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Verney J, Lambert C, Isacco L, Beraud D, Boscaro A, Pereira B, Costes F, Rannou F, Julian V, Duclos M, Boirie Y, Thivel D, Bailly M. Similar maximal aerobic capacity but lower energy efficiency during low-to-moderate exercise in women with constitutional thinness: new results from the NUTRILEAN study. Eur J Appl Physiol 2024:10.1007/s00421-024-05540-0. [PMID: 38904774 DOI: 10.1007/s00421-024-05540-0] [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: 03/29/2024] [Accepted: 06/06/2024] [Indexed: 06/22/2024]
Abstract
PURPOSE Individuals with constitutional thinness have been presented with a lower muscular energy metabolism at the cellular level but their effective aerobic capacities and exercise-related energy efficiency remains unexplored. The present study compares maximal and sub-maximal aerobic capacities between subjects with constitutional thinness and age-matched normal-weight ones. METHODS Anthropometric measures, body composition (Dual-X-ray absorptiometry), physical activity and sedentary time (GT3x actigraphs), and maximal aerobic capacities (cyclingV ˙ O 2peak test) were assessed in 18 constitutionally thin (CT-body mass index < 17.5 kg m-2) and 17 normal-weight (NW-body mass index between 20 and 25 kg m-2) women. Energy efficiency was assessed during a submaximal cycling test and a walking exercise. RESULTS CT had a lower body mass and body mass index compared to NW. Absolute peak oxygen uptake and maximal aerobic power were lower in CT subjects compared to NW (ES: - 1.63 [- 2.40; - 0.86] and - 1.32 [- 2.05; - 0.58], p < 0.001).V ˙ O 2peak related to body mass was not different between groups. Gross and net efficiency (ES: - 0.78 [- 1.48; - 0.06], p = 0.03 and ES: - 0.73 [- 1.43; - 0.01], p = 0.05) were lower in CT compared to NW during the submaximal cycling exercise. The gross energy cost of walking related to body mass was lower in subjects with CT (ES: - 1.80 [- 2.60; - 0.97, p = 0.05), with no difference for the net one. Perceived exertion was similar between groups in responses to both submaximal exercises. CONCLUSION Constitutionally thin women do not show impaired aerobic capacities at moderate to maximal intensities despite lower energy efficiency while cycling and walking at low-to-moderate intensities.
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Affiliation(s)
- Julien Verney
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CS 60026, 63178, Aubière Cedex, France.
| | - Céline Lambert
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Laurie Isacco
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CS 60026, 63178, Aubière Cedex, France
| | - Duane Beraud
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CS 60026, 63178, Aubière Cedex, France
| | - Audrey Boscaro
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CS 60026, 63178, Aubière Cedex, France
| | - Bruno Pereira
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, CHU Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Fabrice Rannou
- Department of Sport Medicine and Functional Explorations, CHU Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, CHU Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, CHU Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Yves Boirie
- Department of Clinical Nutrition, CHU Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CS 60026, 63178, Aubière Cedex, France
| | - Mélina Bailly
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, CS 60026, 63178, Aubière Cedex, France
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Bailly M, Beraud D, Lambert C, Garnier YM, Pereira B, Duclos M, Boirie Y, Isacco L, Thivel D, Verney J. Constitutional thinness might be characterized by physiologically adapted and not impaired muscle function and architecture: new results from the NUTRILEAN study. Eur J Appl Physiol 2024:10.1007/s00421-024-05539-7. [PMID: 38900200 DOI: 10.1007/s00421-024-05539-7] [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: 04/18/2024] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE While muscle mass and skeletal muscle fibers phenotype have been shown atypical in constitutional thinness (CT), force production capacities and its architectural determinants have never been explored. The present study compared muscle functionality and architecture between participants with CT and their normal-weight (NW) counterparts. METHODS Anthropometry, body composition (Dual-X-ray Absorptiometry), physical activity/sedentary behavior (ActiGraph wGT3X-BT), ultrasound recording of the Vastus Lateralis (2D-ultrasound system), and functional capacities at maximal isometric and isokinetic voluntary contractions (MVCISO and MVCCON) during knee extension (isokinetic dynamometer chair Biodex) have been measured in 18 women with CT (body mass index < 17.5 kg/m2) and 17 NW women. RESULTS A lower fat-free mass (ES: -1.94, 95%CI: -2.76 to -1.11, p < 0.001), a higher sedentary time, and a trend for a lower time spent at low-intensity physical activity, were observed in CT vs NW participants. While absolute MVCISO, MVCCON, rate of torque development (RTD), and torque work were all markedly lower in CT, these differences disappeared when normalized to body or muscle mass. Muscle thickness and fascicle length were found lower in CT (ES: -1.29, 95%CI: -2.03 to -0.52, p < 0.001; and ES: -0.87, 95%CI: -1.58 to -0.15, p = 0.02, respectively), while pennation angle was found similar. CONCLUSION Despite lower absolute strength capacities observed in CT, present findings support the hypothesis of physiological adaptations to the low body and muscle mass than to some intrinsic contractile impairments. These results call for further studies exploring hypertrophy-targeted strategies in the management of CT.
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Affiliation(s)
- Mélina Bailly
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Duane Beraud
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Céline Lambert
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Yoann M Garnier
- Prognostic Factors and Regulatory Factors of Cardiac and Vascular Pathologies, EA3920, Université de Franche-Comté, 25000, Besançon, France
| | - Bruno Pereira
- Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, CHU Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Yves Boirie
- Department of Clinical Nutrition, CHU Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Laurie Isacco
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France
| | - Julien Verney
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, CRNH, 63000, Clermont-Ferrand, France.
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Boscaro A, Bailly M, Pereira B, Beraud D, Costes F, Julian V, Duclos M, Finlayson G, Thivel D, Boirie Y, Verney J. Post-exercise energy replacement might lead to reduced subsequent energy intake in women with constitutional thinness: Exploratory results from the NUTRILEAN project. Appetite 2024; 195:107203. [PMID: 38232805 DOI: 10.1016/j.appet.2024.107203] [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: 08/26/2023] [Revised: 12/05/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
While people with Constitutional Thinness (CT) declare a deep willingness to gain weight, there appetitive responses to energy balance manipulations remain unclear. The present work compares the effect of an acute exercise combined or not with an energy replacement load, on subsequent energy intake, appetite and food reward, between normal weight and women with CT. Anthropometric measurements, body composition (Dual X-ray absorptiometry-DXA) and aerobic capacity (VO2max) were assessed in 10 normal-weight (Body Mass Index-BMI): 20-25 kg/m2) and 10 C T (BMI<17.5 kg/m2) women (18-30 years). They randomly performed i) a resting session (CON); ii) an exercise session (EX); iii) an exercise session with energy replacement (EX + R). Their subsequent ad libitum intake, appetite feelings and food reward were evaluated (Leeds-Food-Preference-Questionnaire). CT showed a lower weight (p < 0,001), BMI(p < 0,001), Fat-Mass (%) (p = 0,003) and Fat-Free Mass (kg) (p < 0,001). CT showed a lower ad libitum energy intake on EX + R compared with CON (p = 0,008) and a higher Relative Energy Intake (REI) on CON compared with EX (p = 0,007) and EX + R (p < 0,001). A lower was observed during EX and EX + R compared with CON (p = 0,006,p = 0,009 respectively) in CT. No condition nor group effect was found for hunger. NW only showed a higher pre-meal fullness on EX + R compared to CON and EX (p < 0,001). Choice (p = 0,030), Explicit Liking (p = 0,016), Explicit Wanting (p = 0,004) and Implicit Wanting (p = 0,035) for taste were higher on EX + R than CON and EX. The decreased EI observed in CT when the exercise-induced energy expenditure is compensated by the ingestion of an equivalent energy load, might contribute to explain the difficulty to increase their energy balance and then induce weight gain. Further studies are needed to better understand their energy balance regulation to propose adapted weight gain strategies.
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Affiliation(s)
- Audrey Boscaro
- Université Clermont Auvergne, CRNH, AME2P, F-63000 Clermont-Ferrand, France.
| | - Mélina Bailly
- Université Clermont Auvergne, CRNH, AME2P, F-63000 Clermont-Ferrand, France.
| | - Bruno Pereira
- Biostatistics Unit, Délégation à la Recherche Clinique et à l'Innovation (DRCI), Clermont-Ferrand, France.
| | - Duane Beraud
- Université Clermont Auvergne, CRNH, AME2P, F-63000 Clermont-Ferrand, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Graham Finlayson
- Appetite Control & Energy Balance Research Group, School of Psychology, Faculty of Medicine & Health, University of Leeds, Leeds, West Yorkshire, UK.
| | - David Thivel
- Université Clermont Auvergne, CRNH, AME2P, F-63000 Clermont-Ferrand, France.
| | - Yves Boirie
- Department of Clinical Nutrition, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Julien Verney
- Université Clermont Auvergne, CRNH, AME2P, F-63000 Clermont-Ferrand, France.
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Nagashima Y, Inokuchi M, Sato Y, Hasegawa T. Underweight in young Japanese women over time: a longitudinal retrospective study of the change in body mass index from ages 6 to 20 years. Ann Hum Biol 2024; 51:2345393. [PMID: 38685666 DOI: 10.1080/03014460.2024.2345393] [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: 11/06/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The high prevalence of underweight in young women has become a serious health problem in Japan. When and how young women reach a low body mass index (BMI) has not been clarified. AIM To clarify the characteristics of BMI standard deviation scores (BMI SDS) trajectory of young Japanese women with underweight. SUBJECTS AND METHODS A total of 601 Japanese female university students aged 20 years were classified into underweight and healthy weight groups. Their school health check-up data were available from the ages of 6 to 20 years. We evaluated the estimated mean values of BMI SDS at each age and differences in BMI SDS (ΔBMI SDS) from 6 years to each age using a mixed-effects model and compared between the two groups at each age. RESULTS In the underweight group, the BMI SDS at every age (-1.67 to -0.91) and the ΔBMI SDS after 16 years of age (-0.76 to -0.38) were significantly lower than those in the healthy weight group (-0.41 to -0.13, -0.07 to 0.04), respectively. CONCLUSION Young Japanese women with underweight have at least two characteristics of BMI SDS trajectory: being constitutionally underweight and shifting their weight status from baseline towards underweight in their late teens.
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Affiliation(s)
- Yuka Nagashima
- Health Center, Keio University, Kanagawa, Japan
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Mikako Inokuchi
- Health Center, Keio University, Kanagawa, Japan
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Tomonobu Hasegawa
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
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Hübel C, Abdulkadir M, Herle M, Palmos AB, Loos RJF, Breen G, Micali N, Bulik CM. Persistent thinness and anorexia nervosa differ on a genomic level. Eur J Hum Genet 2024; 32:117-124. [PMID: 37474786 PMCID: PMC10772076 DOI: 10.1038/s41431-023-01431-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 06/15/2023] [Accepted: 07/04/2023] [Indexed: 07/22/2023] Open
Abstract
Thinness and anorexia nervosa are both characterised by persistent low weight. Individuals with anorexia nervosa concurrently report distorted perceptions of their body and engage in weight-loss behaviours, whereas individuals with thinness often wish to gain weight. Both conditions are heritable and share genomics with BMI, but are not genetically correlated with each other. Based on their pattern of genetic associations with other traits, we explored differences between thinness and anorexia nervosa on a genomic level. In Part 1, using publicly available data, we compared genetic correlations of persistent thinness/anorexia nervosa with eleven psychiatric disorders. In Part 2, we identified individuals with adolescent persistent thinness in the Avon Longitudinal Study of Parents and Children (ALSPAC) by latent class growth analysis of measured BMI from 10 to 24 years (n = 6594) and evaluated associations with psychiatric and anthropometric polygenic scores. In Part 1, in contrast to the positive genetic correlations of anorexia nervosa with various psychiatric disorders, persistent thinness showed negative genetic correlations with attention deficit hyperactivity disorder (rgAN = 0.08 vs. rgPT = -0.30), alcohol dependence (rgAN = 0.07 vs. rgPT = -0.44), major depressive disorder (rgAN = 0.27 vs. rgPT = -0.18) and post-traumatic stress disorder (rgAN = 0.26 vs. rgPT = -0.20). In Part 2, individuals with adolescent persistent thinness in the ALSPAC had lower borderline personality disorder polygenic scores (OR = 0.77; Q = 0.01). Overall, results suggest that genetic variants associated with thinness are negatively associated with psychiatric disorders and therefore thinness may be differentiable from anorexia nervosa on a genomic level.
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Affiliation(s)
- Christopher Hübel
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK.
- National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
- Department of Pediatric Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
| | - Mohamed Abdulkadir
- National Centre for Register-based Research, Aarhus Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Moritz Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alish B Palmos
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Ruth J F Loos
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Gerome Breen
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, London, UK
| | - Nadia Micali
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Great Ormond Street Institute of Child Health, University College London, London, UK
- Mental Health Services in the Capital Region of Denmark, Eating Disorders Research Unit, Psychiatric Centre Ballerup, Ballerup, Denmark
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Graphical abstracts in British Journal of Nutrition - ADDENDUM. Br J Nutr 2023; 130:2023-2024. [PMID: 37203591 PMCID: PMC10630149 DOI: 10.1017/s0007114523001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
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Boscaro A, Verney J, Tremblay A, King JA, Pereira B, Costes F, Julian V, Duclos M, Boirie Y, Thivel D, Bailly M. Challenges of considering both extremities of the weight status spectrum to better understand obesity: insights from the NUTRILEAN project in constitutionally thin individuals. Int J Obes (Lond) 2023; 47:1171-1177. [PMID: 37553452 DOI: 10.1038/s41366-023-01360-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/03/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND/OBJECTIVES While the physiology of obesity has been so extensively investigated to date, only an extremely small number of studies (less than 50) have focused on the other extremity of the weight spectrum: constitutional thinness. Yet, this important state of underweight in the absence of any eating disorders provides a mirror model of obesity that might be particularly insightful in understanding obesity. Nevertheless, important methodological and recruitment-related issues appear when it comes to this complex constitutionally thin phenotype, as experienced by our research group with the realization of the ongoing NUTRILEAN clinical trial. To face this challenge, the present paper aims at identifying, analyzing, and discussing the quality of such recruitment processes in publications about constitutional thinness. METHODS In this order, a group of experts collectively created a new grading system to assess the level of rigour and quality achieved by each study based on different criteria. RESULTS The main results were that (i) metabolic-related biasing criteria were poorly observed despite being crucial, (ii) recruitment processes were not detailed enough and with sufficient explicitness, and (iii) recruiting among already identified patients would be associated with both higher sample sizes and better scores of quality. CONCLUSIONS The present work encourages investigators to adopt a high level of rigour despite the complexity and duration of recruitment processes for this specific population, and readers to pay close attention to the quality of recruitment when interpreting the data. To better understand obesity and its physiological adaptations, it seems essential not only to compare it to normal-weight conditions, but also to the other extremity of the weight status spectrum represented by constitutional thinness.
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Affiliation(s)
- Audrey Boscaro
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UPR 3533, CRNH Auvergne, University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Julien Verney
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UPR 3533, CRNH Auvergne, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - James A King
- National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Bruno Pereira
- Biostatistics Unit, Délégation à la Recherche Clinique et à l'Innovation (DRCI), Clermont-Ferrand, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Valérie Julian
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Yves Boirie
- Department of Clinical Nutrition, University Teaching Hospital of Clermont-Ferrand, Diet and Musculoskeletal Health Team, CRNH, INRA, University of Clermont Auvergne, Clermont-Ferrand, France
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UPR 3533, CRNH Auvergne, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Mélina Bailly
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), UPR 3533, CRNH Auvergne, University of Clermont Auvergne, Clermont-Ferrand, France
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Garber AK, Bennett JP, Wong MC, Tian IY, Maskarinec G, Kennedy SF, McCarthy C, Kelly NN, Liu YE, Machen VI, Heymsfield SB, Shepherd JA. Cross-sectional assessment of body composition and detection of malnutrition risk in participants with low body mass index and eating disorders using 3D optical surface scans. Am J Clin Nutr 2023; 118:812-821. [PMID: 37598747 PMCID: PMC10797509 DOI: 10.1016/j.ajcnut.2023.08.004] [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: 05/13/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND New recommendations for the assessment of malnutrition and sarcopenia include body composition, specifically reduced muscle mass. Three-dimensional optical imaging (3DO) is a validated, accessible, and affordable alternative to dual X-ray absorptiometry (DXA). OBJECTIVE Identify strengths and weaknesses of 3DO for identification of malnutrition in participants with low body mass index (BMI) and eating disorders. DESIGN Participants were enrolled in the cross-sectional Shape Up! Adults and Kids studies of body shape, metabolic risk, and functional assessment and had BMI of <20 kg/m2 in adults or <85% of median BMI (mBMI) in children and adolescents. A subset was referred for eating disorders evaluation. Anthropometrics, scans, strength testing, and questionnaires were completed in clinical research centers. Lin's Concordance Correlation Coefficient (CCC) assessed agreement between 3DO and DXA; multivariate linear regression analysis examined associations between weight history and body composition. RESULTS Among 95 participants, mean ± SD BMI was 18.3 ± 1.4 kg/m2 in adult women (N = 56), 19.0 ± 0.6 in men (N = 14), and 84.2% ± 4.1% mBMI in children (N = 25). Concordance was excellent for fat-free mass (FFM, CCC = 0.97) and strong for appendicular lean mass (ALM, CCC = 0.86) and fat mass (FM, CCC = 0.87). By DXA, 80% of adults met the low FFM index criterion for malnutrition, and 44% met low ALM for sarcopenia; 52% of children and adolescents were <-2 z-score for FM. 3DO identified 95% of these cases. In the subset, greater weight loss predicted lower FFM, FM, and ALM by both methods; a greater percentage of weight regained predicted a higher percentage of body fat. CONCLUSIONS 3DO can accurately estimate body composition in participants with low BMI and identify criteria for malnutrition and sarcopenia. In a subset, 3DO detected changes in body composition expected with weight loss and regain secondary to eating disorders. These findings support the utility of 3DO for body composition assessment in patients with low BMI, including those with eating disorders. This trial was registered at clinicaltrials.gov as NCT03637855.
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Affiliation(s)
- Andrea K Garber
- Department of Pediatrics, University of California, San Francisco, CA, United States.
| | - Jonathan P Bennett
- Graduate Program in Human Nutrition, University of Hawai'i Manoa, Honolulu, HI, United States; University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Michael C Wong
- University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Isaac Y Tian
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, United States
| | | | - Samantha F Kennedy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Nisa N Kelly
- University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Yong E Liu
- University of Hawai'i Cancer Center, Honolulu, HI, United States
| | - Vanessa I Machen
- Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - John A Shepherd
- University of Hawai'i Cancer Center, Honolulu, HI, United States
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9
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Lund J, Clemmensen C. Physiological protection against weight gain: evidence from overfeeding studies and future directions. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220229. [PMID: 37482786 PMCID: PMC10363696 DOI: 10.1098/rstb.2022.0229] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 04/24/2023] [Indexed: 07/25/2023] Open
Abstract
Body weight is under physiological regulation. When body fat mass decreases, a series of responses are triggered to promote weight regain by increasing food intake and decreasing energy expenditure. Analogous, in response to experimental overfeeding, excessive weight gain is counteracted by a reduction in food intake and possibly by an increase in energy expenditure. While low blood leptin and other hormones defend against weight loss, the signals that oppose overfeeding-induced fat mass expansion are still unknown. In this article, we discuss insights gained from overfeeding interventions in humans and intragastric overfeeding studies in rodents. We summarize the knowledge on the relative contributions of energy intake, energy expenditure and energy excretion to the physiological defence against overfeeding-induced weight gain. Furthermore, we explore literature supporting the existence of unidentified endocrine and non-endocrine pathways that defend against weight gain. Finally, we discuss the physiological drivers of constitutional thinness and suggest that overfeeding of individuals with constitutional thinness represents a gateway to understand the physiology of weight gain resistance in humans. Experimental overfeeding, combined with modern multi-omics techniques, has the potential to unveil the long-sought signalling pathways that protect against weight gain. Discovering these mechanisms could give rise to new treatments for obesity. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.
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Affiliation(s)
- Jens Lund
- Novo Nordisk Foundation Center for Basic Metabolic Research. Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Christoffer Clemmensen
- Novo Nordisk Foundation Center for Basic Metabolic Research. Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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10
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Fricke C, Voderholzer U. Endocrinology of Underweight and Anorexia Nervosa. Nutrients 2023; 15:3509. [PMID: 37630700 PMCID: PMC10458831 DOI: 10.3390/nu15163509] [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: 06/26/2023] [Revised: 07/27/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
More than any other mental illness, the course, prognosis, and therapy of anorexia nervosa are shaped by the physical changes associated with being underweight. This article provides an overview of the endocrine changes associated with malnutrition and underweight. This overview serves as a basis for understanding the other articles in this special issue, which deal with the health risks associated with being underweight. In this context, the differences between underweight in anorexia nervosa and in constitutional thinness are of particular importance in assessing the impact of intentional weight loss. In this context, the regulation of hunger and satiety deserves special interest, as this is the area in which the intentional influence on body weight comes into play. Clinical consequences on, for example, fertility, bone metabolism, the homeostasis of, for example, serum glucose levels, or body temperature have been observed for a long time; nonetheless, the medical responses, apart from vitamin supplementations and advice to gain weight, are still limited. Therefore, emphasis was placed on the potential improvement of outcomes through the administration of central or peripheral hormones. Studies were identified on PubMed via a selection of relevant keywords; original texts that were cited in reviews were studied where it was advantageous. This review found some promising data on bone health and the administration of transdermal oestrogen, which is not yet widely used, as well as distinct hormonal markers to differentiate between CT and AN. We concluded that the continuous efforts to investigate the role of endocrinology in underweight and/or anorexia nervosa lead to outcome benefits and that more and higher-powered studies are needed.
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Affiliation(s)
| | - Ulrich Voderholzer
- Schoen Klinik Roseneck, 83209 Prien am Chiemsee, Germany;
- Klinik für Psychiatrie und Psychotherapie, Ludwig Maximilians Universität, 80336 Munich, Germany
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11
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Fernandes AE, Rosa PWL, Melo ME, Martins RCR, Santin FGO, Moura AMSH, Coelho GSMA, Sabino EC, Cercato C, Mancini MC. Differences in the gut microbiota of women according to ultra-processed food consumption. Nutr Metab Cardiovasc Dis 2023; 33:84-89. [PMID: 36411218 DOI: 10.1016/j.numecd.2022.09.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS High consumption of ultra-processed food (UPF) has been associated with increased risk of obesity and other metabolic diseases, and this dietary pattern seems to be responsible for chronic changes in the gut microbiota. The aim of this study was to assess the associations of UPF with the gut microbiota and obesity-associated biometrics in women. METHODS AND RESULTS This cross-sectional study examined 59 women. The following parameters were evaluated: food consumption using NOVA classification, anthropometric and metabolic parameters, and gut microbiome by next-generation sequencing. The mean age was 28.0 ± 6.6 years. The mean caloric intake was 1624 ± 531 kcal, of which unprocessed or minimally processed food (G1) accounted for 52.4 ± 13.5%, and UPF accounted for 31.4 ± 13.6%. Leptin levels adjusted for fat mass were negatively associated with G1 and positively associated with UPF. We found 15 species in the gut microbiota that correlated with G1 (3 positively and 12 negatively) and 9 species associated with UPF (5 positively and 4 negatively). CONCLUSION Higher consumption of UPF was directly associated with leptin resistance, and this study suggests that the consumption of UPF or G1 may affect the composition of the gut microbiota.
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Affiliation(s)
- Ariana E Fernandes
- Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - Paula W L Rosa
- Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Maria E Melo
- Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Roberta C R Martins
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Fernanda G O Santin
- Departamento de Nutricao, Faculdade de Saude Publica, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Aline M S H Moura
- Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Graziele S M A Coelho
- Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ester C Sabino
- Instituto de Medicina Tropical, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Cintia Cercato
- Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Marcio C Mancini
- Hospital Das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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12
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Cominetti O, Núñez Galindo A, Corthésy J, Carayol J, Germain N, Galusca B, Estour B, Hager J, Gheldof N, Dayon L. Proteomics reveals unique plasma signatures in constitutional thinness. Proteomics Clin Appl 2022; 16:e2100114. [PMID: 35579096 PMCID: PMC9787820 DOI: 10.1002/prca.202100114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/14/2022] [Accepted: 05/13/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE Studying the plasma proteome of control versus constitutionally thin (CT) individuals, exposed to overfeeding, may give insights into weight-gain management, providing relevant information to the clinical entity of weight-gain resistant CT, and discovering new markers for the condition. EXPERIMENTAL DESIGN Untargeted protein relative quantification of 63 CT and normal-weight individuals was obtained in blood plasma at baseline, during and after an overfeeding challenge using mass spectrometry-based proteomics. RESULTS The plasma proteome of CT subjects presented limited specificity with respect to controls at baseline. Yet, CT showed lower levels of inflammatory C-reactive protein and larger levels of protective insulin-like growth factor-binding protein 2. Differences were more marked during and after overfeeding. CT plasma proteome showed larger magnitude and significance in response, suggesting enhanced "resilience" and more rapid adaptation to changes. Four proteins behaved similarly between CT and controls, while five were regulated in opposite fashion. Ten proteins were differential during overfeeding in CT only (including increased fatty acid-binding protein and glyceraldehyde-3-phosphate dehydrogenase, and decreased apolipoprotein C-II and transferrin receptor protein 1). CONCLUSIONS AND CLINICAL RELEVANCE This first proteomic profiling of a CT cohort reveals different plasma proteomes between CT subjects and controls in a longitudinal clinical trial. Our molecular observations further support that the resistance to weight gain in CT subjects appears predominantly biological. CLINICALTRIALS gov Identifier: NCT02004821.
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Affiliation(s)
- Ornella Cominetti
- Nestlé Institute of Food Safety & Analytical SciencesNestlé ResearchLausanneSwitzerland
| | - Antonio Núñez Galindo
- Nestlé Institute of Food Safety & Analytical SciencesNestlé ResearchLausanneSwitzerland
| | - John Corthésy
- Nestlé Institute of Food Safety & Analytical SciencesNestlé ResearchLausanneSwitzerland
| | - Jérôme Carayol
- Nestlé Institute of Health SciencesNestlé ResearchLausanneSwitzerland,Present address:
Playtika Switzerland SARue du Port‐Franc 2ALausanne1003Switzerland
| | - Natacha Germain
- Division of EndocrinologyDiabetes, Metabolism and Eating Disorders, CHU St‐EtienneFrance
| | - Bogdan Galusca
- Division of EndocrinologyDiabetes, Metabolism and Eating Disorders, CHU St‐EtienneFrance
| | - Bruno Estour
- Division of EndocrinologyDiabetes, Metabolism and Eating Disorders, CHU St‐EtienneFrance
| | - Jörg Hager
- Nestlé Institute of Health SciencesNestlé ResearchLausanneSwitzerland
| | - Nele Gheldof
- Nestlé Institute of Health SciencesNestlé ResearchLausanneSwitzerland,Present address:
VPA ‐ AVP‐R‐Administration, EPFLBI A2 483, Station 7Lausanne1015Switzerland
| | - Loïc Dayon
- Nestlé Institute of Food Safety & Analytical SciencesNestlé ResearchLausanneSwitzerland,Institut des Sciences et Ingénierie ChimiquesÉcole Polytechnique Fédérale de Lausanne (EPFL)LausanneSwitzerland
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13
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Bailly M, Boscaro A, Thomas T, Féasson L, Costes F, Pereira B, Hager J, Estour B, Galusca B, Metz L, Courteix D, Thivel D, Verney J, Germain N. New Insights on Bone Tissue and Structural Muscle-Bone Unit in Constitutional Thinness. Front Physiol 2022; 13:921351. [PMID: 35874537 PMCID: PMC9305386 DOI: 10.3389/fphys.2022.921351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/27/2022] [Indexed: 11/13/2022] Open
Abstract
While few studies pointed out low bone mineral densities in constitutionally thin women, little is known about potential explanations. The objective was to further explore bone architecture in both women and men with constitutional thinness to investigate their mechanical muscle-bone coupling (or uncoupling). Thirty constitutionally thin people and 31 normal weight controls participated in the study. Body composition, hip structural analysis, and trabecular bone score were assessed by dual-energy X-ray absorptiometry, bone architecture using high-resolution peripheral quantitative computed tomography, and muscle explorations through histological staining on muscle biopsies. Thirty-two out of the 48 indexes relative to density, geometry, texture, and architecture of bones were found significantly lower (p < 0.05) in constitutionally thin individuals compared with controls. This observation was particularly pronounced in constitutionally thin men. Bone microarchitecture was more altered in weight-supporting bone (tibia) than in non-weight-supporting (radius) bone, which might refer to a normal physiological adaptation (Frost’s mechanostat theory). Yet, the heat-maps of correlations analyses showed many alterations of body weight or muscle associations with bone parameters in constitutionally thin individuals contrary to controls. Present results might support the idea of intrinsic disturbances of bone cells independently to the small muscle structure, particularly in men.
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Affiliation(s)
- Mélina Bailly
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
- *Correspondence: Mélina Bailly,
| | - Audrey Boscaro
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - Thierry Thomas
- Department of Rheumatology, Hôpital Nord, CHU, Saint-Étienne, France
- INSERM U1059, University of Lyon-Jean Monnet University, Saint-Étienne, France
| | - Léonard Féasson
- Inter-University Laboratory of Human Movement Biology (LIBM) EA 7424, Jean Monnet University, Saint-Étienne, France
| | - Frédéric Costes
- Department of Sport Medicine and Functional Explorations, CHU, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit, Délégation à la Recherche Clinique et à l’Innovation (DRCI), Clermont-Ferrand, France
| | - Jorg Hager
- Metabolic Health Nestlé Research, Lausanne, Switzerland
| | - Bruno Estour
- Eating Disorders Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes Metabolism and Eating Disorders, CHU, Saint-Étienne, France
| | - Bogdan Galusca
- Eating Disorders Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes Metabolism and Eating Disorders, CHU, Saint-Étienne, France
| | - Lore Metz
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - Daniel Courteix
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - David Thivel
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - Julien Verney
- Université Clermont Auvergne, CRNH, AME2P, Clermont-Ferrand, France
| | - Natacha Germain
- Eating Disorders Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes Metabolism and Eating Disorders, CHU, Saint-Étienne, France
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14
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Bailly M, Boscaro A, Pereira B, Féasson L, Boirie Y, Germain N, Galusca B, Courteix D, Thivel D, Verney J. Is constitutional thinness really different from anorexia nervosa? A systematic review and meta-analysis. Rev Endocr Metab Disord 2021; 22:913-971. [PMID: 33929658 DOI: 10.1007/s11154-021-09650-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 01/03/2023]
Abstract
A growing interest in constitutional thinness has been observed in the last decades, but the publications however cover various fields of study and report equivocal results. The present work systematically reviewed any clinical trials enrolling participants with constitutional thinness and bibliographic researches were performed between December 2018 and June 2020. From a total of 1 212 records initially identified, 402 records were removed as duplicates, 381 articles were excluded based on titles or abstracts and 390 references were excluded against eligibility criteria. Thirty-nine articles were finally included in the systematic review. The results showed that constitutionally thin people seem to be underweight but not underfat and present a fat-free mass as blunted as anorexic patients, despite being a little less underweight. The meta-analysis confirmed that constitutionally thin people present normal energy intake and revealed a trend toward a higher resting metabolic rate to fat-free mass ratio which suggests a highly metabolic fat-free mass. Contrary to patients with anorexia nervosa, constitutionally thin people present normal levels of insulin-like growth factor 1, estradiol, growth hormone, follicle-stimulating hormone, and luteinizing hormone. An intermediate level of leptin between anorexic and control participants was however observed in constitutional thinness. While all the studies reported normal free triiodothyronine and cortisol levels in constitutionally thin individuals, a higher fasting free triiodothyronine level (p = 0.033) and a lower 24 h mean cortisol level (p = 0.005) were observed for the first time. Present results give robust evidence that constitutionally thin people present an atypical phenotype highly different from anorexia nervosa.
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Affiliation(s)
- Mélina Bailly
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
| | - Audrey Boscaro
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France.
| | - Bruno Pereira
- Biostatistics Unit, Délégation À La Recherche Clinique Et À L'Innovation (DRCI), Clermont-Ferrand, France
| | - Léonard Féasson
- Inter-University Laboratory of Human Movement Biology (LIBM) EA 7424, Université Jean Monnet, Saint-Étienne, France
| | - Yves Boirie
- Department of Human Nutrition, G. Montpied Hospital, CHU Clermont-Ferrand, Clermont-Ferrand, France
- INRAE, UMR 1019, Clermont-Ferrand, France
| | - Natacha Germain
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes, Metabolism and Eating Disorders, CHU, Saint-Étienne, France
| | - Bogdan Galusca
- Eating Disorders, Addictions and Extreme Bodyweight Research Group (TAPE) EA 7423, Jean Monnet University, Saint-Étienne, France
- Division of Endocrinology, Diabetes, Metabolism and Eating Disorders, CHU, Saint-Étienne, France
| | - Daniel Courteix
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France
| | - David Thivel
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France.
| | - Julien Verney
- Université Clermont Auvergne, CRNH, AME2P, F-63000, Clermont-Ferrand, France
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15
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Underweight but not underfat: is fat-free mass a key factor in constitutionally thin women? Eur J Clin Nutr 2021; 75:1764-1770. [PMID: 33772214 DOI: 10.1038/s41430-021-00895-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/05/2021] [Accepted: 02/23/2021] [Indexed: 02/01/2023]
Abstract
Constitutional thinness is defined as a state of severe underweight with a body mass index similar to anorectic patients (BMI < 17.5 kg/m2), in the absence of any eating disorders or other obvious disruptive factors impacting energy balance. The analysis of body composition is essential as a first approach to characterize constitutional thinness and might help identify new discriminating differences between constitutional thinness and anorexia nervosa. A meta-analytical approach was performed to compare body composition of constitutionally thin, anorectic, and normal-weight subjects from all available studies found in the literature. The statistical analysis was carried out on large sample sizes: n = 205 females with constitutional thinness, n = 228 normal-weight control females, and n = 258 females with anorexia nervosa. Despite being as underweight as anorectic patients, constitutionally thin participants paradoxically presented higher percentages of fat mass than anorectic patients (18.9% vs. 11.4%, respectively; SMD [95% CI]: 1.62 [1.16; 2.08]), even found in the normal healthy ranges. Constitutionally thin people, however, display as low fat-free mass as anorectic patients. These observations question the use of high-fat diets in this population and bring new insights for nutrition and/or training strategies directed toward muscle mass gain. The present results give new elements to further distinguish constitutional thinness from anorexia nervosa and reinforce the need to better investigate the atypical phenotype of constitutional thinness.
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16
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Invited Letter to Editor in response to: Constitutional thinness: body fat metabolism and skeletal muscle are important factors. Br J Nutr 2020; 124:999-1000. [PMID: 32539896 DOI: 10.1017/s0007114520002159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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17
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Constitutional thinness: body fat metabolism and skeletal muscle are important factors. Br J Nutr 2020; 124:998. [PMID: 32539872 DOI: 10.1017/s0007114520002147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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