This Article Full Text Full Text (PDF) All Versions of this Article: 25/12/2451    most recent 01.ATV.0000186208.06964.91v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Isganaitis, E. Articles by Lustig, R. H. Search for Related Content PubMed PubMed Citation Articles by Isganaitis, E. Articles by Lustig, R. H. Pubmed/NCBI databases Medline Plus Health Information Obesity Related Collections Nutrition and Atherosclerosis

(Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25:2451.)
© 2005 American Heart Association, Inc.

Brief Reviews

Fast Food, Central Nervous System Insulin Resistance, and Obesity

Elvira Isganaitis; Robert H. Lustig

From the Department of Pediatrics, University of California, San Francisco, Calif.

Correspondence to Robert H. Lustig, MD, Division of Pediatric Endocrinology, Box 0434, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143-0434. E-mail rlustig{at}peds.ucsf.edu

Series Editor: Margo Denke

Rates of obesity and insulin resistance have climbed sharply over the past 30 years. These epidemics are temporally related to a dramatic rise in consumption of fast food; until recently, it was not known whether the fast food was driving the obesity, or vice versa. We review the unique properties of fast food that make it the ideal obesigenic foodstuff, and elucidate the mechanisms by which fast food intake contributes to obesity, emphasizing its effects on energy metabolism and on the central regulation of appetite. After examining the epidemiology of fast food consumption, obesity, and insulin resistance, we review insulin’s role in the central nervous system’s (CNS) regulation of energy balance, and demonstrate the role of CNS insulin resistance as a cause of leptin resistance and in the promotion of the pleasurable or "hedonic" responses to food. Finally, we analyze the characteristics of fast food, including high-energy density, high fat, high fructose, low fiber, and low dairy intake, which favor the development of CNS insulin resistance and obesity.

Rates of obesity and insulin resistance have climbed sharply over the past 30 years. These epidemics are temporally related to a dramatic rise in consumption of fast food; until recently, it was not known whether the fast food was driving the obesity, or vice versa. We review the unique properties of fast food that make it the ideal obesigenic foodstuff, and elucidate the mechanisms by which fast food intake contributes to obesity, emphasizing its effects on energy metabolism and on the central regulation of appetite.

Key Words: fast food • insulin • leptin resistance • nucleus accumbens • obesity

This article has been cited by other articles:

				D. J Anschutz, R. C. Engels, and T. Van Strien Side effects of television food commercials on concurrent nonadvertised sweet snack food intakes in young children Am. J. Clinical Nutrition, May 1, 2009; 89(5): 1328 - 1333. [Abstract] [Full Text] [PDF]

				H. A. Raynor, R. W. Jeffery, A. M. Ruggiero, J. M. Clark, L. M. Delahanty, and for the Look AHEAD (Action for Health in Diabetes) Weight Loss Strategies Associated With BMI in Overweight Adults With Type 2 Diabetes at Entry Into the Look AHEAD (Action for Health in Diabetes) Trial Diabetes Care, July 1, 2008; 31(7): 1299 - 1304. [Abstract] [Full Text] [PDF]

				M. Desai, J. Babu, and M. G. Ross Programmed metabolic syndrome: prenatal undernutrition and postweaning overnutrition Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2007; 293(6): R2306 - R2314. [Abstract] [Full Text] [PDF]

				K. Pierre, A. Parent, P.-Y. Jayet, A. P. Halestrap, U. Scherrer, and L. Pellerin Enhanced expression of three monocarboxylate transporter isoforms in the brain of obese mice J. Physiol., September 1, 2007; 583(2): 469 - 486. [Abstract] [Full Text] [PDF]

				L. K. Callaway, H. D. McIntyre, M. O'Callaghan, G. M. Williams, J. M. Najman, and D. A. Lawlor The Association of Hypertensive Disorders of Pregnancy with Weight Gain over the Subsequent 21 Years: Findings from a Prospective Cohort Study Am. J. Epidemiol., August 15, 2007; 166(4): 421 - 428. [Abstract] [Full Text] [PDF]

				M. H. Shishehbor, D. Litaker, C. E. Pothier, and M. S. Lauer Association of Socioeconomic Status With Functional Capacity, Heart Rate Recovery, and All-Cause Mortality JAMA, February 15, 2006; 295(7): 784 - 792. [Abstract] [Full Text] [PDF]