Diabesity and the food-brain relationship

Scientists from Imperial College London have enhanced our understanding of the food-brain relationship by discovering a brain mechanism that drives our appetite for foods rich in glucose, which could lead to treatments for diabesity.

Obesity, insulin resistance, metabolic syndrome and type-2 diabetes have reached epidemic proportions, yet few people understand how closely they're related, and what causes them. Diabesity is a metabolic dysfunction that ranges from mild blood glucose imbalance to fully-fledged type-2 diabetes.

Intimate food-brain relationship

Diabesity accounts for between 65 and 85% of new cases of type-2 diabetes, and affects more than one billion people worldwide; including 60 million Europeans, and 100 million Americans.

For most people, neither dieting nor current pharmacological interventions are effective in achieving long-term weight reduction. Therefore, to prevent and treat diabesity we must develop approaches to modulate the ways in which the brain controls body weight.

"This is the first time anyone has discovered a system in the brain that responds to a specific nutrient, rather than energy intake in general, and it raises the potential that diabesity could be reduced and prevented by medication acting on the part of the brain that craves glucose," says Dr James Gardiner who led the study.

Our brain rules our belly
Researchers identified a mechanism, which senses how much glucose is reaching our brain, and if our brain detects a shortfall, it makes prompts to seek more glucose. This mechanism is more active in people who are obese-prone, suggesting that the brain can promote obesity.

The Imperial College study is published in The Journal of Clinical Investigation . According to its lead author, Dr Syed Sufyan Hussain, 'Glucose is a component of carbohydrates, and the main energy source used by brain cells. This study demonstrates that the brain plays a significant role in driving our preference for sweet and starchy foods. Prior to industrialisation, such glucose rich foods were not easily available, but today they're everywhere.'

Addicted to food?
Dr Mohammed Hankir, a neuroscientist at the University of Leipzig, Germany, says, 'It's becoming increasingly clear that when we consume certain types of food, particularly those high in fat and sugar, the same brain circuits are engaged as when taking drugs of abuse. We may therefore have little choice about overeating and becoming obese.'

If the diabesity epidemic is the result of our brains being hard-wired to consume energy rich food, can we cure diabesity with pharmacological manipulation of these brain pathways?

Bowels control the brain
Professor Sir Stephen Bloom, Head of Division for Diabetes, Endocrinology and Metabolism, Imperial College London, thinks we can, and says, 'Gut hormones are chemical messengers secreted by the digestive system that affect our brain and control appetite. Hijacking this natural messenger system is an attractive and likely option for treating diabesity'. The GLP-1 hormone is widely used for the treatment of diabetes. It also leads to weight loss. There are other such gut hormones that need further evaluation because they could provide attractive solutions for obesity. 
 
Takeaways
The food-gut-brain relationship promises a much-needed solution for the diabesity epidemic. Whilst the search continues, we must act now to prevent this. Most healthcare systems are organized to treat the acute symptoms of diabesity, and manage the condition once it's been diagnosed. Healthcare systems are less adept at prevention, and early detection. This requires effective education, which is currently not available. 
 

Are we addicted to foods that make us obese and kill?

Why is it hard for obese people to lose weight despite the social stigma and health consequences associated with being overweight? Is it similar to cigarette smokers who continue to smoke even though they know smoking will give them cancer and heart disease?

Is processed food the new tobacco?

Large growing global epidemic
Over the past 25 years the prevalence of obesity in England has more than doubled and today, most English people are either overweight or obese. Similarly, in the US more than a third of individuals are obese.

It’s estimated that each year, obesity costs the NHS more than £5bn and the US economy about $150bn.

Global epidemicOnce considered a problem only for rich countries, obesity is a rising worldwide challenge. In 1997 the World Health Organization (WHO) formally recognized obesity as a global epidemic and in 2008, claimed that 1.5 billion adults were obese. 

Experts say a couch potato lifestyle and overindulgence in junk food is creating an overweight and obese generation prone to heart disease, diabetes and cancer. In rich countries people have easy access to cheap, high-energy food that is often aggressively marketed.

Call for parents and local authorities to help
The press refers to the “obesity time-bomb” and suggests that misguided parents are bringing up a generation of overweight children who gorge on junk food and sugary treats and rarely get any exercise. UK policy makers say that more should be done to support families to help them tackle the obesity crisis in children and young people.

In January 2014, Professor Philip James told the European Congress on Obesity in Antwerp: “Unless we can act firmly and decisively, we will be condemning a huge number of children . . . to becoming a ‘lost generation’.”

Where should we target our concerns? Parents? Municipal authorities? Or, the food and drinks industry?

Changed environment
Contrary to popular belief, people have not become greedier or less active, but what they eat has changed. Everyday, people are bombarded by food industry adverts to eat more food. New scientific evidence suggests that industrial processed food is biologically addictive.

The tobacco industry
In 1954, the tobacco industry paid to publish a “Frank Statement to Cigarette Smokers” in hundreds of US newspapers. It stated that the industry was concerned about peoples’ health and promised a number of good-faith changes.

What followed were decades of deceit and actions that cost millions of lives. During that time the tobacco industry emphasised personal responsibility and paid scientists to deliver research that triggered doubt and criticised science that found harm associated with smoking.

The food and drink industry

Similarly today, some large food and drink companies fund scientific research to establish health claims about their products.

A 2013 report suggests that scientific research sponsored by the food and drink industry is five times more likely to conclude that there are no links between consumption of sugary drinks and weight gain.

In March 2014, Dame Sally Davies, the UK’s Chief Medical Officer told a committee of MPs that, "research will find sugar is addictive" and that the government, “may need to introduce a sugar tax".

For years the tobacco industry made self-regulatory pledges, aggressively lobbied to stifle government actions and denied both the addictive nature of tobacco and their marketing to children.

Takeaways
Food and tobacco industries are different, but there are significant similarities in the actions they have taken in response to concerns that their products can harm.

Because obesity is now a pandemic the world cannot afford to make the same mistake it did with the tobacco industry.