Sex Effects on the Neurobiology of Eating Behaviors in Veterans with Overweight/Obesity

美国退伍军人的肥胖率特别高，给健康带来了沉重的负担。吃 行为是预防和管理肥胖的一个可能的目标。因此，理解因素 随着肥胖率持续上升，影响退伍军人的饮食行为将是重要的一步。一把钥匙 然而，理解这些因素的障碍是目前缺乏对基于性别的差异的理解 在进食行为上。基于性别的饮食行为差异一直被观察到。例如，女性 比男性更有可能节食，对体重控制表示更多关注，并更多地归因于 健康饮食的重要性。女性也报告了更多与饮食失调有关的行为，并 肥胖率更高。男性和女性的饮食行为和肥胖率的差异涉及 许多因素，如性腺激素、社会压力和规范以及体育活动参与度。 这些因素还与涉及进食行为的神经元过程相互作用。对性爱有清晰的认识- 然而，食物摄取背后的神经元机制的基础差异尚未确定。这个 因此，这项提议的目标是更好地理解性别差异如何影响享乐主义的神经生物学。 进食行为。这与退伍军人的健康特别相关，因为妇女是增长最快的人口 退伍军人在退伍军人管理局接受医疗保健，有近200万活着的女性退伍军人。 了解食物摄入行为背后的神经生物学中基于性别的差异，以及如何 性腺激素导致了这些差异，这对于开发新的治疗方法将是重要的。 超重/肥胖和体重维持。享乐主义的饮食，或超越自我平衡需要的饮食，可能是 尤其与肥胖有关。因此，确定潜在的神经生物学方面的性别差异 享乐饮食具有特别重要的意义。为此，我们最近完成了一项初步研究，调查 禁食和中性人对高享乐值食物的神经元反应的性别差异 美联储表示。在禁食状态下观察到基于性别的差异，女性的反应更大 与男性相比，伏隔核和脑岛中的大脑区域在与食物有关的区域中起着突出的作用 奖励处理。这可能表明女性对显著和有益的方面更敏感。 禁食时的享乐性食物比男人更多。当比较食物和非食物物体时，没有观察到这一点，即 是专门比较享乐性食物和中性食物，而不是作为一个整体的食物。 虽然这些初步调查结果具有挑衅性，但仍有许多问题有待回答 地址。首先，考虑到样本量相对较小，最初研究的敏感性可能不够。 此外，在最初的调查中，所有女性都在月经周期的卵泡期进行了扫描。 鉴于神经元对食物提示的反应在月经的不同阶段观察到的差异 在月经周期方面，重要的是确定月经周期阶段如何影响基于性别的差异。此外， 性腺激素的测量没有包括在初步研究中。这对于理解这一点至关重要 激素对神经元对享乐性食物反应的贡献。最后，以前的研究没有 解决了神经元差异如何转化为真实世界行为的问题，这将是理解 性别之间的神经元差异如何指导治疗方案的发展。 这个应用程序的总体目标是扩展最初的发现，以更好地理解基于性别的 享乐主义饮食行为和基于食物的奖励处理的神经生物学差异，如何 性腺激素导致了这些差异，以及这种差异如何转化为现实生活中的饮食行为 退伍军人。

The rate of obesity is particularly high in U.S. Veterans, conferring a substantial health burden. Eating behaviors are one possible target for obesity prevention and management. As such, understanding factors impacting eating behaviors in Veterans will be an important step as obesity rates continue to rise. A key obstacle in understanding these factors, however, is the current lack of understanding of sex-based differences in eating behaviors. Sex-based differences in eating behaviors are consistently observed. For example, women are more likely to diet than men, express greater concern about weight control, and attribute greater importance to healthy eating. Women also report more behaviors associated with eating disorders, and have higher rates of obesity. Differences in eating behaviors and obesity rates between men and women involve a number of factors, such as gonadal hormones, social pressures and norms, and physical activity engagement. These factors also interact with neuronal processes involved in eating behaviors. A clear understanding of sex- based differences in neuronal mechanisms underlying food intake has yet to be established, however. The goal of this proposal, therefore, is to better understand how sex differences impact the neurobiology of hedonic eating behaviors. This is particularly relevant to Veterans' health, as women are the fastest-growing population of Veterans receiving healthcare at the VA, with almost 2 million living women Veterans. Understanding sex-based differences in the neurobiology underlying food intake behaviors, and how gonadal hormones contribute to these differences, will be important for developing novel treatment methods for overweight/obesity and weight maintenance. Hedonic eating, or eating beyond homeostatic needs, may be particularly associated with obesity. As such, identifying sex-based differences in neurobiology underlying hedonic eating is of particular relevance. To this end, we recently completed a preliminary study investigating sex-based differences in neuronal responses to foods with high (vs. neutral) hedonic value, in both fasted and fed states. Sex-based differences were observed in the fasted state, with greater responses in women compared to men in the nucleus accumbens and insula, brain regions with prominent roles in food-related reward processing. This could indicate that women are more sensitive to salient and rewarding aspects of hedonic foods than men when fasted. This was not observed when comparing foods to non-food objects, i.e., it was specific to the comparison of hedonic to neutral foods, rather than foods as a whole. While these preliminary findings are provocative, many questions remain to be answered and issues addressed. First, the sensitivity of the initial study was likely insufficient, given the relatively small sample size. Additionally, women were all scanned in the follicular phase of the menstrual cycle in the initial investigation. Given that differences in neuronal responses to food cues are observed in different phases of the menstrual cycle, it is important to determine how menstrual cycle phase impacts sex-based differences. Furthermore, measures of gonadal hormones were not included in the preliminary study. This will be critical in understanding the contribution of hormones to neuronal responses to hedonic foods. Lastly, previous studies have not addressed how neuronal differences translate to real-world behaviors, which will be essential in understanding how neuronal differences between sexes can guide development of treatment options. The overall goal of this application is to expand on initial findings to better understand sex-based differences in the neurobiology underlying hedonic eating behaviors and food-based reward processing, how gonadal hormones contribute to these differences, and how this translates to real-life eating behaviors in Veterans.