How neural mediation of anticipatory and compensatory insulin release helps us tolerate food

Learned anticipatory and compensatory responses allow the animal and human to maintain metabolic homeostasis during periods of nutritional challenges, either acutely within each meal or chronically during periods of overnutrition. This paper discusses the role of neurally-mediated anticipatory responses in humans and their role in glucoregulation, focusing on cephalic phase insulin and pancreatic polypeptide release as well as compensatory insulin release during the etiology of insulin resistance. The necessary stimuli required to elicit CPIR and vagal activation are discussed and the role of CPIR and vagal efferent activation in intra-meal metabolic homeostasis and during chronic nutritional challenges are reviewed.

Research Highlights► Review of the role of vagally-mediated hormonal responses in glucose homeostasis. ► Focus on cephalic phase insulin and pancreatic polypeptide responses. ► Anticipatory and conditioned hormonal responses occur in humans. ► Cephalic phase insulin release optimizes glucose tolerance. ► Impaired vagally-mediated responses may contribute to insulin resistance.