Energizing mind and body -
Although a mainstay of diabetes treatment, when secretion increases in response to a low-fat, high-carbohydrate diet or insulin resistance, insulin has been purported to raise blood pressure, potentiate cardiovascular risk, and, to make matters worse, promote weight gain 1 , 2.
But many in the lay public, popular media, and health care are not aware or choose not to acknowledge that insulin predated leptin as an adipostat hormone—one that circulates in the blood in proportion to body weight and binds to key brain centers to lower body weight 3.
Until recently, the mechanistic role of insulin in the central nervous system control of body weight had been worked out exclusively in animal models 4 — 8 , whereas evidence for its effect in humans remained circumstantial and controversial. In contrast, intensive diabetes therapy that includes increasing insulin dosage is frequently accompanied by unwanted weight gain and even obesity Hence the conundrum: is insulin good or bad for body weight in humans?
To answer the question of how central insulin action regulates energy balance, insulin would need to be administered directly to brain centers involved in determining food intake and energy expenditure without increasing peripheral levels, which can lead to hypoglycemia.
In addition, since brain biopsies are not an option in human studies, a noninvasive technique to measures brain responsiveness would also be required. Fortunately, imaging technologies have recently emerged that allow direct or indirect study of human brain function.
These include positron emission tomography and functional magnetic resonance imaging In this issue of Diabetes , Jauch-Chara et al. They conducted a prospective study on 15 healthy, normal-weight men and compared brain responses and food intake among those receiving intranasally administered insulin and placebo.
Intranasal administration delivers the drug to the olfactory mucosa, thereby allowing direct access to the brain. Indeed, studies of intranasally delivered insulin and other hormones have shown rapid penetration to the cerebrospinal fluid 13 as well as changes in brain response, including effects on appetite The dose of 40 IU of rapid-acting insulin chosen for this study did not change peripheral insulin or glucose levels and had previously been shown to decrease body weight in men when given repeatedly But rather than use positron emission tomography or functional magnetic resonance imaging to assess brain responses, the authors used magnetic resonance spectroscopy to measure changes in ATP and phosphocreatine PCr levels in the motor cortex.
Changes in these cellular components reflect the balance of cellular fuel production versus use and represent one mechanism thought to underlie nutrient-induced alterations in food intake and body weight Fig. Compared with placebo, men receiving intranasal insulin had increased ATP and PCr concentrations and reduced food intake during an ad libitum breakfast roughly 90 min later.
However, eating less during an ad libitum meal suggests that intranasal insulin increased fullness, an effect that most likely would have been demonstrated if subjects had been forced to eat the same amount of calories with each study meal isocaloric feeding.
Potential mechanisms of insulin-mediated neuronal signaling in the control of food intake. Adapted from ref. It also provides support for the role of brain energetics in determining food intake in studies of nutrient sensing and weight regulation.
The implications of this study could also be extended to other fields in which obesity and energetics have been linked, such as neurodegenerative diseases rev. in The possibility that intranasal insulin could result in ATP and PCr increases in obese patients, improvement in cognition and memory, and reduction in risk for neurodegenerative disease is a topic that merits further investigation.
Although its results are intriguing, this report has several limitations. First, the study population was limited to normal-weight men, thereby lacking generalizability to women and other weight categories.
Indeed, in the previously cited study of intranasally delivered insulin reducing body weight in men, women who received the same dose did not lose fat mass or body weight A second limitation is that subjects were not studied under circumstances of weight perturbation such as after under- or overfeeding to assess the directionality of the ATP and PCr response, a factor that is important in determining causation.
Third, insulin is known to act on transcription of hypothalamic neurotransmitters regulating food intake 6 , 22 as well as leptin receptor signaling through phosphatidylinositol 3-kinase As a result, it is unclear if the changes reported by Jauch-Chara et al.
Finally, the study lacks anatomic specificity because measuring ATP and PCr in the motor strip of the cortex is well removed from the brain centers currently thought to play important roles in determining energy expenditure and the behavioral control of food intake.
The article by Jauch-Chara et al. expands our understanding of this system by providing an important translational link between animals and humans regarding the role of energetics in body weight regulation.
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Volume 61, Issue 9. Previous Article Next Article. Article Navigation. Commentary August 17 Energizing the Mind and Body Paul Kievit ; Paul Kievit. This Site. Google Scholar. Jonathan Q. Purnell Jonathan Q.
Corresponding author: Jonathan Q. Purnell, purnellj ohsu. Diabetes ;61 9 — Leg extensions: Sitting in your chair, extend your right leg until it is level with your hip.
Hold as long as you are comfortable and then relax. Wrist stretch: Stretch your arm out in front of you with the palm up. With your other hand, grab your fingers and lightly pull them down to stretch your forearm.
Hand stretches: Tense and relax the muscles in your hands. Make fists, spread your fingers and bend your fingers. Research has shown that mindfulness can decrease stress and anxiety and increase mental health and cognitive functioning. Deep breathing: Breathe in deeply, holding that pose and count to five; slowly and comfortably, release your breath.
Repeat this nine more times. Body scan: A ten-minute body scan will help you get in touch with your body, finding and focusing on where you may be feeling tense and then releasing that tension.
The link here is a guided body scan enabling you to close your eyes and really focus on you and not your to-do list. Lunch breaks: Plan time away from your desk, eat alone or connect with others, taking the opportunity to mindfully eat to truly taste and enjoy your food.
These moves, stretches, breathing and mindful practices will certainly help you throughout your day. The end result of these practices may change how we arrive at home each afternoon, less stressed with energy to focus on enjoying our evening.
This article was published by Michigan State University Extension. Energize your mind and body during the work day.
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