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Imagine the typical office birthday party.
It's after lunch, so everybody is full. Then, in comes a luscious chocolate confection. The sight, the smell -- even the sound of the word 'cake!' -- stimulate the reward-and-pleasure circuits of the brain, activating memory centers and salivary glands as well.
Those reactions quickly drown out the subtle signals from the stomach that are saying, in effect, 'Still digesting down here. Don't send more!' Social cues add pressure and permission to indulge. Soon, everybody is having a slice -- or two.
Scholars have understood the different motives for eating as far back as Socrates, who counseled, 'Thou shouldst eat to live, not live to eat.' But nowadays, scientists are using sophisticated brain-imaging technology to understand how the lure of delicious food can overwhelm the body's built-in mechanism to regulate hunger and fullness, what's called 'hedonic' versus 'homeostatic' eating.
One thing is clear: Obese people react much more hedonistically to sweet, fat-laden food in the pleasure and reward circuits of the brain than healthy-weight people do. Simply seeing pictures of tempting food can light up the pleasure-seeking areas of obese peoples' brains.
Two conferences this week on obesity are each examining aspects of how appetite works in the brain and why some people ignore their built-in fullness signals. Scientists hope that breakthroughs will lead to ways to retrain people's thinking about food or weight-loss drugs that can target certain brain areas.
In a study presented this week at the International Conference on Obesity in Stockholm, researchers from Columbia University in New York showed pictures of cake, pies, french fries and other high-calorie foods to 10 obese women and 10 non-obese women and monitored their brain reactions on fMRI scans. In the obese women, the images triggered a strong response in the ventral tegmental area (VTA), a tiny spot in the midbrain where dopamine, the 'desire chemical,' is released. The images also activated the ventral pallidum, a part of the brain involved in planning to do something rewarding.
'When obese people see high-calorie foods, a widespread network of brain areas involved in reward, attention, emotion, memory and motor planning is activated, and all the areas talk to each other, making it hard for them to resist,' says lead investigator Susan Carnell, a research psychiatrist at the New York Obesity Research Center at Columbia University.
Similar brain reactions occurred in the obese subjects even when researchers merely said the words 'chocolate brownie' -- but not when they saw or heard about lower calorie foods such as cabbage and zucchini. Reactions were far less pronounced in the non-obese subjects.
More such studies are being presented in Pittsburgh this week at the annual meeting of the Society for the Study of Ingestive Behavior. In one, neuroscientists from Yale University's John B. Pierce Laboratory had 13 overweight and 13 normal-weight subjects smell and taste chocolate or strawberry milkshakes and observed their brains with fMRI scans.
The overweight subjects had strong reactions to the food in the amygdala -- the emotional center of the brain -- whether they were hungry or not. The healthy-weight subjects showed an amygdala response only when they were hungry.
'If you are of normal weight, your homeostatic mechanisms are functioning and controlling this region of the brain,' says lead investigator Dana Small. 'But in the overweight group, there is some sort of dysfunction in the homeostatic signal so that even though they weren't hungry, they were vulnerable to these external eating cues.'
Studies have found that a diet of sweet, high-fat foods can indeed blunt the body's built-in fullness signals. Most of them emanate from the digestive tract, which releases chemical messengers including cholecystokinin, glucagon-like peptide and peptide YY when the stomach and intestines are full. Those signals travel up to the brain stem and then the hypothalamus, telling the body to stop eating.
Obesity also throws off the action of leptin, a hormone secreted by fat tissue that tells the hypothalamus how much energy the body has stored. Leptin should act as a brake against overeating, and it does in normal-weight people. But most obese people have an overabundance of leptin, and somehow their brains are ignoring the signal.
All these findings beg the question, which came first? Does obesity disrupt the action of leptin, or does a malfunction in leptin signaling make people obese?
Similarly, are some people obese because their brains overreact to tempting food, or do their brains react that way because something else is driving them to overeat? Researchers at Yale and elsewhere are turning to such questions next. 'It's possible that these changes reflect how the brain has adapted to eating patterns in obese people, and that could create a vicious circle, putting them at risk for even more disordered eating.' says Dr. Small.
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讓我們來想象一場典型的同事們給某人過生日的派對場麵。
中飯吃完了，大家都吃得很飽。然後，服務員送進來一個美味的巧克力蛋糕。蛋糕的形狀和香味──甚至是“蛋糕”這個詞本身──都激起人們腦部的快感滿足回路(pleasure and reward circuit)，對蛋糕美味的記憶隨之開啟，唾腺開始分泌。
此時，人們的胃部正發出微弱的信號：“這裏還在消化，別再吃了。”然(ran)而(er)，對(dui)蛋(dan)糕(gao)的(de)自(zi)然(ran)反(fan)應(ying)很(hen)快(kuai)占(zhan)據(ju)壓(ya)倒(dao)性(xing)優(you)勢(shi)。集(ji)體(ti)的(de)心(xin)理(li)暗(an)示(shi)讓(rang)每(mei)個(ge)人(ren)都(dou)覺(jiao)得(de)吃(chi)蛋(dan)糕(gao)是(shi)一(yi)種(zhong)理(li)所(suo)當(dang)然(ran)的(de)快(kuai)樂(le)之(zhi)事(shi)。很(hen)快(kuai)，大(da)家(jia)就(jiu)開(kai)始(shi)分(fen)而(er)食(shi)之(zhi)，一(yi)塊(kuai)，或(huo)是(shi)兩(liang)塊(kuai)。
學者們早就知道，人類的進食存在各種各樣的動機，希臘哲學家蘇格拉底(Socrates)有一句勸誡的名言：“你應該為了活而吃，而不是為了吃而活。”('Thou shouldst eat to live, not live to eat.')但現在，科學家正借助先進的腦部成像技術來探查，為何美食的誘惑能夠戰勝體內控製饑餓和飽腹感的生理機製，也就是“為了快樂而吃”和“為了需求而吃”到底孰強孰弱。
有一點很清楚：肥(fei)胖(pang)人(ren)群(qun)在(zai)麵(mian)對(dui)高(gao)糖(tang)分(fen)高(gao)脂(zhi)肪(fang)的(de)食(shi)品(pin)時(shi)，腦(nao)部(bu)快(kuai)感(gan)體(ti)驗(yan)回(hui)路(lu)的(de)反(fan)應(ying)要(yao)比(bi)體(ti)重(zhong)正(zheng)常(chang)的(de)人(ren)群(qun)積(ji)極(ji)得(de)多(duo)。隻(zhi)要(yao)看(kan)到(dao)美(mei)食(shi)的(de)圖(tu)片(pian)，肥(fei)胖(pang)人(ren)群(qun)腦(nao)部(bu)尋(xun)求(qiu)快(kuai)感(gan)的(de)區(qu)域(yu)就(jiu)馬(ma)上(shang)活(huo)躍(yue)起(qi)來(lai)。
2010年7月(yue)中(zhong)旬(xun)舉(ju)辦(ban)的(de)兩(liang)場(chang)肥(fei)胖(pang)問(wen)題(ti)研(yan)討(tao)會(hui)都(dou)在(zai)研(yan)究(jiu)人(ren)體(ti)腦(nao)部(bu)的(de)食(shi)欲(yu)反(fan)應(ying)機(ji)製(zhi)，以(yi)及(ji)為(wei)什(shen)麼(me)有(you)些(xie)人(ren)會(hui)忽(hu)視(shi)體(ti)內(nei)的(de)飽(bao)腹(fu)感(gan)信(xin)號(hao)。科(ke)學(xue)家(jia)希(xi)望(wang)在(zai)該(gai)領(ling)域(yu)的(de)突(tu)破(po)將(jiang)有(you)助(zhu)於(yu)改(gai)變(bian)人(ren)們(men)對(dui)食(shi)物(wu)的(de)渴(ke)求(qiu)程(cheng)度(du)，或(huo)研(yan)究(jiu)出(chu)能(neng)影(ying)響(xiang)腦(nao)部(bu)特(te)定(ding)區(qu)域(yu)的(de)減(jian)肥(fei)藥(yao)。
其中一個會議是在斯德哥爾摩舉辦的肥胖問題國際研討會(International Conference on Obesity)。在會上，來自紐約州哥倫比亞大學(Columbia University)的研究人員向10名超重女性和10名非超重女性展示了蛋糕、餡餅、薯條等高熱量食品的圖片，並通過功能磁共振成像(fMRI)掃描儀觀察她們的腦部反應。超重女性的中腦腹側被蓋區(ventral tegmental, VTA)迅速產生強烈的反應，導致中腦一個微小的區域分泌出被稱為“欲望化學物質”的多巴胺(dopamine)。這些圖片也激活了她們的腹側蒼白球(ventral pallidum, VP)，一個跟快感體驗行為相關的腦部區域。
“肥胖人群看到高熱量食品時，涉及快感體驗、關注、情緒、記憶和動作計劃的一係列腦部區域開始啟動，各個腦部區域相互溝通，導致他們很難抗拒進食的誘惑。”哥倫比亞大學紐約肥胖研究中心(New York Obesity Research Center)的首席研究員蘇珊.卡奈爾(Susan Carnell)說道。
即使研究人員隻是開口說“黑森林蛋糕”，接jie受shou觀guan察cha的de肥fei胖pang者zhe腦nao部bu也ye會hui產chan生sheng同tong樣yang的de反fan應ying，但dan當dang他ta們men看kan到dao或huo聽ting到dao卷juan心xin菜cai和he西xi葫hu蘆lu等deng低di熱re量liang食shi品pin時shi，腦nao部bu對dui此ci無wu動dong於yu衷zhong。對dui於yu非fei肥fei胖pang人ren群qun來lai說shuo，這zhe種zhong反fan差cha則ze要yao小xiao得de多duo。
攝食行為研究學會(Society for the Study of Ingestive Behavior)的年會本周在匹茲堡舉行，有更多的研究成果在會上公布出來。舉例而言，耶魯大學(Yale University)約翰•皮爾斯實驗室(John B. Pierce Laboratory)神經學家們讓13名超重者和13名正常體重者用鼻子聞並品嚐巧克力奶昔或者草莓奶昔，通過功能磁共振成像掃描儀觀察他們的腦部活動。
超重者的腦部杏仁核區域（大腦的情緒中心）對食物產生強烈反應──無論他們是否感到饑餓。體重正常者則隻有在饑餓的時候杏仁核區才會有類似反應。
“如果你體重正常，那說明你體內的自平衡機製在發揮作用，正控製著腦部的這塊區域。” 約翰•皮爾斯實驗室首席研究員斯莫爾(Dana Small)說，“但對超重者來說，他們的自平衡機製有點問題，因此即使不餓，也抵抗不了外界的美食誘惑。”
yanjiuhaifaxian，gaotangfengaozhifangdeshipinqueshihuirangrentineidebaofuxinhaobiandechidunqilai。juedaduoshuzheleixinhaolaiziyuxiaohuadao，dangweibuhechangdaozhuangmanshiwushi，huishifangchuyixiehuaxuexinshilaichuandibaofuxinhao，baokuodannangshousuosu、胰高血糖素樣肽和肽YY。這些信號依次傳輸到腦幹和丘腦下部，指示身體停止進食。
肥胖人群受瘦素(leptin)的de影ying響xiang也ye不bu明ming顯xian。瘦shou素su是shi一yi種zhong由you脂zhi肪fang組zu織zhi分fen泌mi的de激ji素su，能neng告gao訴su丘qiu腦nao下xia部bu體ti內nei已yi經jing儲chu存cun了le多duo少shao能neng量liang，還hai能neng製zhi止zhi人ren體ti過guo多duo進jin食shi。正zheng常chang體ti重zhong者zhe體ti內nei的de瘦shou素su在zai發fa揮hui作zuo用yong，但dan大da多duo數shu肥fei胖pang者zhe瘦shou素su分fen泌mi過guo剩sheng，導dao致zhi其qi腦nao部bu忽hu略lve了le瘦shou素su傳chuan遞di出chu的de信xin息xi。
所有這些研究都指向一個問題：誰才是罪魁禍首？是肥胖擾亂了瘦素的作用，還是瘦素信號失常導致人們變得肥胖？
haiyouyucileisideyigewenti，shiyixierendenaobuduimeishizuochuguojifanyingzaochengqishentibianpang，haishiyoubiedeyinsuqushitamenguoduojinshicongerdaozhinaobuzuochuguojifanying？yeludaxueheqitajigoudeyanjiurenyuanxiayibujiuyaoyanjiuzhexiewenti。“shifoucunzaizhezhongkenengxing，jifeipangrenqunduimeishideguojifanyingbiaomingqinaobuyijingshiyinglebuliangdeyinshixiguan，congerxingchengexingxunhuan，daozhifeipangzhechuxiangengyanzhongdejinshiwenluan。”斯莫爾說道。
