Toornvliet A C, Pijl H, Tuinenburg J C, Elte-de Wever B M, Pieters M S, Frölich M, Onkenhout W, Meinders A E
Department of General Internal Medicine, Leiden University Hospital, The Netherlands.
Int J Obes Relat Metab Disord. 1997 Oct;21(10):860-4. doi: 10.1038/sj.ijo.0800470.
A defective central serotonergic neurotransmission has been suggested to result in the concomitant occurrence of an appetite disorder and a disturbed mood. This syndrome was termed carbohydrate carving (CC) obesity. Excessive consumption of carbohydrate-rich snacks would, through a plasma amino acid mediated mechanism, restore serotonergic neurotransmission and thereby relieve the symptoms of atypical depression.
To test whether CC obese patients indeed exhibit symptoms of atypical depression, whether these symptoms can be alleviated by carbohydrate-rich snacks and whether they respond differently to the snacks than non-carbohydrate craving (NC) control subjects. Furthermore, we investigated whether differences between CC and NC patients could be related to peripheral metabolic differences.
Double blinded, randomized with cross-over. Patients received three types of snacks (100/0/0, 70/29/1 and 35/3/62 energy percent carbohydrate/fat/protein respectively) on three consecutive test days. Before and after snack administration mood and performance were tested and blood samples were obtained.
9 CC and 17 NC obese patients, matched for sex, age and body mass index.
Mood states (Profile of Mood States and Visual Analogue Scales) and performance (Bourdon-Wiersma cancellation test), serum glucose and insulin and plasma amino acid concentrations.
Before snack consumption, CC patients had slightly higher anger and fatigue scores and tended to have lower mood scores than NC patients. The efficiency of performance increased in both groups after all snacks. No other psychological effects of the snacks were registered. Psychological and metabolic responses of CC and NC patients to the snacks were similar.
Although they may have a somewhat disturbed mood, CC obese patients do not improve their mood states through ingestion of a carbohydrate-rich snack. It seems, from a therapeutic point of view, useless to maintain the concept of carbohydrate craving.
有研究表明，中枢5-羟色胺能神经传递缺陷会导致食欲紊乱和情绪障碍同时出现。这种综合征被称为碳水化合物渴望（CC）肥胖症。过量食用富含碳水化合物的零食会通过血浆氨基酸介导的机制恢复5-羟色胺能神经传递，从而缓解非典型抑郁症的症状。
测试CC肥胖患者是否确实表现出非典型抑郁症的症状，这些症状是否能通过富含碳水化合物的零食得到缓解，以及他们对零食的反应是否与非碳水化合物渴望（NC）对照受试者不同。此外，我们还研究了CC患者和NC患者之间的差异是否与外周代谢差异有关。
双盲、随机交叉试验。患者在连续三个测试日接受三种类型的零食（碳水化合物/脂肪/蛋白质的能量百分比分别为100/0/0、70/29/1和35/3/62）。在零食摄入前后测试情绪和表现，并采集血样。
9名CC肥胖患者和17名NC肥胖患者，在性别、年龄和体重指数方面相匹配。
情绪状态（情绪状态剖面图和视觉模拟量表）、表现（布尔登-维尔斯马消去试验）、血清葡萄糖和胰岛素以及血浆氨基酸浓度。
在食用零食前，CC患者的愤怒和疲劳得分略高于NC患者，情绪得分则较低。所有零食后两组的表现效率均有所提高。未观察到零食的其他心理效应。CC患者和NC患者对零食的心理和代谢反应相似。
尽管CC肥胖患者的情绪可能有些紊乱，但他们不会通过摄入富含碳水化合物的零食来改善情绪状态。从治疗角度来看，维持碳水化合物渴望的概念似乎是无用的。
