The thermic effect of carbohydrate versus fat feeding in man

Caloric restriction-induced weight loss with a high-fat diet does not fully recover visceral adipose tissue inflammation in previously obese C57BL/6 mice

Caloric restriction (CR) reduces body weight and systemic inflammation, but the effects on adipose tissue under dietary lipid overload are controversial. We evaluated the effects of CR-induced weight loss with a high-fat diet on adipose tissue inflammation of obese mice. Male mice were assigned into low-fat diet (LF) and high-fat diet (HF) groups. After 8 weeks, the mice in the HF group were reassigned for another 7 weeks into the following 3 conditions: (i) kept in the HF condition; (ii) changed to low-fat diet ad libitum (LFAL); and (iii) changed to high-fat calorie-restricted (RHF) diet to reach LFAL body weight. Serum markers, adipocytokines, morphology, and inflammatory infiltrates in retroperitoneal adipose tissue (RAT) were accessed. The body weights of the LFAL and RHF groups were reduced, equaling the body weights of the LF group. The LFAL mice had restored almost all inflammatory markers as the LF mice, except tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and adiponectin. Compared with the HF group, the RHF group had lowered visceral adiposity, retroperitoneal adipocyte sizes, and RAT inflammatory cell infiltration, as well as TNF-α, interleukin-6, and hepatic and serum C-reactive protein, which were higher than that of the LFAL group; adiponectin and MCP-1 did not change. CR with high-fat diet reduced body weight and attenuated visceral adiposity but did not fully recover visceral tissue inflammation. Novelty Caloric restriction in a high-fat diet ameliorated visceral adiposity. Caloric restriction in a high-fat diet did not recover visceral adipose tissue inflammation.

Waist-to-Height Gain and Triiodothyronine Concentrations in a Cohort of Socially Vulnerable Short-Stature Women: A Four-Year Follow-Up Study

BACKGROUND

Short stature that results from undernourishment during perinatal period is associated with an increased risk of diabetes and cardiovascular diseases in adulthood, particularly in poor populations. The present study investigated changes on anthropometric and metabolic parameters of socially vulnerable women with short stature.

METHODS

A prospective study with 48 women (19-45 years) who were mothers of undernourished children was conducted. Twenty-five of them were short (height ≤150 cm), and 23 were not short, to serve as a control (height >159 cm). Biochemical, anthropometric and dietary intake data were collected, before and after 4 years of follow-up. A mixed within-between analysis of covariance was used to assess the interaction between 'group' and 'time'.

RESULTS

Waist-to-height ratio increased only in the short stature group, with significant interaction (+0.03 ± 0.03 in short group vs. +0.01 ± 0.03 in control; p for interaction = 0.04). The short stature group showed a significant decrease in the plasma triiodothyronine (T3) concentrations, without significant interaction (-0.16 ± 0.23 ng/ml in short group vs. -0.04 ± 0.29 ng/ml in control; p for interaction = 0.20).

CONCLUSION

Women of short stature presented an increase in waist-to-height ratio, with a simultaneous decrease in total plasma T3. These alterations may lead them to increased risk of comorbidities.

Energy Expenditure Responses to Fasting and Overfeeding Identify Phenotypes Associated With Weight Change

Because it is unknown whether 24-h energy expenditure (EE) responses to dietary extremes will identify phenotypes associated with weight regulation, the aim of this study was to determine whether such responses to fasting or overfeeding are associated with future weight change. The 24-h EE during energy balance, fasting, and four different overfeeding diets with 200% energy requirements was measured in a metabolic chamber in 37 subjects with normal glucose regulation while they resided on our clinical research unit. Diets were given for 24 h each and included the following: (1) low protein (3%), (2) standard (50% carbohydrate, 20% protein), (3) high fat (60%), and (4) high carbohydrate (75%). Participants returned for follow-up 6 months after the initial measures. The decrease in 24-h EE during fasting and the increase with overfeeding were correlated. A larger reduction in EE during fasting, a smaller EE response to low-protein overfeeding, and a larger response to high-carbohydrate overfeeding all correlated with weight gain. The association of the fasting EE response with weight change was not independent from that of low protein in a multivariate model. We identified the following two independent propensities associated with weight gain: a predilection for conserving energy during caloric and protein deprivation and a profligate response to large amounts of carbohydrates.

Central nervous system regulation of brown adipose tissue

Thermogenesis, the production of heat energy, in brown adipose tissue is a significant component of the homeostatic repertoire to maintain body temperature during the challenge of low environmental temperature in many species from mouse to man and plays a key role in elevating body temperature during the febrile response to infection. The sympathetic neural outflow determining brown adipose tissue (BAT) thermogenesis is regulated by neural networks in the CNS which increase BAT sympathetic nerve activity in response to cutaneous and deep body thermoreceptor signals. Many behavioral states, including wakefulness, immunologic responses, and stress, are characterized by elevations in core body temperature to which central command-driven BAT activation makes a significant contribution. Since energy consumption during BAT thermogenesis involves oxidation of lipid and glucose fuel molecules, the CNS network driving cold-defensive and behavioral state-related BAT activation is strongly influenced by signals reflecting the short- and long-term availability of the fuel molecules essential for BAT metabolism and, in turn, the regulation of BAT thermogenesis in response to metabolic signals can contribute to energy balance, regulation of body adipose stores and glucose utilization. This review summarizes our understanding of the functional organization and neurochemical influences within the CNS networks that modulate the level of BAT sympathetic nerve activity to produce the thermoregulatory and metabolic alterations in BAT thermogenesis and BAT energy expenditure that contribute to overall energy homeostasis and the autonomic support of behavior.

Everything Hertz: methodological issues in short-term frequency-domain HRV

Frequency analysis of the electrocardiographic RR interval is a common method of quantifying autonomic outflow by measuring the beat-to-beat modulation of the heart (heart rate variability; HRV). This review identifies a series of problems with the methods of doing so—the interpretation of low-frequency spectral power, the multiple use of equivalent normalized low frequency (LFnu), high frequency (HFnu) and ratio (LF/HF) terms, and the lack of control over extraneous variables, and reviews research in the calendar year 2012 to determine their prevalence and severity. Results support the mathematical equivalency of ratio units across studies, a reliance on those variables to explain autonomic outflow, and insufficient control of critical experimental variables. Research measurement of HRV has a substantial need for general methodological improvement.

Interaction between dietary fat and exercise on excess postexercise oxygen consumption

The objective of this study was to determine the effect of increased physical activity on subsequent sleeping energy expenditure (SEE) measured in a whole room calorimeter under differing levels of dietary fat. We hypothesized that increased physical activity would increase SEE. Six healthy young men participated in a randomized, single-blind, crossover study. Subjects repeated an 8-day protocol under four conditions separated by at least 7 days. During each condition, subjects consumed an isoenergetic diet consisting of 37% fat, 15% protein, and 48% carbohydrate for the first 4 days, and for the following 4 days SEE and energy balance were measured in a respiration chamber. The first chamber day served as a baseline measurement, and for the remaining 3 days diet and activity were randomly assigned as high-fat/exercise, high-fat/sedentary, low-fat/exercise, or low-fat/sedentary. Energy balance was not different between conditions. When the dietary fat was increased to 50%, SEE increased by 7.4% during exercise (P < 0.05) relative to being sedentary (baseline day), but SEE did not increase with exercise when fat was lowered to 20%. SEE did not change when dietary fat was manipulated under sedentary conditions. Physical activity causes an increase in SEE when dietary fat is high (50%) but not when dietary fat is low (20%). Dietary fat content influences the impact of postexercise-induced increases in SEE. This finding may help explain the conflicting data regarding the effect of exercise on energy expenditure.

Lower "awake and fed thermogenesis" predicts future weight gain in subjects with abdominal adiposity

Awake and fed thermogenesis (AFT) is the energy expenditure (EE) of the nonactive fed condition above the minimum metabolic requirement during sleep and is composed of the thermic effect of food and the cost of being awake. AFT was estimated from whole-room 24-h EE measures in 509 healthy subjects (368 Native Americans and 141 whites) while subjects consumed a eucaloric diet. Follow-up data were available for 290 Native Americans (median follow-up time: 6.6 years). AFT accounted for ~10% of 24-h EE and explained a significant portion of deviations from expected energy requirements. Energy intake was the major determinant of AFT. AFT, normalized as a percentage of intake, was inversely related to age and fasting glucose concentration and showed a nonlinear relationship with waist circumference and BMI. Spline analysis demonstrated that AFT becomes inversely related to BMI at an inflection point of 29 kg/m(2). The residual variance of AFT, after accounting for covariates, predicted future weight change only in subjects with a BMI >29 kg/m(2). AFT may influence daily energy balance, is reduced in obese individuals, and predicts future weight gain in these subjects. Once central adiposity develops, a blunting of AFT may occur that then contributes to further weight gain.

Effects of high-fat and high-carbohydrate diets on fat and carbohydrate oxidation and plasma metabolites in healthy cats

High-fat (HF) or high-carbohydrate (HC) diets (30% fat, 18.9% carbohydrate; HF and 10% fat, 46.3% carbohydrate; HC) and lengths of adaptation were investigated in cats (Felis catus; 10 ± 2 months, 3.6 ± 0.3 kg). Cats randomly received each treatment for 14 days in a crossover design with a 14-day washout period between each diet. Three 22-h indirect calorimetry studies were conducted after acute (day 0), semichronic (day 4) and chronic (day 13) dietary exposure. Blood samples were collected after a 24-h fast on days 1, 5 and 14. When cats consumed the HC and HF diet, oxidation of the restricted nutrient exceeded intake while oxidation of the nutrient in excess matched intake. Mean max energy expenditure (EE) of cats consuming the HF and HC diet were 107 and 102 kcal/kg(0.67)/day and occurred at a mean of 4 and 12 h post-feeding respectively. Maximal fat (0.90 g/h) and carbohydrate (carbohydrate; 1.42 g/h) oxidation were attained at 26 min and 10.4 h post-feeding respectively. The changes observed in macronutrient oxidation and EE suggest that cats adapt whole-body nutrient metabolism in response to changes in dietary macronutrient content, but may require longer than 14 day to adapt to a macronutrient that is present at a lower concentration in the diet.

Extent and determinants of thermogenic responses to 24 hours of fasting, energy balance, and five different overfeeding diets in humans

CONTEXT

Individual variation in the ability to convert excess calories to heat and the effects of dietary macronutrient composition are unclear.

OBJECTIVE

Stability and determinants of the energy expenditure (EE) response to overconsumption were assessed.

DESIGN, SETTING, AND PARTICIPANTS

Twenty subjects (75% male) with normal glucose regulation were evaluated during 24 hours each of energy balance, fasting, and 5 different diets with 200% energy requirements in a clinical research unit.

INTERVENTIONS

Five 1-day overfeeding diets were given in random order: high carbohydrate (75%) and low protein (3%); high carbohydrate and normal protein (20%); high fat (46%) and low protein; high fat (60%) and normal protein; and balanced (50% carbohydrates, 20% protein).

MAIN OUTCOME MEASURES

The 24-hour EE, sleeping EE, and thermic effect of food (TEF) during each diet were measured with a metabolic chamber. Appetitive hormones were measured before and after the diets.

RESULTS

The EE response to overfeeding exhibited good intraindividual reproducibility. Similar increases above eucaloric feeding in 24-hour EE (mean 10.7 ± 5.7%, P < .001; range 2.9-18.8%) and sleeping EE (14.4 ± 11.3%, P < .001; range 1.0-45.1%) occurred when overfeeding diets containing 20% protein, despite differences in fat and carbohydrate content, but the EE response during overfeeding diets containing 3% protein was attenuated. The percent body fat negatively correlated with TEF during normal protein overfeeding (r = -0.53, P < .01). Fasting peptide YY negatively correlated with TEF (r = -0.56, P < .01) and the increase in sleeping EE (r = -0.54, P < .01) during overfeeding.

CONCLUSIONS

There is an intrinsic EE response to overfeeding that negatively associates with adiposity, although it represents a small percentage of consumed calories.

Postprandial lysophospholipid suppresses hepatic fatty acid oxidation: the molecular link between group 1B phospholipase A2 and diet-induced obesity

Decrease in fat catabolic rate on consuming a high-fat diet contributes to diet-induced obesity. This study used group 1B phospholipase A(2) (Pla2g1b)-deficient mice, which are resistant to hyperglycemia, to test the hypothesis that Pla2g1b and its lipolytic product lysophospholipid suppress hepatic fat utilization and energy metabolism in promoting diet-induced obesity. The metabolic consequences of hypercaloric diet, including body weight gain, energy expenditure, and fatty acid oxidation, were compared between Pla2g1b(+/+) and Pla2g1b(-/-) mice. The Pla2g1b(-/-) mice displayed normal energy balance when fed chow, but were resistant to obesity when challenged with a hypercaloric diet. Obesity resistance in Pla2g1b(-/-) mice is due to their ability to maintain elevated energy expenditure and core body temperature when subjected to hypercaloric diet, which was not observed in Pla2g1b(+/+) mice. The Pla2g1b(-/-) mice also displayed increased postprandial hepatic fat utilization due to increased expression of peroxisome proliferator-activated receptor (PPAR)-alpha, PPAR-delta, PPAR-gamma, cd36/Fat, and Ucp2, which coincided with reduced postprandial plasma lysophospholipid levels. Lysophospholipids produced by Pla2g1b hydrolysis suppress hepatic fat utilization and down-regulate energy expenditure, thereby preventing metabolically beneficial adaptation to a high-fat diet exposure in promoting diet-induced obesity and type 2 diabetes.

Changes in energy expenditure associated with ingestion of high protein, high fat versus high protein, low fat meals among underweight, normal weight, and overweight females

Background

Metabolic rate is known to rise above basal levels after eating, especially following protein consumption. Yet, this postprandial rise in metabolism appears to vary among individuals. This study examined changes in energy expenditure in response to ingestion of a high protein, high fat (HPHF) meal versus an isocaloric high protein, low fat (HPLF) meal in underweight, normal weight, or overweight females (n = 21) aged 19–28 years.

Methods

Energy expenditure, measured using indirect calorimetry, was assessed before and every 30 minutes for 3.5 hours following consumption of the meals on two separate occasions. Height and weight were measured using standard techniques. Body composition was measured using bioelectrical impedance analysis.

Results

Significant positive correlations were found between body mass index (BMI) and baseline metabolic rate (MR) (r = 0.539; p = 0.017), between body weight and baseline MR (r = 0.567; p = 0.011), between BMI and average total change in MR (r = 0.591; p = 0.008), and between body weight and average total change in MR (r = 0.464; p = 0.045). Metabolic rate (kcal/min) was significantly higher in the overweight group than the normal weight group, which was significantly higher than the underweight group across all times and treatments. However, when metabolic rate was expressed per kg fat free mass (ffm), no significant difference was found in postprandial energy expenditure between the overweight and normal groups. Changes in MR (kcal/min and kcal/min/kg ffm) from the baseline rate did not significantly differ in the underweight (n = 3) or in the overweight subjects (n = 5) following consumption of either meal at any time. Changes in MR (kcal/min and kcal/min/kg ffm) from baseline were significantly higher in normal weight subjects (n = 11) across all times following consumption of the HPHF meal versus the HPLF meal.

Conclusion

There is no diet-induced thermogenic advantage between the HPHF and HPLF meals in overweight and underweight subjects. In contrast, in normal weight subjects, ingestion of a HPHF meal significantly increases MR (69.3 kcal/3.5 hr) versus consumption of a HPLF meal and provides a short-term metabolic advantage.

Thermogenesis associated to the intake of a diet non-supplemented or supplemented with n-3 polyunsaturated fatty acid-rich fat, determined in rats receiving the same quantity of metabolizable energy

The beneficial effects of n-3 polyunsaturated fatty acids (PUFA) are well known, but their consumption in western countries is chronically insufficient, and so it is recommended that diets should be supplemented with a fat rich in these fatty acids. However, the effect of such diets on the energy expenditure remains a controversial question. Precise data concerning the effect of using under the same metabolizable energy intake, a diet non-supplemented or supplemented with a fat rich in n-3 PUFA are not available. This type of information was obtained using rats at weaning fed a diet supplemented or non-supplemented with 10% of fish oil. Between the 30th and 60th day after starting the experiment, the energy and protein balance was established by means of the comparative slaughter method. The blood levels of different metabolites were also determined. Although total thermogenesis did not vary between the two groups, consumption of the fish oil diet led to a lower level of thermogenesis associated with the oxidation of protein, and a higher one of that associated with the oxidation of fat. We conclude that the thermic effect of feeding is a combination of independent processes. Due to their specific metabolism, n-3 PUFA may be considered essential compounds to maintain the energy balance.

Sugars: hedonic aspects, neuroregulation, and energy balance

The prevalence of obesity has increased dramatically in recent years in the United States, with similar patterns seen in several other countries. Although there are several potential explanations for this dramatic increase in obesity, dietary influences are a contributing factor. An inverse correlation between dietary sugar intake and body mass index has been reported, suggesting beneficial effects of carbohydrate intake on body mass index. In this review we discuss how sugars interact with regulatory neurochemicals in the brain to affect both energy intake and energy expenditure. These neurochemicals appear to be involved in dietary selection, and sugars and palatable substances affect neurochemical changes in the brain. For example, rats that drink sucrose solutions for 3 wk have major changes in neuronal activity in the limbic area of the brain, a region involved in pleasure and other emotions. We also investigate the relations between sucrose (and other sweet substances), drugs of abuse, and the mesolimbic dopaminergic system. The presence of sucrose in an animal's cage can affect the animals desire to self-administer drugs of abuse. Also, an animal's level of sucrose preference can predict its desire to self-administer cocaine. Such data suggest a relation between sweet taste and drug reward, although the relevance to humans is unclear. Finally, we address the influence of sugar on body weight control. For example, sucrose feeding for 2 wk decreases the efficiency of energy utilization and increases gene expression of uncoupling protein 3 in muscle, suggesting that sucrose may influence uncoupling protein 3 activity and contribute to changes in metabolic efficiency and thus regulation of body weight.

Metabolic adaptation to high-fat and high-carbohydrate diets in children and adolescents

BACKGROUND

Difficulty adapting to high-fat (HF) and high carbohydrate (HC) diets may predispose children to obesity and diabetes.

OBJECTIVE

We tested the hypothesis that children have metabolic flexibility to adapt to HF and HC diets.

DESIGN

In protocol 1, 12 children aged 6-9 y and 12 adolescents aged 13-16 y were randomly assigned in a crossover design to consume low-fat (LF), HC (25% and 60% of energy, respectively) or HF, low-carbohydrate (LC) (55% and 30% of energy, respectively) diets. In protocol 2, 12 adolescents aged 13-16 y were randomly assigned in a crossover design to consume an LF-HC diet with 11% or 40% of carbohydrate as fructose. Total energy expenditure, nonprotein respiratory quotients (NPRQs), and substrate utilization were measured by using 24-h calorimetry. Effects of sex, puberty, body fat (dual-energy X-ray absorptiometry), intraabdominal fat (magnetic resonance imaging), and fitness on substrate utilization were tested.

RESULTS

Substrate utilization was not affected by puberty, body fat, intraabdominal fat, or fitness. Total energy expenditure was not affected by diet. In protocol 1, NPRQs and carbohydrate and fat utilization were significantly affected by diet (P = 0.001) and sex (P = 0.005). NPRQs and carbohydrate utilization increased with the LF-HC diet. NPRQs decreased and fat utilization increased with the HF-LC diet; changes in substrate utilization were less pronounced in females than in males. In protocol 2, 24-h NPRQs and 24-h substrate utilization were not significantly affected by fructose, although net carbohydrate and fat utilization were significantly lower and higher, respectively, with the high-fructose diet during fasting (P = 0.01) and in the subsequent feeding period (P = 0.05).

CONCLUSION

Healthy, nonobese children and adolescents adapt appropriately to HF and HC diets.

Effect of orosensory stimulation on postprandial thermogenesis in humans

This study assessed the effects of orosensory stimulation by equipalatable stimuli that differed in macronutrient content (lipid and carbohydrate) on postprandial thermogenesis. Sixteen healthy, normal-weight adults (eight males, eight females) participated in six test sessions conducted weekly. The test sessions were administered randomly after overnight fasts and included: ingestion of 50 g of butter in capsules (to avoid oral stimulation with lipids) and 500 ml of water in 15 min followed by no oral stimulation or oral stimulation with a cracker or one of the following foods on a cracker-butter, unsaturated fatty acid (UFA) margarine, jelly, UFA margarine+jelly. Sensory stimulation entailed masticating and expectorating approximately 5.0 g samples of each stimulus every 3 min for 110 min. Blood was drawn immediately after preload ingestion and at minutes 35, 85, 200, 320, and 440 postloading and was analyzed for insulin, glucagon, and glucose. No significant treatment differences were observed for thermogenesis or oxidation of carbohydrate or lipid. Insulin, glucagon, and glucose concentrations were not different between treatments. These data suggest that orosensory stimulation with stimuli differing in lipid and carbohydrate content, but rated similarly in palatability, does not elicit an increased or differential diet-induced thermogenic response.

Plasma lipid and lipoprotein responsiveness to dietary fat and cholesterol in premenopausal African American and white women

BACKGROUND

Premenopausal African American women have a 2-3 times greater incidence of coronary heart disease (CHD) than do white women. The plasma lipid responsiveness to dietary fat, which may be associated with CHD, has not been adequately studied in premenopausal African American or white women.

OBJECTIVE

The objective of our study was to compare the effect of diet on fasting plasma lipids and lipoproteins and postprandial lipemia in premenopausal African American and white women.

DESIGN

Thirteen African American and 9 white healthy premenopausal women were fed a low-fat, high-fiber diet and a high-fat, low-fiber diet for 4 wk each in a randomized crossover design. Fasting plasma lipid and lipoprotein concentrations and the 24-h plasma triacylglycerol response to a standard fatty test meal were measured at the end of each dietary period.

RESULTS

Plasma total and LDL-cholesterol concentrations were higher after the high-fat, low-fiber diet in both white and African American women (P < 0.0001). The 24-h area under the plasma triacylglycerol curve after the test meal was lower after the low-fat diet than after the high-fat diet (P < 0.04).

CONCLUSIONS

African American and white women had lower fasting plasma total and LDL-cholesterol concentrations and less postprandial lipemia after the low-fat than the high-fat diet. Diets low in total and saturated fat and cholesterol and high in fiber may reduce the risk of CHD by lowering fasting plasma total and LDL-cholesterol concentrations and by reducing the lipemic response to fatty meals.

Reduced beta-cell function contributes to impaired glucose tolerance in dogs made obese by high-fat feeding

The ability to increase beta-cell function in the face of reduced insulin sensitivity is essential for normal glucose tolerance. Because high-fat feeding reduces both insulin sensitivity and glucose tolerance, we hypothesized that it also reduces beta-cell compensation. To test this hypothesis, we used intravenous glucose tolerance testing with minimal model analysis to measure glucose tolerance (K(g)), insulin sensitivity (S(I)), and the acute insulin response to glucose (AIR(g)) in nine dogs fed a chow diet and again after 7 wk of high-fat feeding. Additionally, we measured the effect of consuming each diet on 24-h profiles of insulin and glucose. After high-fat feeding, S(I) decreased by 57% (P = 0.003) but AIR(g) was unchanged. This absence of beta-cell compensation to insulin resistance contributed to a 41% reduction of K(g) (P = 0.003) and abolished the normal hyperbolic relationship between AIR(g) and S(I) observed at baseline. High-fat feeding also elicited a 44% lower 24-h insulin level (P = 0.004) in association with an 8% reduction of glucose (P = 0.0003). We conclude that high-fat feeding causes insulin resistance that is not compensated for by increased insulin secretion and that this contributes to the development of glucose intolerance. These effects of high-fat feeding may be especially deleterious to individuals predisposed to type 2 diabetes mellitus.

Hyperglycemia suppresses the sympatho-adrenal response to hypoxia, but not to handling stress

We hypothesized that the ability of prior hyperglycemia to suppress the sympatho-adrenal response would depend on the type of stress. To test this hypothesis, hyperglycemia was induced in chronically catheterized rats, before submitting them to either hypoxia (7.5% O2) or handling stress. Central venous blood samples were drawn for the determination of plasma glucose, epinephrine (EPI), norepinephrine (NOR) and insulin concentrations. Hypoxia caused significant increases in plasma EPI and NOR concentrations (deltaEPI = + 2.95+/-0.68 nmol/l, deltaNOR = + 12.45+/-1.29 nmol/l). Hyperglycemia, antecedent to hypoxia, dose dependently reduced the sympatho-adrenal response. In contrast, the sympatho-adrenal response to handling stress was not affected by even marked antecedent hyperglycemia (deltaEPI = + 2.48+/-0.46 nmol/l, deltaNOR = + 3.12+/-0.69 nmol/l at glucose = 20.7+/-0.6 mmol/l; vs. deltaEPI = + 2.48 + 0.58 nmol/l, deltaNOR= +2.97+/-0.11 nmol/l at glucose = 6.77+/-0.17 mg/dl). Thus, antecedent hyperglycemia suppresses the hypoxia-induced activation of both the sympathetic nerves and the adrenal medulla, but not the activation induced by handling. We conclude that the ability of hyperglycemia to suppress sympathetic activation depends on the stress producing the activation. We therefore speculate that hypoxic stress has a metabolic component to its central activation that handling stress does not.

Effects of carbohydrate and lipid on resting energy expenditure, heart rate, sleepiness, and mood

The effects of gastric infusions of fat and carbohydrate on physiological and psychological measures were compared using a within subject design in 9 healthy subjects (6 males). Each subject received isovolaemic rapid gastric infusions of sucrose solution (100% energy carbohydrate), lipid emulsion (100% energy fat, 20% Intralipid), and a non-nutrient control (0.9% saline) in a randomised order. Nutrient infusions were isoenergetic, containing one-third of an individual subject's estimated daily energy requirements (mean, 3227 kJ; range, 2479-3971 kJ). Measures of heart rate (HR), energy expenditure (EE), mood, and sleepiness were collected before the infusions and every 0.5 h for 3.5 h. Mean postingestive HR, EE, and satiation were significantly greater after the nutrient infusions than after the control. Sucrose induced a rapid increase in HR and EE, whereas lipid had a lesser and more delayed effect. Thirty minutes after the gastric infusions, HR and EE were significantly higher after the sucrose than after the lipid and saline. Hedonic tone was greater and tension lower after the saline and sucrose infusions than after the lipid infusion. From 3 to 3.5 h after ingestion, subjects felt significantly more sleepy after the lipid infusion than they did at these times after the saline infusion, and significantly more dreamy after the lipid infusion than they did after the sucrose infusion. In conclusion, the presence of lipid and sucrose in the intestine induces significant and differing physiological and psychological effects, which are independent of cognitive and orosensory influences.

The thermic effect of food and obesity: a critical review

This review has examined the factors that influence the thermic effect of food (TEF) by evaluating 49 studies that have compared subjects who are obese with those who are lean. Meal size, meal composition, the nature of the previous diet, insulin resistance, physical activity, and ageing influence TEF. In the studies of individuals who are obese or lean, of those who used intravenous glucose infusions, all but one found an impaired thermic response. A total of 29 out of 49 studies of individuals of normal weight or with obesity were identified where there was no difference in age between the groups, and where the subjects who were "overweight" were clearly obese. Of these 29, 22 reported a statistically significant reduction in TEF, 3 studies were not designed to look primarily at the effect of obesity on TEF, and the other 4 may not have had sufficiently palatable meals. From this review, we conclude that the reduction of TEF in obesity is related to the degree of insulin resistance, which may be influenced by a low level of sympathetic activity.

The response of broiler chickens and turkey poults to dietary energy supplied either by fat or carbohydrates

The efficacy of fat and carbohydrates as energy sources was compared in 1- to 4- and 4- to 7-wk-old broiler chickens and in 16- to 19-wk-old turkeys. An increase in dietary energy by carbohydrate was made by a graded replacement of wheat bran by wheat. Energy was increased by fat through a graded replacement of soybean hulls with refined soybean oil. In the experiments with broiler chickens, the feed efficiency responses to added energy were observed within the entire range of dietary energy tested, with no significant differences between the responses to carbohydrate and fat as energy supplements. The growth response to energy from either source appeared to be characterized by diminishing returns in the chicken. In the 16- to 19-wk-old turkeys, the growth and feed efficiency responses were linear within the range from 2,650 to 3,250 kcal/kg. In chickens and in turkeys, the growth and feed efficiency responses to energy supplied by fat were indistinguishable from those of carbohydrates. In chickens, the fractions of abdominal fat and pectoral muscle were not affected significantly by the energy density and source.

Involvement of alpha 2-adrenoceptors in metabolic and hormonal responses to a mixed meal in beagle dogs

The effects of alpha 2-adrenoceptor blockade or activation on glucose, insulin, free fatty acids (FFA), and glycerol responses to a mixed meal were studied in the beagle dog. The alpha 2-adrenoceptor antagonist deriglidole (1 mg/kg po), administered 45 min before feeding, significantly reduced glycemia and increased insulin, FFA, and glycerol levels. Although the alpha 2-adrenoceptor agonist UK-14.304 (3 micrograms/kg sc), administered 15 min before feeding, had no effect per se, it completely blocked meal-induced insulin release, thus promoting a mild increase in glycemia, and prolonged the meal-induced FFA decrease. Deriglidole antagonized the reduction of insulin secretion and the hyperglycemia induced by UK-14.304. The meal-induced fall in FFA levels was still observed after deriglidole treatment and was markedly amplified when UK-14.304 was administered with deriglidole. These results suggest that, in the dog, insulin release and lipolysis are very sensitive to alpha 2-adrenoceptor stimulation. It is also suggested that the meal-evoked decrease in lipid mobilization results from an increase in alpha 2-adrenoceptor stimulation rather than from an increase in insulin secretion.

The thermic effect of food in normal-weight and overweight pregnant women

A defective thermic response to food may be an energy-sparing adaptation in both obesity and pregnancy. To evaluate the combined effect of obesity and pregnancy on postprandial thermogenesis, the thermic effect of food was assessed for a 240 min period following a high-carbohydrate meal and a typical mixed meal in nine normal-weight non-pregnant, eight overweight non-pregnant, eight normal-weight pregnant and six overweight pregnant women using indirect calorimetry. A test meal that provided 60% of each subject's measured daily requirement for basal metabolism was used. Pregnant women were studied during weeks 30-35 of gestation. Neither obesity nor pregnancy altered the thermic effect of food, although the response to the mixed meal was greater (P < 0.01) than that to the high-carbohydrate meal in all cases. The mean responses for the high-carbohydrate and mixed meals were 26.9 (SD 6.0) and 30.1 (SD 6.2) % baseline energy expenditure respectively, and 7.4 (SD 1.6) and 8.3 (SD 1.6) % of the meal energy load respectively. Obesity and pregnancy were associated with hyperinsulinaemia (P < 0.005) following both test meals, suggesting that postprandial thermogenesis was not altered by insulin resistance in this group. The incremental glucose response was elevated (P < 0.001) in the pregnant women following both test meals; overweight women tended to have a greater incremental glucose response following the high-carbohydrate meal, but it was not significant (P = 0.065). These results do not provide evidence of an impaired thermic response to food in either overweight or third trimester pregnant women.

[Thermogenesis and energy utilization of olive oil and fish oil in a model study with sows]

An animal model experiment was conducted with nine adult sows to study the effect of olive oil and fish oil (40% polyunsaturated fatty acids) on thermogenesis compared to wheat starch as control. The treatments were given to each animal according to a latin square design. The basal diet (20 g DM/kg W0.75) was mainly based on barley and soybean meal, and matched 60% of the ME requirements with all the other nutrients meeting maintenance requirements. The isoenergetic supplements amounted to 176 kJ gross energy per kg W0.75 and day. During each experimental period a complete energy balance was recorded for each animal using indirect calorimetry technique (RQ-method) as well as the carbon-nitrogen-balance technique. The treatments did not influence the digestibility of the rations. Digestibility of energy and of carbon averaged 83.4% and 83.3%, respectively. All three supplements were nearly completely digested as calculated by the difference method. Fish oil increased urine energy and decreased CH4 production, the shifts, however, were in absolute terms very small. The mean O2 consumption was 1,002 l/d showing no significant treatment effects. CO2 production was lowered with olive oil by 10%, and with fish oil by 13% compared to the starch diet. The daily heat production was 20.95, 20.72, and 20.04 MJ when starch, olive oil or fish oil was given. Corrected for equal energy retention the difference of thermogenesis between olive oil and starch was -0.4 MJ/d, and between fish oil and starch -1.2 MJ/d. These differences corresponded to a relation of starch:olive oil:fish oil = 1:0.95:0.86. The relation between starch and olive oil reflected exactly the theoretical expectation, calculated from the ATP regeneration by oxidation of both nutrients. When fish oil was added, the daily heat production was lower than theoretically calculated, which might be interpreted as an effect on the metabolic rate in general rather than especially on the efficiency of ATP formation from fish oil oxidation. In any case, there was no hint of a facultative thermogenesis induced by the oils.

Dietary fat and adiposity: a dose-response relationship in adult male rats fed isocalorically

This study examined the effects of increasing levels of dietary fat fed isocalorically on body weight, body composition, and adipose distribution. Adult male rats were weight matched into four groups. One group that was fed a low-fat diet (12%) served as reference controls. The other three groups were fed diets of 24, 36, or 48% fat in amounts to equal the energy intake of the control group. After 6 wk, body weights of the four groups were not significantly different. Intrascapular brown fat did not differ between groups. Total body fat and adipose depot weights, however, increased in proportion to the level of fat in the diet. Total body fat and retroperitoneal and mesenteric depot weights of the 48% fat group were greater than controls (P < 0.05). Mesenteric fat in this group was also significantly increased over all other groups (P < 0.05). These results show that high-fat diets fed to adult animals cause increased body fat in the absence of significant changes in body weight and that mesenteric fat is increased disproportionately.

Feeding-induced changes in energy expenditure in children with cystic fibrosis

Seven children with cystic fibrosis (aged 7 to 12 years) were studied in the fasted and fed states. Using a primed, constant, intravenous infusion of NaH13CO3, the rate of appearance of CO2 (RaCO2) was estimated. Net CO2 excretion (VCO2) was also measured. Energy expenditure was calculated using the food quotient. RaCO2 (mean +/- SD) (mumol.kg-1.min-1) in the fasted and fed states (297 +/- 59 and 359 +/- 67) was 117% and 105% of VCO2 (259 +/- 48 and 352 +/- 72). Feeding induced a 23% and a 37% increase in RaCO2 and VCO2, respectively, and respective 19% and 33% increases in energy expenditure (p < .05). Measurement of CO2 production by isotopic dilution is a useful index of group changes in energy expenditure, including those induced by feeding.

Thermogenic response to food: intra-individual variability and measurement reliability

The objective of this study was to assess the reliability and variability of the thermogenic response to food (TRF) in healthy adult subjects. Eight healthy adults (4 men, 4 women) participated in three sets of measurements of TRF, evaluated by indirect calorimetry with a ventilated hood system during 6 hours after a standardized meal. The reliability of TRF measurement was estimated using a one-way analysis of variance with repeated measurements. After the 6-hour period of measurement, the within-subject coefficient of variation for TRF was 10.7%, while the between-subject variability was twice as high (24.1%, p < 0.01). The overall reliability estimate of TRF was acceptable (RE > or = 0.80) after a single measurement which lasted at least 6 hours postprandially, while duplicate and triplicate measurements reached a similar degree of reliability in 3 hours. These results suggest that intra-individual variability contributes little to the variability commonly seen in TRF studies, provided that the measurement period is at least 6 hours.

Early postprandial energy expenditure and macronutrient use after a mixed meal in cirrhotic patients

The effect of meal ingestion (9 kcal/kg of body weight, 53% carbohydrate, 30% fat, 17% protein, as a liquid formula) on energy expenditure and oxidation rate of carbohydrate, fat, and protein was assessed by indirect calorimetry and urinary nitrogen excretion before and for 3 hours after eating in stable cirrhotic patients and control subjects of comparable age. Postprandial modifications of substrate and hormone levels were also studied. Compared with basal values, the mean +/- SD resting energy expenditure during the first 3 hours after meal ingestion increased similarly in cirrhotic patients (+0.32 +/- 0.12 kcal/min) and control subjects (+0.31 +/- 0.08 kcal/min). Dietary induced thermogenesis was equivalent to 10% of the energy contained in the meal in both groups. Before eating, the carbohydrate oxidation rate was lower and fat oxidation higher in cirrhotic patients than in the control subjects. After eating, glucose oxidation increased whereas fat and protein oxidation rates were reduced in both groups. As a consequence the amount of fat oxidized in the postprandial period remained higher in cirrhotic patients than in the control subjects. After meal ingestion, serum glucose levels increased whereas plasma free fatty acid and glycerol levels decreased in both groups. The substrates, however, remained significantly higher in cirrhotic patients than in control subjects, despite the higher postprandial insulin increment in the patients group, thus suggesting the presence of insulin resistance. Because the postprandial glucose oxidation rate was normal, the low insulin-mediated glucose uptake observed in cirrhotic patients seems to reflect a defect in the nonoxidative disposal of the glucose ingested.(ABSTRACT TRUNCATED AT 250 WORDS)

Thermic effect of a meal. 2. Role in chronic undernutrition

The thermic effect of a standard liquid meal (TEM; energy 2.5 MJ; containing (g/kg) protein 100, fat 150, carbohydrate 750; volume 350 ml) was measured in a chronically undernourished (UN; n 9) group of human subjects and was compared with results from two control groups, one normal weight (NW)-for-height (BMI greater than 20; n 10) and the other underweight (UW)-for-height (BMI less than 18, n 10), using a ventilated-hood system over a period of 6 h after ingestion of the meal. Results indicated that the UN subjects had lower values for body-weight, height, percentage fat and fat-free mass (FFM) compared with those of either control group. Basal metabolic rates were lowest in the UN group in absolute terms; however, there were no significant differences among groups on an analysis of covariance (ANACOVA) with FFM as the covariate. TEM responses in the UN group were significantly higher when expressed either in absolute terms or as a percentage of the energy density of the meal. The post-meal total energy output was significantly lower (P less than 0.05) in the UW and UN groups as compared with the NW group in absolute terms; however, on adjusting for differences in FFM (by ANACOVA) there were no significant differences among groups. This would suggest that in the chronically undernourished thermogenic responses to a meal are unlikely to contribute towards any energy saving and may not constitute a part of any adaptive response to the undernourished state.

Thermic effect of a meal. 1. Methodology and variation in normal young adults

The variation in the thermic effect of a meal (TEM) was investigated in two groups of five subjects following a standard test meal. Results demonstrated a 50% lower response over 6 h, in the same subjects, when measured intermittently (protocol 2) as compared with a continuous measurement (protocol 1). The variation in TEM among occasions (measured on three occasions in each subject) was large (coefficient of variation (CV) 18.7%, P less than 0.02). However, the post-meal total energy output (CV 1.4%, P greater than 0.05), non-protein respiratory quotient (CV 1.9%, P greater than 0.05) and substrate oxidation rate were not different (P greater than 0.05) in the same individual on separate occasions. Small variations in the basal metabolic rate (BMR) from occasion to occasion (CV 2.6%) contributed to the variation in TEM. However, after allowing for the changes in BMR, variation in TEM (CV 8.6%, P greater than 0.05) was still sizeable though not statistically significant.

Role of dietary fat in calorie intake and weight gain

This paper reviews the literature on the role of dietary fat in calorie intake and body weight gain in humans and laboratory animals. An overview of 40 animal studies which compared growth on high-fat (HF) and high-carbohydrate (HC) solid/powdered diets indicated that the HF diet elicited greater weight gain in 33 out of 40 studies. Enhanced growth on the HF diet was often, but not exclusively, attributable to greater caloric intake. Additional evidence for the growth-enhancing effect of HF diets emerges from "diet option" and "supermarket" feeding studies in rats, and experimental and epidemiological studies in humans. Three principal factors that contribute to the different responses to HF and HC diets are (a) caloric density, (b) sensory properties and palatability, and (c) postabsorptive processing. It is concluded that both calorie intake and metabolic energy expenditure are biased towards weight gain when a HF diet is consumed, and that the high caloric density of high-fat diets plays a primary role in weight gain. Humans may be biologically predisposed to gain weight when a HF diet is consumed.

Relation of obesity and diet to sympathetic nervous system activity

The hypothesis that dietary intake and obesity stimulate the sympathetic nervous system was investigated in a cross-sectional study of 572 men aged 43-85 years from the Normative Aging Study. Habitus was represented by body mass index, as a measure of overall adiposity, and by the ratio of abdomen-to-hip circumference (abdomen/hip ratio), as a measure of centripetal fat distribution. Sympathetic activity was assessed by measurement of 24-hour urinary norepinephrine excretion. Increased body mass index and total caloric intake were independently associated with increased 24-hour urinary norepinephrine excretion (p = 0.0001 and p = 0.0055, respectively). In addition, mean urinary norepinephrine excretion was higher in subjects classified as either hyperglycemic (serum fasting glucose greater than or equal to 113 mg/dl) and hyperinsulinemic (serum fasting insulin greater than or equal to 19 microIU/ml) (p = 0.0023) or in subjects classified as either hyperglycemic or hyperinsulinemic (p = 0.0063) than the mean urinary norepinephrine excretion in normal subjects. These relations were demonstrated to be independent of age, smoking status, and physical activity. Our results are consistent with the hypothesis that insulin mediates sympathetic stimulation in response to dietary intake and increases sympathetic nervous system activity in the obese.

Obesity, blood pressure, and the sympathetic nervous system

Obesity has long been recognized as a major risk factor for the development of hypertension. Recently, insulin level has been shown to correlate with blood pressure in clinical and population-based studies. Since insulin is a major signal in the relationship between dietary intake and sympathetic nervous system activity, the possibility that insulin-mediated sympathetic stimulation is involved in the pathogenesis of hypertension in the obese has been raised. This hypothesis, developed on the basis of studies in laboratory rodents and normal human subjects, is currently being tested in the Normative Aging Study in Boston. Utilizing epidemiologic techniques applied to this defined population, evidence in support of this hypothesis has been accumulated. The preliminary results indicate that in this population, the abdominal form of obesity is associated with higher insulin levels and increased 24-hour urinary norepinephrine excretion (an index of sympathetic activity).

Decreased thermogenic response to food with intragastric vs. oral feeding

To examine the effects of sensory stimulations associated with eating on postprandial energy expenditure, thermogenic response to food (TRF) was measured in nine subjects after ingestion of a test meal and after intragastric injection of the same pureed meal through a nasogastric tube. A third measure was made after ingestion of water and a fourth after chewing the meal without deglutition. Each measurement lasted 6 h. Intragastric injection of the meal elicited a lower TRF than oral ingestion in every subject, and this difference was seen whether TRF was calculated from the pretest energy expenditure (PTEE) or from energy expenditure measured after water ingestion (EEW) (175 +/- 57 vs. 83 +/- 32 and 209 +/- 68 vs. 106 +/- 45 kJ for PTEE and EEW, respectively; P less than 0.05 for each test). In both tests, changes in respiratory quotient, plasma glucose, and insulin were similar. Sensory stimulation by the meal without deglutition did not induce a significant change in energy expenditure. These results suggest that TRF has two components in humans, one of which is dependent on preabsorptive sensory stimulations. Lack of change in substrate oxidations between oral and intragastric feeding suggests that TRF related to preabsorptive stimulations does not depend on the preferential use of fatty acids or glucose as a source of fuel.

Deceleration in cumulative food intake curves, changes in body temperature and diet-induced thermogenesis

In order to assess the relationship between the shape of the cumulative food intake curve and a reflection of internal processes, eating behaviour, postprandial thermogenesis, and skin and core temperature of normal weight restrained and unrestrained eating women and of obese restrained eating women were recorded during four-course solid food lunches, eaten in a laboratory setting (respiration chamber) at a constant ambient temperature of 22 degrees C. The skin temperature (upper arm, upper leg, liver proximity) and core temperature were measured constantly from one hour prior to until two hours after the lunch. Normal weight unrestrained eaters displayed decelerated cumulative food intake curves and an increase in the liver temperature data of 0.8-1.5 degrees C, from the beginning of the meal onwards, remaining high until 60-90 minutes after the meal was consumed. The postprandial thermogenesis of normal weight unrestrained eaters was on average 8.1 +/- 1.3%, calculated over two and a half hours from the beginning of the meal. Overweight and normal weight restrained eaters displayed linear cumulative food intake curves, almost no changes in skin and core temperatures and a postprandial thermogenesis of 4.2 +/- 0.3% and 4.8 +/- 0.7%, calculated over two and a half hours from the beginning of the meal onwards. In conclusion, deceleration in cumulative food intake curves is positively correlated with a temperature increase in the skin in the proximity of the liver, and with postprandial thermogenesis.

Thermic effect of a meal over 3 and 6 hours in lean and obese men

Controversy regarding defective postprandial thermogenesis in obesity may partly be due to methodological factors such as duration of measurement. To clarify further the role of blunted thermogenesis in obesity, the thermic effect of food was compared in seven lean (mean +/- SEM, 15.7% +/- 1.5% body fat, by densitometry) and seven obese men (37.3% +/- 3% fat) over 3 and 6 hours. The groups were matched for age (35 +/- 2 and 33 +/- 2 years for the lean and obese groups; range, 25 to 39 years), fat-free mass (FFM), and aerobic fitness. Resting metabolic rate (RMR) was measured by indirect calorimetry for 6 hours on two mornings, in randomized order: (1) after a 720-kcal liquid mixed meal, which was 24% protein, 21% fat, and 55% carbohydrate; and (2) in the postabsorptive state. The thermic effect of food, calculated as postprandial minus postabsorptive RMR, was significantly greater for the lean than obese men for the first 3 hours of measurement (67 +/- 6 v 49 +/- 3 kcal/3 hours; P less than .01). During the second 3 hours, the thermic effect of food was marginally, but not significantly, greater for the lean than obese men (34 +/- 8 v 20 +/- 4 kcal/3 hours; P = .10, NS). Over the entire 6 hours, the thermic effect of food was significantly greater for the lean than obese men (100 +/- 12 v 69 +/- 5 kcal/6 hours; P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Thermic effect of food in man: effect of meal composition, and energy content

The effect of meal composition and energy content on the thermic effect of food (TEF) was investigated in sixteen adult, non-obese female subjects. Each subject consumed four different test meals, each meal on a different day. Meals were of high-carbohydrate-low-fat (HCLF) with 0.70, 0.19 and 0.11 of the energy content from carbohydrate, fat and protein respectively, and low-carbohydrate-high-fat (LCHF) with 0.24, 0.65 and 0.11 of the energy content from carbohydrate, fat and protein respectively. The energy contents of the test meals for each composition were 2520 kJ (600 kcal) and 5040 kJ (1200 kcal). The basal metabolic rate (BMR) and the postprandial metabolic rate (PP-MR) were measured by open-circuit indirect calorimetry using the Douglas bag technique while the subjects were in the supine position. The mean BMR value was 3.63 (SE 0.07) kJ/min (0.87 kcal/min (SE 0.017)). The 5 h-TEF value for the 2520 kJ (600 kcal) HCLF meal was 228 (SE 11.8) kJ (54 kcal (SE 2.8)) and for the LCHF meal was 228 (SE 9.6) kJ (54 kcal (SE 2.3)). The corresponding values for the 5040 kJ (1200 kcal) meals were 356 (SE 20.4) kJ (85 kcal (SE 4.9)) and 340 (SE 15.8) kJ (81 kcal (SE 3.8)). There was no significant (P = 0.49) effect of meal composition on TEF, but the energy content of the meals had a significant (P less than 0.001) effect on TEF. In all subjects and for all meals, PP-MR had not returned to premeal level 5 h after a meal, indicating that the TEF values measured underestimate total TEF. The present study suggests that TEF is significantly influenced by the energy content of a meal but not by meal composition.

The thermic effect of feeding in older men: the importance of the sympathetic nervous system

We have previously published direct evidence that approximately one third of the thermic effect of feeding (TEF) in young healthy men can be accounted for by the meal-induced increment in sympathetic nervous system (SNS) activity. The elderly are known to have abnormal beta-adrenergic mechanisms and blunted responsiveness to sympathetic stimulation. Therefore, we postulated that the elderly might also have a blunted thermic response to a meal. In the present study, we evaluated the TEF in 25 young (age, 29.4 +/- 4.6 years) and 12 older (66.6 +/- 7.0 years), healthy weight-stable, untrained, nonsmoking men on no medications. Energy expenditure (ventilated hood system) and SNS activity (arterialized plasma catecholamine concentrations and norepinephrine [NE] kinetics) were measured before and following ingestion of an 800-kcal high-carbohydrate meal. At baseline, arterialized plasma NE concentration (P = .001) and appearance rate (P = .05) were 40% and 28% higher, respectively, in the elderly. Resting energy expenditure was related to fat-free mass (r = .54, P less than .01), and was 21% lower in the older men (P less than .01). Energy expenditure increased in both groups following the meal, but this TEF was 48% lower in the older men (P less than .001). This reduced TEF observed in the older subjects was associated with only a slight, nonsignificant, blunting of the SNS response to the meal. The TEF was related to the arterialized plasma NE appearance rate in the young, but not the older group. The TEF was unrelated to either glucose or insulin concentrations in either group.(ABSTRACT TRUNCATED AT 250 WORDS)

Meal-induced thermogenesis in obese patients before and after weight reduction

The purpose of this study was to find out whether human obesity is associated with a diminished meal-induced thermogenesis and, if so, to what extent this response is influenced by weight reduction. Ten obese subjects (body mass index 42 +/- 2) and 10 age- and sex-matched non-obese volunteers were studied with continuous indirect calorimetry in the basal state and after the ingestion of a standardized test meal. Six obese subjects (body mass index 44 +/- 2) were examined on two occasions, once before and once after gastric banding and an average weight reduction of 18 +/- 3 kg. Basal oxygen uptake and energy expenditure were 30% (P less than 0.001) greater in the obese subjects compared to non-obese controls. After the meal, pulmonary oxygen uptake and energy expenditure increased rapidly and reached a relatively constant level after 60 min; for pulmonary oxygen uptake the average rise above basal was less in the obese (17.7 +/- 1.6%) than the non-obese (27.8 +/- 1.9%, P less than 0.001); the increase in energy expenditure was 18.5 +/- 1.7% in obese and 30.8 +/- 2.1% in non-obese subjects (P less than 0.001). After weight reduction, oxygen uptake and energy expenditure in the basal state were 20% lower (P less than 0.05) than before weight reduction. The average post-prandial increase in oxygen uptake was greater after weight reduction (24.8 +/- 2.0%) than before (16.7 +/- 1.6%, P less than 0.001). Corresponding values for energy expenditure were 27.2 +/- 2.2 and 18.2 +/- 2.2% (P less than 0.001). It is concluded that: (1) the thermogenic response to a mixed meal is lower in obese compared to non-obese individuals; and, (2) this impaired response is partly normalized after weight reduction. These findings suggest that a diminished meal-induced thermogenesis is a secondary phenomenon rather than a primary pathogenic factor in human obesity.

Prostaglandins, brown fat and weight loss

In obesity, a situation is created in which energy intake exceeds energy expenditure. The three components of energy expenditure are resting metabolism, physical activity, and thermogenesis. Increasing attention is being paid to the role of impaired energy expenditure in obesity. Evidence indicates that impairment in activity of the sympathetic nervous system, which stimulates thermogenic processes, contributes to the etiology of obesity. In addition, insulin resistance, a well-recognized metabolic consequence of obesity, appears to interfere with feeding-related, insulin-mediated increases in thermogenesis in brown adipose tissue. This thermogenic defect results in reduced energy buffering by brown adipose tissue leading to deficient energy expenditure and an increased efficiency in weight gain. A unique weight loss program, The Princeton Metabolic Diet Program, is presented. The Program stimulates metabolism by stimulating the sympathetic nervous system and correcting insulin resistance, thereby enhancing thermogenesis in brown adipose tissue. Methods include: 1) alternating diet composition and caloric intake and, 2) the use of nutritional metabolic stimulants. This type of non-toxic therapy, directed at correcting biochemical defects, will enhance metabolic mechanisms and induce weight loss.