Role of addiction and stress neurobiology on food intake and obesity.
Role of addiction and stress neurobiology on food intake and obesity.
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DOI：
10.1016/j.biopsycho.2017.05.001
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发表时间：
2018-01
影响因子：
2.6
通讯作者：
Sinha R
中科院分区：
文献类型：
--
作者：
Sinha R
美国仍然处于全球肥胖流行的前沿，对公众健康产生了重大的负面影响。虽然众所周知，能量摄入和消耗之间的平衡是通过体内平衡调节来控制体重的，但越来越多的证据表明，影响肥胖风险的食物摄入的社会、神经行为和代谢因素是多因素的。这篇综述提出了一些因素，如在环境中普遍存在的奖励食物，以及这些食物刺激大脑奖励动机和压力回路以影响饮食行为的显著性增加。这些有益的食物通过条件反射和强化效应不仅刺激代谢，还刺激应激激素，进而劫持大脑的情感（边缘）和动机（纹状体）通路，促进对食物的渴望和过量的食物摄入。此外，高水平的压力和创伤以及改变的代谢环境（如体重增加，胰岛素敏感性改变）对调节食物摄入和肥胖风险的情绪，动机和内脏稳态机制的前额叶皮层自我控制过程的影响也进行了讨论。本文提出了一个启发式框架，在这个框架中，代谢、动机和应激神经生物学中的神经行为适应的交互动态效应可能以复杂的前馈方式进一步支持食物渴望、过度食物摄入和体重增加。本文讨论了大脑成瘾-动机和应激途径中这种适应的含义及其对过量食物摄入和体重增加的影响，以突出需要未来研究关注的关键问题，以便更好地理解和解决日益增长的肥胖流行病。
The US remains at the forefront of a global obesity epidemic with a significant negative impact on public health. While it is well known that a balance between energy intake and expenditure is homeostatically regulated to control weight, growing evidence points to multifactorial social, neurobehavioral and metabolic determinants of food intake that influence obesity risk. This review presents factors such as the ubiquitous presence of rewarding foods in the environment and increased salience of such foods that stimulate brain reward motivation and stress circuits to influence eating behaviors. These rewarding foods via conditioned and reinforcing effects stimulate not only metabolic, but also stress hormones, that, in turn, hijack the brain emotional (limbic) and motivational (striatal) pathways, to promote food craving and excessive food intake. Furthermore, the impact of high levels of stress and trauma and altered metabolic environment (e.g. higher weight, altered insulin sensitivity) on prefrontal cortical self-control processes that regulate emotional, motivational and visceral homeostatic mechanisms of food intake and obesity risk are also discussed. A heuristic framework is presented in which the interactive dynamic effects of neurobehavioral adaptations in metabolic, motivation and stress neurobiology may further support food craving, excessive food intake and weight gain in a complex feed-forward manner. Implications of such adaptations in brain addictive-motivational and stress pathways and their effects on excessive food intake and weight gain are discussed to highlight key questions that requires future research attention in order to better understand and address the growing obesity epidemic.
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