het dopaminerge beloningssysteem 27/05/2016 | 51
mesolimbic DA system
lekker eten zorgt voor DA afgifte 27/05/2016 | 52
Bassareo and Di Chiara, 1997
palatable food and dopamine
DA response
why would some people overeat and gain weight? hypersensitivity to reward • larger DA response
time
palatable food and dopamine
DA response
why would some people overeat and gain weight?
time
experiment Stoeckel et al., 2008 › brain activation in response to different pictures
• overweight versus control • presentation of visual stimuli • fMRI, brain regions associated with reward (VTA, NAc)
food reward and (over)weight
brain activation
higher activation in response to pictures of high-caloric food in overweight subjects. overweight control
high cal
low cal
cars Adapted from Stoeckel et al., 2008
palatable food and dopamine
Sensitivity to reward
positive relation between sensitivity to reward and BMI
BMI
adapted from Davis et al., 2004
palatable food and dopamine
DA response
why would some people overeat and gain weight? hyposensitivity to reward • lower DA response insensitive DA receptor “self-medication” to enhance DA activation and improve mood (Bowirrat & Oscar-Berman, 2005)
time
chronic overeating leads to hyposensitivity 27/05/2016 | 59
[C-11]raclopride: radiotracer, binds to DA D2 receptors lower D2 binding in obese individuals Wang et al., 2001
chronic overeating leads to tolerance 27/05/2016 | 60
down-regulation of DA D2R caused by chronic overeating
Wang et al., 2001
palatable food and dopamine negative relation between sensitivity to reward and BMI
Adapted from Pagoto et al., 2006; Davis et al., 2004.
palatable food and reward hyposensitivity to reward
hypersensitivity to reward
?
obesity and reward for food hypersensitivity to reward
normal to overweight subjects BMI: 20 – 30 kg/m2
hyposensitivity to reward
obese subjects BMI ≥ 30 kg/m2
obesity and reward for food
Davis and Fox, 2008
obesity and reward for food
reward dependence
Davis and Fox, 2008
food addiction can be compared with drug dependence
sensitization
tolerance
liking wanting
compulsief overeten 27/05/2016 | 67
- overeten activeert het
beloningssysteem in de hersenen R Simerly. Feeding signals and drugs meet in the midbrain. Nature Medicine - 12, 1244 - 1246 (2006). Overeating may share neurobiological mechanisms with the addictive properties of drugs of abuse.
- is overeten verslavend? comfort food, tolerantie (steeds meer nodig), rol van omgevingsfactoren en stress: alle kenmerken zijn aanwezig
compulsive overeating 27/05/2016 | 68
the problem usual treatment for addiction: - change the environment - stop intake of the drug (100%)
tolerantie 27/05/2016 | 69
tolerantie bij verslaving is het gevolg van conditionering door omgevingsfactoren
compulsive overeating 27/05/2016 | 70
the problem usual treatment for addiction: - change the environment - stop intake of the drug (100%) addicted to eating: - if you stop eating, you die …..
voorkom overgewicht 27/05/2016 | 71
1) verminder het hedonisch overeten let op de invloed van de omgeving, stress, comfort food etc
regulatie van het lichaamsgewicht (set range) 27/05/2016 | 72
maximaal acceptabel niveau externe factoren: lichaams gewicht (vet)
stress sociale factoren fysieke activiteit hedonics laagst acceptabel niveau leeftijd genen en homeostase bewaken de grenzen
regulatie van het lichaamsgewicht (set range) 27/05/2016 | 73
hioogst acceptabel niveau
lichaams gewicht (vet)
fysieke activiteit sport beweging (NEAT) laagst acceptabel niveau leeftijd genen en homeostase bewaken de grenzen
Obesity Trends* Among U.S. Adults BRFSS, 2010 (*BMI ≥30, or ~ 30 lbs. overweight for 5䇻 4䇿 person)
No Data
<10%
10%–14%
15%–19%
20%–24%
Source: Behavioral Risk Factor Surveillance System, CDC.
25%–29%
≥30%
2008 estimates of leisure-time physical inactivity among adults aged ≥ 20 years year 27/05/2016 27/05/ /2016 | 7 75
Percent 0 - 20.0 20.1 - 24.4 24.5 - 28.2 28.3 - 32.7 > 32.8
2008 www.cdc.gov/diabetes
verminderde fysieke activiteit 27/05/2016 | 77
1950 vs 2000 vrijwel geen verschil in energie opname Nederland in 2002: minder dan 40% voldoet aan de minimum eis: 5x per week 30 min/dag matige inspanning
27/05/2016 | 78
voorkom overgewicht 27/05/2016 | 80
1) verminder het hedonisch overeten en 2) verhoog de fysieke activiteit life style interventie !
DPP Lifestyle: Weight Change
Weight Change (Kg)
+
1 0 -1 -2 -3 -4 -5 -6 -7 -8
Placebo
58% in Risk Lifestyle
Modest weight loss = Major health benefit
0
6
12
18
24
30
36
Months in study
42
48 81
NEAT 27/05/2016 | 83
percent of daily energy expenditure
100
exercise activity
75 DIT 50
non-exercise activity thermogenesis (NEAT)
BMR 25
0
James A. Levine Science 1999
verkoop huishoudelijke apparaten en energie opname versus het % obesitas in de USA 27/05/2016 | 84
Levine, J. A. Am J Physiol Endocrinol Metab 286: E675-E685 2004
NEAT is belangrijk 27/05/2016 | 85
percent of daily energy expenditure
100 Exercise 75
NEAT
DIT 50
BMR 25
0 JA Levine et al, Science 2005
lage activiteit 27/05/2016 | 86
27/05/2016 | 87
Environmental Change Policy
Education 27/05/2016 | 88
+2000 steps -100 kcal/day Stop Weight Gain
pedometer / step counter 27/05/2016 | 89
27/05/2016 | 90
27/05/2016 | 91
27/05/2016 | 92
voorkom overgewicht 27/05/2016 | 93
1) verminder het hedonisch overeten en 2) verhoog de fysieke activiteit life style interventie !
