1
|
Volek JS, Kackley ML, Buga A. Nutritional Considerations During Major Weight Loss Therapy: Focus on Optimal Protein and a Low-Carbohydrate Dietary Pattern. Curr Nutr Rep 2024; 13:422-443. [PMID: 38814519 PMCID: PMC11327213 DOI: 10.1007/s13668-024-00548-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW Considering the high prevalence of obesity and related metabolic impairments in the population, the unique role nutrition has in weight loss, reversing metabolic disorders, and maintaining health cannot be overstated. Normal weight and well-being are compatible with varying dietary patterns, but for the last half century there has been a strong emphasis on low-fat, low-saturated fat, high-carbohydrate based approaches. Whereas low-fat dietary patterns can be effective for a subset of individuals, we now have a population where the vast majority of adults have excess adiposity and some degree of metabolic impairment. We are also entering a new era with greater access to bariatric surgery and approval of anti-obesity medications (glucagon-like peptide-1 analogues) that produce substantial weight loss for many people, but there are concerns about disproportionate loss of lean mass and nutritional deficiencies. RECENT FINDINGS No matter the approach used to achieve major weight loss, careful attention to nutritional considerations is necessary. Here, we examine the recent findings regarding the importance of adequate protein to maintain lean mass, the rationale and evidence supporting low-carbohydrate and ketogenic dietary patterns, and the potential benefits of including exercise training in the context of major weight loss. While losing and sustaining weight loss has proven challenging, we are optimistic that application of emerging nutrition science, particularly personalized well-formulated low-carbohydrate dietary patterns that contain adequate protein (1.2 to 2.0 g per kilogram reference weight) and achieve the beneficial metabolic state of euketonemia (circulating ketones 0.5 to 5 mM), is a promising path for many individuals with excess adiposity.
Collapse
Affiliation(s)
- Jeff S Volek
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA.
| | - Madison L Kackley
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA
| | - Alex Buga
- Department of Human Sciences, The Ohio State University, 305 Annie & John Glenn Ave, Columbus, OH, 43210, USA
| |
Collapse
|
2
|
Anyiam O, Phillips B, Quinn K, Wilkinson D, Smith K, Atherton P, Idris I. Metabolic effects of very-low calorie diet, Semaglutide, or combination of the two, in individuals with type 2 diabetes mellitus. Clin Nutr 2024; 43:1907-1913. [PMID: 38996661 DOI: 10.1016/j.clnu.2024.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND & AIMS Very-low calorie diets (VLCD) and the glucagon-like peptide-1 receptor agonist (GLP1RA) Semaglutide induce significant weight loss and improve glycaemic control in individuals with type 2 diabetes (T2D). This pilot study was conducted to explore the comparative short-term effects of these interventions individually, and in combination, on weight, body composition and metabolic outcomes. METHODS Thirty individuals with T2D (age 18-75 years, BMI 27-50 kg m-2) were randomly assigned to receive Semaglutide (SEM), 800 kilocalorie/day VLCD (VLCD), or both in combination (COMB) for 12 weeks. Measurement of weight and glycated haemoglobin (HbA1c), dual energy X-ray absorptiometry, and intravenous glucose tolerance tests (IVGTT) were performed at baseline and post-intervention. Diet diaries were utilised to assess compliance. Insulin first phase response during IVGTT provided a marker of pancreatic beta-cell function, and insulin sensitivity was estimated using HOMA-IR. RESULTS Significantly greater reductions in body weight and fat mass were observed in VLCD and COMB, than SEM (p < 0.01 v both). VLCD and COMB resulted in a 5.4 and 7 percentage-point greater weight loss than SEM, respectively. HbA1c and fasting glucose reduced significantly in all groups, however fasting insulin and HOMA-IR improved in VLCD and COMB only. Insulin first phase response during IVGTT increased in SEM and COMB, and this increase was significantly greater in COMB than VLCD (p < 0.01). CONCLUSION VLCD elicited greater short-term losses of weight and fat mass than Semaglutide. Adding VLCD to Semaglutide stimulated further weight loss than Semaglutide alone. The combination did not yield any additive effects on weight and body composition above VLCD alone, but did provoke greater improvements in pancreatic beta-cell function. Thus, combination of Semaglutide and VLCD warrants further exploration as a novel approach to T2D management.
Collapse
Affiliation(s)
- Oluwaseun Anyiam
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK; Department of Endocrinology and Diabetes, University Hospitals Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK
| | - Bethan Phillips
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK
| | - Katie Quinn
- College of Agriculture, Food & Nutrition, University College Dublin, Ireland
| | - Daniel Wilkinson
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK
| | - Kenneth Smith
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK
| | - Philip Atherton
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK.
| | - Iskandar Idris
- MRC/ARUK Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre (BRC), School of Medicine, University of Nottingham, Derby, DE22 3DT, UK; Department of Endocrinology and Diabetes, University Hospitals Derby and Burton NHS Foundation Trust, Derby, DE22 3NE, UK.
| |
Collapse
|
3
|
Griffin SB, Palmer MA, Strodl E, Lai R, Chuah TL, Burstow MJ, Ross LJ. Preoperative dietitian-led Very Low Calorie Diet (VLCD) Clinic for adults living with obesity undergoing gynaecology, laparoscopic cholecystectomy and hernia repair procedures: a pilot parallel randomised controlled trial. Br J Nutr 2024; 131:1436-1446. [PMID: 38220220 PMCID: PMC10950445 DOI: 10.1017/s0007114524000114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/05/2023] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
Obesity can increase the risk of postoperative complications. Despite increased demand for patients living with obesity to lose weight prior to common surgical procedures, the impact of intentional weight loss on surgical outcomes is largely unknown. We aimed to conduct a pilot study to assess the feasibility of a full-scale randomised controlled trial (RCT) to examine the effect of preoperative dietitian-led Very Low Calorie Diet (VLCD) Clinic on surgical outcomes in gynaecology and general surgeries. Between August 2021 and January 2023, a convenience sample of adults living with obesity (BMI ≥ 30 kg/m2) awaiting gynaecology, laparoscopic cholecystectomy and ventral hernia repair procedures were randomised to dietitian-led VLCD (800-1000 kcal using meal replacements and allowed foods), or control (no dietary intervention), 2-12 weeks preoperatively. Primary outcome was feasibility (recruitment, adherence, safety, attendance, acceptability and quality of life (QoL)). Secondary outcomes were anthropometry and 30-d postoperative outcomes. Outcomes were analysed as intention-to-treat. Fifty-one participants were recruited (n 23 VLCD, n 28 control), mean 48 (sd 13) years, 86 % female, and mean BMI 35·8 (sd 4·6) kg/m2. Recruitment was disrupted by COVID-19, but other thresholds for feasibility were met for VLCD group: high adherence without unfavourable body composition change, high acceptability, improved pre/post QoL (22·1 ± 15 points, < 0·001), with greater reductions in weight (-5·5 kg VLCD v. -0·9 kg control, P < 0·05) waist circumference (-6·6 cm VLCD v. +0·6 control, P < 0·05) and fewer 30-d complications (n 4/21) than controls (n 8/22) (P > 0·05). The RCT study design was deemed feasible in a public hospital setting. The dietitian-led VLCD resulted in significant weight loss and waist circumference reduction compared with a control group, without unfavourable body composition change and improved QoL.
Collapse
Affiliation(s)
- Sally B. Griffin
- Department of Nutrition & Dietetics, Logan Hospital, Meadowbrook, QLD, Australia
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Michelle A. Palmer
- Department of Nutrition & Dietetics, Logan Hospital, Meadowbrook, QLD, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rainbow Lai
- Department of Nutrition & Dietetics, Logan Hospital, Meadowbrook, QLD, Australia
| | - Teong L. Chuah
- Surgical and Critical Care Services, Logan Hospital, Meadowbrook, QLD, Australia
- Department of Surgery, Mater Hospital, South Brisbane, QLD, Australia
- Mayne Academy of Surgery, Faculty of Medicine, University of Queensland, St Lucia, QLD, Australia
| | - Matthew J. Burstow
- Surgical and Critical Care Services, Logan Hospital, Meadowbrook, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Lynda J. Ross
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| |
Collapse
|
4
|
Song J, Kim DY, Lee HS, Rhee SY, Lim H. Efficacy of Crataegus Extract Mixture on Body Fat and Lipid Profiles in Overweight Adults: A 12-Week, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2024; 16:494. [PMID: 38398818 PMCID: PMC10892674 DOI: 10.3390/nu16040494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/28/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
A Crataegus Extract Mixture (CEM) is a combination of extracts from Crataegus pinnatifida leaves and Citrus unshiu peels, well-known herbs used for treating obesity and dyslipidemia. We aimed to investigate the efficacy and safety of a CEM on the body fat and lipid profiles in overweight adults. A 12-week, randomized, double-blind, placebo-controlled, parallel-group trial was conducted on 105 subjects aged 20-60 years with body mass indexes between 25 and 30 kg/m2. Eligible subjects were randomly assigned in a 1:1:1 ratio to receive either a high dose of the CEM (400 mg tid), a low dose of the CEM (280 mg tid), or a placebo. Body fat was evaluated using dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and anthropometric measurements. The blood lipid and adipokine profiles were measured before and after the administration. After 12 weeks, the reductions in the fat percentages measured by DXA and BIA were significantly greater in the CEM groups than in the placebo group. The CEM also significantly decreased the body weights, body mass indexes, and blood leptin levels. An additional per-protocol analysis revealed that the high dose of the CEM also lowered the blood levels of triglycerides and very low-density lipoprotein cholesterol. No adverse events occurred after the CEM treatment. Our results suggest that CEMs are safe and effective for reducing the body fat and body weight and regulating the blood lipid and leptin levels in overweight or mildly obese individuals.
Collapse
Affiliation(s)
- Jungbin Song
- Department of Herbal Pharmacology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea;
| | - Do-Yeon Kim
- Research Institute of Medical Nutrition, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea; (D.-Y.K.); (H.S.L.)
| | - Han Songyi Lee
- Research Institute of Medical Nutrition, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea; (D.-Y.K.); (H.S.L.)
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
- Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Hyunjung Lim
- Research Institute of Medical Nutrition, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea; (D.-Y.K.); (H.S.L.)
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si 17104, Gyeonggi-do, Republic of Korea
| |
Collapse
|
5
|
Janssen TAH, Van Every DW, Phillips SM. The impact and utility of very low-calorie diets: the role of exercise and protein in preserving skeletal muscle mass. Curr Opin Clin Nutr Metab Care 2023; 26:521-527. [PMID: 37724991 PMCID: PMC10552824 DOI: 10.1097/mco.0000000000000980] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
PURPOSE OF REVIEW Very low-calorie diets (VLCD) are used as a weight loss intervention, but concerns have been raised about their potential negative impact on lean mass. Here, we review the available evidence regarding the effects of VLCD on lean mass and explore their utility and strategies to mitigate reductions in skeletal muscle. RECENT FINDINGS We observed that VLCD, despite their effects on lean mass, may be suitable in certain populations but have a risk in reducing lean mass. The extent of the reduction in lean mass may depend on various factors, such as the duration and degree of energy deficit of the diet, as well as the individual's starting weight and overall health. SUMMARY VLCD may be a viable option in certain populations; however, priority needs to be given to resistance exercise training, and secondarily to adequate protein intake should be part of this dietary regime to mitigate losing muscle mass.
Collapse
|
6
|
Ho C, Samwil SNM, Kahairudin Z, Jamhuri N, Abd Aziz A. Exercise and pre-habilitation with high whey-protein-based meal replacement therapy promote weight loss and preserve muscle mass before bariatric surgery. Asian J Surg 2023; 46:3716-3721. [PMID: 36931924 DOI: 10.1016/j.asjsur.2023.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/01/2023] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Bariatric surgery is considered as an effective therapy for those with morbid obesity. Preoperative weight loss with a very low-calorie diet is commonly used to ease the bariatric surgery. Pre-habilitation increases functional and physiological capacity. The study demonstrated the changes of body composition and functional status following short term pre-habilitation before bariatric surgery. METHOD This prospective study targeted those admitted for bariatric surgery. Participants underwent the biweekly pre-habilitation program included an individualized high whey-based protein very low-calorie (VLCHP) enteral regime (600-900 kcal/day) and moderate intensive exercise before bariatric surgery. Body composition and waist circumference were assessed after fortnight. Participants were segregated into morbid obese (MOG) (BMI <49 kg/m2) and super morbid obese group (SMOG) (BMI ≥50 kg/m2) for analysis. RESULT Majority of participants were female (71%) with median age 36.0 years old (MOG) and 34.3 years old (SMOG) respectively. SMOG achieved significant greater loss in weight (-7.4 kg vs -4.0 kg), fat percentage (-4.4% vs -1.7%) and fat mass (-9.9 kg vs -3.8 kg); but MOG had a significant increment in muscle mass (3.2 kg vs 2.8 kg) as compared to SOG (p < 0.001). DISCUSSION Body composition measurement and changes remain critical in nutritional assessment to achieve successful surgery and minimize nutritional complication. Whey-based VLCHP attenuates muscle loss and preserves myofibrillar protein synthesis; promotes a better muscle strength and mass growth during periods of negative energy balance combined with moderately intense aerobic activity. CONCLUSION Individualized whey-based VLCHP enteral regime and moderate intensive exercise encourage weight loss; increases muscle mass and strength; improve function status prior to bariatric surgery.
Collapse
Affiliation(s)
- ChiouYi Ho
- Department of Dietetics and Food Services, Institut Kanser Negara, Ministry of Health, 4, Jalan P7, Presint 7, 62250, Putrajaya, Malaysia.
| | - Siti Nuraini Mohd Samwil
- Department of Dietetics and Food Services, Institut Kanser Negara, Ministry of Health, 4, Jalan P7, Presint 7, 62250, Putrajaya, Malaysia
| | - Zuliehaiza Kahairudin
- Department of Dietetics and Food Services, Institut Kanser Negara, Ministry of Health, 4, Jalan P7, Presint 7, 62250, Putrajaya, Malaysia
| | - Norshariza Jamhuri
- Department of Dietetics and Food Services, Institut Kanser Negara, Ministry of Health, 4, Jalan P7, Presint 7, 62250, Putrajaya, Malaysia
| | - Adibah Abd Aziz
- Unit of Physiotherapy, Institut Kanser Negara, Ministry of Health, 4, Jalan P7, Presint 7, 62250, Putrajaya, Malaysia
| |
Collapse
|
7
|
Tizmaghz A, Bahardoust M, Hosseini M, Pazouki A, Alizadeh Otaghvar H, Shabestanipour G. Changes in Body Composition, Basal Metabolic Rate, and Blood Albumin during the First Year following Laparoscopic Mini-Gastric Bypass. J Obes 2022; 2022:7485736. [PMID: 35800664 PMCID: PMC9256454 DOI: 10.1155/2022/7485736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/19/2022] [Accepted: 04/30/2022] [Indexed: 11/18/2022] Open
Abstract
Bariatric surgery is currently the only method that can significantly and continuously reduce weight and improve obesity-related comorbidities in morbidly obese patients. Significant weight loss through bariatric surgery can lead to changes in body composition. This study shows the changes in body composition, basal metabolic rate (BMR), and serum albumin in obese people following bariatric surgery. The study included 880 patients who underwent laparoscopic mini-gastric bypass surgery (LMGBP) between 2016 and 2020. The body mass index (BMI), bioelectrical impedance analysis (BIA), age, gender, blood albumin, WC (waist circumference), HC (hip circumference), BMR, and blood albumin were recorded at 0, 3, 6, and 12 months, postoperatively. The reduction in serum albumin concentration was not consistent with weight loss. Bariatric surgery promotes the breakdown of both fat and lean mass on the arms, torso, and thighs. This size reduction usually aggravates the concomitant skin redundancy in these areas which is a challenge for the plastic surgery team. Interestingly, the rate of lean mass reduction of the arms is faster than that of the torso and thighs. Excessive loss of lean body mass will also lower BMR and lead to subsequent weight gain. Despite the faster loss of proteins and lean mass in somatic areas, internal organs and viscera lose fats faster than proteins. According to this study, visceral proteins are the latest proteins to be affected by weight loss. This finding shows a different metabolic response of viscera comparing to somatic areas.
Collapse
Affiliation(s)
- Adnan Tizmaghz
- General Surgery, Iran University of Medical Sciences, Tehran, Iran
| | - Mansour Bahardoust
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Minimally Invasive Surgery Research Center, Rasool -e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- General Surgery, Iran University of Medical Sciences, Tehran, Iran
| | - Abdulreza Pazouki
- General Surgery and Minimally Invasive Surgery, Iran University of Medical Science, Minimally Invasive Research Center, Center of Excellence of European Branch of International Federation for Surgery of Obesity, Tehran, Iran
| | - Hamidreza Alizadeh Otaghvar
- General Surgery and Plastic Surgery, Iran University of Medical Science, Minimally Invasive Research Center, Center of Excellence of European Branch of International Federation for Surgery of Obesity, Tehran, Iran
| | | |
Collapse
|
8
|
Fonseca GWPD, von Haehling S. The fatter, the better in old age: the current understanding of a difficult relationship. Curr Opin Clin Nutr Metab Care 2022; 25:1-6. [PMID: 34861670 DOI: 10.1097/mco.0000000000000802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Obesity has shown a protective effect on mortality in older adults, also known as the obesity paradox, but there are still controversies about this relationship. RECENT FINDINGS Recent studies have shown a J or U-shaped relationship between BMI and mortality, wherein an optimal range is described between 22 and 37 kg/m2 depending on the condition. Many mechanisms can explain this protective effect of higher BMI, fat/muscle mass storage, more aggressive treatment in obese individuals, loss of bone mineral content and selection bias. However, BMI must be used with caution due to its limitations to determine body composition and fat distribution. SUMMARY Although BMI is an easy tool to evaluate obesity, its protective effect may be present to certain extend, from normal range to class I obesity (BMI 30-34.9 kg/m2), but then it becomes detrimental. Skeletal muscle mass and muscle function associated with adipose tissue assessment can add valuable information in the risk stratification. Further studies should be performed prospectively, adjust BMI for cofounding variable and consider other elderly subpopulations. To promote healthy ageing, excessive fat mass should be avoided and maintenance or improvement of skeletal muscle mass and muscle function should be stimulated in older adults.
Collapse
Affiliation(s)
- Guilherme Wesley Peixoto da Fonseca
- Heart Institute (InCor), University of São Paulo Medical School, São Paulo/SP, Brazil
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center (UMG)
- German Centre for Cardiovascular Research (DZHK) Partner Site, Göttingen, Germany
| |
Collapse
|
9
|
Newmire DE, Webb HE. The role of age in the physiological adaptations and psychological responses in bikini-physique competitor contest preparation: a case series. J Int Soc Sports Nutr 2021; 18:45. [PMID: 34108008 PMCID: PMC8188543 DOI: 10.1186/s12970-021-00445-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/24/2021] [Indexed: 12/22/2022] Open
Abstract
The increased popularity of the bikini-physique competitions has not translated to greater research identifying the influence of age on adaptations during contest preparation. The purpose of this case series was to observe how age may influence the adaptations normally seen during preparation and the exploration of newer protocols to address adaptations more relative to the judging standards. Over a 16-week pre-contest preparation, a 32-y bikini competitor (BC) and 44-y master's bikini competitor (MBC) visited the laboratory bi-weekly to observe changes in body fat mass (BF), lean body mass (LBM), bone mineral density (BMD), total body water (TBW); exploratory measures of deltoid cross-sectional area (DeltCSA), gluteus maximus muscle thickness (GMMT), and subcutaneous adipose tissue thickness (SAT); reproductive hormones estradiol (E2), luteinizing hormone (LH), and energy balance hormones triiodothyronine (T3), leptin and ghrelin; hydration status during contest preparation and the week of competition; resting metabolic rate (RMR); psychometric data related to perceived anxiety, stress, and body image were assessed. No differences between BC and MBC were observed in BF, LBM, BMD, and TBW. Both competitors showed a small loss in LBM. Both BC and MBC showed a contrasting increase in DeltCSA and a loss in GMMT. MBC showed to be slightly more dehydrated (1.025 vs 1.021 g·mL- 1) than BC. Both competitors maintained a euhydration status the day of the competition. No time differences were found between BC and MBC during RMR. BC showed a higher mean difference RMR compared to MBC (2.66 ± 0.75 kcal·kgLBM- 1·d- 1). MBC showed a higher mean difference in LH concentration (84.6 ± 6.01 IU·L- 1), which may be explained by perimenopausal status. MBC had a higher mean difference concentration of leptin (2.51 ± 0.24 ng·mL- 1·kgFM- 1), which was unperturbed by fat loss may be interrelated LH. BC self-reported a higher mean energy intake (15.07 ± 3.43 kcal·kgLBM- 1·d- 1) and higher aerobic training volume (93.26 ± 40.68 min·d). BC and MBC showed similar composition changes, slightly differing metabolic rates, and differing hormonal LH and leptin responses. This finding is in contrast to previous work showing both LH inhibition and leptin diurnal disturbance in younger, female athletes with low energy availability. The exploratory measures may have some benefit for bikini-physique competitors related to the judging criteria. Age did not seem to play a role in contest preparation adaptations.
Collapse
Affiliation(s)
- Daniel E Newmire
- Department of Kinesiology, Exercise Physiology and Biochemistry Lab, Texas A&M University-Corpus Christi, Corpus Christi, TX, 78412, USA.
| | - Heather E Webb
- Department of Kinesiology, Exercise Physiology and Biochemistry Lab, Texas A&M University-Corpus Christi, Corpus Christi, TX, 78412, USA
| |
Collapse
|