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HowTheHormonesGhrelinandLeptinAffectAppetite

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AppetiteControl

Thesethreehormones,orexin,gherlinandleptin,actonyourbraintonormalizeyourdriveforfood.Inthiswayyour
bodyrespondsappropriatelywithhungerforbreakfast.Breakfastisthecombinationoftwowords,breakandfast.

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HowTheHormonesGhrelinandLeptinAffectAppetite

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Whileghrelinisanappetitestimulatingpeptide,leptinisanappetitesuppressingone.Ghrelin,secretedfromthe
stomach,particularlyinfluencesthemetabolismoffattissuebypromotingitsstorageduringhardtimes.Leptinand

Eating&Sex

ghrelinfunctioninterdependentlyinhealthyhumans.

Ghrelin&Leptin

TheworldleptinmeansfullinGreek.Leptinisproducedinthefatcellsandreleasedinthebrain.Leptingivesusa
feelingofsatisfaction.Whileghrelinenhancesappetite,leptinactsasasatietysignaltodiminishit.Yet,itsnotthat
simple.Therearemultiplereceptorsinfatcells.Theseproduceotherhormones,whichcaninterfereinourresponseto

DrK'sDiet
Calories

foodintake.Abalanceexistsbetweenyourfatcellsandyourappetite.

Thediscoveryofghrelinattheendofthelastcentury,definitelycontributedtotheunderstandingoftheregulationof
appetiteandeatingbehavior.Ghrelin,consistingof28aminoacids,wasfirstidentifiedinthestomachin1999.Itis
producedinglandularcellsofthestomachlining,butisalsofoundinthepituitary,thehypothalamusandthe
pancreas.

Accordingtoongoingresearch,ghrelinhasmultiplebiologicalroles:forexample,ghrelinstimulatesthereleaseof
growthhormoneandalsoinducesariseintheconcentrationofotherhormonesincludingcortisol.Throughthese
multiplemechanismsghrelincanacceleratefoodintakeboostingweight.
Highlevelsofbloodsugartriggerthisovereatingbehavior.Inotherwords,bingeeatingoroutofcontrolfeeding,
calledhyperphagia,isassociatedwithamalfunctioninthebrainshungersignals.Thelevelofghrelindependsonthe
stateofnutritionandhydrationofanindividual.Soitseffectdoesnotendwithhunger,itaffectsthirstaswell.
Ghrelinfluctuatesbothbeforeandafterfoodintakewithanincreasepriortoamealandadecreaseafterwards.
Ghrelinalsoregulateswaterandfluidintake,soifyoudrinkaglassofwaterwhenyouarehungry,ghrelinsignalscan
besatisfiedandweakenedslightly.Thisprovidesasimplewaytocontrolyourhunger.Oneglassofwaterbefore
everymealdecreasestheamountyouwilleatbyatleast8ouncesandsuppressesghrelin.
Slimwomenhavelearnedtolowertheirghrelinlevel,buttheseamountsriseimmediatelywithdietinducedweight
loss.Yes,thinpeopledonotdietforthatveryreason.Iftheydid,theywouldstarttogainweight.Themoreaperson
diets,thehungriertheyget.Itisalmostasifsemistarvationtriggersgherlintoincrease.Thismaybepartofthe
reasonthatweregainweightlostbydietingandthensome.Thesecretistostopdieting.
InadditiontostimulatingGHsecretion,ghrelinaffectsyourstomachacidsecretionandhowsmoothlythefoodmoves
alongyourgut.Thisfunctioncalledintestinalmotilityisdamagedinbothconstipationanddiarrhea.Aconditioncalled
irritablebowelsyndromemaybenothingmorethanaghrelinimbalance.Moreresearchisneeded.
Ghrelininducesothermetabolicactionssuchasspikesinbloodsugar,calledthehyperglycemiceffect.Therefore
modifiedfasting,whichdecreasesghrelinsecretionandincreasesleptin,mayprovideaneffectivetechniquefor
treatingobesity.
Asyourcirculatingghrelinadaptstoweightloss,hungerdissipates.Ihavetoremindyouhowever,thatghrelinlevels
risewithdietingsothatthemoreyourestrictfoodintake,thehungrieryouget.Buthowcanfastinghelp?Thereisan
interestingslanttothisanswer.
Themoreyourestrictyourcalories,thelowerthebaselineforghrelin.Ghrelinlevelstendtodecreasenaturallyafter
youfastforafewdays.Thatmeansthatafterfastingformorethan48hours,yourhungerdiminishes.
Bydecreasingtheinflowoffoodandreducingcaloricintakeforaslittleasafewdays,youcanlessentheattendant
cravings.Thisisanimportanttiptoremember.Whenyouaregainingweight,fastfortwoorthreedaysandyouwill
becomelesshungryandregainsomecontrol.
Fortunately,throughthehelpofcertainmedications,youmaybeabletodecreaseghrelinforalongtime.Lowered
levelsofghrelinwillnotonlydecreaseyourappetite,butalsohelpyoutodevelopaleanerbody.Anotherinteresting
resultisthatasghrelindiminishes,growthhormonerises.
Increasedgrowthhormoneshiftsyourbodyfattoleanmusclewhileloweringbloodpressureandcholesterollevels.In

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HowTheHormonesGhrelinandLeptinAffectAppetite
thiscase,Iamreferringtonaturalgrowthhormone,whichincreasesafteryouhaveagoodnights
sleep.

Anincreaseintheghrelinlevelboostshungeroverthelongrun.Forthisreasonwithinayearoflosingoverten
pounds,almost95percentofdietersregaintheweighttheylost.
Anotherwayofputtingitisthatweightlosscauseschangesinappetiteandenergyexpenditurethateventually
promoteweightregaintotheoriginalsetpoint.Thisfactiswellknowntomostdieters,whoinevitablyreclaimalltheir
lostweightwithinayearbecausetheyweresohungryallthetime.Whatcanawellregimentedrepeatdietercando
besidesgetfatterandfatterwitheachdiet?
Stopdieting!Bynowyouhavediscoveredthatthedesireforfoodiscontrolledbycomplexinteractionsbetween
hunger/satietyandcaloricorenergyrequirements.Byslowingdowndigestionandincreasingthelengthoftimefood
staysinthestomach,itispossibletomaintainequilibriumbetweenghrelinandleptin.Throughfastingandchewing
yourfoodslowlyyoucansuppressghrelinandhungeratitsorigin.
Anothertipinvolvesaddingsolublefiberandeatinglargeamountsofcomplexcarbohydrates.Youcanfeelfulllonger
andslowdownthepassageoffooddownyourintestine.Slowdigestionabolisheshungerbyprovidingashortcutto
thelongtermsatietycenterinyourhypothalamus.
Selectinghighqualityprotein,lowfatfoodsthatrequireslowdigestionwhilechewingfoodveryunhurriedlyand
thoroughly,signalsyourbrainthatyouaregettingsatisfied.Finallyyoucanstopeatingafterthemealisover.
Letushaveaquickreview:thehormoneleptinactsinyourbraintoadjusttheexpressionofseveralchemicalsfrom
yourhypothalamus.Thesechemicalsmaintainthebalancewhenleptinfromyourfatcells,alertsyourbrainthatyou
havehadenoughtoeat.Whathappensnextisthatyoubecomelesshungry.
Thetransmitterthatmaintainstherelationshipbetweenfattissueandthebrainisknownasanendocannabinoid,
whichtranslatestheinformationastotheamountofbodyfatneededtodealwithenergyrequirement.Thinkofleptin
asafatcellthermostat,activeinthefatdepots,whilemonitoringyourenergymaintenancesystem.
Leptindoesthisbymodifyingtheappetiteregulatingchemicalscalledpeptides,whichareeitherappetitestimulating
(orexigenic)orappetitesuppressing(anorexigenic).Leptinalsosuppressesaliverenzymethatconvertsunsaturated
fatsintomonounsaturatedfatsburningfatasenergy.
Thebalanceandcommunicationbetweenthesetwosystemssetsalimitonfoodintakeandgrowthhormonerelease.
Animpairmentofthisequilibriumresultsindisordersoffeedingbehaviorsuchasweightgainorweightloss
(cachexia).Neitherisverydesirable.Ifleptinissouseful,whataboutgettingleptinshots?
Unfortunately,doctorscantgivesomeonealeptinshottomakethemstopeating,sinceinseverelyobesepeople,
unlikemice,hormonesseemtoworkdifferently.Ingeneticallyalteredmice,withoutthereceptorforleptin,injecting
leptinwillonlypartiallycorrectthedefectreversingtheirobesity.Thisindicatesthatotherfactorsplaysupporting
roles.Leptincorrectsinsulinresistance,ordiabetes,inmicethatlackfattissue(aconditioncalledlipodystrophy).
Scientistshavetriedleptinreplacementtherapyinlipodystrophichumanswithgoodresults.
Peoplewhoareoutofcontrolwiththeireatingmayhavebecomeleptininsensitive.Inreality,whentheyarefull,they
dontstopeating.Theyhavebecomeresistanttotheirownleptineffects.Ifleptinisnotworkingthentheenzyme
mentionedearlierrisesandmorefatisstoredintheliver.Womenseemtosufferfromthisproblemmorethanmen.
Butrememberthatmostofthesegeneticeffectshavebeenbredintoourspeciesovertime.Youcanmodifyyour
genetics.
HellstromPM,etal.Peripheralandcentralsignalsinthecontrolofeatinginnormal,obeseandbingeeatinghuman
subjects.BrJNutr.2004Aug92Suppl1:S4757.
BroglioF,etal.JClinEndocrinolMetab.2001Oct86(10):50836.Ghrelin,anaturalGHsecretagogueproducedby
thestomach,induceshyperglycemiaandreducesinsulinsecretioninhumans.
TritosNA,MaratosFlierE.Twoimportantsystemsinenergyhomeostasis:melanocortinsandmelaninconcentrating
hormone.Neuropeptides.1999Oct33(5):33949
DiMarzoV,etal.Leptinregulatedendocannabinoidsareinvolvedinmaintainingfoodintake.Nature.
2001Apr12410(6830):8225
OralEA,SimhaV,etal.Leptinreplacementtherapyforlipodystrophy.NEnglJMed.2002Feb21346(8):5708.
elif_arioglu@nih.gov

ChanJL,etal.Ghrelinlevelsarenotregulatedbyrecombinantleptinadministrationand/orthreedaysof
fastinginhealthysubjects.JClinEndocrinolMetab.2004Jan89(1):33543.
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Copyright20062009,AbrahamHKryger,MD,DMD.
ContacttheDoctor:DrK@wellnessmd.com

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Disclaimer:Thisbookisforpeopleinwhombeingoverweightcontributestopoorhealthandinterfereswithadesired,activelifestyle.Itisrecommended
thatyouconsultyourownphysicianbeforeusinganyofthemedicationsorsupplementsdiscussedinthisbook.Theplansarenotforeveryone,WellnessMD
ontheWebdoesnotwarrantytheresultsandshallhavenoliabilityforinformationprovidedonthisoranyotherInternetwebsite.Therecommendationsfor
dietarysupplementsareonlyforhealthpurposes.Thisinformationisprovidedsolelyasaguidelinetobeusedwhendiscussingaweightlossprogramwitha
medicalprofessional.

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