A new perspective on glucocorticoid feedback: Relation to stress, carbohydrate feeding and feeling better

Input to and regulation of activity in the hypothalamic-pituitary-adrenal (HPA) axis is diverse and complex. Glucocorticoid feedback is a major component that determines activity in this classic neuroendocrine axis and, while feedback occurs through the brain, the pathways that mediate glucocorticoid feedback remain unknown. In this review, I discuss findings that have led us to view glucocorticoid feedback in the HPA axis in a new light. Much of what has precipitated this view comes from a very surprising finding in our laboratory; sucrose ingestion normalizes feeding, energy balance and central corticotropin releasing factor expression in adrenalectomized (ADX) rats. Since this discovery, a diverse set of literature that supports this view of glucocorticoid feedback has been found. Taken together, recent findings of the well-known importance of glucocorticoids to feeding and energy balance, and the modulatory actions of carbohydrate ingestion on both basal and stress-induced activity in the HPA axis, strongly suggest that many metabolic (e.g. obesity) and psychological (e.g. depression) pathologies, which often present together and have been associated with stress and HPA dysregulation, might, in part, be understood in light of our new view of glucocorticoid feedback.