinner in both years, while smoking women were thinner in 1990 and slightly (not significantly) thinner in 1996. In both sexes there was an increase in the mean and range of body mass index (BMI, W/H2) over the 6-year interval. Smoking women showed a significantly smaller increment in BMI after allowing for areca nut use, which was associated with a similar trend, and this finding depended on including areca use in the model. The trend for men was similar. Possible effects of areca use could reflect variation in 'affluence' or conservatism, or appetite suppression. However, resting metabolic rate in 54 men and 70 women aged 24-60 years was associated with areca use. This association appeared to be mediated by the maximum room temperature of the 24 h preceding measurement. In women, a significant curvilinear association of RMR with maximum temperature was found in users of areca nut but not in non-users. In men, RMR was 7% higher (p < 0.05) in users of areca nut than in non-users, after allowing for age, height, weight, the sum of four skinfold thicknesses, and haemoglobin, but the association with maximum temperature was similar in both groups. It is speculated that constituents of areca nut modulate thermoregulatory pathways, resulting in prolonged temperature-dependent and hyperthermic heat production in this population; that males are more responsive to this effect than females; and that by this mechanism, and possibly also through centrally mediated effects on appetite for food, areca use could contribute to long-term variation in energy balance represented by change in BMI.

Matched MeSH terms: Appetite Regulation/physiology
Disseminated Melioidosis with Spinal Intraosseous Abscess

Soo KC, Lee KS, Ooi SY, Darwina A, Sannasey S, Lee HG

Med J Malaysia, 2021 03;76(2):251-253.
PMID: 33742639

Melioidosis is endemic in the State of Sabah, Malaysia. We report a case of a 34-year-old man with one-week history of fever and cough, three days history of diarrhoea and vomiting, which was associated with a loss of appetite and loss of weight for one-month. Clinically, he had hepatosplenomegaly and crepitation over his right lower zone of lung. Chest radiograph showed right lower lobe consolidation. Ultrasound abdomen showed liver and splenic abscesses. Ultrasound guided drainage of splenic abscess yielded Burkholderia pseudomallei. Magnetic resonance imaging (MRI) lumbosacral confirmed right sacral intraosseous abscess after he developed back pain a week later. He received 6 weeks of intravenous antibiotics and oral co-trimoxazole, followed by 6 months oral co-trimoxazole and had full recovery.

Matched MeSH terms: Appetite
Fulltext The physiology of leptin: revisited

Singh, Harbindar Jeet

Medical Health Reviews, 2009;2009(1):95-133.
MyJurnal

Leptin, a 167 amino-acid product of the ob or LEP gene, was first reported in 1994 after a 40-year search that began following the emergence of a mutant strain of mice with hyperphagia, early on-set obesity, and delayed sexual maturation. Since then, leptin deficiency has also been reported in the rat, and more recently in humans. It is secreted constitutively primarily by the white adipose tissue, and in smaller quantities by a number of non-adipose tissues. It acts by binding to specific membrane bound leptin receptors, belonging to the class 1 cytokine receptor family, and activating the JAK-STAT system. Leptin regulates appetite and body weight mainly through its actions on the hypothalamus involving the NPYmelanocortin pathway, and, to a lesser extent, through increased energy expenditure by way of sympathoactivation and increased substrate cycling. Its effects on reproduction, puberty in particular, are mediated through actions on the hypothalamic-pituitary-gonadal axis and on the gonads. Leptin also appears to have permissive roles in CNS development during the neonatal period, bone growth and development, and in haemopoietic and immune functions. Although it was its deficiency state that first led to its discovery, it now appears that the clinical significance of leptin lies not only in the consequences of its deficiency but also when it is in excess as occurs in obesity. Emerging evidence is implicating leptin as a link between obesity associated cardiovascular disease risks and infertility. Besides this, leptin is also being implicated as a growth factor in cancer. The story that started with a search for a body weight regulating factor is now unfolding into one that is revealing roles for leptin that stretch beyond the regulation of appetite and body weight.

Matched MeSH terms: Appetite
Fulltext Factors associated with adherence to low protein diet among patients with stage iii-v of chronic kidney disease in an outpatient clinic at Hospital Pakar Sultanah Fatimah

Sim-Kian Leong, Yi-Loon Tye, Nik Mahani Nik Mahmood, Zulfitri Azuan Mat Daud

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):131-139.
MyJurnal

Introduction: Although the benefit of low protein diet (LPD) on chronic kidney disease (CKD) progression is well documented, patients’ adherence remains as the main challenge. Therefore, this study sought to identify adherence towards LPD among CKD patients and determine possible associating factors. Methods: This cross-sectional study was done at the Hospital Pakar Sultanah Fatimah in Muar, Johor, among stage III to V CKD patients. Three-day dietary recalls were used to quantify dietary energy (DEI) and protein intake (DPI). Factors investigated include socio-demo- graphic characteristics, medical history, anthropometry and body composition measurements, dietary knowledge, appetite level, handgrip strength, perceived stress, and health locus of control. Associating variables were analysed with logistic regression analysis. Results: The final analysis included 113 patients (54% male) with a mean estimated glomerular filtration rate of 17.5±11.2mL/min/1.73m2 and the average age of 56.3±12.8 years. Mean DEI and DPI were 22.4±5.9kcal/kg/day and 0.83±0.28g/kg/day, respectively. Only 34.5% of patients adhere to the LPD diet with 59% exceeding the DPI recommendation. Poorer LPD adherence was associated with longer duration of hospitaliza- tion (OR 0.707, 95%CI 0.50-1.00, p=0.048), higher energy intake (OR 0.744, 95%CI 0.65-0.85, p

Matched MeSH terms: Appetite
Fulltext Assessing protein energy wasting in a Malaysian haemodialysis population using self-reported appetite rating: a cross-sectional study

Sahathevan S, Se CH, Ng SH, Chinna K, Harvinder GS, Chee WS, et al.

BMC Nephrol, 2015;16:99.
PMID: 26149396 DOI: 10.1186/s12882-015-0073-x

Poor appetite could be indicative of protein energy wasting (PEW) and experts recommend assessing appetite in dialysis patients. Our study aims to determine the relationship between PEW and appetite in haemodialysis (HD) patients.

Matched MeSH terms: Appetite*
Fulltext Understanding Development of Malnutrition in Hemodialysis Patients: A Narrative Review

Sahathevan S, Khor BH, Ng HM, Gafor AHA, Mat Daud ZA, Mafra D, et al.

Nutrients, 2020 Oct 15;12(10).
PMID: 33076282 DOI: 10.3390/nu12103147

Hemodialysis (HD) majorly represents the global treatment option for patients with chronic kidney disease stage 5, and, despite advances in dialysis technology, these patients face a high risk of morbidity and mortality from malnutrition. We aimed to provide a novel view that malnutrition susceptibility in the global HD community is either or both of iatrogenic and of non-iatrogenic origins. This categorization of malnutrition origin clearly describes the role of each factor in contributing to malnutrition. Low dialysis adequacy resulting in uremia and metabolic acidosis and dialysis membranes and techniques, which incur greater amino-acid losses, are identified modifiable iatrogenic factors of malnutrition. Dietary inadequacy as per suboptimal energy and protein intakes due to poor appetite status, low diet quality, high diet monotony index, and/or psychosocial and financial barriers are modifiable non-iatrogenic factors implicated in malnutrition in these patients. These factors should be included in a comprehensive nutritional assessment for malnutrition risk. Leveraging the point of origin of malnutrition in dialysis patients is crucial for healthcare practitioners to enable personalized patient care, as well as determine country-specific malnutrition treatment strategies.

Matched MeSH terms: Appetite

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