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Treviño-Alvarez AM, Cabeza de Baca T, Stinson EJ, Gluck ME, Piaggi P, Votruba SB, Krakoff J, Chang DC. Acid accumulation is associated with metabolic alterations; higher energy, fat, and protein intake; and energy expenditure. Obesity (Silver Spring) 2024; 32:1541-1550. [PMID: 38932559 DOI: 10.1002/oby.24086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE The objective of this study was to study how acid accumulation (lower plasma bicarbonate and higher anion gap [AG] and corrected anion gap [CAG]) correlates with metabolic parameters, food intake, and 24-h energy expenditure (EE). METHODS Acid accumulation was measured in 286 healthy adults with estimated glomerular filtration rate > 60 mL/min/1.73 m2. Measurements included body composition by dual-energy x-ray absorptiometry scan, ad libitum energy intake by a vending machine paradigm over 3 days, and 24-h EE in a whole-room indirect calorimeter. RESULTS Lower bicarbonate, higher AG, and higher CAG were correlated with higher waist and thigh circumferences, body fat (percentage), fat mass, triglycerides, and lower high-density lipoprotein cholesterol. Acid accumulation markers were correlated with higher total energy (CAG partial r = 0.17; p = 0.02), fat (CAG partial r = 0.17; p = 0.02), protein intake (CAG partial r = 0.20; p = 0.006), and 24-h EE (CAG partial r = 0.24; p = 0.0007). A mediation analysis of CAG and total energy intake found that 24-h EE was a partial mediator (40%), but the association remained significant (β = 0.15; p < 0.0001). CONCLUSIONS In healthy individuals, acid accumulation was associated with an unfavorable metabolic phenotype; higher 24-h EE; and increased total energy, fat, and protein intake. Acid accumulation markers, as putative markers of higher dietary acid load (e.g., from protein), may affect energy balance physiology promoting weight gain.
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Affiliation(s)
- Andrés M Treviño-Alvarez
- Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Tomás Cabeza de Baca
- Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Emma J Stinson
- Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Marci E Gluck
- Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Paolo Piaggi
- Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Susanne B Votruba
- Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Jonathan Krakoff
- Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
| | - Douglas C Chang
- Department of Health and Human Services, Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA
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Hollstein T, Piaggi P. How can we assess "thrifty" and "spendthrift" phenotypes? Curr Opin Clin Nutr Metab Care 2023; 26:409-416. [PMID: 37294042 PMCID: PMC10531526 DOI: 10.1097/mco.0000000000000952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE OF REVIEW There is a large inter-individual variability in the magnitude of body weight change that cannot be fully explained by differences in daily energy intake and physical activity levels and that can be attributed to differences in energy metabolism. Measuring the short-term metabolic response to acute changes in energy intake can better uncover this inter-individual variability and quantify the degree of metabolic thriftiness that characterizes an individual's susceptibility to weight gain and resistance to weight loss. This review summarizes the methods used to identify the individual-specific metabolic phenotype (thrifty vs. spendthrift) in research and clinical settings. RECENT FINDINGS The metabolic responses to short-term fasting, protein-imbalanced overfeeding, and mild cold exposure constitute quantitative factors that characterize metabolic thriftiness. SUMMARY The energy expenditure response to prolonged fasting is considered the most accurate and reproducible measure of metabolic thriftiness, likely because the largest energy deficit best captures interindividual differences in the extent of metabolic slowing. However, all the other dietary/environmental challenges can be used to quantify the degree of thriftiness using whole-room indirect calorimetry. Efforts are underway to identify alternative methods to assess metabolic phenotypes in clinical and outpatient settings such as the hormonal response to low-protein meals.
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Affiliation(s)
- Tim Hollstein
- Institute of Diabetes and Clinical Metabolic Research. Düsternbrooker Weg 17, 24195 Kiel, Germany
| | - Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, 4212 N 16 Street, Phoenix Arizona 85016, USA
- Department of Information Engineering, University of Pisa, Pisa 56122, Italy
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The complex pattern of the effects of prolonged frequent exercise on appetite control, and implications for obesity. Appetite 2023; 183:106482. [PMID: 36754171 DOI: 10.1016/j.appet.2023.106482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
From a public health perspective, much of the interest in the relationship between exercise and appetite rests on the implications for energy balance and obesity. Energy balance reflects a dynamic 2-way interaction between energy expenditure (EE) and energy intake (EI). Physical activity and exercise, and appetite are the behavioural components of EE and EI, respectively. Beyond EE, exercise is a powerful and complex physiological stimulus acting on several bodily systems. There are multiple effects of frequent and prolonged exercise on appetite which include inter alia an increase in fasting hunger, an enhancement of post-prandial satiety, a modulation of the hedonic responses to food and improvements in eating behaviour traits. These lead to variable adjustments in EI and in a reduction in the susceptibility to overconsumption. Frequent and prolonged physical activity and exercise behaviour can strengthen and sensitise the appetite control system, whilst physical inactivity and sedentariness (low level of EE) fails to downregulate EI and can permit overconsumption. Not all of the effects of exercise operate uniformly to drive appetite in the same direction. The complexity of the interaction between EE and EI means that the effects of prolonged exercise are characterised by substantial individual heterogeneity. This leads to variable effects on energy balance and body mass.
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Piaggi P, Rodzevik TL, Wohlers E, Ruud K, Moon J, Krakoff J, Chang DC. Closed-loop control of air supply to whole-room indirect calorimeters to improve accuracy and standardize measurements during 24-hour dynamic metabolic studies. Obesity (Silver Spring) 2023; 31:780-788. [PMID: 36788466 DOI: 10.1002/oby.23683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/10/2022] [Accepted: 11/21/2022] [Indexed: 02/16/2023]
Abstract
OBJECTIVE The aim of this study was to test proportional-integral-derivative (PID) control of air inflow rate in a whole-room indirect calorimeter to improve accuracy in measuring oxygen (O2 ) consumption ( V ̇ O 2 ) and carbon dioxide (CO2 ) production ( V ̇ CO 2 ). METHODS A precision gas blender infused nitrogen (N2 ) and CO2 into the calorimeter over 24 hours based on static and dynamic infusion profiles mimicking V ̇ O 2 and V ̇ CO 2 patterns during resting and non-resting conditions. Constant (60 L/min) versus time-variant flow set by a PID controller based on the CO2 concentration was compared based on errors between measured versus expected values for V ̇ O 2 , V ̇ CO 2 , respiratory exchange ratio, and metabolic rate. RESULTS Compared with constant inflow, the PID controller allowed both a faster rise time and long-term maintenance of a stable CO2 concentration inside the calorimeter, resulting in more accurate V ̇ CO 2 estimates (mean hourly error, PID: -0.9%, 60 L/min = -2.3%, p < 0.05) during static infusions. During dynamic infusions mimicking exercise sessions, the PID controller achieved smaller errors for V ̇ CO 2 (mean: -0.6% vs. -2.7%, p = 0.02) and respiratory exchange ratio (mean: 0.5% vs. -3.1%, p = 0.02) compared with constant inflow conditions, with similar V ̇ O 2 (p = 0.97) and metabolic rate (p = 0.76) errors. CONCLUSIONS PID control in a whole-room indirect calorimeter system leads to more accurate measurements of substrate oxidation during dynamic metabolic studies.
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Affiliation(s)
- Paolo Piaggi
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Theresa L Rodzevik
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
| | | | | | - Jon Moon
- MEI Research, Ltd., Edina, Minnesota, USA
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
| | - Douglas C Chang
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA
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Hopkins M, Blundell JE. Striking a balance: Orexigenic and energy-consuming effects of energy expenditure on body weight. Obesity (Silver Spring) 2022; 30:575-576. [PMID: 35166057 PMCID: PMC9305097 DOI: 10.1002/oby.23393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/05/2022]
Affiliation(s)
- Mark Hopkins
- School of Food Science and NutritionFaculty of EnvironmentUniversity of LeedsLeedsUK
| | - John E. Blundell
- Appetite and Energy Balance Research GroupSchool of PsychologyFaculty of Medicine and HealthUniversity of LeedsLeedsUK
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