Zusammenfassung
Die Regulation der Nahrungsaufnahme erfolgt im Zusammenspiel von Magen, Zentralnervensystem
und Fettgewebe. Der Verzehr einer Mahlzeit führt zu einer Aktivierung von Sättigungssignalen,
die innerhalb von 30 - 60 min ein Maximum erreichen und zur Unterbrechung der Nahrungsaufnahme
führen. Während der anschließenden Stunden nimmt das Sättigungsgefühl ab, während
das Hungergefühl wieder ansteigt. Die initiale Sättigung entsteht im Wesentlichen
durch Füllung des Magens. Die daraus resultierenden Dehnungsreize werden über vagale
Afferenzen in die übergeordneten Regulationszentren im Hypothalamus geleitet, wo sie
zu einer Aktivierung anorektischer Neurotransmitter führen. Das Auftreten des Hungergefühls
wird unter anderem durch den Wiederanstieg des gastralen Hormons Ghrelin aktiviert,
das im Hypothalamus zur vermehrten Freisetzung orexigener Neurotransmitter beiträgt.
Diese akute Regulation von Sättigung und Hunger wird durch das Volumen der Nahrung
und ergänzend in geringem Maß durch den Nährstoffgehalt bestimmt. Der Energiegehalt
der konsumierten Nahrung ist keine Regelgröße. Dementsprechend ist die Energieaufnahme
stark abhängig von der Energiedichte der verzehrten Lebensmittel. Frühe Untersuchungen
aus den 80er-Jahren haben Kohlenhydraten einen größeren Sättigungseffekt als Fett
zugeschrieben, während Protein wiederum einen stärkeren Einfluss auf die Aktivierung
von Sättigungssignalen als Kohlenhydrate haben soll. Diese Experimente haben die sättigende
Wirkung der einzelnen Makronährstoffe auf der Basis isokalorischer Testmahlzeiten
verglichen, was bedeutet, dass die Volumina kohlenhydrathaltiger Mahlzeiten im Vergleich
zu fettreichen Mahlzeiten immer größer ausgefallen sind. Legt man als Endpunkt der
Nahrungsaufnahme Sättigung zugrunde, so ist die verzehrte Nahrungsmenge unabhängig
vom Makronährstoffgehalt identisch und die Energieaufnahme entspricht der Energiedichte.
Insgesamt haben Kohlenhydrate keinen nährstoffspezifischen Effekt auf die akute Sättigung.
Ausmaß und Dauer von Sättigung und Hunger sowie die nachfolgende Nahrungs- und Energieaufnahme
werden durch Kohlenhydrate ebenfalls nicht nährstoffspezifisch beeinflusst. Die Daten
über Zucker und Nahrungsaufnahme sind sehr kontrovers. Detailliertere Studien mit
realistischen Zuckermengen sind dringend erforderlich.
Abstract
Food intake is regulated by a coordination of gastric, central nervous system and
adipose tissue functions. Meal ingestion activates satiety signals within 30 - 60
minutes to a maximum which leads to an interruption of food intake. During the following
hours satiety signals decrease while hunger sensations regain increasing activity.
Initial activation of satiety is mainly due to the filling of the stomach with subsequent
distension of the gastric wall. This leads to activation of afferent vagal fibers
which in turn stimulate anorectic hypothalamic neurotransmitters. The recurrence of
hunger sensations is at least in part due to the increase of the gastric hormone ghrelin
which stimulates orexigenic hypothalamic neurotransmitters. This acute postprandial
control of hunger and satiety is regulated primarly bei the ingested volume of the
food with a minor contribution of the nutrient content. The energy content of ingested
food has no acute effect on satiety wich means that energy intake is largely determined
by the energy density of the food items. Studies in the 80ies have suggsted that carbohydrates
are more satiating than fat, while protein is superior in this context compared to
the other two macronutrients. These experiments have compared the individual macronutrients
on an isocaloric basis, which means that ingested amounts of carbohydrates were greater
than those of fat-rich food. Food intake on the basis of satiation and satiety has
shown that consumption of the various macronutrients is related to volume so that
a nutrient specific satiation does not exist for carbohydrates. The extent and duration
of satiety as well as subsequent food and energy intake is regulated neither by nutrient-specific
effects. The available data about the role of simple sugars in feeding regulation
are a matter of debate and require more extensive studies considering more realistic
amounts of sugar intake with adequate control experiments.
Schlüsselwörter
Sätigung - Hunger - Magen - Vagus - Fett - Eiweiß - Kohlenhydrate - Energiedichte
- Hypothalamus
Key words
Satiety - hunger - stomach - vagus serve - fat - protein - carbohydrate - energy density
- hypothalamus
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Prof. Dr. med. V. Schusdziarra
Else-Kröner-Fresenius-Zentrum für Ernährungsmedizin · Klinikum rechts der Isar · TU
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