Controversies Surrounding High-Protein Diet Intake: Satiating Effect and Kidney and Bone Health

Long-term consumption of a high-protein diet could be linked with metabolic and clinical problems, such as loss of bone mass and renal dysfunction. However, although it is well accepted that a high-protein diet may be detrimental to individuals with existing kidney dysfunction, there is little evidence that high protein intake is dangerous for healthy individuals. High-protein meals and foods are thought to have a greater satiating effect than high-carbohydrate or high-fat meals. The effect of high-protein diets on the modulation of satiety involves multiple metabolic pathways. Protein intake induces complex signals, with peptide hormones being released from the gastrointestinal tract and blood amino acids and derived metabolites being released in the blood. Protein intake also stimulates metabolic hormones that communicate information about energy status to the brain. Long-term ingestion of high amounts of protein seems to decrease food intake, body weight, and body adiposity in many well-documented studies. The aim of this article is to provide an extensive overview of the efficacy of high protein consumption in weight loss and maintenance, as well as the potential consequences in human health of long-term intake.     

Peripheral and central signals in the control of eating in normal, obese and binge-eating human subjects

The worldwide increase in the incidence of obesity is a consequence of a positive energy balance, with energy intake exceeding expenditure. The signalling systems that underlie appetite control are complex, and the present review highlights our current understanding of key components of these systems. The pattern of eating in obesity ranges from over-eating associated with binge-eating disorder to the absence of binge-eating. The present review also examines evidence of defects in signalling that differentiate these sub-types. The signalling network underlying hunger, satiety and metabolic status includes the hormonal signals leptin and insulin from energy stores, and cholecystokinin, glucagon-like peptide-1, ghrelin and peptide YY3-36 from the gastrointestinal tract, as well as neuronal influences via the vagus nerve from the digestive tract. This information is routed to specific nuclei of the hypothalamus and brain stem, such as the arcuate nucleus and the solitary tract nucleus respectively, which in turn activate distinct neuronal networks. Of the numerous neuropeptides in the brain, neuropeptide Y, agouti gene-related peptide and orexin stimulate appetite, while melanocortins and alpha-melanocortin-stimulating hormone are involved in satiety. Of the many gastrointestinal peptides, ghrelin is the only appetite-stimulating hormone, whereas cholecystokinin, glucagon-like peptide-1 and peptide YY3-36 promote satiety. Adipose tissue provides signals about energy storage levels to the brain through leptin, adiponectin and resistin. Binge-eating has been related to a dysfunction in the ghrelin signalling system. Moreover, changes in gastric capacity are observed, and as gastric capacity is increased, so satiety signals arising from gastric and post-gastric cues are reduced. Understanding the host of neuropeptides and peptide hormones through which hunger and satiety operate should lead to novel therapeutic approaches for obesity; potential therapeutic strategies are highlighted.     

Gut-derived signaling molecules and vagal afferents in the control of glucose and energy homeostasis

PURPOSE OF REVIEW: The control of glucose and energy homeostasis, including feeding behaviour, is tightly regulated by gut-derived peptidic and nonpeptidic endocrine mediators, autonomic nervous signals, as well as nutrients such as glucose. We will review recent findings on the role of the gastrointestinal tract innervation and of portal vein glucose sensors; we will review selected data on the action of gastrointestinally released hormones. RECENT FINDINGS: The involvement of mechanosensory vagal afferents in postprandial meal termination has been clarified using mouse models with selective impairments of genes required for development of mechanosensory fibres. These activate central glucogen-like peptide-1/glucogen-like peptide-2 containing ascending pathways linking the visceroceptive brainstem neurons to hypothalamic nuclei. Mucosal terminals comprise the chemosensory vagal afferents responsive to postprandially released gastrointestinal hormones.The mechanism by which the hepatoportal glucose sensor stimulates glucose utilization by muscles was demonstrated, using genetically modified mice, to be insulin-independent but to require GLUT4 and AMP-kinase. This sensor is a key site of glucogen-like peptide-1 action and plays a critical role in triggering first phase insulin secretion. PeptideYY and ghrelin target intracerebral receptors as they are bidirectionally transported across the blood brain barrier. The anorectic functions of peripherally released peptideYY may however be mediated both via vagal afferents and intracerebral Y2 receptors in the brainstem and arcuate nucleus. SUMMARY: These recent findings demonstrate that the use of improved anatomical and physiological techniques and animal models with targeted gene modifications lead to an improved understanding of the complex role of gastrointestinal signals in the control of energy homeostasis.     

Fos-positive neurons are increased in the nucleus of the solitary tract and decreased in the ventromedial hypothalamus and amygdala by a high-protein diet in rats

Transition from a normal- (NP) to a high-protein (HP) diet induces a rapid depression in food intake and a progressive but incomplete return to the initial intake during the succeeding days. The aim of this study was to determine which CNS regions are involved in the HP diet-induced satiety in rats. Brains were collected from 3 groups of adult rats after habituation to an NP diet (21 d), during the transition phase to a HP diet (2 d), or after habituation to the HP diet (21 d). Fos expression was measured in several brain areas that are involved in the control of food intake (solitary tract nucleus, anterior piriform cortex, lateral hypothalamus, arcuate nucleus, posterior para ventricular nucleus, medio ventral hypothalamus, dorso medial hypothalamus, amygdala, and accumbens nucleus). Changes occurred in the majority of these regions during the transition period from the NP diet to the HP diet. After habituation to the HP diet, significant changes in Fos expression were restricted to an increase in the nucleus of the solitary tract and a decrease in the ventromedial hypothalamus and the cortex of the amygdala. Considering the functional characteristics of these areas, the present results suggest that the vagus nerve conveys the information relative to the quantity of protein ingested, that hypothalamic sites regulate food intake and may alter sympathetic nervous system activity, and that higher brain functions such as memory processing by the limbic system or food reward system are involved in the HP diet-induced satiety in rats.     

Effects of Oro-Sensory Exposure on Satiation and Underlying Neurophysiological Mechanisms—What Do We Know So Far?

The mouth is the first part of the gastrointestinal tract. During mastication sensory signals from the mouth, so-called oro-sensory exposure, elicit physiological signals that affect satiation and food intake. It has been established that a longer duration of oro-sensory exposure leads to earlier satiation. In addition, foods with more intense sweet or salty taste induce earlier satiation compared to foods that are equally palatable, but with lower taste intensity. Oro-sensory exposure to food affects satiation by direct signaling via the brainstem to higher cortical regions involved in taste and reward, including the nucleus accumbens and the insula. There is little evidence that oro-sensory exposure affects satiation indirectly through either hormone responses or gastric signals. Critical brain areas for satiation, such as the brainstem, should be studied more intensively to better understand the neurophysiological mechanisms underlying the process of satiation. Furthermore, it is essential to increase the understanding of how of highly automated eating behaviors, such as oral processing and eating rate, are formed during early childhood. A better understanding of the aforementioned mechanisms provides fundamental insight in relation to strategies to prevent overconsumption and the development of obesity in future generations.     

Biology of eating behavior in obesity

Understanding normal and dysfunctional energy regulation and body weight regulation requires neural evaluation of the signals involved in the control of food intake within a meal, as well as signals related to the availability of stored fuels. Work from our laboratory has focused on peripheral and central nervous system studies of behavior and physiology designed to improve our understanding of the role of gut-brain communication in the control of food intake and energy homeostasis. Gastrointestinal administration of nutrients reduces subsequent meal size, suggesting a potent role for peripheral nutrient sensing in the negative feedback control of ingestion. Vagal afferent nerves supply gastrointestinal sites stimulated during food intake, and these nerves are responsive to mechanical and nutrient chemical properties of ingested food. In addition, the presence of nutrients in these gastrointestinal sites stimulates the release of peptides that affect energy intake. These gut peptides also modulate the activity of peripheral gastrointestinal sensory nerves in ways that may contribute to their effects on food intake. In the central nervous system, adiposity hormones and their downstream mediators have been shown to work at both hindbrain and forebrain sites to affect food intake and metabolism. Importantly, recent data has shown that adiposity hormones acting in the brain increase the behavioral and neural potency of feeding inhibitory gastrointestinal stimuli. These data support the suggestion that insensitivity to adiposity hormones in obesity may be characterized by alterations in their ability to modulate the neural processing of food signals important in determining how much food is consumed during a meal.     

Peripheral signals affecting food intake.

Peripheral signals arise from the sequence involving location, selection, ingestion, digestion, and absorption of food. These signals can be anatomically localized to gastrointestinal signals, circulating factors, metabolic signals, nutrient stores, and the sensory capabilities of the nervous system. Since many of the physiologic signals thought to affect feeding are triggered by nutrient ingestion and feeding behavior is influenced by diet composition, it is useful to consider peripheral appetite signals in the context of energy and nutrient balance. Evidence suggests that nutrient metabolism is (directly or indirectly) related to postingestive satiety. Protein is the most satiating macronutrient and has the greatest detectable effect on qualitative intake. Carbohydrates (CHOs) exert potent effects on satiety. Inhibition of CHO metabolism stimulates intake, as do transient declines in plasma glucose. Inhibition of fat metabolism also stimulates intake, but fat is the least readily metabolized macronutrient, and therefore, joule for joule, is less satiating than CHO or protein. High-fat, energy-dense diets lead to excess energy intakes (EIs) and weight gain relative to lower-fat, less energy-dense diets, and fat intake is a risk factor for subsequent weight gain. Earlier models viewed peripheral control of feeding as due to one or more simple negative feedback loops. More recently research has focused on the multiple signalling systems involved in the maintenance of nutrient and energy balance (EB). While protein influences satiety at several levels, relatively little is known about "aminostatic" mechanisms. CHO status appears to be monitored in both the central nervous system (CNS) and periphery; signals relating to fat status largely appear to arise in the periphery. More progress has been made in identifying peripheral signals and some of their connections to the brain than in understanding their quantitative importance for normal feeding.     

Current and emerging concepts on the role of peripheral signals in the control of food intake and development of obesity

The gastrointestinal peptides are classically known as short-term signals, primarily inducing satiation and/or satiety. However, accumulating evidence has broadened this view, and their role in long-term energy homeostasis and the development of obesity has been increasingly recognised. In the present review, the recent research involving the role of satiation signals, especially ghrelin, cholecystokinin, glucagon-like peptide 1 and peptide YY, in the development and treatment of obesity will be discussed. Their activity, interactions and release profile vary constantly with changes in dietary and energy influences, intestinal luminal environment, body weight and metabolic status. Manipulation of gut peptides and nutrient sensors in the oral and postoral compartments through diet and/or changes in gut microflora or using multi-hormone 'cocktail' therapy are among promising approaches aimed at reducing excess food consumption and body-weight gain.     

Proteins activate satiety-related neuronal pathways in the brainstem and hypothalamus of rats

Our objective was to study the relationship between the satiety induced by high-protein meals and the activation of brain areas involved in the onset of satiety. In rats, we used immunohistochemistry to monitor brain centers activated by a meal by receiving information from the gastrointestinal tract or via humoral pathways. In the nucleus of the solitary tract (NTS), the acute or chronic intake of high-protein meals led to increased activation of the noradrenergic/adrenergic neurons involved in cholecystokinin-induced satiety. In the arcuate nucleus of the hypothalamus, the melanocortin pathway was also more strongly activated after the acute or chronic intake of high-protein meals. Moreover, the glucagon-like peptide 1 pathway arising from the NTS, which is triggered, among other behaviors, during nonphysiological anorexia, was not activated by high-protein meals, supporting the lack of aversive behavior associated with this diet. Taken together, these results show that the ability of high-protein meals to inhibit food intake occurs alongside the activation, in nutrient-sensitive brain areas, of several specific neuronal populations involved in satiety.     

Effect of Dairy Proteins on Appetite,Energy Expenditure,Body Weight,and Composition: a Review of the Evidence from Controlled Clinical Trials

Evidence supports that a high proportion of calories from protein increases weight loss and prevents weight (re)gain. Proteins are known to induce satiety, increase secretion of gastrointestinal hormones, and increase diet-induced thermogenesis, but less is known about whether various types of proteins exert different metabolic effects. In the Western world, dairy protein, which consists of 80% casein and 20% whey, is a large contributor to our daily protein intake. Casein and whey differ in absorption and digestion rates, with casein being a “slow” protein and whey being a “fast” protein. In addition, they differ in amino acid composition. This review examines whether casein, whey, and other protein sources exert different metabolic effects and targets to clarify the underlying mechanisms. Data indicate that whey is more satiating in the short term, whereas casein is more satiating in the long term. In addition, some studies indicate that whey stimulates the secretion of the incretin hormones glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide more than other proteins. However, for the satiety (cholecystokinin and peptide YY) and hunger-stimulating (ghrelin) hormones, no clear evidence exists that 1 protein source has a greater stimulating effect compared with others. Likewise, no clear evidence exists that 1 protein source results in higher diet-induced thermogenesis and promotes more beneficial changes in body weight and composition compared with other protein sources. However, data indicate that amino acid composition, rate of absorption, and protein/food texture may be important factors for protein-stimulated metabolic effects.     

L’intestin un organe endocrine : de la physiologie aux implications thérapeutiques en nutrition

The gastrointestinal tract produces a very wide variety of peptides and is considered as the largest and most complex endocrine glands. Since the discovery of secretin, more than 30 genes encoding pro-hormones have been identified and, due to alternative splicing and/or regulated post-translational maturation, these genes allow the production and secretion of more than 100 different peptides. These intestinal hormones, also called enterohormones, exert numerous effects on the gastrointestinal tract itself but also at distance (brain, pancreas, liver…) participating in the control of the entry of nutrients into the body, the food intake, carbohydrate homeostasis. Enterohormones are produced by enteroendocrine cells scattered along the gastrointestinal tract and secreted in response to luminal, but also endocrine, paracrine, and neuronal signals. Enteroendocrine function is impaired during undernutrition or obesity. Bariatric surgery, the main treatment for severe obesity, and extensive resection of the small intestine leading to short bowel syndrome (the main cause of intestinal failure) induce significant changes in the secretions of several enterohormones. This review summarizes the latest knowledge in the physiology of intestinal endocrine function (enteroendocrine cells, the signals stimulating them, the main roles of enterohormones) but also during nutritional pathologies (obesity, undernutrition) and the possible approaches to target this function for specific therapeutic purposes.     

Physiological effects of medium-chain triglycerides: potential agents in the prevention of obesity

Medium chain fatty acids (MCFA) are readily oxidized in the liver. Animal and human studies have shown that the fast rate of oxidation of MCFA leads to greater energy expenditure (EE). Most animal studies have also demonstrated that the greater EE with MCFA relative to long-chain fatty acids (LCFA) results in less body weight gain and decreased size of fat depots after several months of consumption. Furthermore, both animal and human trials suggest a greater satiating effect of medium-chain triglycerides (MCT) compared with long-chain triglycerides (LCT). The aim of this review is to evaluate existing data describing the effects of MCT on EE and satiety and determine their potential efficacy as agents in the treatment of human obesity. Animal studies are summarized and human trials more systematically evaluated because the primary focus of this article is to examine the effects of MCT on human energy metabolism and satiety. Hormones including cholescytokinin, peptide YY, gastric inhibitory peptide, neurotensin and pancreatic polypeptide have been proposed to be involved in the mechanism by which MCT may induce satiety; however, the exact mechanisms have not been established. From the literature reviewed, we conclude that MCT increase energy expenditure, may result in faster satiety and facilitate weight control when included in the diet as a replacement for fats containing LCT.     

Sweetness, satiation, and satiety

Satiation and satiety are central concepts in the understanding of appetite control and both have to do with the inhibition of eating. Satiation occurs during an eating episode and brings it to an end. Satiety starts after the end of eating and prevents further eating before the return of hunger. Enhancing satiation and satiety derived from foodstuffs was perceived as a means to facilitate weight control. Many studies have examined the various sensory, cognitive, postingestive, and postabsorptive factors that can potentially contribute to the inhibition of eating. In such studies, careful attention to study design is crucial for correct interpretation of the results. Although sweetness is a potent sensory stimulus of intake, sweet-tasting products produce satiation and satiety as a result of their volume as well as their nutrient and energy content. The particular case of energy intake from fluids has generated much research and it is still debated whether energy from fluids is as satiating as energy ingested from solid foods. This review discusses the satiating power of foods and drinks containing nutritive and nonnutritive sweeteners. The brain mechanisms of food reward (in terms of "liking" and "wanting") are also addressed. Finally, we highlight the importance of reward homeostasis, which can help prevent eating in the absence of hunger, for the control of intake.     

Nutrient-Induced Cellular Mechanisms of Gut Hormone Secretion

The gastrointestinal tract can assess the nutrient composition of ingested food. The nutrient-sensing mechanisms in specialised epithelial cells lining the gastrointestinal tract, the enteroendocrine cells, trigger the release of gut hormones that provide important local and central feedback signals to regulate nutrient utilisation and feeding behaviour. The evidence for nutrient-stimulated secretion of two of the most studied gut hormones, glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), along with the known cellular mechanisms in enteroendocrine cells recruited by nutrients, will be the focus of this review. The mechanisms involved range from electrogenic transporters, ion channel modulation and nutrient-activated G-protein coupled receptors that converge on the release machinery controlling hormone secretion. Elucidation of these mechanisms will provide much needed insight into postprandial physiology and identify tractable dietary approaches to potentially manage nutrition and satiety by altering the secreted gut hormone profile.     

Multivariate analysis of dietary patterns in 939 Swiss adults: sociodemographic parameters and alcohol consumption profiles

A dietary survey of 939 Swiss adults, randomly selected from the population of Geneva and its surrounding communities, was performed according to the history method. A factor analysis, using average weekly intakes for 33 food variables, reveals three principal components of the diet: satiating capacity, healthfulness and culinary complexity. These characteristics, together with the energy content of the diet, were analysed for differences according to sex, age, relative weight index, birthplace, marital status and occupation. All of these sociodemographic variables influence some dimension of dietary habits. Alcohol consumption is positively associated with satiating, protein rich diets, but energy intake from foods does not significantly differ between various groups of abstainers and drinkers. Although the energy contribution of alcoholic beverages is globally additive, we suggest that cultural and societal norms may modulate the relationship of alcohol and diet.     

Effect of fat-reduced diets on 24-h energy expenditure: comparisons between animal protein, vegetable protein, and carbohydrate

BACKGROUND: Single-meal tests have shown that protein has greater thermogenic and satiating effects than does carbohydrate, which may be relevant for the prevention and treatment of obesity if these effects can be maintained over 24 h. OBJECTIVE: The effects of pork-meat protein, soy protein, and carbohydrate on 24-h energy expenditure were compared. DESIGN: Twelve young, healthy, overweight and mildly obese [body mass index (in kg/m(2)): 26-32] nonsmoking men participated in a randomized, single-blind, 3-way crossover study lasting 4 d. The intervention had a 1-10-wk washout period. The 3 isoenergetic intervention diets were as follows: pork diet (29% of energy as fat and 29% as protein, mainly from pork meat), soy diet (29% of energy as fat and 28% as protein, mainly from soy), and carbohydrate diet (28% of energy as fat and 11% as protein). Twenty-four-hour energy expenditure was measured in a respiratory chamber at baseline and on day 4 of each intervention period. RESULTS: Twenty-four-hour energy expenditure was higher with the pork than with the soy (248 kJ/d, 1.9%; P: = 0.05) or carbohydrate (492 kJ/d, 3.9%; P: < 0.0001) diet and higher with the soy than with the carbohydrate (244 kJ/d, 1.9%; P: < 0.05) diet. However, because of a higher satiating effect, energy intake was 10-15% lower during the chamber stay than at baseline (P: > 0.05) with all 3 diets. The differences in energy expenditure remained unchanged after adjustment for differences in 24-h energy balance. CONCLUSIONS: Substitution of carbohydrate with 17-18% of energy as either pork-meat or soy protein produced a 3% higher 24-h energy expenditure. The animal protein in pork meat produced a 2% higher 24-h energy expenditure than did the vegetable protein in soy.     

Afferent signals regulating food intake

Food intake is a regulated system. Afferent signals provide information to the central nervous system, which is the centre for the control of satiety or food seeking. Such signals can begin even before food is ingested through visual, auditory and olfactory stimuli. One of the recent interesting findings is the demonstration that there are selective fatty acid taste receptors on the tongue of rodents. The suppression of food intake by essential fatty acids infused into the stomach and the suppression of electrical signals in taste buds reflect activation of a K rectifier channel (K 1.5). In animals that become fat eating a high-fat diet the suppression of this current by linoleic acid is less than that in animals that are resistant to obesity induced by dietary fat. Inhibition of fatty acid oxidation with either mercaptoacetate (which blocks acetyl-CoA dehydrogenase) or methylpalmoxirate will increase food intake. When animals have a choice of food, mercaptoacetate stimulates the intake of protein and carbohydrate, but not fat. Afferent gut signals also signal satiety. The first of these gut signals to be identified was cholecystokinin (CCK). When CCK acts on CCK-A receptors in the gastrointestinal tract, food intake is suppressed. These signals are transmitted by the vagus nerve to the nucleus tractus solitarius and thence to higher centres including the lateral parabrachial nucleus, amygdala, and other sites. Rats that lack the CCK-A receptor become obese, but transgenic mice lacking CCK-A receptors do not become obese. CCK inhibits food intake in human subjects. Enterostatin, the pentapeptide produced when pancreatic colipase is cleaved in the gut, has been shown to reduce food intake. This peptide differs in its action from CCK by selectively reducing fat intake. Enterostatin reduces hunger ratings in human subjects. Bombesin and its human analogue, gastrin inhibitory peptide (also gastrin-insulin peptide), reduce food intake in obese and lean subjects. Animals lacking bombesin-3 receptor become obese, suggesting that this peptide may also be important. Circulating glucose concentrations show a dip before the onset of most meals in human subjects and rodents. When the glucose dip is prevented, the next meal is delayed. The dip in glucose is preceded by a rise in insulin, and stimulating insulin release will decrease circulating glucose and lead to food intake. Pyruvate and lactate inhibit food intake differently in animals that become obese compared with lean animals. Leptin released from fat cells is an important peripheral signal from fat stores which modulates food intake. Leptin deficiency or leptin receptor defects produce massive obesity. This peptide signals a variety of central mechanisms by acting on receptors in the arcuate nucleus and hypothalamus. Pancreatic hormones including glucagon, amylin and pancreatic polypeptide reduce food intake. Four pituitary peptides also modify food intake. Vasopressin decreases feeding. In contrast, injections of desacetyl melanocyte-stimulating hormone, growth hormone and prolactin are associated with increased food intake. Finally, there are a group of miscellaneous peptides that modulate feeding. beta-Casomorphin, a heptapeptide produced during the hydrolysis of casein, stimulates food intake in experimental animals. In contrast, the other peptides in this group, including calcitonin, apolipoprotein A-IV, the cyclized form of histidyl-proline, several cytokines and thyrotropin-releasing hormone, all decrease food intake. Many of these peptides act on gastrointestinal or hepatic receptors that relay messages to the brain via the afferent vagus nerve. As a group they provide a number of leads for potential drug development.     

The effect of salatrim, a low-calorie modified triacylglycerol, on appetite and energy intake

BACKGROUND: Salatrim is modified triacylglycerol that is rich in short-chain fatty acids and stearic acid. It is used as a lower-calorie fat replacer. In addition, it has been hypothesized that salatrim's reduced absorption in the small intestine may lead to greater amounts of fat in the gastrointestinal tract, which may decrease appetite and energy intake through the release of appetite-regulating gastrointestinal hormones. OBJECTIVE: We aimed to compare the effects of salatrim and traditional fat on appetite, ad libitum energy intake, and gastrointestinal hormones. DESIGN: Twenty-two healthy, young, normal-weight men participated in a randomized, double-blind, crossover study. Test meals were a traditional fat meal and a salatrim meal with a mixture of traditional fat and salatrim. Visual analogue scales were used to record appetite and well-being every 30 min, and blood was sampled frequently. An ad libitum lunch was served 4.5 h after the test meal. RESULTS: The salatrim meal increased fullness (P = 0.04) and decreased hunger (P = 0.06) significantly more than did the traditional fat meal. The traditional fat meal increased well-being (P = 0.02). There was no significant difference in ad libitum energy intake or overall energy intake between the 2 test days. No significant differences in blood glucose, insulin, triacylglycerol, ghrelin, cholecystokinin, glucagon-like peptide-1, or peptide YY concentrations were found. A significantly (P = 0.01) smaller increase in free fatty acids was observed after the salatrim meal than after the traditional fat meal. CONCLUSIONS: Salatrim had a modestly more suppressive effect on appetite than did a traditional fat. Gastrointestinal hormones did not seem to be involved.     

The regulation of food intake by hypothalamic malonyl-coenzyme A: the MaloA hypothesis

In animals, food intake and therefore energy balance is regulated by a center in the hypothalamus of the brain. Neurons there release appetite-inhibiting (anorexigenic) or appetite-stimulating (orexigenic) peptide hormones according to whether energy intake exceeds or is less than expenditure, respectively. Recent evidence for the "malonyl coenzyme A hypothesis" showed that the level of malonyl coenzyme A (MalCoA) in the arcuate nucleus of the hypothalamus determines the stimulation or inhibition of food intake. A high level of MalCoA, indicative of energy surplus, signals the release of anorexigenic neuropeptides, resulting in decreased food intake; a low level of MalCoA, due to an energy deficit such as during fasting, signals the release of orexigenic neuropeptides, stimulating food intake.     

Protein, amino acids and the control of food intake

The influence of protein and amino acid on the control of food intake and the specific control of protein and amino acid intakes remains incompletely understood. The most commonly accepted conclusions are: (1) the existence of an aversive response to diets deficient in or devoid of protein or deficient in at least one essential amino acid; (2) the existence of a mechanism that enables attainment of the minimum requirement for N and essential amino acids by increasing intake of a low-protein diet; (3) a decrease in the intake of a high-protein diet is associated with different processes, including the high satiating effect of protein. Ingested proteins are believed to generate pre- and post-absorptive signals that contribute to the control of gastric kinetics, pancreatic secretion and food intake. At the brain level, two major afferent pathways are involved in protein and amino acid monitoring: the indirect neuro-mediated (mainly vagus-mediated) pathway and the direct blood pathway. The neuro-mediated pathway transfers pre-absorptive and visceral information. This information is for the main part transferred through the vagus nerve that innervates part of the oro-sensory zone: the stomach, the duodenum and the liver. Other information is directly monitored in the blood. It is likely that the system responds precisely when protein and essential amino acid intake is inadequate, but in contrast allows a large range of adaptive capacities through amino acid degradation and substrate interconversion.