Lipoprotein lipase activity and intramuscular triglyceride stores after long-term high-fat and high-carbohydrate diets in physically trained men

Long-term fat diet adaptation effects on performance, training capacity, and fat utilization

It is well known that adaptation to a fat-rich carbohydrate-poor diet results in lower resting muscle glycogen content and a higher rate of fat oxidation during exercise when compared with a carbohydrate-rich diet. The net effect of such an adaptation could potentially be a sparing of muscle glycogen, and because muscle glycogen storage is coupled to endurance performance, it is possible that adaptation to a high-fat diet potentially could enhance endurance performance. Therefore, the first issue in this review is to critically evaluate the available evidence for a potential endurance performance enhancement after long-term fat-rich diet adaptation. Attainment of optimal performance is among other factors dependent also on the quality and quantity of the training performed. When exercise intensity is increased, there is an increased need for carbohydrates. On the other hand, consumption of a fat-rich diet decreases the storage of glycogen in both muscle and liver. Therefore, training intensity may be compromised in individuals while consuming a fat-rich diet. During submaximal exercise, fat for oxidation in muscle is recruited from plasma fatty acids, plasma triacylglycerol, and muscle triacylglycerol: the final question addressed in this review is which of these source(s) of fat contributes to the increased oxidation of fat during submaximal exercise after long-term fat diet adaptation.

Effects of short-term fat adaptation on metabolism and performance of prolonged exercise

The concept of manipulating an individuals habitual diet before an exercise bout in an attempt to modify patterns of fuel substrate utilization and enhance subsequent exercise capacity is not new. Modern studies have focused on nutritional and training strategies aimed to optimize endogenous carbohydrate (CHO) stores while simultaneously maximizing the capacity for fat oxidation during continuous, submaximal (60-70% of maximal O(2) uptake [(.)VO(2max)] exercise. Such "nutritional periodization" typically encompasses 5-6 d of a high-fat diet (60-70% E) followed by 1-2 d of high-CHO intake (70-80% E; CHO restoration). Despite the brevity of the adaptation period, ingestion of a high-fat diet by endurance-trained athletes results in substantially higher rates of fat oxidation and concomitant muscle glycogen sparing during submaximal exercise compared with an isoenergetic high-CHO diet. Higher rates of fat oxidation during exercise persist even under conditions in which CHO availability is increased, either by having athletes consume a high-CHO meal before exercise and/or ingest glucose solutions during exercise. Yet, despite marked changes in the patterns of fuel utilization that favor fat oxidation, fat-adaptation/CHO restoration strategies do not provide clear benefits to the performance of prolonged endurance exercise.

A ketogenic diet favorably affects serum biomarkers for cardiovascular disease in normal-weight men

Very low-carbohydrate (ketogenic) diets are popular yet little is known regarding the effects on serum biomarkers for cardiovascular disease (CVD). This study examined the effects of a 6-wk ketogenic diet on fasting and postprandial serum biomarkers in 20 normal-weight, normolipidemic men. Twelve men switched from their habitual diet (17% protein, 47% carbohydrate and 32% fat) to a ketogenic diet (30% protein, 8% carbohydrate and 61% fat) and eight control subjects consumed their habitual diet for 6 wk. Fasting blood lipids, insulin, LDL particle size, oxidized LDL and postprandial triacylglycerol (TAG) and insulin responses to a fat-rich meal were determined before and after treatment. There were significant decreases in fasting serum TAG (-33%), postprandial lipemia after a fat-rich meal (-29%), and fasting serum insulin concentrations (-34%) after men consumed the ketogenic diet. Fasting serum total and LDL cholesterol and oxidized LDL were unaffected and HDL cholesterol tended to increase with the ketogenic diet (+11.5%; P = 0.066). In subjects with a predominance of small LDL particles pattern B, there were significant increases in mean and peak LDL particle diameter and the percentage of LDL-1 after the ketogenic diet. There were no significant changes in blood lipids in the control group. To our knowledge this is the first study to document the effects of a ketogenic diet on fasting and postprandial CVD biomarkers independent of weight loss. The results suggest that a short-term ketogenic diet does not have a deleterious effect on CVD risk profile and may improve the lipid disorders characteristic of atherogenic dyslipidemia.

Regulation of fat metabolism in skeletal muscle

Regulation of carbohydrate and fat utilization by skeletal muscle at rest and during exercise has been the subject of investigation since the early 1960s when Randle et al. proposed the so-called glucose-fatty acid cycle to explain the reciprocal relationship between carbohydrate and fat metabolism. The suggested mechanisms were based on the premise that an increase in fatty acid (FA) availability would result in increased fat metabolism and inhibition of carbohydrate metabolism. Briefly, accumulation of acetyl-CoA would result in inhibition of pyruvate dehydrogenase (PDH), accumulation of citrate would inhibit phosphofructokinase (PFK), and accumulation of glucose-6-phosphate (G6P) would reduce hexokinase (HK) activity. Ultimately, this would inhibit carbohydrate metabolism with increasing availability and oxidation of FA. Although there is some evidence for the existence of the glucose-FA cycle at rest and during low-intensity exercise, it cannot explain substrate use at moderate to high exercise intensities. More recently, evidence has accumulated that increases in glycolytic flux may decrease fat metabolism. Potential sites of regulation are the transport of FA into the sarcoplasma, lipolysis of intramuscular triacylglycerol (IMTG) by hormone-sensitive lipase (HSL), and transport of FA across the mitochondrial membrane. There are several potential regulators of fat oxidation: first, malonyl-CoA concentration, which is formed from acetyl-CoA, catalyzed by the enzyme acetyl-CoA carboxylase (ACC), which in turn will inhibit carnitine palmitoyl transferase I (CPT I). Another possible mechanism is accumulation of acetyl-CoA that will result in acetylation of the carnitine pool, reducing the free carnitine concentration. This could theoretically reduce FA transport into the mitochondria. There is also some recent evidence that CPT I is inhibited by small reductions in pH that might be observed during exercise at high intensities. It is also possible that FA entry into the sarcolemma is regulated by translocation of FAT/CD36 in a similar manner to glucose transport by GLUT-4. Studies suggest that the regulatory mechanisms may be different at rest and during exercise and may change as the exercise intensity increases. Regulation of skeletal muscle fat metabolism is clearly multifactorial, and different mechanisms may dominate in different conditions.

Myocellular triacylglycerol breakdown in females but not in males during exercise

The resting content and use of myocellular triacylglycerol (MCTG) during 90 min of submaximal exercise [60% of peak oxygen uptake (VO(2 peak))] were studied in 21 eumenorrheic female and 21 male subjects at different training levels [untrained (UT), moderately trained (MT), and endurance trained (END)]. Males and females were matched according to their VO(2 peak) expressed relative to lean body mass, physical activity level, and training history. All subjects ingested the same controlled diet for 8 days, and all females were tested in the midfollicular phase of the menstrual cycle. Resting MCTG, measured with the muscle biopsy technique, averaged 48.4 +/- 4.2, 48.5 +/- 8.4, and 52.2 +/- 5.8 mmol/kg dry wt in UT, MT, and END females, respectively, and 34.1 +/- 4.9, 31.6 +/- 3.3, and 38.4 +/- 3.0 mmol/kg dry wt in UT, MT, and END males, respectively (P < 0.001, females vs. males in all groups). Exercise decreased MCTG content in the female subjects by an average of 25%, regardless of training status, whereas in the male groups MCTG content was unaffected by exercise. The arterial plasma insulin concentration was higher (P < 0.05) and the arterial plasma epinephrine concentration was lower (P < 0.05) in the females than in the males at rest and during exercise. MCTG use was correlated to the resting concentration of MCTG (P < 0.001). We conclude that resting content and use of MCTG during exercise are related to gender and furthermore are independent of training status.

Adaptations to short-term high-fat diet persist during exercise despite high carbohydrate availability

PURPOSE

Five days of a high-fat diet produce metabolic adaptations that increase the rate of fat oxidation during prolonged exercise. We investigated whether enhanced rates of fat oxidation during submaximal exercise after 5 d of a high-fat diet would persist in the face of increased carbohydrate (CHO) availability before and during exercise.

METHODS

Eight well-trained subjects consumed either a high-CHO (9.3 g x kg(-1) x d(-1) CHO, 1.1 g x kg(-1) x d(-1) fat; HCHO) or an isoenergetic high-fat diet (2.5 g x kg(-1) x d(-1) CHO, 4.3 g x kg(-1) x d(-1) fat; FAT-adapt) for 5 d followed by a high-CHO diet and rest on day 6. On day 7, performance testing (2 h steady-state (SS) cycling at 70% peak O(2) uptake [VO(2peak)] + time trial [TT]) of 7 kJ x kg(-1)) was undertaken after a CHO breakfast (CHO 2 g x kg(-1)) and intake of CHO during cycling (0.8 g x kg(-1) x h(-1)).

RESULTS

FAT-adapt reduced respiratory exchange ratio (RER) values before and during cycling at 70% VO(2peak); RER was restored by 1 d CHO and CHO intake during cycling (0.90 +/- 0.01, 0.80 +/- 0.01, 0.91 +/- 0.01, for days 1, 6, and 7, respectively). RER values were higher with HCHO (0.90 +/- 0.01, 0.88 +/- 0.01 (HCHO > FAT-adapt, P < 0.05), 0.95 +/- 0.01 (HCHO > FAT-adapt, P < 0.05)). On day 7, fat oxidation remained elevated (73 +/- 4 g vs 45 +/- 3 g, P < 0.05), whereas CHO oxidation was reduced (354 +/- 11 g vs 419 +/- 13 g, P < 0.05) throughout SS in FAT-adapt versus HCHO. TT performance was similar for both trials (25.53 +/- 0.67 min vs 25.45 +/- 0.96 min, NS).

CONCLUSION

Adaptations to a short-term high-fat diet persisted in the face of high CHO availability before and during exercise, but failed to confer a performance advantage during a TT lasting approximately 25 min undertaken after 2 h of submaximal cycling.

Influence of endurance running and recovery diet on intramyocellular lipid content in women: a 1H NMR study

Using a randomly assigned crossover design, we evaluated the change in intramyocellular lipid stores (IMCL) from baseline after a 2-h treadmill run [67% of maximal oxygen uptake (VO2 max)] and the recovery of IMCL in response to a postexercise very low-fat (10% of energy, LFAT) or moderate-fat (35% of energy, MFAT) recovery diet in seven female runners. IMCL was measured in soleus muscle by use of water-suppressed 1H-NMR spectroscopic imaging before (baseline), after, and approximately 22 h and 70 h after the run. IMCL fell by approximately 25% (P < 0.05) during the endurance run and was dependent on dietary fat content for postexercise recovery (P = 0.038, diet x time interaction). Consumption of the MFAT recovery diet allowed IMCL stores to return to baseline by 22 h and to overshoot (vs. baseline) by 70 h postexercise. In contrast, consumption of the LFAT recovery diet did not allow IMCL stores to return to baseline even by 70 h after the endurance run (P < 0.01 at 70 h). These results suggest that a certain quantity of dietary fat is required to replenish IMCL after endurance running.

Fat utilization during exercise: adaptation to a fat-rich diet increases utilization of plasma fatty acids and very low density lipoprotein-triacylglycerol in humans

1. This study was carried out to test the hypothesis that the greater fat oxidation observed during exercise after adaptation to a high-fat diet is due to an increased uptake of fat originating from the bloodstream. 2. Of 13 male untrained subjects, seven consumed a fat-rich diet (62 % fat, 21 % carbohydrate) and six consumed a carbohydrate-rich diet (20 % fat, 65 % carbohydrate). After 7 weeks of training and diet, 60 min of bicycle exercise was performed at 68 +/- 1 % of maximum oxygen uptake. During exercise [1-(13)C]palmitate was infused, arterial and venous femoral blood samples were collected, and blood flow was determined by the thermodilution technique. Muscle biopsy samples were taken from the vastus lateralis muscle before and after exercise. 3. During exercise, the respiratory exchange ratio was significantly lower in subjects consuming the fat-rich diet (0.86 +/- 0.01, mean +/- S.E.M.) than in those consuming the carbohydrate-rich diet (0.93 +/- 0.02). The leg fatty acid (FA) uptake (183 +/- 37 vs. 105 +/- 28 micromol min(-1)) and very low density lipoprotein-triacylglycerol (VLDL-TG) uptake (132 +/- 26 vs. 16 +/- 21 micromol min(-1)) were both higher (each P < 0.05) in the subjects consuming the fat-rich diet. Whole-body plasma FA oxidation (determined by comparison of (13)CO(2) production and blood palmitate labelling) was 55-65 % of total lipid oxidation, and was higher after the fat-rich diet than after the carbohydrate-rich diet (13.5 +/- 1.2 vs. 8.9 +/- 1.1 micromol min(-1) kg(-1); P < 0.05). Muscle glycogen breakdown was significantly lower in the subjects taking the fat-rich diet than those taking the carbohydrate-rich diet (2.6 +/- 0.5 vs. 4.8 +/- 0.5 mmol (kg dry weight)(-1) min(-1), respectively; P < 0.05), whereas leg glucose uptake was similar (1.07 +/- 0.13 vs. 1.15 +/- 0.13 mmol min(-1)). 4. In conclusion, plasma VLDL-TG appears to be an important substrate source during aerobic exercise, and in combination with the higher plasma FA uptake it accounts for the increased fat oxidation observed during exercise after fat diet adaptation. The decreased carbohydrate oxidation was apparently due to muscle glycogen sparing and not to diminished plasma glucose uptake.

Postexercise fat intake repletes intramyocellular lipids but no faster in trained than in sedentary subjects

The hypotheses that postexercise replenishment of intramyocellular lipids (IMCL) is enhanced by endurance training and that it depends on fat intake were tested. Trained and untrained subjects exercised on a treadmill for 2 h at 50% peak oxygen consumption, reducing IMCL by 26-22%. During recovery, they were fed 55% (high fat) or 15% (low fat) lipid energy diets. Muscle substrate stores were estimated by (1)H (IMCL)- and (13)C (glycogen)-magnetic resonance spectroscopy in tibialis anterior muscle before and after exercise. Resting IMCL content was 71% higher in trained than untrained subjects and correlated significantly with glycogen content. Both correlated positively with indexes of insulin sensitivity. After 30 h on the high-fat diet, IMCL concentration was 30-45% higher than preexercise, whereas it remained 5-17% lower on the low-fat diet. Training status had no significant influence on IMCL replenishment. Glycogen was restored within a day with both diets. We conclude that fat intake postexercise strongly promotes IMCL repletion independently of training status. Furthermore, replenishment of IMCL can be completed within a day when fat intake is sufficient.

High fat intake lowers hepatic fatty acid synthesis and raises fatty acid oxidation in aerobic muscle in Shetland ponies

The metabolic effects of feeding soyabean oil instead of an isoenergetic amount of maize starch plus glucose were studied in ponies. Twelve adult Shetland ponies were given a control diet (15 g fat/kg DM) or a high-fat diet (118 g fat/kg DM) according to a parallel design. The diets were fed for 45 d. Plasma triacylglycerol (TAG) concentrations decreased by 55 % following fat supplementation. Fat feeding also reduced glycogen concentrations significantly by up to 65 % in masseter, gluteus and semitendinosus muscles (P < 0.05 and P < 0.01 and P < 0.01 respectively). The high-fat diet significantly increased the TAG content of semitendinosus muscle by 80 % (P < 0.05). Hepatic acetyl-CoA carboxylase and fatty acid synthase activities were 53 % (P < 0.01) and 56 % (P < 0.01) lower respectively in the high-fat group, but diacylglycerol acyltransferase activity was unaffected. Although carnitine palmitoyltransferase-I (CPT-I) activity in liver mitochondria was not influenced, fat supplementation did render CPT-I less sensitive to inhibition by malonyl-CoA. There was no significant effect of diet on the activity of phosphofructokinase in the different muscles. The activity of citrate synthase was raised significantly (by 25 %; P < 0.05) in the masseter muscle of fat-fed ponies, as was CPT-I activity (by 46 %; P < 0.01). We conclude that fat feeding enhances both the transport of fatty acids through the mitochondrial inner membrane and the oxidative capacity of highly-aerobic muscles. The higher oxidative ability together with the depressed rate of de novo fatty acid synthesis in liver may contribute to the dietary fat-induced decrease in plasma TAG concentrations in equines.

Effects of fat adaptation and carbohydrate restoration on prolonged endurance exercise

We determined the effect of fat adaptation on metabolism and performance during 5 h of cycling in seven competitive athletes who consumed a standard carbohydrate (CHO) diet for 1 day and then either a high-CHO diet (11 g. kg(-1)x day(-1) CHO, 1 g x kg(-1) x day(-1) fat; HCHO) or an isoenergetic high-fat diet (2.6 g x kg(-1) x day(-1) CHO, 4.6 g x kg(-1) x day(-1) fat; fat-adapt) for 6 days. On day 8, subjects consumed a high-CHO diet and rested. On day 9, subjects consumed a preexercise meal and then cycled for 4 h at 65% peak O(2) uptake, followed by a 1-h time trial (TT). Compared with baseline, 6 days of fat-adapt reduced respiratory exchange ratio (RER) with cycling at 65% peak O(2) uptake [0.78 +/- 0.01 (SE) vs. 0.85 +/- 0.02; P < 0.05]. However, RER was restored by 1 day of high-CHO diet, preexercise meal, and CHO ingestion (0.88 +/- 0.01; P < 0.05). RER was higher after HCHO than fat-adapt (0.85 +/- 0.01, 0.89 +/- 0.01, and 0.93 +/- 0.01 for days 2, 8, and 9, respectively; P < 0.05). Fat oxidation during the 4-h ride was greater (171 +/- 32 vs. 119 +/- 38 g; P < 0.05) and CHO oxidation lower (597 +/- 41 vs. 719 +/- 46 g; P < 0.05) after fat-adapt. Power output was 11% higher during the TT after fat-adapt than after HCHO (312 +/- 15 vs. 279 +/- 20 W; P = 0.11). In conclusion, compared with a high-CHO diet, fat oxidation during exercise increased after fat-adapt and remained elevated above baseline even after 1 day of a high-CHO diet and increased CHO availability. However, this study failed to detect a significant benefit of fat adaptation to performance of a 1-h TT undertaken after 4 h of cycling.

The role of high-fat diets and physical activity in the regulation of body weight

The prevalence of obesity is increasing in westernized societies. In the USA the age-adjusted prevalence of BMI > 30 kg/m2 increased between 1960 and 1994 from 13% to 23% for people over 20 years of age. This increase in the prevalence of obesity has been attributed to an increased fat intake and a decreased physical activity. However, the role of the impact of the level of dietary fat intake on human obesity has been challenged. High-fat diets, due to their high energy density, stimulate voluntary energy intake. An increased fat intake does not stimulate its own oxidation but the fat is stored in the human body. When diet composition is isoenergetically switched from low to high fat, fat oxidation only slowly increases, resulting in positive fat balances on the short term. Together with a diminished fat oxidation capacity in pre-obese subjects, high-fat diets can therefore be considered to be fattening. Another environmental factor which could explain the increasing prevalence of obesity is a decrease in physical activity. The percentage of body fat is negatively associated with physical activity and exercise has pronounced effects on energy expenditure and substrate oxidation. High-intensity exercise, due to a lowering of glycogen stores, can lead to a rapid increase in fat oxidation, which could compensate for the consumption of high-fat diets in westernized societies. Although the consumption of high-fat diets and low physical activity will easily lead to the development of obesity, there is still considerable inter-individual variability in body composition in individuals on similar diets. This can be attributed to the genetic background, and some candidate genes have been discovered recently. Both leptin and uncoupling protein have been suggested to play a role in the prevention of diet-induced obesity. Indeed, leptin levels are increased on a high-fat diet but this effect can be attributed to the increased fat mass observed on the high-fat diet. No effect of a high-fat diet per se on leptin levels is observed. Uncoupling proteins are increased by high-fat diets in rats but no data are available in human subjects yet. In conclusion, the increased intake of dietary fat and a decreasing physical activity level are the most important environmental factors explaining the increased prevalence of obesity in westernized societies.

Fasting lipoprotein and postprandial triacylglycerol responses to a low-carbohydrate diet supplemented with n-3 fatty acids

BACKGROUND

The effects of a prolonged low-carbohydrate diet rich in n-3 fatty acids on blood lipid profiles have not been addressed in the scientific literature.

OBJECTIVE

This study examined the effects of an eight-week ketogenic diet rich in n-3 fatty acids on fasting serum lipoproteins and postprandial triacylglycerol (TG) responses.

DESIGN

Ten men consumed a low-carbohydrate diet rich in monounsaturated fat (MUFA) and supplemented with n-3 fatty acids for eight weeks. Fasting blood samples were collected before and after one week of habitual diet and on two consecutive days after 2, 4, 6 and 8 weeks of the intervention diet. Postprandial TG responses to a fat-rich test meal were measured prior to and after the intervention diet.

RESULTS

Compared to the habitual diet, subjects consumed significantly (p < or = 0.05) greater quantities of protein, fat, MUFA and n-3 fatty acids and significantly less total energy, carbohydrate and dietary fiber. Body weight significantly declined over the experimental period (-4.2+/-2.7 kg). Compared to baseline, fasting total cholesterol, LDL cholesterol and HDL cholesterol were not significantly different after the intervention diet (+1.5%, +9.7% and +10.0%, respectively). Fasting TG were significantly reduced after the intervention diet (-55%). There was a significant reduction in peak postprandial TG (-42%) and TG area under the curve (-48%) after the intervention diet.

CONCLUSIONS

A hypocaloric low-carbohydrate diet rich in MUFA and supplemented with n-3 fatty acids significantly reduced postabsorptive and postprandial TG in men that were not hypertriglyceridemic as a group before the diet. This may be viewed as a clinically significant positive adaptation in terms of cardiovascular risk status. However, transient increases in total cholesterol and LDL cholesterol were also evident and should be examined further in regard to which particular subfractions are elevated.

Acetyl-L-carnitine infusion increases glucose disposal in type 2 diabetic patients

Little information is available in the literature on the effect of L-carnitine to improve glucose disposal in healthy control subjects and type 2 diabetic patients. No data are reported on the pharmacological properties of acetyl-L-carnitine (ALC) in type 2 diabetes mellitus. The present study evaluates glucose uptake and oxidation rates with either ALC or placebo administration in 18 type 2 diabetic patients. On different days, each patient received both a primed-constant infusion of ALC (5 mg/kg body weight [BW] priming bolus and either 0.025, 0.1, or 1.0 mg/kg BW/min constant infusion) and a comparable placebo formulation. During the infusion period, continuous indirect calorimetric monitoring and a euglycemic-hyperinsulinemic clamp (EHC) study were performed. The total end-clamp glucose tissue uptake (M value) was significantly increased by the administration of ALC (from 3.8 to 5.2 mg/kg/min, P = .006), and the dose dependence of this effect reached borderline statistical significance (P = .037). The increase in the M/I ratio was also highly significant after ALC administration (from 3.9 to 5.8 x 10(-2) mg/kg/min/(microUI/mL, P < .001), while no statistically significant effect was attributable to the different dosages. The increase in the M value was related to increased glucose storage (highly significant effect of ALC) rather than increased glucose oxidation (no statistical significance). In conclusion, the effect of ALC on glucose disposal has no relationship to the amount administered. This could be due to an effect of ALC on the enzymes involved in both the glycolytic and gluconeogenetic pathways, and a possible reversibility of glycogen synthase inhibition in diabetic subjects.

A perspective on fat intake in athletes

Performance in endurance events is dependent upon the maximal aerobic power, the percentage of that power that can be sustained and the availability of substrates (carbohydrates [CHO] and fats). The purpose of this paper is to present a perspective of recent studies that demonstrate the role of fat intake and oxidation on endurance performance. Studies have shown that fatigue is associated with reduced muscle glycogen and that increasing muscle glycogen or blood glucose prolongs performance while increasing fat and decreasing CHO decreases performance. This has led to an emphasis on CHO intake in athletes in endurance sports, which quite often leads to low caloric intake. It is well known that trained subjects have higher levels of fat oxidative capacity, which spares glycogen during endurance sports. Data from recent studies in trained athletes, who were fed iso-caloric high-fat diets (42% to 55%) that maintained adequate CHO levels, have shown an increase in endurance in both men and women when compared to diets composed of low fat intake (10% to 15%). The magnitude of the effect on endurance was significant at high percentages of maximal aerobic power and increased as the percentage of maximal aerobic power decreased. Based on this review, a baseline diet comprising 20% protein, 30% CHO and 30% fat, with the remaining 20% of the calories distributed between CHO and fat based on the intensity and duration of the sport, is recommended for discussion and future research.

L-carnitine improves glucose disposal in type 2 diabetic patients

OBJECTIVE

Aim of the present study is to evaluate the effects of L-carnitine on insulin-mediated glucose uptake and oxidation in type II diabetic patients and compare the results with those in healthy controls.

DESIGN

Fifteen type II diabetic patients and 20 healthy volunteers underwent a short-term (2 hours) euglycemic hyperinsulinemic clamp with simultaneous constant infusion of L-carnitine (0.28 micromole/kg bw/minute) or saline solution. Respiratory gas exchange was measured by an open-circuit ventilated hood system. Plasma glucose, insulin, non-esterified fatty acids (NEFA) and lactate levels were analyzed. Nitrogen urinary excretion was calculated to evaluate protein oxidation.

RESULTS

Whole body glucose uptake was significantly (p<0.001) higher with L-carnitine than with saline solution in the two groups investigated (48.66+/-4.73 without carnitine and 52.75+/-5.19 micromoles/kg(ffm)/minute with carnitine in healthy controls, and 35.90+/-5.00 vs. 38.90+/-5.16 micromoles/kg(ffm)/minute in diabetic patients). Glucose oxidation significantly increased only in the diabetic group (17.61+/-3.33 vs. 16.45+/-2.95 micromoles/kg(ffm)/minute, p<0.001). On the contrary, glucose storage increased in both groups (controls: 26.36+/-3.25 vs. 22.79+/-3.46 micromoles/kg(ffm)/minute, p<0.001; diabetics: 21.28+/-3.18 vs. 19.66+/-3.04 micromoles/kg(ffm)/minute, p<0.001). In type II diabetic patients, plasma lactate significantly decreased during L-carnitine infusion compared to saline, going from the basal period to the end-clamp period (0.028+/-0.0191 without carnitine and 0.0759+/-0.0329 with carnitine, p<0.0003).

CONCLUSIONS

L-carnitine constant infusion improves insulin sensitivity in insulin resistant diabetic patients; a significant effect on whole body insulin-mediated glucose uptake is also observed in normal subjects. In diabetics, glucose, taken up by the tissues, appears to be promptly utilized as fuel since glucose oxidation is increased during L-carnitine administration. The significantly reduced plasma levels of lactate suggest that this effect might be exerted through the activation of pyruvate dehydrogenase, whose activity is depressed in the insulin resistant status.

Influence of low and high dietary fat on physical performance in untrained males

PURPOSE

Dietary manipulations have been used in athletes to enhance aerobic performance. We intended to verify whether the quality of energy substrate provided by food (percentage of total calories from fat and carbohydrates) per se has the ability to affect aerobic performance in sedentary humans.

METHOD

Fourteen healthy sedentary males were sequentially submitted to 4-wk eucaloric diets (spontaneous diet: 30% of total calories from fat; low-fat, 15% fat; high-fat, 55% fat; and spontaneous, 30% fat). After each diet period, individual body mass, percentage body fat (plicometry), VO2max (incremental bicycle-ergometry) and endurance (pedaling time to exhaustion at 75%VO2max) were measured. VO2, VCO2, VE, R, and heart rate (HR) were measured at rest and during exercise tests. Body composition and performance data (VO2max and endurance) were compared for significant differences by repeated measures ANOVA.

RESULTS

Subjects' body weight, percentage body fat, and fitness status (indicated by intercept and slope of the HR/VO2 linear relationship) did not change significantly during the study, thus ruling out the influence of these potential confounders. For a given workload, VO2, VE, and R were unaffected by diet composition. VO2max and endurance time were not significantly modified by the different diets.

CONCLUSIONS

Our study showed no impact, positive or negative, of diet's macronutrient composition on physical performance. It appears that the quality of energy substrate provided by food does not have the ability to affect either maximal or submaximal aerobic performance in untrained individuals.

Human skeletal muscle pyruvate dehydrogenase kinase activity increases after a low-carbohydrate diet

To characterize human skeletal muscle enzymatic adaptation to a low-carbohydrate, high-fat, and high-protein diet (LCD), subjects consumed a eucaloric diet consisting of 5% of the total energy intake from carbohydrate, 63% from fat, and 33% from protein for 6 days compared with their normal diet (52% carbohydrate, 33% fat, and 14% protein). Biopsies were taken from the vastus lateralis before and after 3 and 6 days on a LCD. Intact mitochondria were extracted from fresh muscle and analyzed for pyruvate dehydrogenase (PDH) kinase, total PDH, and carnitine palmitoyltransferase I activities and mitochondrial ATP production rate (using carbohydrate and fat substrates). beta-Hydroxyacyl CoA dehydrogenase, active PDH (PDHa), and citrate synthase activities were also measured on whole muscle homogenates. PDH kinase (PDHK) was calculated as the absolute value of the apparent first-order rate constant of the inactivation of PDH in the presence of 0.3 mM Mg2+-ATP. PDHK increased dramatically from 0.10 +/- 0.02 min-1 to 0.35 +/- 0.09 min-1 at 3 days and 0.49 +/- 0. 06 min-1 after 6 days. Resting PDHa activity decreased from 0.63 +/- 0.17 to 0.17 +/- 0.04 mmol. min-1. kg-1 after 6 days on the diet, whereas total PDH activity did not change. Activities for all other enzymes were unaltered by the LCD. In summary, severe deficiency of dietary carbohydrate combined with a twofold increase in dietary fat and protein caused a rapid three- to fivefold increase in PDHK activity in human skeletal muscle. The increased PDHK activity downregulated the amount of PDH in its active form at rest and decreased carbohydrate metabolism. However, an increase in the activities of enzymes involved in fatty acid oxidation did not occur.

Effects of high fat versus high carbohydrate diets on plasma lipids and lipoproteins in endurance athletes

PURPOSE AND METHODS

Recent research suggesting the performance benefits of high fat diets for endurance athletes have been viewed with caution because of the potential negative health consequences, including increased coronary heart disease risk. This study examined the effects of a high fat (HF: 50% of total energy from fat, 37% carbohydrate) versus a high carbohydrate (HC: 15% of total energy from fat, 69% carbohydrate) diet on plasma lipids and lipoproteins in 32 endurance trained cyclists over a 3-month period. Plasma total, low density lipoprotein (LDL), high density lipoprotein (HDL), HDL2 and HDL3 cholesterol, triglycerides, apolipoprotein A1, and hematocrit (Hct) were measured at baseline and after weeks 4, 8, and 12.

RESULTS

Changes in lipids and lipoproteins from baseline to week 12 did not differ between the two groups except for triglycerides, which increased significantly from 1.04 +/- 0.17 mmol.L-1 to 1.28 +/- 0.31 mmol.L-1 in HC (P = 0.012). The only significant changes that occurred within each group from baseline to week 12 was the significant increase in total cholesterol and triglycerides in HC. Body composition changes did not differ between the two groups from baseline to week 12 as measured by dual x-ray absorptiometry.

CONCLUSIONS

During periods of endurance training when energy requirements are high, increasing the percentage of fat in the diet to approximately 50% of total energy did not result in adverse changes to the plasma lipoprotein profiles of this group of athletes.

Effects of epinephrine on lipid metabolism in resting skeletal muscle

The effects of physiological (0, 0.1, 2.5, and 10 nM) and pharmacological (200 nM) epinephrine concentrations on resting skeletal muscle lipid metabolism were investigated with the use of incubated rat epitrochlearis (EPT), flexor digitorum brevis (FDB), and soleus (SOL) muscles. Muscles were chosen to reflect a range of oxidative capacities: SOL > EPT > FDB. The muscles were pulsed with [1-14C]palmitate and chased with [9,10-3H]palmitate. Incorporation and loss of the labeled palmitate from the triacylglycerol pool (as well as mono- and diacylglycerol, phospholipid, and fatty acid pools) permitted the simultaneous estimation of lipid hydrolysis and synthesis. Endogenous and exogenous fat oxidation was quantified by 14CO2 and 3H2O production, respectively. Triacylglycerol breakdown was elevated above control at all epinephrine concentrations in the oxidative SOL muscle, at 2.5 and 200 nM (at 10 nM, P = 0.066) in the FDB, and only at 200 nM epinephrine in the EPT. Epinephrine stimulated glycogen breakdown in the EPT at all concentrations but only at 10 and 200 nM in the FDB and had no effect in the SOL. We further characterized muscle lipid hydrolysis potential and measured total hormone-sensitive lipase content by Western blotting (SOL > FDB > EPT). This study demonstrated that physiological levels of epinephrine cause measurable increases in triacylglycerol hydrolysis at rest in oxidative but not in glycolytic muscle, with no change in the rate of lipid synthesis or oxidation. Furthermore, epinephrine caused differential stimulation of carbohydrate and fat metabolism in glycolytic vs. oxidative muscle. Epinephrine preferentially stimulated glycogen breakdown over triacylglycerol hydrolysis in the glycolytic EPT muscle. Conversely, in the oxidative SOL muscle, epinephrine caused an increase in endogenous lipid hydrolysis over glycogen breakdown.

Impact of a fat-rich diet on endurance in man: role of the dietary period

OBJECTIVE

The aim of the present study was to evaluate the effect of duration on the interaction between training and a fat-rich or a carbohydrate-rich diet on endurance performance.

METHODS

Fifteen untrained males were randomly assigned to consume a fat-rich (T-FAT) or a carbohydrate-rich diet (T-CHO) while following an endurance training program. Endurance performance at 80% of pretraining VO2max was measured before, after 2 wk, and after 4 wk.

RESULTS

Time to exhaustion, when exercising at the same absolute workload, was similar in T-FAT and T-CHO at all tests and was significantly increased by 166% and 150% in T-FAT and T-CHO, respectively, after 4 wk. Maximal oxygen uptake increased by 9% in both groups (P < 0.05). After 4 wk, RER was significantly lower during exercise in T-FAT both compared with the initial test and with T-CHO, while no changes appeared in T-CHO.

CONCLUSIONS

The present findings showed that endurance performance was enhanced similarly after both 2 and 4 wk of adaptation to training and a fat-rich or a carbohydrate-rich diet.

Influence of diet on the metabolic responses to exercise

The relationship between dietary intake and skeletal-muscle exercise metabolism is central to the interests of exercise physiologists. This area has been examined experimentally for over 100 years. Classic studies with male subjects demonstrated the importance of dietary CHO in maximizing muscle and liver glycogen stores in an attempt to optimize exercise performance. CHO becomes the predominant fuel for exercise at power outputs above 50-60% Vo2max and its availability limits prolonged aerobic exercise at intensities corresponding to 65-85% VO2max. Recent information suggests that female subjects are less able to maximize muscle glycogen stores through dietary means. Contemporary studies have documented in more detail the greater reliance on CHO metabolism following a high-CHO-low-fat and -protein diet and the greater reliance on fat metabolism following a low-CHO-high-fat and protein diet. More emphasis on documenting key enzymic changes in the energy-producing pathways and transport proteins has appeared. However, very little is known regarding the mechanisms that induce these changes over the short or long term in human skeletal muscle. For example, the central role of PDH activity in the selection of intramuscular fuel during exercise and the role of carnitine palmitoyltransferase 1 in the entry of NEFA into the mitochondria, and the effects of diet on these enzymes has received little attention to date. Many research studies have examined extreme diet variations (% total energy; > 85% CHO v. < 5-10% CHO) for short periods of time in an attempt to maximize diet-induced alterations and study the mechanisms responsible for the changes. However, future studies will need to examine less-severe diet alterations for longer periods of time that more accurately reflect what the normal population might experience, such as a diet containing (% total energy) 60 fat, 20 CHO, 20 protein or the recently popular diet with (% total energy) 30 fat, 40 CHO, 30 protein.

Dodecanedioic acid infusion induces a sparing effect on whole-body glucose uptake, mainly in non-insulin-dependent diabetes mellitus

Even-numbered dicarboxylic acids (DA) have been proposed as an alternative fuel substrate in parenteral nutrition. In particular, dodecanedioic acid (C12) shows a rapid plasma clearance from tissues, a very low urinary excretion compared with other DA and a high oxidation rate. The aim of the present study was to investigate the effect of C12 infusion on insulin-stimulated glucose uptake in patients with non-insulin-dependent diabetes mellitus (NIDDM) compared with healthy volunteers. A primed-constant infusion of C12 (0.39 mmol/min) was administered over 240 min, and at 120 min a 2 h euglycaemic hyperinsulinaemic clamp was performed. Blood specimens were sampled every 30 min and fractioned urines were collected over 24 h. The levels of C12 were measured by HPLC. Indirect calorimetry was performed continuously during the entire session. Body composition was assessed in all subjects studied to obtain fat-free mass (FFM) values. Whole-body glucose uptake decreased significantly during C12 infusion in both groups, although this effect was much more evident (P < 0.01) in NIDDM patients (52.4 (SD 15.8) % decrease compared with saline) than in controls (25.9 (SD 12.1) % decrease). The M value (mumol/kgFFM per min) was reduced by C12 to lower levels in NIDDM patients than in normal controls (12.6 (SD 3.9) v. 25.9 (SD 4.5), P < 0.01). Urinary excretion of C12 over 24 h was significantly lower in NIDDM patients than in controls (4.26 (SD 0.30) mmol v. 5.43 (SD 0.48), P < 0.01), corresponding to less than 3% of the administered dose. The infusion of C12 decreased non-protein RQ significantly in both groups of patients. In conclusion, this study shows, for the first time, that C12 significantly reduces glucose uptake in both normal controls and NIDDM patients, although this sparing effect on glucose uptake is much more pronounced in diabetic patients. These data suggest that C12 decreases glucose uptake and oxidation, mainly through a mechanism of substrate competition. Thus, it might be a useful alternative substrate in enteral or parenteral nutrition, sparing glucose utilization and increasing glycogen stores, in those clinical conditions, like NIDDM, where reduced insulin-induced glucose uptake and oxidation are observed.

Metabolic adaptation to fat-supplemented diet by the thoroughbred horse

Following 10 weeks of fat supplementation a group of aerobically trained thoroughbred horses exhibited a significant decrease in postprandial plasma triacylglycerol concentration. This decrease was associated with a mean 50% increase in plasma total lipase activity following pentosan polysulfate administration and an increase in postprandial plasma cholesterol concentration. A significant increase in the activity of muscle citrate synthase (EC 4.1.3.7), expressed as a ratio to the total fractional area occupied by type I and type IIa muscle fibres, was also observed. No significant change in the concentration of resting muscle glycogen or triacylglycerol occurred as a result of fat supplementation. These results suggest that there was improved management of the fat load and that the triacylglycerol-clearing capacity of the horses was increased as a result of fat supplementation. It is suggested that the increase in plasma total lipase activity following pentosan polysulfate administration may have reflected an increase in muscle lipoprotein lipase (EC 3.1.1.34) activity, which would increase the capacity of muscle for free fatty acid uptake from circulating triacylglycerol-rich plasma lipoproteins. Fat supplementation may also enhance the oxidative capacity of muscle, as suggested by the significant increase in muscle citrate synthase and the trend towards an increase in beta-hydroxyacyl CoA dehydrogenase (EC 1.1.1.35) following 10 weeks of fat supplementation.

The insulin sensitizer, BRL 49653, reduces systemic fatty acid supply and utilization and tissue lipid availability in the rat

Thiazolidinediones are oral insulin-sensitizing agents that may be useful for the treatment of non-insulin-dependent diabetes mellitus (NIDDM). BRL 49653 ameliorates insulin resistance and improves glucoregulation in high-fat-fed (HF) rats. It is known that thiazolidinediones bind to the peroxisome proliferator-activated receptor (PPAR gamma) in fat cells, but the extent to which the improved glucoregulation and hypolipidemic effects relate to adipose tissue requires clarification. We therefore examined BRL 49653 effects on lipid metabolism in HF and control (high-starch-fed [HS]) rats. The diet period was 3 weeks, with BRL 49653 (10 mumol/kg/d) or vehicle gavage administered over the last 4 days. Studies were performed on animals in the conscious fasted state. In HF rats, rate constants governing 3H-palmitate clearance were unaffected by BRL 49653. This finding, taken with a concurrent decrease of fasting plasma nonesterified fatty acids (NEFA) (P < .01, ANOVA), demonstrated that systemic NEFA supply and hence absolute utilization are reduced by BRL 49653. Hepatic triglyceride (TG) production (HTGP) assessed using Triton WR1339 was unaffected by diet or BRL 49653. In liver, BRL 49653 increased insulin-stimulated conversion of glucose into fatty acid in both HF (by 270%) and HS (by 30%) groups (P < .05). Relative to HS rats, HF animals had substantially elevated levels of muscle diglyceride (diacylglycerol[DG] by 240%, P < .001). BRL 49653 significantly reduced muscle DG in HF (by 30%, P < .05) but not in HS rats. The agent did not reduce the intake of dietary lipid. In conclusion, these results are consistent with a primary action of BRL 49653 in adipose tissue to conserve lipid by reducing systemic lipid supply and subsequent utilization. The parallel effects of diet and BRL 49653 treatment on insulin resistance and muscle acylglyceride levels support the involvement of local lipid oversupply in the generation of muscle insulin resistance.

Effects of dietary fat restriction on particle size of plasma lipoproteins in postmenopausal women

Hypertriglyceridemia is an independent risk factor for coronary artery disease (CAD) and is also commonly associated with other coronary risk factors, ie, small, dense low-density lipoprotein (LDL) particles and low plasma levels of high-density lipoprotein cholesterol (HDL-C). Dietary fat restriction is recommended for the prevention of nutrition-related cancers. Low-fat, high-carbohydrate intake can increase plasma triglyceride (TG) and decrease HDL-C. In general, plasma TG levels are inversely related to the particle size of LDL. We investigated the effects of dietary fat restriction on the concentration and particle size of plasma lipoproteins in 14 healthy postmenopausal women (aged 61 +/- 11 years). During a 4-month period of eucaloric controlled feeding, dietary fat was reduced stepwise from a habitual intake of 33% +/- 8% to 23% and then to 14% of daily energy. Changes in the plasma lipid level and particle size of very-low-density lipoprotein (VLDL), LDL, and HDL were determined at the end of each dietary phase. Increasing carbohydrate intake without weight loss was associated with an increase in plasma TG (1.86 +/- 0.30 v 2.47 +/- 0.37 mmol/L) and decreases in total cholesterol (5.82 +/- 0.25 v 5.40 +/- 0.21 mmol/L), LDL-C (3.07 +/- 0.18 v 2.61 +/- 0.21 mmol/L), HDL-C (1.42 +/- 0.1 v 1.24 +/- 0.1 mmol/L), and apolipoprotein (apo) A1 (5.14 +/- 0.25 v 4.61 +/- 0.36 mmol/L), whereas plasma apo B did not change. The particle size of VLDL increased (42.7 +/- 1.4 v 47.0 +/- 0.9 nm). However, there was no change in either LDL (25.1 +/- 0.2 v 25.3 +/- 0.2 nm) or HDL particle size. Although at each level of dietary fat intake LDL particle size correlated inversely with plasma TG and apo B, there was no relationship between the increase in plasma TG and LDL particle size. These results show that hypertriglyceridemia caused by a eucaloric high-carbohydrate intake is not associated with a decrease in LDL particle size. Therefore, carbohydrate-induced hypertriglyceridemia may not have the same atherogenic potential as genetic hypertriglyceridemias.

Effects of diet on muscle triglyceride and endurance performance

The purpose of this investigation was to examine the effects of diet on muscle triglyceride and endurance performance. Seven endurance-trained men completed a 120-min cycling bout at 65% of maximal oxygen uptake. Each subject then ingested an isocaloric high-carbohydrate (Hi-CHO; 83% of energy) or a high-fat (Hi-Fat; 68% of energy) diet for the ensuing 12 h. After a 12-h overnight fast, a 1,600-kJ self-paced cycling bout was completed. Muscle triglyceride measured before (33.0 +/- 2.3 vs. 37.0 +/- 2.1 mmol/kg dry wt) and after (30.9 +/- 2.4 vs. 32.8 +/- 1.6 mmol/kg dry wt) the 120-min cycling bout was not different between the Hi-CHO and Hi-Fat trials, respectively. After the 24-h dietary-fasting period, muscle triglyceride was significantly higher for the Hi-Fat (44.7 +/- 2.4 mmol/kg dry wt) vs. the Hi-CHO (27.5 +/- 2.1 mmol/kg dry wt) trial. Furthermore, self-paced cycling time was significantly greater for the Hi-Fat (139.3 +/- 7.1 min) compared with the Hi-CHO (117.1 +/- 3.2 min) trial. These data demonstrate that there was not a significant difference in muscle triglyceride concentration before and after a prolonged moderate-intensity cycling bout. Nevertheless, a high-fat diet increased muscle triglyceride concentration and reduced self-paced cycling performance 24 h after the exercise compared with a high-carbohydrate diet.

Effect of a high or a low fat diet on cardiovascular risk factors in male and female runners

Dietary fat may be associated with coronary heart disease (CHD). Studies suggest that restricting fat intake may compromise endurance performance and that increasing fat intake may improve endurance performance. We studied the effects of varying dietary fat intake on CHD risk factors in runners. Twelve male and 13 female runners increased fat from 16% to 30% of daily calories (4 wk each). Of this group, six males and six females increased fat to 42% of daily calories (4 wk). Physiological and lipoprotein risk factors were measured after each diet. Results were analyzed by repeated measures ANOVA. Increasing dietary fat from 16% to 42% of daily calories did not change adiposity, weight, heart rate, blood pressure, serum triglycerides, total cholesterol, LDL cholesterol. Apolipoprotein B, or the Apo A1/Apo B ratio. Compared with those eating higher fat, subjects eating 16% fat had lower HDL cholesterol (50 +/- 3 vs 62 +/- 3 mg.dl-1, P < 0.0001) and Apolipoprotein A1 (111 +/- 6 v. 134 +/- 6 mg/dl, P < 0.0005) and a higher TC/HDL-C ratio (4.05 +/- 0.27 vs 3.42 +/- 0.24, P < 0.0005). Runners who increased fat intake to 42% further raised HDL cholesterol (64 +/- 6 to 69 +/- 5 mg.dl-1, P < 0.04) without adversely affecting other lipoproteins. In conclusion, a 42% fat diet maintained favorable CHD risk factors in female and male runners whereas a 16% fat diet lowered Apo A1 and HDL-C and raised the TC/HDL-C ratio.

Olive oil and rapeseed oil differ in their effect on plasma low-density lipoprotein metabolism in the guinea-pig

The effects of olive oil and rapeseed oil, two different high-oleic-acid oils, on plasma LDL and hepatic cholesterol metabolism were compared in guinea-pigs. Animals were fed on semipurified diet containing 150 g fat/kg as either olive oil (OL), rapeseed oil plus 100 g palm oil/kg (C-P) or olive oil plus 350 g safflowerseed oil/kg (OL-S). Olive oil was enriched with safflowerseed oil (OL-S diet) to increase linoleic acid and to decrease palmitic acid concentrations, in order to evaluate whether differences in plasma LDL concentrations were due to intrinsic effects of the specific oil (rapeseed or olive oil) or to differences in the content of specific fatty acids. No differences due to dietary fat source were found in plasma total and HDL-cholesterol levels or in LDL composition. Plasma LDL-cholesterol levels were lower on the C-P diet than the OL diet (P < 0.05) while plasma LDL-cholesterol levels in animals fed on the OL-S diet were not significantly different from either dietary group (P > 0.05). The number of hepatic apo B/E (LDL) receptors was on average 25% higher in animals fed on the C-P diet compared with those fed on diets containing olive oil. Likewise, cardiac muscle lipoprotein lipase (EC 3.1.1.34) activity was significantly higher in the C-P group than in the OL and OL-S dietary groups. Dietary fat source had no effect on hepatic cholesterol levels or 3-hydroxy-3-methylglutaryl (HMG) CoA reductase (EC 1.1.1.34) activity. The results indicate that olive oil and rapeseed oil, both rich sources of monounsaturated fatty acids, differ in their effect on LDL metabolism in the guinea-pig.

Nutrition, hormones, and breast cancer: is insulin the missing link?

Breast cancer incidence rates are high in societies with a Western lifestyle characterized by low levels of physical activity, and by an energy-dense diet rich in total and saturated fat and refined carbohydrates. Epidemiologic studies, so far mostly on postmenopausal women, have shown that breast cancer risk is increased in hyperandrogenic women, with decreased levels of plasma sex-hormone binding globulin, and with increased levels of testosterone and of free estrogens. This paper describes the role of hyperinsulinemia as a physiologic link between nutritional lifestyle factors, obesity, and the development of a hyperandrogenic endocrine profile, and reviews evidence that may or may not support the theory that chronic hyperinsulinemia is an underlying cause of breast cancer. An hypothesis is presented, stipulating that breast cancer risk is increased not only in hyperandrogenic postmenopausal women, but also in premenopausal women with mild hyperandrogenism and normal (ovulatory) menstrual cycles. The author suggests further investigation as to whether there is a positive association between risk of breast cancer before menopause and subclinical forms of the polycystic ovary syndrome (PCOS), and to what extent diet and physical activity during childhood, by modulating the degree of insulin resistance during adolescence, may or may not be determinants of a PCO-like hyperandrogenic endocrine profile persisting into adulthood.

Baseline dietary intake and physical activity of Japanese American men in relation to glucose tolerance at 5-year follow-up

Japanese American men (n = 124), with normal glucose tolerance (NGT, n = 69) or impaired glucose tolerance (IGT, n = 55) at baseline, were studied for effects of baseline dietary intake and physical activity on glucose tolerance at baseline and at 5-year follow-up. At baseline, both NGT and IGT men with positive family history of diabetes (FH) showed high intakes of animal fat and protein, but only the NGT men countered this with high levels of energy expenditure. In the total sample at 5-year follow-up, 2-hour plasma glucose was significantly related to intake of animal fat (AF), partial correlation r = 0.32, P < 0.001, adjusted for total energy intake, age, self-reported health, body mass index, FH, and baseline glucose tolerance category. Energy expenditure (EE) was not related to 5-year 2-hour plasma glucose in the total sample, but displayed a relationship with 5-year 2-hour plasma glucose in those IGT (r = -0.27, P < 0.05), but not in those NGT at baseline, and in those with positive FH (r = -0.33, P < 0.05), but not in those with negative FH. Additionally, AF showed a relationship to 5-year 2-hour plasma glucose only for those in the lowest (r = 0.37, P < 0.05) and middle (r = 0.33, P < 0.05) tertiles, but not in the highest tertile of EE. For baseline IGT men, 5-year 2-hour plasma glucose was related to "high vs. low risk" categories of AF intake and EE, but only in men with a positive FH (AF ≥ 25 vs. < 25 g/day: 180.1 ± 38.6 vs. 143.6 ± 39.7 mg/dl, P = 0.048; EE ≤ 2,000 kcal/week vs. > 2,000 kcal/week, 189.9 ± 39.2 vs. 150.8 ± 37.4 mg/dl, P = 0.028; with risk categories combined, i.e., both high, mixed, both low: 192.0 ± 41.3, 165.4 ± 28.4, 139.4 ± 40.9 mg/dl, P = 0.045, linear trend, P = 0.014). Thus, high AF intake and low EE may have long-range detrimental effects on glucose tolerance, especially for those with IGT and positive FH. © 1996 Wiley-Liss, Inc.

Induction and reversibility of an obesity syndrome by intracerebroventricular neuropeptide Y administration to normal rats

Intracerebroventricular neuropeptide Y (NPY) administration to normal rats for 7 days produced a sustained, threefold increase in food intake, resulting in a body weight gain of more than 40 g. Basal plasma insulin and triglyceride levels were increased in NPY-treated compared to vehicle-infused rats by about four- and two-fold, respectively. The glucose utilization index of white adipose tissue, measured by the labelled 2-deoxy-D-glucose technique was four times higher in NPY-treated rats compared to controls. This change was accompanied by an increase in the insulin responsive glucose transporter protein (GLUT 4). In marked contrast, muscle glucose utilization was decreased in NPY-treated compared to vehicle-infused animals. This change was accompanied by an increase in triglyceride content. When NPY-treated rats were prevented from overeating, there was no decrease in muscle glucose uptake, nor was there an increase in muscle triglyceride content. This suggests that muscle insulin resistance of ad libitum-fed NPY-treated rats is due to a glucose-fatty acid (Randle) cycle. When intracerebroventricular NPY administration was stopped and rats kept without any treatment for 7 additional days, all the abnormalities brought about by the neuropeptide were normalized. A tonic central effect of NPY is therefore needed to elicit and maintain most of the hormonal and metabolic abnormalities observed in the present study. Such abnormalities are analogous to those seen in the dynamic phase of obesity syndromes in which high hypothalamic NPY levels have been reported.

Effects of low-fat diet, calorie restriction, and running on lipoprotein subfraction concentrations in moderately overweight men

We studied the effects of exercise (primarily running), calorie restriction (dieting), and a low-fat, high-carbohydrate diet on changes in lipoprotein subfractions in moderately overweight men in a randomized controlled clinical trial. After 1 year, complete data were obtained for 39 men assigned to lose weight through dieting without exercise, 37 men assigned to lose weight through dieting with exercise (primarily running), and 40 nondieting sedentary controls. We instructed both diet groups to consume no more than 30% total fat, 10% saturated fat, and 300 mg/d of cholesterol, and at least 55% carbohydrates, and the controls were instructed to maintain their usual food choices. Analytic ultracentrifugation was used to measure changes in plasma lipoprotein mass concentrations. In addition, the absorbance of protein-stained polyacrylamide gradient gels was used as an index of concentrations for five high-density lipoprotein (HDL) subclasses that have been identified by their particle sizes, ie, HDL3c (7.2 to 7.8 nm), HDL3b (7.8 to 8.2 nm), HDL3a (8.2 to 8.8 nm), HDL2a (8.8 to 9.7 nm), and HDL2b (9.7 to 12 nm). Relative to controls, weight decreased significantly in men who dieted with exercise (net difference +/- SE, -3.3 +/- 0.4 kg/m2) and in men who dieted without exercise (-2.0 +/- 0.4 kg/m2). Dieting with exercise significantly decreased very-low-density lipoprotein (VLDL)-mass concentrations and significantly increased plasma HDL2-mass, HDL3a, HDL2a, and HDL2b relative to both control and dieting without exercise. There were no significant changes in lipoprotein mass and HDL protein for dieters who did not run.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of high fat-feeding to rats on the interrelationship of body weight, plasma insulin, and fatty acyl-coenzyme A esters in liver and skeletal muscle

Rats fed a high-saturated fat diet consumed more energy, gained more weight, and displayed hyperinsulinemia (P less than .05) without an elevation in the fasting plasma glucose level, compared with animals on two different high-carbohydrate diets. The total fatty acyl-coenzyme A (CoA) concentration was 18% (P less than .0001) and 46% (P less than .0001) higher in liver and skeletal muscle, respectively, from rats fed the high-fat diet compared with each of the other diet groups. Major long-chain fatty acyl-CoA molecular species of both tissues in high fat-fed rats reflected the fatty acid profile of the diet. Approximately 29%, 21%, and 16% of total liver and skeletal muscle fatty acyl-CoAs were comprised of oleoyl-CoA, palmitoyl-CoA, and stearoyl-CoA, respectively. The amounts of these three fatty acyl-CoA esters were significantly higher in liver and skeletal muscle after high-fat feeding than with the other diet treatments (P less than .0001). In contrast, the concentration of linoleoyl-CoA was lower in both tissues after high-fat feeding (P less than .0001). In rats fed the high-fat diet, plasma insulin levels were significantly correlated with gain in body weight or body weight (r = .80, P less than .001 for insulin and gain in body weight; r = .73, P less than .001 for insulin and body weight). Total fatty acyl-CoA ester content in liver and skeletal muscle was also strongly correlated with the plasma insulin concentration in high fat-fed rats (r = .80, P less than .001 for liver; r = .78, P less than .001 for skeletal muscle).(ABSTRACT TRUNCATED AT 250 WORDS)

Lipoprotein lipase. A multifunctional enzyme relevant to common metabolic diseases

Lipoprotein lipase is an important regulator of lipid and lipoprotein metabolism. It also contributes to the lipid and energy metabolism of different tissues in varying ways. Although the synthesis, manner of secretion, and mechanism of endothelial binding of lipoprotein lipase appear similar in all tissues, the factors that control gene expression and posttranslational events related to processing vary from tissue to tissue. The actual molecular events that determine this tissue specificity are not yet understood. In the future, however, it may be possible to stimulate or inhibit the activity of lipoprotein lipase in specific tissues and to alter metabolic processes so as to improve the quality and length of life in patients with metabolic diseases such as hypertriglyceridemia, HDL2 deficiency, and obesity.

The acute effect of prolonged walking and dietary changes on plasma lipoprotein concentrations and high-density lipoprotein subfractions

The effect of diet on exercise-induced changes in the plasma concentrations of lipoproteins was examined in six healthy male subjects during walks of 37 km on each of four successive days. With a high-carbohydrate diet (85% of the calories as carbohydrate) there was an increase (P less than .05) in the concentration of very-low-density lipoprotein (VLDL)-cholesterol and VLDL-triglyceride and a decrease (P less than .01) in the concentration of high density lipoprotein (HDL)-cholesterol, due mainly to a decrease in HDL3-cholesterol (P less than .01), and HDL-protein (P less than .001). In contrast, a high-fat diet (75% fat) produced a decrease (P less than .01) in the concentration of VLDL-cholesterol and VLDL-triglyceride with increases (P less than .01) in HDL-protein concentration and in HDL-cholesterol concentrations that arose largely from an increase (P less than .001) in HDL2-cholesterol. Gradient gel electrophoretic analysis showed an increase (P less than .01) in the relative concentration of HDL2b (subspecies of diameter 10.57 nm) with a decrease (P less than .01) in the concentration of HDL2a (9.16 nm) plus HDL3a (8.44 nm) with the high-fat diet, but no significant or consistent change with the high-carbohydrate diet. There was no change in the level of the apolipoprotein E-rich HDL subfraction with either diet. Plasma lecithin:cholesterol acyltransferase activity decreased (P less than .05) with the high-fat diet but not with the high-carbohydrate diet. Thus, diet can strongly influence the changes that occur in plasma lipoprotein concentrations during prolonged low-intensity exercise.