Methodological approaches to assess body-weight regulation and aetiology of obesity

Personalized weight loss strategies-the role of macronutrient distribution

A large number of different dietary approaches have been studied in an attempt to achieve healthy, sustainable weight loss among individuals with overweight and obesity. Restriction of energy intake is the primary method of producing a negative energy balance leading to weight loss. However, owing to the different metabolic roles of proteins, carbohydrates and lipids in energy homeostasis, diets of similar overall energy content but with different macronutrient distribution can differentially affect metabolism, appetite and thermogenesis. Evidence increasingly suggests that the fuel values of calories provided by distinct macronutrients should be considered separately, as metabolism of specific molecular components generates differences in energy yield. The causes of variation in individual responses to various diets are currently under debate, and some evidence suggests that differences are associated with specific genotypes. This Review discusses all available systematic reviews and meta-analyses, and summarizes the results of relevant randomized controlled intervention trials assessing the influence of macronutrient composition on weight management. The initial findings of research into personalized nutrition, based on the interactions of macronutrient intake and genetic background and its potential influence on dietary intervention strategies, are also discussed.

Interaction between genes and lifestyle factors on obesity

Obesity originates from a failure of the body-weight control systems, which may be affected by changing environmental influences. Basically, the obesity risk depends on two important mutually-interacting factors: (1) genetic variants (single-nucleotide polymorphisms, haplotypes); (2) exposure to environmental risks (diet, physical activity etc.). Common single-nucleotide polymorphisms at candidate genes for obesity may act as effect modifiers for environmental factors. More than 127 candidate genes for obesity have been reported and there is evidence to support the role of twenty-two genes in at least five different populations. Gene-environment interactions imply that the synergy between genotype and environment deviates from either the additive or multiplicative effect (the underlying model needs to be specified to appraise the nature of the interaction). Unravelling the details of these interactions is a complex task. Emphasis should be placed on the accuracy of the assessment methods for both genotype and lifestyle factors. Appropriate study design (sample size) is crucial in avoiding false positives and ensuring that studies have enough power to detect significant interactions, the ideal design being a nested case-control study within a cohort. A growing number of studies are examining the influence of gene-environmental interactions on obesity in either epidemiological observational or intervention studies. Positive evidence has been obtained for genes involved in adiposity, lipid metabolism or energy regulation such as PPARgamma2 (Pro12Ala), beta-adrenoceptor 2 (Gln27Glu) or uncoupling proteins 1, 2 and 3. Variants on other genes relating to appetite regulation such as melanocortin and leptin receptors have also been investigated. Examples of some recently-identified interactions are discussed.

Sequential responses to high-fat and high-calorie feeding in an obese mouse model

OBJECTIVE

Reports on the immediate and long-term responses to high-fat and high-calorie (HFC) feeding are controversial. Therefore, we examined the sequential effects of an HFC diet.

METHODS AND PROCEDURES

C57BL/6J mice were randomly assigned to consume either the control (C) or the HFC diet. Body weights and food intake were measured weekly and other measurements at weeks 2, 4, and 10. Microarrays were used for screening the transcriptional response of the livers at the three time points. Genes, encoding enzymes regulating key steps of lipid metabolism, were then selected from the microarray data for validation by quantitative real-time reverse-transcription polymerase chain reaction (qRT-PCR) and their protein expression by western blot assays.

RESULTS

Mice fed with HFC diet for 2 weeks showed no increase in food intake and no difference in weight gain compared to the C mice. At weeks 4 and 10, the HFC mice increased their food intake and gained more weight than their controls (by 1.4 times and 2.5 times, respectively) (P<0.01 at week 10). Genes involved in fatty acid oxidation (FAO) were initially upregulated and then downregulated, whereas the lipogenic genes and genes involved in cholesterol synthesis showed reverse trends. The differential mRNA expression of Cpt1L, Fas, and Hmgcr were confirmed by RT-PCR and their protein expression by western blot assays.

DISCUSSION

Our findings suggested that when mice were fed an HFC diet, they could develop initial compensatory response to resist the increased energy balance; however, a prolonged consumption of an HFC diet appeared to disrupt this adaptation.

Liraglutide, a once-daily human glucagon-like peptide-1 analog, minimizes food intake in severely obese minipigs

OBJECTIVES

To evaluate the efficacy of liraglutide, a new, stable, once-daily human analog of glucagon-like peptide-1, in a new animal model of obesity.

RESEARCH METHODS AND PROCEDURES

Liraglutide was administered subcutaneously once daily (7 microg/kg for 7 weeks) to six female obese Göttingen minipigs. Food intake and feeding patterns were monitored using a novel automated feeding system that allowed continuous recording of food intake.

RESULTS

Food intake was strongly suppressed. A steady-state level of reduced food intake was achieved within 3 weeks and was maintained for the remaining 4 weeks of the treatment period. During the 4-week steady-state period with liraglutide treatment, daily food intake was 7.3+/-0.3 megajoule (MJ) compared with 18.4+/-0.6 MJ in the pre-treatment period and 19.2+/-0.5 MJ in the post-treatment period (p<0.001). The food intake in the treatment period was equivalent to the amount of food that would have been offered to normal-weight pigs for maintenance. Body weight decreased 4.3+/-1.2 kg (4% to 5%) during the 7 weeks of treatment and increased 7.0+/-1.0 kg during the 7 weeks of post-treatment (p<0.01). Appetite suppression was quickly reversed within 4 days after termination of liraglutide administration.

DISCUSSION

Overall, liraglutide was well tolerated and had a profound and persistent anorectic effect that resulted in weight loss. These results, in conjunction with the previously established glucose-lowering efficacy of liraglutide, suggest that the anorectic actions of liraglutide will be very important in clinical trials of both obese patients with type 2 diabetes and obese non-diabetic patients.

Genetic manipulation in nutrition, metabolism, and obesity research

We summarize the current standard methods for overexpressing, inactivating, or manipulating genes, with special focus on nutritional and obesity research. These molecular biology procedures can be carried out with the maintenance of the genetic information to subsequent generations (transgenic technology) or devised to exclusively transfer the genetic material to a given target animal, which cannot be transmitted to the future progeny (gene therapy). On the other hand, the RNA interference (RNAi) approach allows for the creation of new experimental models by transient ablation of gene expression by degrading specific mRNA, which can be applied to assess different biological functions and mechanisms. The combination of these technologies contributes to the study of the function and regulation of different metabolism- and obesity-related genes as well as the identification of new pharmacologic targets for nutritional and therapeutic approaches.

Estudios sobre la obesidad en genes candidatos

There are more than 430 chromosomic regions with gene variants involved in body weight regulation and obesity development. Polymorphisms in genes related to energy expenditure--uncoupling proteins (UCPs), related to adipogenesis and insulin resistance--hormone-sensitive lipase (HLS), peroxisome proliferator-activated receptor gamma (PPAR gamma), beta adrenergic receptors (ADRB2,3), and alfa tumor necrosis factor (TNF-alpha), and related to food intake--ghrelin (GHRL)--appear to be associated with obesity phenotypes. Obesity risk depends on two factors: a) genetic variants in candidate genes, and b) biographical exposure to environmental risk factors. It is necessary to perform new studies, with appropriate control groups and designs, in order to reach relevant conclusions with regard to gene/environmental (diet, lifestyle) interactions.

DNA microarray analysis of genes differentially expressed in diet-induced (cafeteria) obese rats

OBJECTIVE

To better understand the molecular basis of dietary obesity, we examined adipose tissue genes differentially expressed in an obesity model using DNA microarray analysis.

RESEARCH METHODS AND PROCEDURES

We assessed the expression level of over 12,500 transcripts in epididymal fat pads from (cafeteria) obese and control rats with the aid of the array technology.

RESULTS

Cafeteria (obese) rats weighed 50% more and had 2.5-fold higher levels of epididymal fat and elevated levels of circulating leptin. Adipose genes differentially expressed in obese and control rats were categorized into five groups: macronutrient metabolism, transcription factors, hormone receptor and signal transduction, redox and stress proteins, and cellular cytoskeleton. Interestingly, the expression levels of a number of genes involved in lipid metabolism such as glycerol-3-phosphate dehydrogenase, stearoyl coenzyme A desaturase, together with the transcription factors implicated in adipocyte differentiation (CAAT/enhancer binding protein-alpha and peroxisome proliferator-activated receptor-gamma), were significantly increased in obese animals compared with control. The most up-regulated transcripts were the ob (49.2-fold change) and the fatty acid-binding protein genes (15.7- fold change). In contrast, genes related to redox and stress protein were generally down-regulated in obese animals compared with the control.

DISCUSSION

Our study showed that in diet-induced obesity, the expression levels of some important genes implicated in lipid metabolism were up-regulated, whereas those related to redox and stress protein were down-regulated in obese animals compared with control. This pattern of gene expression may occur in human obesity cases after high-fat intake.