Initial Hunger, a Subjective, Reproducible Limit in Intake Associated with Low Blood Glucose: A Training for Malnourished Infants and Overweight Adults

  • Mario CiampoliniEmail author
Living reference work entry


In this review, we describe the training of the passage from scheduled to demanded meals in infants and adults. Reduction in energy intake was obtained by subjectively abolishing conditioned meals and by administering food only after demand by the infant or after hunger perception by the adult (Initial Hunger Meal Pattern; IHMP). Conditioned meals were those scheduled and/or presented to the infant as well to the adult by sight, smell, mentioning, gesturing, or simply at a fixed mealtime. In contrast IHMP training consisted of meal suspension and of feeding after the first infant’s demand or after an adult’s self-noticing arousal of hunger. IHMP was checked by measuring blood glucose (MBG) and was associated with significant decreases in diary-reported energy-intake, preprandial blood glucose, glycated hemoglobin, body weight, insulin AUC in glucose tolerance tests and in days with diarrhea as compared to randomized control subjects who maintained conditioned meals. There were metabolic differences between those who received conditioned and demanded (IHMP) meals. Subjects adapted themselves to IHMP training easily. We explain characteristics like hunger equivalents, adjustments of energy intake to energy expenditure, blood glucose measurements, and characteristics that emerge in IHMP in contrast with scheduled meals. We also review previous studies in which the meals upon demand have been used. Other areas mentioned in this review include coverage on portable glucose monitoring, standard measurements of blood glucose, training protocols to remove conditioned meals and implement IHMP, the features of Initial Hunger, and other aspects of metabolic control that interlink hunger, meal feeding, blood glucose, and energy balance.


Blood glucose Diabetes Insulin resistance Overweight Fattening Energy balance Energy intake Limit in energy intake Hunger Meal onset Energy availability Bowel disorders Malnutrition 

List of Abbreviations


Area under curve of GTT


Blood glucose, an index of energy availability in blood for the whole body


Body mass index = body weight in kg divided by squared height in meters


Oral glucose tolerance test


Initial hunger


Initial hunger meal pattern


Mean preprandial blood glucose


Resting metabolic rate


Daily total energy expenditure


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PaediatricsUniversity of FlorenceFlorenceItaly

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