Mokhoa oa moputso oa lijo: Pono ea morao-rao le litlhoko tsa ho etsa lipatlisiso nakong e tlang (2015)

Miguel Alonso-Alonso, Stephen C. Woods, Marcia Pelchat, Patricia Sue Grigson, Eric Stice, Sadaf Farooqi, Chor San Khoo, Richard D. Matt, Gary K. Beauchamp

DOI: http://dx.doi.org/10.1093/nutrit/nuv002

E phatlalalitsoe pele inthaneteng: 9 April 2015

inahaneloang

Sengoloa sena se lekola lipatlisiso tsa morao-rao le maikutlo a khalemelo mabapi le methapo ea moputso oa lijo ho liphoofolo le batho, e hlahloba mohopolo oa saense mabapi le tšebeliso ea lijo, e bua ka liphephetso tsa mekhoa le polelo, mme e supa likheo tsa tsebo le litlhoko tsa lipatlisiso tsa nako e tlang. Lihlooho tse boletsoeng mona li kenyelletsa karolo ea moputso le likarolo tsa hedonic taolong ea takatso ea lijo, neuroanatomy le neurobiology ea tsamaiso ea moputso ho liphoofolo le batho, karabelo ea ts'ebetso ea moputso oa boko lijong le lithethefatsi tse fumanehang habonolo, phetolelo ea takatso e matla ea ho khahlano le temallo taolo ea moputso oa lijo. Litaba li thehiloe ho seboka se tšoaretsoeng 2013 ke Lekala la Amerika Leboea la Setsi sa Saense sa Bophelo sa Machabeng.

  • lemalla ntho
  • takatso
  • litlhaloso
  • Sisteme ea moputso oa lijo
  • lijo tse monate
  • mahlale a phetolelo

SELELEKELA

Ho hola tsebo holima karolo ea tsamaiso ea moputso oa lijo ho batho tsamaisong ea phepelo ea lijo, hammoho le khokahano e boletsoeng pakeng tsa mokhoa oa moputso oa lijo le ho lemalla, ho khothalelitse thahasello le lipatlisiso kahara sechaba sa mahlale. Lintho tse ngata tse tloaelehileng tsa lijo li tšoantšoa le lithethefatsi tseo hangata li hlekefetsoang ke batho, tse kang nicotine, joala, matekoane, methamphetamine, koae le opioids (Setšoantšo sa 1). Lithethefatsi tsena li 'nile tsa amahanngoa le tšebeliso ea tloaelo e khetholloang ka litlamorao tse sa khaotseng (tlhekefetso) le ts'ehetso ea mmele. Lipotso tse ngata tsa morao-rao li shebile hore na lijo (mohlala, tsoekere, linoko, letsoai le mafura) li ka etsa hore ho be joalo. Melemo ea lijo ea hedonic e ka susumetsa ho fepa le ha litlhoko tsa matla li fihletsoe, li tlatsetsa ho matlafeng le botenya.1 Likhakanyo tsa morao-rao tsa botaki ba bongoana le tsa batho ba baholo United States li bonts'a hore, kamora kholo ea lilemo tse mashome a 3, litekanyetso tsa botona li theohile lilemong tse leshome tse fetileng.2 Leha ho le joalo ho ata ha botenya ho ntse ho phahame haholo, ho beha Maamerika kotsing ea mathata a mangata a bophelo bo botle le ho eketsa litšenyehelo tsa tlhokomelo ea bophelo ba naha.

Setšoantšo sa 1

Maemo a tlhekefetso? Saense e ntse e lokela ho tseba mekhoa eohle ea ketso e ka khethollang lijo ho lithethefatsi mabapi le ho lakatsa, ho ts'epahalla, ho mamellana le tlhekefetso.

Lithethefatsi le lijo tse fumanehang habonolo li arolelana thepa e 'maloa. Ka bobeli li na le litlamorao tse matlafatsang tse arohaneng, ka karolo e 'ngoe, ka ho eketseha ha dopamine ka tšohanyetso tsamaisong ea moputso oa boko.3 Tlhahlobo ena e shebisisa lintlha tsena tse tšoanang le tšusumetso ea likarabo tsa hedonic lijong tsa ho ingestive boits'oaro, ho ja matla le botenya. Lihlooho tse boletsoeng li kenyelletsa tlatsetso e matla ea taolong ea lijo ho batho, neuroanatomy le melaoana e akaretsang ea moputso oa boko, likarabo tsa moputso oa lijo le ho tšoana pakeng tsa lijo le lithethefatsi, tlatsetso ea liphatsa tsa lefutso le ho nona haholo, taolo ea kelello ea moputso oa lijo, lits'ebeliso tsa phetolelo, le liphephetso ho ho hlalosa “bokhoba” litabeng tsa lijo. Leha mosebetsi ona o tsoela pele ho hlakisa mohopolo oa bokhoba ba lijo le tšebeliso ea oona, ponaletso, le botsamaisi, ho hlakile hore lipotso tse thata mabapi le litsela tse ikhethang le likarabo tse tšoanang tsa lipakeng tsa lithethefatsi le lintho tsa lijo le litlamorao tsa ts'ebetso ea ho ja li lula li sa arajoa le hloka lipatlisiso tsa nako e tlang bathong.

TLHALOSO EA HEDONIC HO TLOTLISANG BOPHELO BA LINTHO TSE KENG HO BATHO

Ho ata ha botenya le tšebeliso ea lijo ka bongata United States e eketsehile haholo ho tloha li-1970 tsa morao-rao,4 e hatisa tlhokahalo ea ho utloisisa ka botlalo likarolo tse ka tlase tsa "neuronal" tse jang tlasa lijo. Molao oa taolo ea lijo o kenyelletsa kamano e haufi pakeng tsa lintlha tsa homeostatic le nonhomeostatic. Lintho tsa pele li amana le litlhoko tsa phepo e nepahetseng le ho lekola matla a fumanehang ka har'a mali le mabenkele a mafura, athe a morao-rao a nkuoa a sa amanngoe le litlhoko tsa phepo le matla, leha mefuta eo ka bobeli e sebetsa lipakeng tsa methapo ea mantlha ea boko. Ho boloka matla a lekantsoeng kamehla ho hloka boemo bo nepahetseng ba taolo: esita le tšebeliso e poteletseng empa e tsitsitseng pakeng tsa tšebeliso ea matla le tšebeliso ea matla e ka baka phaello ea boima ba 'mele.5 Tekanyo e ntle ea likhalori tse 11 ka letsatsi ho feta tlhoko ea matla ea letsatsi le letsatsi (e eketsehang ka boima ba 'mele), kapa kcal e ka bang 4000 ka selemo,6-8 e ka fella ka phaello ea boima ba lik'hilograma tse fetang selemo ho motho ea boima bo itekanetseng. Ho boloka boima ba 'mele ho theosa le lilemo, ho tlameha ho be le botsitso bo botle bo lebisang ho nyollo e kholo ea phepelo e felletseng (joalo ka ha ho bonoa ho batho ka kakaretso, moo ho kenella ho nyolohileng ka> 1 kcal / d nakong e fetileng ea 200 y); leha ho le joalo, ho leka-lekana feela ho hloka ho ba ntle ka chelete e nyane letsatsi le letsatsi.

Boithuto ba boithuto maemong a laoloang a tikoloho (mohlala, liphoofolo maemong a laboratori) li fana ka maikutlo a hore ho na le lintlha tsa homeostatic tse tsamaellanang le tšebeliso ea matla le matla a hlokahalang ho laola ka nepo boima ba 'mele nako e telele ea nako.9 Ka lehlakoreng le leng, datha ea palo ea baahi ho tsoa liphuputsong tsa lefu la seoa e bontša tloaelo e matla ea ho nona ho boima ba batho. Lilemong tsa 30 tse fetileng, litheko tsa batho ba baholo ba botenya li boetse li imena habeli, ho tloha 15% ho 1976 ho 35.7% ho 2009-2010. Batho ba baholo ba Amerika ba boima ho feta liponto tsa 24 kajeno ho feta ho 1960,10 le 68.7% ea batho ba baholo ba US ba na le boima bo feteletseng kapa ba batenya.11 Keketseho ena e boima bo itekanetseng e kanna ea bonts'a phetoho tikolohong. E boetse e fana ka maikutlo a hore, ha nako e ntse e tsamaea, batho ba sa tlatsetseng ho tlatseng lijo ba ka ba le tšusumetso ho feta ea homeostatic (Setšoantšo sa 2).

Setšoantšo sa 2 - Litšusumetso tsa homeostatic le nonhomeostatic taolong ea phepelo ea lijo. Takatso ea lijo e khethoa ke tšebelisano lipakeng tsa taolo e thata ea homeostatic le nonhomeostatic. Sesebelisoa: CCK, cholecystokinin.

Mekhoa e mengata e sa amaneng le tumellano le moputso oa boko. Ho utloisisa karolo ea bona ke karolo ea pele lefapheng lena la lipatlisiso. Ho fihlela haufinyane tjena, lithuto tse ngata li ile tsa shebana le karolo ea karolo ea takatso ea takatso ea lijo le li-signature tsa homeostatic tse kang li-hormone tsa metabolic le ho fumaneha ha limatlafatsi maling.12 Leha ho le joalo, thahasello ea ho utloisisa hore na liphoofolo le batho ba ja joang ka tsela e sa laoloang, kapa litlhoko tsa metabolic, e se e le ntho ea bohlokoa lilemong tsa morao tjena.12 Likarolo tse latelang li bua ka neuropransmitter dopamine, e hlahisoang bohareng ba mpa mme e tsosa libaka tsa maoto tse kang li-nucleus accumbens. Dopamine e hlahile e le tšusumetso e kholo ea nonhomeostatic holim'a tšebeliso ea lijo.

Mekhoa ea ho qala lijo hangata ha e anyohe, athe tse khethollang boholo ba lijo hangata li hlobaetsa (ke hore, lintlha tse susumetsang ha lijo li tla qala li fapana ka tsela e fapaneng le e khethollang hore na lijo li tla fela neng). Lijo tse lebelletsoeng esale pele li etelletsoa pele ke sechu e laoloang ke lihormone tse laoloang ke tsamaiso ea methapo ea lijo bakeng sa mojaro oa matla o lebelletsoeng13 mme e fetoloa ka moputso o lemohuoang, ho ithuta, tloaelo, bonolo, monyetla le maemo a bophelo. Ka lehlakoreng le leng, ho felisoa ha lijo (ke hore, boholo ba lijo le maikutlo a ho tlala kapa satiation) e laoloa ka karolo ke lipontšo tse tsoang pampiring ea gastrointestinal (mohlala, cholecystokinin, glucagon-like peptide-1, ghrelin, apolipoprotein A-IV, peptide YY) ka tekanyo ea limatlafatsi tse kengoang, 'me karolo e' ngoe e sebelisoa ke matšoao a sa amaneng.9 Babuelli ba bang ba li-hormonal (mohlala, ghrelin le leptin) ba sebetsa ka tšusumetso e kopanetsoeng libakeng tsa boko tse kenyelletsang ho melaoana ea homeostatic le nonhomeostatic.

Taolo ea homeostatic taolong ea lijo hangata e tsamaisoa ke taolo ea nonhomeostatic, le ea ho lekola hore na motho o tla ja lijo tse kae. Matšoao ana ke a bohlasoa ebile a fetoloa habonolo ke lintho tse sa bonahaleng. Ho fumaneha ho ntseng ho eketseha ha lijo tse matlafatsang le tse fumanehang habonolo lilemong tse mashome a seng makae tse fetileng ho bontša tšusumetso eo lipontšo tse amanang le moputso li ka fanang ka tsona. Haele hantle, lipontšo tse amanang le moputso li ka fetisa matšoao a lapeng a ka etsang hore a be le boima bo tsitsitseng, ka ho etsa joalo a kenya letsoho ho ho ja ho feta tekano.13

Lithethefatsi le lijo li arolelana litšobotsi tse itseng, empa li fapana ka mekhoa ea boleng le ea boholo. Lithethefatsi tsa tlhekefetso, joalo ka cocaine le amphetamine, li susumetsa ka kotloloho mekhahlelo ea dopamine ea boko; lithethefatsi tse ling li susumetsa lipotoloho tse tšoanang tsa boko hape li na le phihlello e potlakileng, ea potoloho ea meputso ea boko. Lijo li susumetsa lipotoloho tse tšoanang ka mekhoa e meng e 'meli e sa tobang. Ea pele ke ho kenella ka neural ho tsoa ho litlatsetso ho ea ho dopamine-secreting neurons bokong, 'me ea bobeli ke karolo ea morao-rao e fetisoang ke lihormone le matšoao a mang a hlahisoang ke tšilo le ho monya lijo tse kenngoeng. Taba ea bohlokoa, leha ho le joalo, ke hore litšusumetso tse fapaneng tsa ho ja lijo le dichotomies tsa khafetsa (mohlala, homeostatic vs nonhomeostatic kapa appetitive vs moputso) lia thetsa hobane litataiso li tsamaellana ka botlalo maemong ohle a neural potoloho le ka ho khetheha li-neurotransmitters tse amehang. Lithuto tsa nako e tlang li hloka ho lekola likhopolo tsena ka ho bapisa phello ea lithethefatsi kapa lijo ho motho a le mong. Ka kakaretso, mekhoa e metle ea boits'oaro e hlokahala ho ithuta taolo ea phepelo ea lijo ho batho.

TLHOKOMELISO EA MOTSOALLE OA LEBITLENG LA METSOALLE: NEUROANATOMY LE MELAO-MOTHEO EA PELE

Hoo e batlang e le eng kapa eng ea boiphihlelo ba motho e ka ba e ntle, ea e fa monyetla oa ho lemalla, 'me sena se bonahala hohle le ka litso tse fapaneng. Ho latela khatiso ea 5th ea Mokhatlo oa American Psychiatric Association's Buka ea ho hlahloba le ea Statistical ea Mathata a kelello (DSM-5),14 Tlhahlobo ea ho lemalla lithethefatsi e hloka bonyane tse peli tsa tse latelang: ho tlosa, ho mamella, ho sebelisa lintho tse ngata ho feta nako e telele, ho qeta nako e ngata ho fumana le / kapa ho sebelisa ntho eo, liteko tse phetoa-phetoang tsa ho tlohela, mesebetsi e filoeng, mme o tsoelapele ho sebelisoa le ha o bile le litlamorao tse mpe (Setšoantšo sa 3).14 Kahoo, joalo ka tšusumetso leha e le efe e 'ngoe, lijo li belaela.

Setšoantšo sa 3  Litekanyetso tsa DSM-5 tsa bothata ba tšebeliso ea lithethefatsi. Ts'oaetso e hlahlojoa e le ntho e bobebe (lintho tsa 2-3), e leka-lekaneng (lintho tsa 4-5), kapa e matla (6 kapa lintho tse ling).14

Sistimi ea neural e parolang boiphihlelo ba moputso e na le khokahano ea libaka tsa boko tseo lithuto li bonts'ang li hola ka palo le ho rarahana.15 Tsela ea mesocorticolimbic ke karolo ea mantlha ea sistimi ena. E hlaha ho li-neuron tsa dopaminergic tse sebakeng sa bohareng ba mokokotlo tse romellang ho supa libaka sebakeng sa matsoele a maoto, haholoholo ea li-nucleus, hammoho le cortex ea pele.16 Cortex ea pele, le eona e fana ka lipakanyo tse theohelang ho li-bokono tsa bokellase le sebaka se kenellang hare.17 Potoloho ena ea mesocorticolimbic, ka hona, ke sebapali sa bohlokoa tseleng e tloaelehileng e hlophisang lipontšo le ho laola boitšoaro bo susumetsang lithutong mme ho ea ka datha ea ho nahana ka batho.18

Ho ts'ehetsa karolo e bohareng e khothalelitsoeng bakeng sa tsela ea mesolimbic, lithuto li bonts'a maemo a phahameng a dopamine ka har'a li-nucleus tse bokellanang tsa likhoto ka mor'a ho pepesetsoa lijo,19 liswiti,20 le thobalano.21 Lithethefatsi tse iphelisang (mohlala, cocaine, morphine, le ethanol) le tsona li lebisa ho nyolohelo ea li-dopamine tsa li-nucleus.22 Maemo a dopamine a phahame le ho tsepamisa mohopolo ha monate23 le sethethefatsi ka har'a likhoto.22 Kamora nako, lithuto tse inahaneloang bathong li tlaleha ts'ebetso ea striatum ho arabela lijo,24 lithethefatsi,25 chelete,26 le maikutlo a lerato.27

Kamora nako, batho le liphoofolo ha ba fumane meputso feela: ba e lebelletse. E le karolo ea ts'ebetso ea ho ithuta, maemo a dopamine ka har'a li-nucleus tsa li-nucleus le tšebetso ea li-neuron tsa nucleus li phahamisoa ho arabela mekhoa ea lijo,28 liswiti,29 thobalano,21 kapa lithethefatsi.30 Ts'ebetso ea Neural bokong ba li-nucleus le eona e eketseha ka karabelo ea likhakanyo bakeng sa meputso e meholo le e menyenyane.29 Joalo ka boko ba rat, boko ba motho bo boetse bo arabela linthong tse amanang le lijo, lithethefatsi kapa joala.3,31

Maemong a mang, cue e ka supa ho fumaneha ha moputso hanghang. Ho a mang, ho ka supa hore moputso o haufi empa taba eo e tla hloka ho emela ho fumana moputso. Le ha ho bonahala ho supa ho fumaneha ha moputso kapele ho nyolla maemo a dopamine, a bona a bonts'a lebelo le lebisang maemong a fokolisitsoeng a li-nucleus accumbens dopamine litekong.32 Ho joalo, ho emela sethethefatsi ke boemo bo seng monate lipapaling le bathong, 'me ho qala ha eona ho amana le ho nyolla meputso e meng. Ho nahana ka meputso e meng ke mokhoa o mong o tsebahalang oa ho lemalla. Kahoo, likhoto li qoba ho jella cessine ea mofuta oa eona e ntle haholo ha u ntse u emetse monyetla oa ho sebelisa k'hok'heine. Ha ho qojoa lekhopo la tatso ho le hoholo, le ho feta le ho feta leo le sebelisang lithethefatsi.33-35 Ka mokhoa o ts'oanang, batho ba emeng ho tsuba ba bonts'a boits'oaro bo fapaneng le ba bona mme ba sitoa ho etsa karabelo e tloaelehileng ea ho ts'oara le ho lahleheloa ke chelete. Habohlokoa, liphetho tsena li ne li amana le ho tsuba le ho etsa tlhahlobo ea likhetho tse peli.26,36,37 Tlas'a maemo ana, ho sebelisa lithethefatsi (cocaine lithutong tsa litent le nicotine lithutong tsa batho) ke khalemelo e ntle ho feta boemo bo fetohileng bo fetohileng, ka hona ho matlafatsa (ke hore, "stamping-in") ho tsoela pele ka ts'ebeliso ea lithethefatsi ka ts'ebeliso e mpe.38

Likarabo tsa batho ka bomong li fapana haholo, 'me batho ba bang le liphoofolo ba arabela ka tsela e fapaneng ho feta tse ling. Ka hona, ho a khonahala ho fetola ka mokhoa o makatsang karabelo ea motho meputsong, haholo lithethefatsi, ka boiphihlelo. Ts'ebeliso ea lithethefatsi le joala e fokotseha haholo kamora ho pepesetsoa tikoloho e ntlafalitsoeng39 le ho fihlella lebili le tsamaeang40 ka likhoto, kapa kamora ho pepesetsoa boikoetliso bathong.41 Ka lehlakoreng le leng, ho haelloa ke boroko ho sa feleng ho eketsa karabelo ea lijo bathong le karabelo ea koae ho likhoto.42,43 Ka mokhoa o ts'oanang, bathong, ho na le phapang e kholo lipakeng tsa ts'ebeliso e mpe ea lithethefatsi le mathata a ho ja a tšoaetsoang ke ho ja lijo tse sa thibeloang letho.44 Litekong, boitšoaro bo kang bokhoba ba koae bo matlafatsoa (bo feta makhetlo a mararo) ke nalane ea ho itlotsa ka mafura,45 'me ho arabela ethanol ho matlafatsoa ke nalane ea ho itlopa joala ka tsoekere.46

Ka bokhutšoanyane, dopamine ha e latele feela meputso eohle ea tlhaho le lithethefatsi tsa tlhekefetso tse lekiloeng litsing le bathong, e boetse e latela mohlala oa lintho tsena. Tabatabelo ea tebello ea monko o monate haholo47,48 kapa sethethefatsi sa tlhekefetso26,49 e lebisa ho devaluation ea moputso o fokolang. Ho joalo, litakatso tsa lithethefatsi ha li tlise tlhatlhobo feela empa hape le ho qaleha ha boemo bo khopameng ha ho tlameha ho emeloa ho fumana moputso oo ba o batlang. Mmuso ona o ka kenyelletsa ho lakatsa kapa ho tlohela. Lintlha tsa morao-rao li bonts'a hore boemo bona bo mahlonoko bo ka ntlafala ka mor'a ho pepeseha ts'ebetso ea lithethefatsi mme bo ka bolela esale pele hore na mang ea tla nka sethethefatsi ke neng, neng le neng.50 Leha ho le joalo, joalo ka ha ho hlalositsoe pejana, kotsi ea motho ka mong e ka fokotsoa kapa ea eketsoa ka likhoto le batho ka lintlha tse 'maloa, ho kenyelletsa le boiphihlelo (mohlala, ho fumaneha ha moputso o mong, monyetla oa ho ikoetlisa, ho hloka boroko bo sa feleng, kapa nalane ea ho loants'a. ka mafura).

Ho bohlokoa ho hlokomela hore, ka mefuta eohle ea boitšoaro ba batho, mefuta eohle ea menahano e ka ba moputso (mohlala, ho chesoa ke letsatsi, ho ea mabenkeleng, ho becha, ho phunya tattoo, ho ikoetlisa, lijo, lino, thobalano le lithethefatsi). E 'ngoe le e' ngoe ea lintho tsena e susumetsa, e ka ts'ehetsa nts'etsopele ea boitšoaro bo lemallo, ho kenyelletsa ho batla, ho nka, le / kapa ho kenya letsoho, ka linako tse ling ka tefo e kholo. Tse ling tsa litšusumetso tsena li ka lemalla ho feta tse ling, 'me batho ba bang ba hlaseleha habonolo. Lijo, joalo ka tšusumetso e 'ngoe e ntle, ka hona e na le monyetla oa ho ts'ehetsa nts'etsopele ea boitšoaro bo lemalloang. Bophelo, ka lehlakoreng le leng, bo khothaletsoa ka teka-tekano, ho ba teng ha meputso e fapaneng, le teka-tekano ho pholletsa le boitšoaro bo susumetsoang.

ETSA LITLHOHONOLOFATSO TSE TSOANG HO PHELISO LE LITLHALOSO TSE LE METSOALLE E LE MABAPI LE LITLHAKISO TSA MOTSOALLE

Lithethefatsi tsa tlhekefetso le lijo tse fumanehang habonolo li bontša ho tšoana ho latela hore na ba etsa moputso joang ho phoofolo le batho. Taba ea pele, lithethefatsi li etsa hore libaka tse ithute ka moputso le ho saena dopamine51; lijo tse fumanehang habonolo li sebetsa tseleng e tšoanang.24 Taba ea bobeli, batho ba mpefatsa ts'ebeliso ea lithethefatsi ka lebaka la mamello, e bakoang ke liphetoho tsa polasetiki tsamaisong ea methapo ea methapo (ho theoha hoa li-receptors tsa D2 le ho nyolisoa ha li-receptor tsa D1)52,53; Ho ja lijo tse matlafatsang ho baka litlamorao tse tšoanang.54,55 Taba ea boraro, mathata a ho tlohela ts'ebeliso ea lithethefatsi a amahanngoa le karabelo e matla ea kelello maemong a boko bo amanang le moputso le tlhokomelo tse amanang le litekanyetso tsa lithethefatsi.56,57; lithuto tse feteletseng li bonts'a mokhoa o ts'oanang oa ts'ebetso ha li pepesetsoa mekhoa e metle ea lijo.58,59

Ts'ebeliso e mpe ea lithethefatsi e lebisa ho neuroadaptation mekotlong ea moputso ka tsela e eketsang kholo ea ho ja. Liteko tsa liteko tsa liphoofolo li fana ka maikutlo a hore tšebeliso e tloaelehileng ea lithethefatsi tsa tlhekefetso e baka phokotso ea litheko tsa dopamine li-dopamine le dopamine.53 Ho tloaela ho tloaela ho etsa lintho hape ho lebisa tlhokomelong e fokolisang ea libaka tsa moputso ho ja lithethefatsi le ho tsosa motlakase liphoofolong tsa liteko tse amanang le ho laola liphoofolo.52,60 Liphumano tsena li lumellana le datha ea likarolo tse bonts'a hore batho ba lemaletseng lithethefatsi ba bonts'a ho fumaneha ha li-D2 tse tlase le ho tsebahala ha moputso, ho lokolloa ha dopamine ho tsoa lithethefatsing, le ho fokotseha ho amanang le litheko tsa taolo e phetseng hantle.61,62 Ka mokhoa o tšoanang, liteko tsa liphoofolo li tlaleha kabelo eo ho maemo a feteletseng a nsoverfeeding e fella ka phokotso ea ho fumaneha ha li-D2 receptor, phokotso ea ho fumaneha ha dopamine le phokotso, le ho fokotsa karabelo ea libaka tsa moputso ho kenyelletsong ea lijo, tsamaiso ea lithethefatsi, le tšusumetso ea motlakase.54,63

Lintlha tse kaholimo li lumellana le bopaki ba tšebeliso ea hore batho ba batenya ba na le li-receptor tse fokolang tsa D2 ho feta batho ba nang le leeme ebile ba na le karabelo e fokolitsoeng ea moputso sebakeng sa lijo tse fumanehang habonolo.64,65 Ntle le moo, liphuputso tse telele ho batho li fana ka maikutlo a hore karabelo ena ea moputso o foufetseng oa lijo li ka bakoa ke ho nona haholo le ho nona.66 Qeto ena e tšehetsoa ke liteko tsa ho leka ho nona ho liphoofolo tse kang litoeba le likolobe.67 Bopaki bo eketsehileng ho batho bo tsoa liphuputsong tsa liteko tseo ho tsona barupeluoa ba neng ba sa fuoe lijo tse tsitsitseng kapa tse natefisang mmele letsatsi le letsatsi. Sehlopheng sa morao-rao sena se fella ka ho fokotseha ha lijo, empa ho eketseha ha tlhokahalo.68 Buka ea morao-rao e fana ka maikutlo a hore karabelo e sa bonahaleng ea striatum e bonoang ka ts'ebetso ea matla a matla a matla a matla a matla a sefahleho ho batho e na le lintlha tse hlakileng. Bafo ba tlalehang khafetsa ho ja li-ice cream khafetsa ba bonts'a karabelo e fokolang ea moputso tikolohong ea ho amohela mongoli o mong oa ice-cream o tsoang ho bacha ba jang feela ice cream ka seoelo; Ts'ebeliso ea lijo tse ling tse nang le mafura a mangata, joalo ka chokolete le lipompong, li ne li sa amanngoe le moputso oa karabelo ea sebaka ka kamohelo ea ice cream.69 Khetho ena e fana ka maikutlo a tšoanang le mohopolo oa mamello o bonoang bokhobeng ba lithethefatsi.

Sebaka se seng se khahlisang se bua ka bolebeliso ba ho nona boima nakong e tlang. Boithuto ho batho ba bacha ba kotsing ea ho theola boima ba mmele bo supa hore ho phaellana ha ts'ebetso, ho bonahatsoang e le karabelo e matla ea likaroloana tsa lijo libakeng tsa boko tse amanang le moputso le tlhokomelo, e bolela esale pele phaello ea boima ba nako e tlang.70-72 Sena e kanna ea ba sesosa sa ho lokisa se hlahang kamora nako ea ho ja ho feta tekano, ho fapana le ho ba tlokotsing ea pele. Mekgwa e tlasa ntshetsopele ya maikutlo a kgothatsang e bonahala e amana le dikarabo tsa moputso tse phahamisitsoeng tsa pele ho lijo tse fumanehang habonolo le bokhoni bo phahameng ba ho ithuta bo kopaneng.73

THa re kopane, bopaki bo bokelletsoeng bo lumellana le mokhoa o matla oa ho ba kotsing ea ho ba kotsing ea ho ba le botenya ha karabelo ea mantlha ea moputso o tsoang lijong tsa lijo e lebisa ho ho ja ho tlola tekano, ha litheko tsa methapo ea methapo ea D2 li se li fokotseha ka lebaka la takatso ea lijo. le ha karabelo e kholo ea libaka tse kenyang litšekamelo tsa motheong oa litheko tsa lijo ka mokhoa oa pele-pele li hlaha74 (Setšoantšo sa 4).

Setšoantšo sa 4    

Mohlala oa ho ba kotsing ea ho ba motenya. TaqIA e bua ka polymorphism ea single-nucleotide ea ANKK1 gene (rs1800497), e nang le phapang ea 3: A1 / A1, A1 / A2, 'me A2 / A2.

Nakong e tlang, lithuto tsa monahano oa boko tse sebelisoang meralo ea khafetsa li ka ba molemo bakeng sa ho hlahloba litekanyetso tse matla tsa tlokotsi, joalo ka ha ho arabela ka mokhoa o hlakileng litekanyetsong tsa lijo ho bolela kotsi e kholo ea ho nona ha boima nakong e tlang. Patlisiso ea ts'ebetso ea ts'ebetso ea thibelo le ts'ebetso ea ts'ebetso ea methapo ea kutlo (mohlala, ho lokisa karabelo e hlakileng ea lijo ka lijo) e tla ba tsa bohlokoa, joalo ka netefatso ea liteko tsa likamano tsa hypothesised.

Ho tšoana lipakeng tsa litlamorao tsa neural tsa ho ja ho feta tekano le tšebeliso ea lithethefatsi lia tšoana empa ha li tšoane. Lithethefatsi tsa tlhekefetso li lebisa ho popong ea maiketsetso ea dopamine signing e sa etsahaleng ea lijo. Leha ho na le phapang ena le tse ling, ho na le ho ts'oana ho lekanang ho fana ka maikutlo a hore lithethefatsi le lijo tse fumanehang habonolo li na le bokhoni ba ho kenyelletsa ts'ebetso ea moputso ka tsela e khothaletsang kholo ea tšebeliso ea lijo. Leha ho le joalo, ha ho na thuso ho tseba hore na lijo tse itseng lia lemalla; ke palo e fokolang feela ea batho ba lekang boitšoaro bo khahlisang ba e lemalloang. Sebakeng seo, mekhoa e hlahisang litholoana e ngata ke ho shebisisa kutloisiso ea hore na lithethefatsi tsa tlhekefetso le lijo tse fumanehang habonolo li kenya tšebetsong ts'ebetso ea moputso oa ts'ebeliso e ntseng e phahama, le ho ithuta liphapang tse tsamaisanang le lits'ebetso tse peli tse kenyang (likarabelo tse sa nepahalang ka lebaka la kamohelo ea lijo kapa lithethefatsi, le karabelo e matla ea libaka tse amanang le moputso le tse amanang le ho tsotelloa ke litakatso tse lebelletsoeng). Kamora nako, ho ka ba molemo ho feta ho nahana ka maikutlo a "tlhekefetso ea lijo" ho e-na le ts'ebeliso ea "bokhoba ba lijo" (ho bolelang, ho its'epaha), hobane bopaki ba ts'epo bo kopantsoe mme bo sa khethollehe, empa lipatlisiso tse kholo li bontša ka ho hlaka hore botena bo hlahisa litholoana tse mpe. bophelo bo botle le litlamorao sechabeng.

LITLHAKISO TSA BOTSOANG TSA HO BULA LE HO TSOELA PELE

Patlisiso ea morao-rao e bonts'a karolo ea bohlokoa eo liphatsa tsa lefutso tsa motho li e nkang ho bonts'a mekhoa ea boko ea moputso oa lijo. Boithuto ba mefuta e matla ea botona bo amanang le phenotypes e feteletseng ea ho ja ho feta tekano e fana ka mokhoa o tsamaeang oa ho rarolla mathata a rarahaneng a kang botena le lefu la tsoekere. Ba ka hlahisa bopaki ba molaoana oa mofuta o le mong oa 'mele le tsela eo ba utloisisang' mele ka eona le mekhoa e laolang boima ba 'mele le li-phenotypes tse amanang le tsona. Mokhoa ona o ka ntšetsa pele tšibollo ea lithethefatsi ka ho netefatsa liphofu tsa khale le tse ncha le ho theha sethala sa meriana e ikemetseng. E ka boela ea tlisetsa bakuli melemo ea tsoelo-pele e fumanoeng tlhahlobong, tlhabollo le tlhabollo.

Lithuto tsa Twin, tsa lelapa le tsa ho ba le bana li bontša hore boima ba 'mele bo matla haholo. Ho nona ho tloaelehileng ke polygenic, ka tlatsetso ea liphatsa tsa lefutso ho pharologanyo e fapaneng e lekantsoeng ho 40% -70%.75 Genetics ea joale ea limolek'hule e thathamisitse mefuta e tloaelehileng ea DNA e amang boima ba 'mele. Liphuputso tse kopaneng tsa genome tse ngata li fuputse lipatlisiso tsa liphatsa tsa lefutso tsa batho ba makholo a likete lefatšeng ka bophara. Leha ho le joalo, lintlha tsohle tsa lefutso tse khethiloeng ho fihlela joale ho akhaonto li ka ba ka 5% ea phapang ea index ea mmele (BMI).76 Ho fumanoe mefuta e mengata e sa tloaelehang ea liphatsa tsa lefutso ho bakuli ba batenya haholo, ka liphetoho tse amanang le eona molemong oa moputso oa boko.

Li-peptide le lihormone, haholo leptin, li ka sebetsa e le li-modulators tsa botsitso ba matla. Leptin ke mohloli oa bohlokoahali oa matla a motho ka tšusumetso ea likarolo tsa boko tse kenyelletsang moputsong oa lijo. Khaello ea Leptin e eketsa takatso ea lijo le takatso ea lijo. Hormone ena e boetse e bontša ho rata lijo, e lumellanang le ts'ebetso ea li-nucleus tse bokellitsoeng ka dopamine. Liphetoho tse tsebahalang tseleng ea leptin-melanocortin tseleng ea hypothalamus e lebisa ho hyperphagia (Setšoantšo sa 5). Boithuto bo lekotse phenotypes ho bakuli ba nang le khaello ea leptin ba sebelisang fMRI. Thutong ea seminal, Farooqi et al.77 e ile ea lekola likarabo tsa boko ho bakuli ba batho ba 2 ba nang le bofokoli ba congenital leptin. Litšoantšo tsa lijo pele le kamora matsatsi a 67 tsa phekolo e tlisoang ke leptin li bonts'itse ts'ebetso ea neural activation ea libaka tsa bohlokoa tsa striatal, a fana ka maikutlo a hore phekolo e fokotse pono ea moputso oa lijo ha e ntse e ntlafatsa karabelo ho matšoao a satiety a hlahisoang nakong ea lijo.77

Setšoantšo sa 5  Liphetoho tse bang teng tseleng ea leptin-melanocortin bathong ba batho. khutsufalitsoeng: ACTH, hormone ea adrenocorticotropic; AgRP, peptide e amanang le Agouti; BDNF, neurotrophic factor e tsoang bokong; CB1, mofuta oa cannabinoid mofuta oa 1 receptor; incr., e eketsehile; LEP, leptin; LEPR, leptin receptor; MCH, hormone e shebaneng le melanin; MC4R, melanocortin 4 mofuta oa li-receptor; α-MSH, alpha-melanocyte e matlafatsang; NPY, neuropeptide Y; Ob-Rb, leptin receptor, Ob-Rb isoform; PC1 / 3, prohormone converase 1 / 3; POMC, pro-opiomelanocortin; RQ, quotient ea ho phefumoloha; SIM1, 1 e nang le kelello e le 'ngoe; TRKB, tyrosine kinase B.
 

Phetolelong ea melanocortin 4 receptor (MC4R) liphatsa tsa lefutso ke sesosa se atileng haholo sa botenya ba motho.78 Ho fumanoe likhetho tse 'maloa tsa kalafo (mohlala, sibutramine, serotonin, le noradrenalin uptake inhibitors) lithutong tsa batho le MC4R liphetoho. Leha ho le joalo, ho lokisoa ha boima ba 'mele ka nako e telele ha ho fihlellehe.78 Ts'ebeliso ea data ea fMRI ho bapisa ts'ebetso ea ts'ebetso ho bakuli ba 10 heterozygous bakeng sa MC4R khaello le taolo ea 20 (10 obese le 10 lean) li bontšitse seo MC4R khaello e ne e amahanngoa le ts'ebetso e fetotsoeng ea ts'ebetso ea striatal le moputso oa lijo.79 Sena se fana ka maikutlo a hore molumo oa "melanocortinergic" o ka fetolela liphetoho tsa dopaminergic tse etsahalang ka boima ba 'mele.

Liphetoho tse ling tsa liphatsa tsa lefutso tse eketsehileng, haholo-holo tse bakang hyperphagia hammoho le ho se sebetse hantle maikutlong, ho sebetsa maikutlong, le boitšoaro ba mofuta o mong, li sa tsoa hokahanngoa le 1 e nang le kelello e le ngoe - karolo ea mantlha ea phetisetso ea helix-loop-helix e kenyelletsang kholisong le tšebetsong ea mokokotlo oa potoloho ea methapo. the hypothalamus (Setšoantšo sa 5).80

Bongata ba ho ferekanya ha methapo ea methapo ea kelello bokong ba botenya bo sebelisa lithuto tsa fMRI ho hlahloba likarolo tsa tšebetso ea moputso oa bokong tse amanang le sephetho sa kalafo kamora ho ja ka matla ka sibutramine81 kapa mohanyetsi e mocha oa µ-opioid receptor.82

Mohlomong ho na le phapang e fetang ena potolohong e amehang moputsong oa lithethefatsi le moputso oa lijo ho feta hona joale, e leng se etsang hore nyeoe ea hore botenya bo lokele ho ithutoa ka tokelo ea bona. Boiteko ba ho khetha lijo e le lekhoba la tahi hangata ha bo na thuso. Ho fapana le moo, ho utloisisa tlatsetso ea neural ea ho ja ka li-phenotypes tse fapaneng ke mohato oa bohlokoa oa ho tsoela pele tšimong. Ho na le tlhoko ea ho qapa lisebelisoa tsa ho hlalosa bophelo bo botle ba 'mele ka mokhoa o hlakileng le o nang le sepheo le ho utloisisa biology ea boitšoaro bo ka tlase.

TLHALOSO EA TLHOKOMELISO EA TLHOKOMELISO EA LINAKO TSA BOPHELO

Kahara batho, litloaelo tsa boits'oaro bakeng sa lijo tse monate li fetoloa ke ts'ebetso ea kelello. Ts'ebetso tsena tse phahameng tsa kelello li ts'ehetsa melao ea boits'ebetso ea ho ja le limmapa ho li-network tse kenyelletsang likarolo tsa bokong tse kang dorsolateral pre peleal cortex, dorsal anterior cingrate, le parietal cortex. Tikoloho eo re phelang ho eona e phephetsa lisebelisoa tsa rona tse fokolang tsa 'mele ho hatella lijo. Bothata bo kahare bophelong ba letsatsi le letsatsi bo kenyelletsa ho leka-lekanya lipakanyo tsa hau tsa ka hare (ke hore, tsebo, melao-motheo, kapa litloaelo tse sebelisoang ho tataisa boits'oaro, joalo ka ho ja hantle ho lula o phetse hantle kapa ho laola boima ba mmele) ka litlamorao tsa ho ja lijo tse thobang le ho fumaneha hanghang. Khohlano ena e thata haholo ka lijo tse lakatsehang kapa tse lakatsoang; khokahano lipakeng tsa kutloisiso le moputso ke karolo ea mantlha ea taolo ea phepelo ea lijo bathong.

Lithuto tsa morao-rao tse nang le fMRI li bonts'a bokhoni ba ho hatella litlamorao tse tlisoang ke lijo. Litlaleho tsena li bonts'a ho hira libaka tsa boko tse amanang le mesebetsi e meholo / taolo ea kelello ha barupeluoa ba botsoa hore ba nahane ho lieha ts'ebeliso ea lijo tse matlafatso tse bontšitsoeng litšoantšong kapa ho nahana ka melemo ea nako e telele ea ho se je lijo tse khethehileng.83 Ho kenella ka mokhoa o ts'oanang oa likarolo tsena tsa boko ho bonahala ha banna ba botsoa hore ba felise tlala ka boithaopo.84 Ho boetse ho na le bopaki ba hore litakatso tsa lijo li kena-kenana le tlhoko ea tlholisano ea tlhaloganyo, ka lebaka la tataiso ea boiketsetso ea lisebelisoa tsa kelello ho litakatso tse amanang le eona,85 ka hona khethollo e lebisang tlhokomelo ho lijo tse se nang phepo e ka bolela keketseho ea BMI ha nako e ntse e feta.86

Ho kenella likarolo tsa morao-rao tsa cortex ea pele e ka ba lets'oao la neural la mekhoa e tlatselletsang ho hlola tloaelo ea motho ea ho ja ho feta tekano le ho nona. Liphuputso tse hlokometsoeng li bonts'itse ts'ebetso e phahameng libakeng tsena tsa boko lithutong tse atlehileng tsa ho fokotsa boima ba 'mele tse tsamaeang le mafu a fokolang haholo.87,88 Ho fumana hona ho arolelana lintho tse tšoanang le se bonoang lebaleng la botahoa, joalo ka beng ka motho oa pele ea lemaletseng joala a sa amehang a bonahatsa ts'ebetso e matla ea pele ho phomolo, leha e le maemong a phahameng ho feta a batho ba phetseng hantle.89 Ka lebaka la data e lekanyelitsoeng ea nako e telele le liteko, tsela e ikhethileng ea khokahano lipakeng tsa ho tsofala / botenya le kelello e tsebahala hanyane feela. Boithuto ba nakong e tlang bo tlaleha hore batho ba nang le ts'ebetso e fokotsang litekong tse lekanyang mesebetsi ea tsamaiso, haholo taolo ea thibelo, ba bonts'a monyetla o moholo oa ho nona ka boima nakong e tlang.90 Leha ho le joalo, boima bo eketsehileng bo ka senya kapa ba kena-kenana le mekhoa ena ea tefo, e leng ho etsang hore ho be le potoloho e mpe. Bopaki bo ntseng bo hola ba likarolo tse fapaneng bo bonts'a botenya (BMI> 30 kg / m2) e amahanngoa le ts'ebetso ea kelello e sa sebetseng, ho kenyelletsa mesebetsi ea tsamaiso, tlhokomelo le memori.91 Le tlholo ea kelello phomolong e kopantsoe hampe le BMI libakeng tse amanang le mesebetsi e metle, joalo ka cingex cortex.92 Sena se bonahala le mehlaleng ea liphoofolo ea botenya.67 Ho fokotsa boima ba 'mele ho hokahana le ntlafatso e nyane ts'ebetsong ea motsamaisi le memori ho batho ba batenya haholo (empa eseng ho feta).93 Bopaki bo bokelletsoeng bo tsoang litlhahlobong tsa methapo ea kutlo le lingoliloeng tsa botho bo fana ka maikutlo a hore libaka tse tlang pele ho pele tse ipehang taolong, hammoho le libaka tse tsitsitseng tse khothalletsoang lijo, ke litsamaiso tsa bohlokoa tsa neural tse amanang le phapang ea boitšoaro ba motho le ho ba mothating oa ho nona.94

Ho ka sebelisoa maano a mangata nakong e tlang ho ntlafatsa ts'ebetso ea libaka tsa boko tse amanang le taolo ea kelello, ho kenyeletsa le kelello-boits'oaro, koetliso ea kelello, boikoetliso, tšusumetso ea boko bo sa sebetseng, neurofeedback, phetoho ea lijo le meriana. Le ha lefapha lena le sa le monyane, ho ka etsahala hore lijo tse ling kapa lihlahisoa tse nang le phepo e ntle li ka tsamaisa liphetoho tse joalo tsa boko. Mekhoa ea neuroscience e ka sebelisoa ho hlahloba lisebelisoa tse kenelletseng kapa ho kena lipakeng, ho fana ka tlhaiso-leseling e nang le sepheo ebile e tebile.

Lipatlisiso tsa morao-rao tse laoloang ke placebo li tlaleha ts'ebetso ea libaka tse tlang pele le 8-beke ea ho ja li-supposa tsa docosahexaenoic acid omega-3,95 7 ea letsatsi le leng le le leng ea lijo tsa likhoho tsa batho ba tsofetseng,96 le lijo tse nang le nitrate tse nang le lihora tse ngata tsa 24 (meroho e makhasi a matala le lero la beetroot) lithutong tsa maqheku.97 Liphetho tsena li bonts'a karolo ea bohlokoa ea lijo le limatlafatsi libakeng tsa boko tse ka tsamaisang taolo ea moputso oa lijo. Ka lehlakoreng le leng, Edward et al.98 tlaleha hore ho ja lijo tse nang le mafura a mangata (74% kcal) bakeng sa matsatsi a 7 ho fifalitsoe ke ts'ebeliso ea kelello ho banna ba lutseng. Mekhoa e meng ea ho ntlafatsa tlatsetso ea taolo ea kelello ka ho ja lijo tse kenyelletsang motsoako oa koetliso ea kelello le ho hlasimolla ha kelello.99

Ts'ebetsano lipakeng tsa methapo ea boko e amanang le ts'ebetso ea kelello, moputso, le homeostasis ha li itlhahele feela; ho fapana le moo, li kenelletse tikolohong le lintlha tse tlisoang ke eona (Setšoantšo sa 6).100 Tlhokahalo e teng bakeng sa lithuto tse ngata tse etsoang tikolohong e nepahetseng ea tikoloho le lipatlisiso tse ka kopanyang likarolo tse haufi le tšebelisano ea 'nete ea motho ka mong-lijo. Mohlala, ha ho tsejoehale ka hore na boleng ba setso bo bopa joang meputso ea monehelo oa lijo, e ka etsahalang ka tšusumetso ea kelello. Litloaelo le maikutlo a amanang le setso li ka susumetsa ts'ebetso le tlhahiso ea moputso oa lijo.

Setšoantšo sa 6   

Taolo ea kelello ea moputso oa lijo le tšusumetso ea tikoloho. Taolo ea phepelo ea lijo, haholo-holo phello ea maikutlo a taolo ea kelello mabapi le moputso oa lijo, e etsahala maemong a tšusumetso ea tikoloho. Ho latela Gidding et al. (2009),100 ho na le maemo a 4 a tšusumetso: boemo ba motho ka mong (boemo ba 1) bo fumaneha kahare ho tikoloho ea lelapa (boemo ba 2) mme bo susumetsoa ke likarolo tse kang mohlala oa setaele, mokhoa oa ho fepa, phepelo le ho fumaneha ha lijo, joalo-joalo; boemo ba microenveloal (level 3) e bua ka tikoloho ea lehae kapa sechaba 'me e kenyelletsa likolo tsa lehae, libaka tsa ho bapala, libaka tsa maoto le limaraka tsa mabenkele tse sitisang kapa tse sitisang boitšoaro bo botle ba ho ja; le boemo ba macroenveloal (boemo ba 4) bo bua ka melaoana e pharaletseng ea naha, naha, naha le machabeng tsa moruo le tsa indasteri, tse ka amang likhetho tsa motho ka mong. Gidding et al. (2009)100 e bolela hore mohlala ona "o lemoha bohlokoa ba ho hlaneloa ka mekhahlelo kahare ho e mong le tšusumetso ea boiphetetso maemong a mang."

 

Ka kakaretso, lefapha le fana ka maikutlo a ho qapa mekhoa ea ho tlisa tsoelo-pele ea mahlale ho tloha laboratoring ho ea tleliniking. Tsena li kenyelletsa li-neurotechnologies tse hlahang tse kang lisebelisoa tse nkehang, lisebelisoa tse senang tšenyo le tlhahlobo ea likhomphutha ho hlahloba likarolo tsa bohlokoa tsa ts'ebetso ea ho ja. Mekhoa ena e ka thusa ho theha motheo oa tsebo ka tšusumetso ea limatlafatsi, lihlahisoa tsa lijo le lijo tse tsoang bokong tse amanang le ho ja ka mokhoa o phetseng hantle le taolo ea boima ba 'mele.

LITLHAKISO TSE TLANG HO HO FINYELELA “KHAOLO” BOTLENG BA PHOPOLO

Mehloli e mengata ea pherekano e tloaelehileng e amana le poleloana e reng, "bokhoba" ebile e bua ka mantsoe a mane a latelang: ho rata, ho putsa, ho batla le ho lakatsa. Ho rata ho hlalosoa e le karabelo ea hedonic kapa monate oa tšusumetso. Moputso hangata ho nahanoa hore o tsamaisana le monyaka empa o hlalosoa ke boits'oaro e le o ntlafatsang ketso e bileng pele ho eona. Ka hona, batšepisi ba ka sebetsa ba sa hlokomele kapa ba natefeloa (mohlala, boemo ba matla thutong ea morao-rao). Ho batla ho lekana le takatso. Phetohong ea eona ea ho ba ntho e lakatsehang, ntho e boleloa e fumane botsitso ba ho susumetsoa, ​​bo hlahisoang ke ho kopanya moputso ka lintho kapa likhoto. Takatso ke takatso e matla haholo.

Litakatso tsa lijo (ke hore, litakatso tse matla tsa ho ja lijo tse itseng) li atile haholo101 hape ha se hore ke tsa tlhaho. Lijo ha lia lokela ho ba monate ha li lakatseha. Litakatso tsa lijo li hokahane le BMI e phahameng hammoho le boits'oaro bo ka lebisang ho boima ba mmele, ho kenyelletsa ho nyekeloa ka sekhahla ha lijo, ho latela lithibelo tse mpe tsa lijo, le ho itlopa lijo ka matla.102,103 Ha ho bapisoa, ba bangata ba lumela hore litakatso li bontša "bohlale ba 'mele" (ke hore, tlhoko ea phepo e nepahetseng). Le ha ho le joalo, monotony kapa thibelo ha ho na phepo e nepahetseng ea phepo e ntle le eona e ka tlisa takatso ea motho. Thutong ea bacha ba baholo ke Pelchat le Shaefer,104 lithuto li tlaleha litakatso tse kholo haholo nakong ea thetso ea monotony ho feta nakong ea motheo.

Mabapi le mofuta oa litakatso tsa lijo, mofuta oa lijo o fapana ka setso. Ha ho tsejoe hore na ho na le litšobotsi tsa bohlokoa tsa lijo (mohlala, ho hloka matla, matla, mafura, kapa sethala sa tsoekere) tse lebisang ho lakatseng, kapa hore na ke eona tsela eo lijo li jeoang ka teng (mohlala, haeba ho bonoa e sa lumelloa, kapa haeba e jeoa ka mokhoa o ikhethileng, e thibetsoeng). Karolo ea thibelo ea phihlello ho batho e sa tsoa qala ho hlahlojoa ka liteko. Mohlala, mochine ona o ne o reretsoe ho hlalosa ho phahama ha takatso ea basali har'a basali ba Japane.105 Ho rarolla lipotso tsena ho bohlokoa haholo mme ho ka ba le litlamorao ho leano (mohlala, hore na ho ka boleloa hore lino tse tsoekere kapa tse nang le tsoekere)

Phuputso ea seminal e sebelisitse fMRI ho hlahloba ts'ebetso ea boko nakong ea ho kenella ha litakatso tsa lijo. Pelchat et al.106 o fumane hore liphetoho li etsahetse hippocampus, insula, le caudate - libaka tsa 3 tse kenyelletsang takatso ea lithethefatsi. Le ha ho le joalo, ts'ebetso ka har'a likarolo tse tšoanang tsa moputso oa boko e tloaelehile haholo ebile e ka bonoa bakeng sa boithabiso bo se nang molato, bo kang 'mino.107 Mokhoa o joalo oa ts'ebetso ea ts'ebetso ea boko ha o bolele ho lemalla. Ho kenya ts'ebetsong litseleng tsa moputso oa boko ho arabela lijo ke mokhoa o hlakileng o tebileng, hobane mehloli e mengata ea monyaka le boits'oaro bo susumetsang bo lebisa ts'ebetsong ea sistimi ena. Neuroimaging e bohlokoa molemong oa kutloisiso; leha ho le joalo, ha se mokhoa o nepahetseng oa ho tseba hore o lemaletse o le mong.

American Psychiatric Association ha e ananele temallo ea lijo e le bothata ba ho ja kapa bothata ba tlhekefetso ea lithethefatsi. Leha ho le joalo, litekanyetso tsa DSM li ntse li sebelisoa e le sekala sa tšebeliso ea lijo.108 Ho amohela tekanyo ena, ho bohlokoa ho fumana hore na tlhahlobo e lumellana le karabelo e sa lumellaneng le lijo tsohle kapa mofuta o itseng oa lijo. Hape ha ho na bonnete ba hore na mehopolo ea ho mamella le ho tlohela e ka bolela eng molemong oa lijo. Mabota a ho se sebetse hantle ha a tsebe hantle ebile ha a hlalose lijo le lithethefatsi. Qetellong, bokhoba ba lijo e tla ba tšoaetso e thehiloeng litlamorao tse mpe tsa boits'oaro bo bobe, empa ho lemalla lijo ha ho bake letho.

QETELLO

Tlhahlobo ena e senola lintlha tse 'maloa tsa bohlokoa tse fumanoeng. Taba ea mantlha, taolo ea phepelo ea lijo e rarahane ebile e kenyelletsa maemo a mangata a taolo ka mekhoa ea tikoloho le kelello, maikutlo, metabolic, endocrine le litsela tsa neural. Thepa e ruisang lijo e ka fetisa matšoao a satiation a mantlha a hlahisoang litsing tsa homeostatic. Taba ea bobeli, lijo le lithethefatsi li tsamaisana le meputso e mengata ea boko, 'me ka bobeli li khothaletsa ho lokolloa ha dopamine. Leha ho le joalo, ho na le liphapang tsa bohlokoa, tse boleng le boholo. Lithethefatsi tse atisang ho hlekefetsoa ka tloaelo li lelefatsa ho buoa ka dopamine, athe lijo tse fumanehang hantle ha li etse. Taba ea boraro, bokhoba bo khethoa ke boiphihlelo bo ikemetseng ba motho. Tekanyo e itseng ea tokollo ea dopamine le ts'ebetso ea ts'ebetso ea moputso oa boko ha ea hlokahala kapa maemo a lekaneng a ho lemalla. Kamora nako, liphihlelo tsa motho ka mong le phapang ea liphatsa tsa lefutso tse tlasa karohano ea hore na kelello e arabela joang mehlolong ea lijo. Bophelong ba 'nete, likarabo tsena tsa boko li khethoa ke lintlha tse ling (mohlala, meputso e meng, ho lemoha le tšusumetso ea tikoloho).

Lethathamong le tlase ke litlhoko tse 'maloa tsa lipatlisiso tse khethiloeng tse ka rarolloang hamolemo ka mekhoa e kopanetsoeng.

  • Ho pharalla. Boholo ba lipatlisiso lefapheng la moputso oa lijo bo lokela ho atolosoa ho lekola tlhahlobo ea litheko tsa boits'oaro ba lijo le likelello tsa bona tsa kelello le methapo ea kutlo le tlhahlobo ea bohlokoa ba tšebeliso ea litheko tsa lijo le bohlokoa ba tsona.

  • Mekhoa ea ho lemalla lithethefatsi khahlanong le lithethefatsi. Tlhahisoleseling e teng e lokela ho tlatsana le katoloso ea lipatlisiso mabapi le phapang lipakeng tsa mekhoa ea ho lemalla joala le lithethefatsi bakeng sa lijo le lithethefatsi. Ho na le liphapang tse ngata ho potoloha ho sebelisang lithethefatsi le lijo tse fetang tse tsejoang hona joale.

  • Moputso oa lijo le ho hlaseloa habonolo ke motho ka mong. Tlatsetso ea thepa e tlatsetsang ea lijo e hloka ho aroloa ho tsoa lintšing tsa ho itšireletsa ha motho ka mong, ka tšebelisano le matla lipakeng tsa likarolo tsa 2 tse khethiloeng. Ho na le tlhoko ea ho khetholla lijo kapa litšobotsi tsa lijo tseo e ka bang liphofu tse ikhethileng bakeng sa boits'ebetso bo khotsofatsang le bo lematsang. Ntle le moo, na ho na le lijo kapa, mohlomong, motsoako oa lijo o ka "eketsang"? Maemo le liphihlelo ke life?

  • Boitšoaro ba ho ja hoa motho. Mekhoa e mecha le lisebelisoa tsa ho hlalosa hamolemonyana le ho utloisisa boits'oaro ba boitšoaro ba batho ba ho ja le biology e kenyelletsoeng, ho kenyelletsa mofuta oa tlatsetso ea litheko tsa lijo, o hloka ho ntlafatsoa. Mekhoa ena e lokela ho ba bonolo le ho sebetsa, e fana ka tlhaiso-leseling e hlakileng. Ka ho khetheha, hoa hlokahala ho khetholla le ho nts'etsapele matšoao a macha a ka khethollang phetoho ho tloha ho qobelloang ho ea ho qobelloang ho etsa boits'oaro bo bobe maemong a ho ja.

  • Tlhaloso ea poleloana le metriki. Ho lumellanoa hamolemo le tumellano ea li-semantics, litlhaloso, le metric bakeng sa ho hlalosa ho fapana hoa boitšoaro ba batho ba ho ja hoa hlokahala. Haholo-holo, ho na le tlhokahalo ea ho hlakisa hore na mohopolo le tlhatlhobo ea tlhekefetso joalo ka ha e bonts'itsoe ho DSM-5 (Setšoantšo sa 3)14 li ka sebelisoa kapa hona ho sebelisoa lijong. Sena se hlokahala ho qoba ho hlahisa lijo ka mokhoa o fosahetseng le / kapa lintho tse ling ho se na tumellano ka li-metric tse netefalitsoeng. Hoa hlokahala ho tiisa hore na tlhaloso ea DSM-5 e lumellana le karabelo e sa lumellaneng le lijo tsohle kapa mofuta o itseng oa lijo kapa motsoako. Hape ha ho na bonnete ba hore na mehopolo ea ho mamella le ho iketla e ka bolela eng maemong a lijo. Mabaka a ho se sebetse hantle ha a tsebe hantle ebile ha a hlalosoe joalo ka khokahano le litlamorao tsa bophelo bo botle (mohlala, botenya).

  • Etiology, Causality, le ho boloka ho ja ho feta tekano. Patlisiso e eketsehileng ho tsebisa mabaka a ts'ebetso ea etiologic e lebisang ho ho ja ho feta tekano le lits'ebetso tsa tlhokomelo e li bolokang bathong li lokela ho tsamaisoa. Boithuto bo tsoelang pele boa hlokahala ho hlakisa nako e nepahetseng ea likarabo tsa dopamine le ts'ebetso ea moputso oa boko. Patlisiso ea boithuto, joalo ka liteko tse laoloang ka mokhoa o sa reroang, e ka thusa ho tseba hore na ho lemalla lijo le / kapa botenya li khanna phetoho boleng ba meputso kapa ka mokhoa o fapaneng.

  • Phetoho ea tsamaiso ea moputso oa lijo. Kutloisiso e kholo ea likarolo tsa phetoho ea moputso oa lijo mohloling ona oa hlokahala. Na sistimi ea moputso oa motho e bile teng e lebelletse le ho arabela lijong, mme ka hona e le ho boloka polokeho, kapa e bile e bopetsoe / e fetotsoe hape ke tikoloho ea lijo, mme haeba ho le joalo, ho fihla bo kae?

Kamora nako, ho na le tlhoko e akaretsang ea mekhoa e mecha tšimong ho lekola likarolo tsa ts'ebetso ea motho ea ho ja. Nts'etsopele ea mekhoa e mecha sebakeng sena e ka ntlafatsa ho sibolloa mme qetellong ea thusa ho theha motheo oa tsebo mabapi le tšusumetso ea limatlafatsi, lihlahisoa tsa lijo le lijo tsa kelello. E ka fana ka motheo oa mekhoa e mecha ea ho khothaletsa mekhoa ea ho thibela pelehi le ho hatella mekhoa ea ts'ebetso, ka litlamorao tse ka hlahisoang ke mafapha a lijo le phepo e nepahetseng, meriana le bophelo bo botle ba sechaba.

lumela hore baa fokola

Lekala la Amerika Leboea la Setsi sa Machaba sa Mahlale sa Bophelo (ILSI Leboea Leboea) le ile la kopanya "Tokomane ho Tsebo ea Tsebo e mabapi le Meelelo ea Hona Joale ka Mokhoa oa Moputso oa Lijo tsa Batho" ka Mots'eanong 9, 2013, setsing sa pokello ea nalane ea sekolo sa Charles Sumner le Archives Washington, DC . Sengoloa sena se akaretsa litlhahiso tse entsoeng ke libui, 'me litaba tsa tlhahiso e ngoe le e ngoe li bonts'a maikutlo a bangoli ba amehang. Bangoli ba leboha Rita Buckley, Christina West, le Margaret Bouvier oa Meg Bouvier Medical Writing bakeng sa ho fana ka lits'ebeletso tsa bophatlalatsi nts'etsopele ea buka e ngotsoeng ka letsoho le David Klurfeld ho tsoa Lefapheng la US la Temo / Ts'ebetso ea Lipatlisiso tsa Temo ka ho sebeletsa komiting ea meralo ea meralo ea kopano. Bangoli ba boetse ba leboha Eric Hentges le Heather Steele ba ILSI Amerika Leboea ka moralo oa lithupelo le maikutlo mabapi le mosebetsi ona.

Lithuso. Seboka sena se tšehelitsoe ke Lefapha la Temo la Temo / Temo ea Amerika ho Amerika, ILSI Leboea Leboea, Setsi sa Monell Chemical Sense, le Setsi sa Lipatlisiso sa Ingestive Behaeve sa US. Lithuso tsa lichelete bakeng sa lits'ebeletso tsa bophatlalatsi le bakeng sa libui tse nkileng karolo sebokeng seo mme tsa kenya letsoho ho sengoloa sena li fanoe ke ILSI Amerika Leboea.

Phatlalatso ea phaello. MA-A. e fumana tšehetso ea lipatlisiso ho tsoa ho Ajinomoto le Rippe Lifestyle Institute, hape ke moeletsi oa saense bakeng sa Wrigley le ILSI Amerika Leboea. GKB e ho Boto ea Babapatsi ba ILSI Amerika Leboea.

Ena ke sengoloa sa Open Access se tsamaisitsoeng tlasa maemo a laesense ea Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/), e lumellang tšebeliso e sa thijoeng, phetiso le phetiso ea mofuta o fe kapa o fe, ha feela mosebetsi oa pele o boletsoe ka nepo.

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