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Hunger can be taught: Hunger Recognition regulates eating and improves energy balance

Authors Ciampolini M, Lovell-Smith HD, Kenealy T, Bianchi R

Received 23 November 2012

Accepted for publication 15 March 2013

Published 17 June 2013 Volume 2013:6 Pages 465—478

DOI https://doi.org/10.2147/IJGM.S40655

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2


Video abstract presented by David Lovell-Smith

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Mario Ciampolini,1 David Lovell-Smith,2 Timothy Kenealy,3 Riccardo Bianchi4

1Unit of Preventive Gastroenterology, Department of Pediatrics, Università di Firenze, Florence, Italy; 2Department of General Practice, University of Otago, Christchurch, New Zealand; 3Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand; 4Department of Physiology and Pharmacology, State University of New York Downstate Medical Center, Brooklyn, NY, USA


Abstract: A set of spontaneous hunger sensations, Initial Hunger (IH), has been associated with low blood glucose concentration (BG). These sensations may arise pre-meal or can be elicited by delaying a meal. With self-measurement of BG, subjects can be trained to formally identify and remember these sensations (Hunger Recognition). Subjects can then be trained to ensure that IH is present pre-meal for most meals and that their pre-meal BG is therefore low consistently (IH Meal Pattern). IH includes the epigastric Empty Hollow Sensation (the most frequent and recognizable) as well as less specific sensations such as fatigue or light-headedness which is termed inanition. This report reviews the method for identifying IH and the effect of the IH Meal Pattern on energy balance. In adults, the IH Meal Pattern has been shown to significantly decrease energy intake by one-third, decrease preprandial BG, reduce glycosylated hemoglobin, and reduce insulin resistance and weight in those who are insulin resistant or overweight. Young children as well as adults can be trained in Hunger Recognition, giving them an elegant method for achieving energy balance without the stress of restraint-type dieting. The implications of improving insulin sensitivity through improved energy balance are as wide as improving immune activity.

Keywords: energy intake, hunger, energy balance, food intake regulation, prevention, insulin resistance, obesity, diabetes, inflammation, risks

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