CARTAS AL DIRECTOR

 

Alcohol intake and hormonal dysregulation of food intake: would be a path to contributor of obesity?

El consumo de alcohol y la desregulación hormonal de la ingesta de alimentos: sería un camino a la contribución de la obesidad?

 

 

Correspondence

 

 

Historically, the consumption of alcoholic beverages in conjunction with meals or as an aperitif has been observed worldwide.¹ Moreover alcohol intake has been always a topic of great interest to medical community and patients. It follows from this those medical practitioners need information on how best to respond the patients´ questions about alcohol and gain weight.

Recent studies have reported increased appetite after alcohol intake, and has been suggested that alcohol may have multiple effects on appetite, such as suppresses fatty acid oxidation and leptin and stimulated neuropeptide Y (NPY) and ghrelin, affecting innumerable neuroendocrine and peripheral systems involved in appetite control.^2,3

Several studies also showed that the alcoholist and/or when the individual pass for periods of withdrawal occur increase of hunger and food intake.^3,4 Clinical studies showed that these processes homeostatic are mediated by greater secretion of ghrelin and by the powerful orexigenic neurons, such as NPY and agouti-related protein (AgRP).^1,3

Briefly, it is known that alcohol intake moderate to high (up to two doses equivalent to 30 grams of ethanol/day) can decrease the oxidation of fatty acids in the liver, increases or not change energy expenditure, activates the secretion of NPY,⁴ activates the release of ghrelin,^2,3 a orexigenic hormone and inhibit the anorexigenic hormones, such as leptin,⁵ serotonin (5HT),¹ and GLP-1.⁵ On the other hand, abstinence/alcohol dependence increases the desire to eat sweet food, leading to weight gain and obesity.

However, no study had showed that the effects of alcohol intake alone lead to weight gain. Likewise, is known that alcohol intake is more associated with abdominal fat than with body mass index. At the same time, strong evidences^3-5 indicates that ethanol intake from low to high quantities may to stimulate several orexigenic peptides and inhibit the anorectic peptides. However, the literature is still scarce and more epidemiological studies could report better the relationship between alcohol and hormones that appetite control.

Therefore, the relation between alcohol intake and obesity represent a challenge for medical providers and scientific investigators, and also contentment for patients who are vulnerable to the misinformation that exists regarding alcohol and appetite regulation. Otherwise, health care providers are in the position of having to simplify much of the information provided by the scientific investigations.

 

Acknowledgements

The authors are supported by grants from Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP, Brazil).

 

G. D. Pimentel¹, F. S. Lira² y J. C. Rosa^2
1Department of Internal Medicine. FCM, State University of Campinas (UNICAMP), Campinas, SP. Brazil.
²Department of Physiology Nutrition, Federal University of São Paulo (UNIFESP), São Paulo, SP. Brazil.

 

References

1. Yeomans MR, Caton S, Hetherington MM. Alcohol and food intake. Curr Opin Clin Nutr Metab Care 2003; 6 (6): 639-44.         [ Links ]

2. Konturek SJ, Konturek JW, Pawlik T, Brzozowki T. Brain-gut axis and its role in the control of food intake. J Physiol Pharmacol 2004; 55 (1): 137-54.         [ Links ]

3. Pimentel GD, Bressan J. Alcohol consumption alters the appetite regulation hormones, increasing the hungry and body weight. Rev Bras Nutr Clin 2010; 25 (1): 83-90. [In portuguese]         [ Links ].

4. Kim DJ, Yoon SJ, Choi B, Kim TS, Woo YS, Kim W et al. Increased fasting plasma ghrelin levels during alcohol abstinence. Alcohol Alcohol 2005; 40 (1): 76-9.         [ Links ]

5. Raben A, Agerholm-Larsen L, Flint A, Holst JJ, Astrup A. Meals with similar energy densities but rich in protein, fat, carbohydrate, or alcohol have different effects on energy expenditure and substrate metabolism but not on appetite and energy intake. Am J Clin Nutr 2003; 77 (1): 91-100.         [ Links ]

 

 

Correspondence:
Gustavo Duarte Pimentel.
Department of Internal Medicine.
State University of Campinas (UNICAMP).
Rua: Tessália Vieira de Camargo, 126.
CEP: 13083-970 Distrito Baräo Geraldo-Campinas/SP. Brazil.
E-mail: gupimentel@yahoo.com.br

Recibido: 3-II-2011.
Aceptado: 5-IV-2011.