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Karimi R, Yanovich A, Elbarbry F, Cleven A. Adaptive Effects of Endocrine Hormones on Metabolism of Macronutrients during Fasting and Starvation: A Scoping Review. Metabolites 2024; 14:336. [PMID: 38921471 PMCID: PMC11205672 DOI: 10.3390/metabo14060336] [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] [Revised: 06/08/2024] [Accepted: 06/12/2024] [Indexed: 06/27/2024] Open
Abstract
Food deprivation can occur for different reasons. Fasting (<24 h duration) occurs to meet religious or well-being goals. Starvation (>1-day duration) occurs when there is intentional (hunger strike or treatment of a medical condition) or unintentional (anorexia nervosa, drought, epidemic famine, war, or natural disaster) food deprivation. A scoping review was undertaken using the PubMed database to explore 1805 abstracts and review 88 eligible full-text articles to explore the adaptive relationships that emerge between cortisol, insulin, glucagon, and thyroid hormones on the metabolic pathways of macronutrients in humans during fasting and starvation. The collected data indicate that fasting and starvation prime the human body to increase cortisol levels and decrease the insulin/glucagon ratio and triiodothyronine (T3) levels. During fasting, increased levels of cortisol and a decreased insulin/glucagon ratio enhance glycogenolysis and reduce the peripheral uptake of glucose and glycogenesis, whereas decreased T3 levels potentially reduce glycogenolysis. During starvation, increased levels of cortisol and a decreased insulin/glucagon ratio enhance lipolysis, proteolysis, fatty acid and amino acid oxidation, ketogenesis, and ureagenesis, and decreased T3 levels reduce thermogenesis. We present a potential crosstalk between T3 and the above hormones, including between T3 and leptin, to extend their adaptive roles in the metabolism of endogenous macronutrients during food deprivation.
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Affiliation(s)
- Reza Karimi
- Pacific University School of Pharmacy, 222 SE 8th Avenue, HPC-Ste 451, Hillsboro, OR 97123, USA; (A.Y.); (F.E.); (A.C.)
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Stec K, Pilis K, Pilis W, Dolibog P, Letkiewicz S, Głębocka A. Effects of Fasting on the Physiological and Psychological Responses in Middle-Aged Men. Nutrients 2023; 15:3444. [PMID: 37571381 PMCID: PMC10421233 DOI: 10.3390/nu15153444] [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: 07/09/2023] [Revised: 07/28/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Tracking changes in the body during fasting takes into account indicators of mental well-being and physiological parameters. The aim of the study was to measure psychological and physiological reactions, along with their mutual relations, caused by 8 days of water-only fasting. Fourteen men aged 35 to 60 participated in the study, divided into two groups, younger and elder. In addition to physiological parameters, psychological data were collected using four different tests. The obtained results confirmed reduction in body weight, systolic blood pressure, resting diastolic blood pressure and glucose level, and increase in resting heart rate, cortisol and β-hydroxybutyrate concentration. However, no significant psychological changes were observed under the influence of fasting intervention. A significant interaction effect occurred for the state anxiety variable determined before and after the fasting intervention for both groups. Moreover, negative correlations between physiological (cortisol) and psychological factors of subjectively assessed stress were revealed. The only effect on cognitive ability was seen when responding to simple tasks. The study confirmed the beneficial effect of 8 days of water-only fasting on physiological variables without affecting mental well-being. The relatively high level of well-being after fasting intervention was independent of the physiological indicators of stress.
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Affiliation(s)
- Krzysztof Stec
- Collegium Medicum, Jan Dlugosz University in Czestochowa, ul. Waszyngtona 4/8, 42-200 Częstochowa, Poland; (K.S.); (W.P.); (S.L.)
| | - Karol Pilis
- Collegium Medicum, Jan Dlugosz University in Czestochowa, ul. Waszyngtona 4/8, 42-200 Częstochowa, Poland; (K.S.); (W.P.); (S.L.)
| | - Wiesław Pilis
- Collegium Medicum, Jan Dlugosz University in Czestochowa, ul. Waszyngtona 4/8, 42-200 Częstochowa, Poland; (K.S.); (W.P.); (S.L.)
| | - Paweł Dolibog
- Department of Biophysics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland;
- Institute of Health Sciences, University of Opole, 45-401 Opole, Poland
| | - Sławomir Letkiewicz
- Collegium Medicum, Jan Dlugosz University in Czestochowa, ul. Waszyngtona 4/8, 42-200 Częstochowa, Poland; (K.S.); (W.P.); (S.L.)
| | - Alicja Głębocka
- Department of Economy in Opole, WSB Merito University in Wroclaw, 53-609 Wroclaw, Poland;
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Nykänen T, Ojanen T, Vaara JP, Pihlainen K, Heikkinen R, Kyröläinen H, Fogelholm M. Energy Balance, Hormonal Status, and Military Performance in Strenuous Winter Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4086. [PMID: 36901097 PMCID: PMC10001933 DOI: 10.3390/ijerph20054086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Severe energy deficit may impair hormonal regulation and physical performance in military trainings. The aim of this study was to examine the associations between energy intake, expenditure, and balance, hormones and military performance during a winter survival training. Two groups were studied: the FEX group (n = 46) had 8-day garrison and field training, whereas the RECO group (n = 26) had a 36-h recovery period after the 6-day garrison and field training phase. Energy intake was assessed by food diaries, expenditure via heart rate variability, body composition by bioimpedance, and hormones by blood samples. Strength, endurance and shooting tests were done for evaluating military performance. PRE 0 d, MID 6 d, POST 8 d measurements were carried out. Energy balance was negative in PRE and MID (FEX -1070 ± 866, -4323 ± 1515; RECO -1427 ± 1200, -4635 ± 1742 kcal·d-1). In POST, energy balance differed between the groups (FEX -4222 ± 1815; RECO -608 ± 1107 kcal·d-1 (p < 0.001)), as well as leptin, testosterone/cortisol ratio, and endurance performance (p = 0.003, p < 0.001, p = 0.003, respectively). Changes in energy intake and expenditure were partially associated with changes in leptin and the testosterone/cortisol ratio, but not with physical performance variables. The 36-h recovery restored energy balance and hormonal status after strenuous military training, but these outcomes were not associated with strength or shooting performance.
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Affiliation(s)
- Tarja Nykänen
- Army Academy, Finnish Defence Forces, 53600 Lappeenranta, Finland
| | - Tommi Ojanen
- Finnish Defence Research Agency, Finnish Defence Forces, 04310 Tuusula, Finland
| | - Jani P. Vaara
- Department of Leadership and Military Pedagogy, National Defence University, Finnish Defence Forces, 00861 Helsinki, Finland
| | - Kai Pihlainen
- Defence Command, Finnish Defence Forces, 00130 Helsinki, Finland
| | - Risto Heikkinen
- Statistical Analysis Services, Analyysitoimisto Statisti Oy, 40720 Jyväskylä, Finland
| | - Heikki Kyröläinen
- Department of Leadership and Military Pedagogy, National Defence University, Finnish Defence Forces, 00861 Helsinki, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, 40114 Jyväskylä, Finland
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, 00014 Helsinki, Finland
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Ehrlicher SE, Chui TK, Clina JG, Ellison KM, Sayer RD. The Data Behind Popular Diets for Weight Loss. Med Clin North Am 2022; 106:739-766. [PMID: 36154698 DOI: 10.1016/j.mcna.2022.05.003] [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] [Indexed: 11/30/2022]
Abstract
Both scientific evidence and popular diet trends have sought to identify the ideal diet for weight loss with strategies focused on either restricting carbohydrates or fat. While there is a strong physiologic rationale for either carbohydrate restriction or fat restriction to achieve a calorie deficit needed for weight loss, evidence from randomized controlled trials suggest either type of diet is effective for weight loss. The level of adherence, rather than macronutrient content, is the driver of successful weight loss.
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Affiliation(s)
- Sarah E Ehrlicher
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 256, 1675 University Boulevard, Birmingham, AL 35294, USA.
| | - Tsz-Kiu Chui
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 630, 1675 University Blvd, Birmingham, AL 35294, USA
| | - Julianne G Clina
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 630, 1675 University Blvd, Birmingham, AL 35294, USA
| | - Katie M Ellison
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 630, 1675 University Blvd, Birmingham, AL 35294, USA
| | - R Drew Sayer
- Department of Nutrition Sciences, University of Alabama at Birmingham, Webb 634, 1675 University Boulevard, Birmingham, AL 35294, USA
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Hajipoor S, Hekmatdoost A, Pasdar Y, Mohammadi R, Alipour M, Rezaie M, Nachvak SM, Balthazar CF, Sobhiyeh MR, Mortazavian AM, Cruz AG. Consumption of probiotic yogurt and vitamin D‐fortified yogurt increases fasting level of GLP‐1 in obese adults undergoing low‐calorie diet: A double‐blind randomized controlled trial. Food Sci Nutr 2022; 10:3259-3271. [PMID: 36249978 PMCID: PMC9548356 DOI: 10.1002/fsn3.2816] [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: 05/28/2021] [Revised: 08/27/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022] Open
Abstract
Energy restriction and manipulation of macronutrient composition of the diet are the main approaches that are used by people who aim to lose weight. When such strategies are employed, appetite and endocrine regulators of satiety, such as gut peptides, all are deeply affected. The gut microbiota–brain axis controls energy homeostasis in humans by affecting central satiety and gut peptides. The purpose of this study was to evaluate if the synergistic effect of probiotics and vitamin D in yogurt matrix can modulate this effect. In the double‐blind, randomized, placebo‐controlled trial, 140 obese adults were randomly allocated into four groups: 1) regular yogurt plus low‐calorie diet; 2) PY plus low‐calorie diet; 3) vitamin D‐fortified yogurt plus low‐calorie diet, and 4) probiotic and vitamin D co‐fortified yogurt plus low‐calorie diet. All groups were encouraged to increase their physical activity. Glucagon‐like peptide‐1 (GLP‐1), peptide Tyrosin‐Tysrosin (PYY), ghrelin, anthropometric variables, insulin, fasting blood sugar (FBS), insulin resistance/sensitivity, 1,25(OH)2 D3, dietary intake, and physical activity were measured before and after 10 weeks. The difference between groups for GLP‐1 after 10 weeks was significant after adjusting for baseline GLP‐1 and protein intake as confounders. PY showed the largest effect size (ES) on GLP‐1 (p = 14.2) and FBS (p = 14) compared with others. Pairwise comparison of yogurts effect sizes on GLP‐1 showed a significant difference in group 1 vs. group 2 (p = .001), group 1 vs. group 3 (p = .003), and group 1 vs. group 4 (p = .048). Vitamin D‐fortified yogurt had the largest effect size on the serum level of vitamin D and it showed a significant difference with RY (p = .018) and PY (p = .002). Consumption of vitamin D‐fortified yogurt and PY could be regarded as a promising approach during calorie restriction.
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Affiliation(s)
- Shima Hajipoor
- Student Research Committee Department of Nutritional Sciences School of Nutritional Sciences and Food Technology Kermanshah University of Medical Sciences Kermanshah Iran
| | - Azita Hekmatdoost
- Department of Nutrition and Food Science Beheshti University of Medical Science Tehran Iran
| | - Yahya Pasdar
- Department of Nutritional Sciences School of Nutritional Sciences and Food Technology Kermanshah University of Medical Sciences Kermanshah Iran
| | - Reza Mohammadi
- Department of Food Science and Technology, School of Nutrition Sciences and Food Technology Kermanshah University of Medical Sciences Kermanshah Iran
| | - Meysam Alipour
- Department of Nutrition Shoushtar Faculty of Medical Sciences Shoushtar Iran
| | - Mansour Rezaie
- Research Centre for Environmental Determinacies of HealthHealth InstituteSchool of Public HealthKermanshah University of Medical Sciences Kermanshah Iran
| | - Seyed Mostafa Nachvak
- Department of Nutritional Sciences School of Nutritional Sciences and Food Technology Kermanshah University of Medical Sciences Kermanshah Iran
| | - Celso Fasura Balthazar
- Department of Food Technology Veterinary CollegeFederal Fluminense University Rio de Janeiro Brazil
| | - Mohammad Reza Sobhiyeh
- Vascular and Endovascular Surgeon Department of Surgery Imam Reza HospitalKermanshah University of Medical Science Kermanshah Iran
| | - Amir Mohammad Mortazavian
- Department of Food Science and Technology National Nutrition and Food Technology Research InstituteFaculty of Nutrition SciencesFood Science and TechnologyShahid Beheshti University of Medical Sciences Tehran Iran
| | - Adriano G. Cruz
- Instituto Federal de EducaçãoCiência e Tecnologia do Rio de Janeiro (IFRJ)Departamento de Alimentos Rio de Janeiro Brazil
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Very Low-Calorie Ketogenic Diet: A Potential Application in the Treatment of Hypercortisolism Comorbidities. Nutrients 2022; 14:nu14122388. [PMID: 35745118 PMCID: PMC9228456 DOI: 10.3390/nu14122388] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 12/24/2022] Open
Abstract
A very low-calorie ketogenic diet (VLCKD) is characterized by low daily caloric intake (less than 800 kcal/day), low carbohydrate intake (<50 g/day) and normoproteic (1−1.5 g of protein/kg of ideal body weight) contents. It induces a significant weight loss and an improvement in lipid parameters, blood pressure, glycaemic indices and insulin sensitivity in patients with obesity and type 2 diabetes mellitus. Cushing’s syndrome (CS) is characterized by an endogenous or exogenous excess of glucocorticoids and shows many comorbidities including cardiovascular disease, obesity, type 2 diabetes mellitus and lipid disorders. The aim of this speculative review is to provide an overview on nutrition in hypercortisolism and analyse the potential use of a VLCKD for the treatment of CS comorbidities, analysing the molecular mechanisms of ketogenesis.
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Nykänen T, Ojanen T, Heikkinen R, Fogelholm M, Kyröläinen H. Changes in Body Composition, Energy Metabolites and Electrolytes During Winter Survival Training in Male Soldiers. Front Physiol 2022; 13:797268. [PMID: 35250611 PMCID: PMC8889070 DOI: 10.3389/fphys.2022.797268] [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: 10/18/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to examine changes in body composition, energy metabolites and electrolytes during a 10-day winter survival training period. Two groups of male soldiers were examined: the REC group (n = 26; age 19.7 ± 1.2 years; BMI 23.9 ± 2.7) had recovery period between days 6 and 8 in the survival training, whereas the EXC group (n = 42; age 19.6 ± 0.8 years; BMI 23.1 ± 2.8) did not. The following data were collected: body composition (bioimpedance), energy balance (food diaries, heart rate variability measurements), and biomarkers (blood samples). In survival training, estimated energy balance was highly negative: −4,323 ± 1,515 kcal/d (EXC) and −4,635 ± 1,742 kcal/d (REC). Between days 1 and 10, body mass decreased by 3.9% (EXC) and 3.0% (REC). On day 6, free fatty acid and urea levels increased, whereas leptin, glucose and potassium decreased in all. Recovery period temporarily reversed some of the changes (body mass, leptin, free fatty acids, and urea) toward baseline levels. Survival training caused a severe energy deficit and reductions in body mass. The early stage of military survival training seems to alter energy, hormonal and fluid metabolism, but these effects disappear after an active recovery period.
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Affiliation(s)
- Tarja Nykänen
- Army Academy, Finnish Defence Forces, Lappeenranta, Finland
- *Correspondence: Tarja Nykänen,
| | - Tommi Ojanen
- Finnish Defence Research Agency, Finnish Defence Forces, Tuusula, Finland
| | - Risto Heikkinen
- Statistical Analysis Services, Analyysitoimisto Statisti Oy, Jyväskylä, Finland
| | - Mikael Fogelholm
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Heikki Kyröläinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- Finnish Defence Forces, National Defence University, Helsinki, Finland
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Buso MEC, Seimon RV, McClintock S, Muirhead R, Atkinson FS, Brodie S, Dodds J, Zibellini J, Das A, Wild-Taylor AL, Burk J, Fogelholm M, Raben A, Brand-Miller JC, Sainsbury A. Can a Higher Protein/Low Glycemic Index vs. a Conventional Diet Attenuate Changes in Appetite and Gut Hormones Following Weight Loss? A 3-Year PREVIEW Sub-study. Front Nutr 2021; 8:640538. [PMID: 33829034 PMCID: PMC8019730 DOI: 10.3389/fnut.2021.640538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/12/2021] [Indexed: 01/06/2023] Open
Abstract
Background: Previous research showed that weight-reducing diets increase appetite sensations and/or circulating ghrelin concentrations for up to 36 months, with transient or enduring perturbations in circulating concentrations of the satiety hormone peptide YY. Objective: This study assessed whether a diet that is higher in protein and low in glycemic index (GI) may attenuate these changes. Methods: 136 adults with pre-diabetes and a body mass index of ≥25 kg/m2 underwent a 2-month weight-reducing total meal replacement diet. Participants who lost ≥8% body weight were randomized to one of two 34-month weight-maintenance diets: a higher-protein and moderate-carbohydrate (CHO) diet with low GI, or a moderate-protein and higher-CHO diet with moderate GI. Both arms involved recommendations to increase physical activity. Fasting plasma concentrations of total ghrelin and total peptide YY, and appetite sensations, were measured at 0 months (pre-weight loss), at 2 months (immediately post-weight loss), and at 6, 12, 24, and 36 months. Results: There was a decrease in plasma peptide YY concentrations and an increase in ghrelin after the 2-month weight-reducing diet, and these values approached pre-weight-loss values by 6 and 24 months, respectively (P = 0.32 and P = 0.08, respectively, vs. 0 months). However, there were no differences between the two weight-maintenance diets. Subjective appetite sensations were not affected by the weight-reducing diet nor the weight-maintenance diets. While participants regained an average of ~50% of the weight they had lost by 36 months, the changes in ghrelin and peptide YY during the weight-reducing phase did not correlate with weight regain. Conclusion: A higher-protein, low-GI diet for weight maintenance does not attenuate changes in ghrelin or peptide YY compared with a moderate-protein, moderate-GI diet. Clinical Trial Registry:ClinicalTrials.gov registry ID NCT01777893 (PREVIEW) and ID NCT02030249 (Sub-study).
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Affiliation(s)
- Marion E C Buso
- Division of Human Nutrition and Health, Wageningen University, Wageningen, Netherlands.,The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Radhika V Seimon
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Sally McClintock
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Roslyn Muirhead
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Fiona S Atkinson
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Shannon Brodie
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Jarron Dodds
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Jessica Zibellini
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Arpita Das
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Anthony L Wild-Taylor
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Jessica Burk
- The Boden Collaboration for Obesity, Nutrition, Exercise, and Eating Disorders, Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Mikael Fogelholm
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Anne Raben
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.,Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Jennie C Brand-Miller
- School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda Sainsbury
- School of Human Sciences, Faculty of Science, The University of Western Australia, Crawley, WA, Australia
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Schmalbach I, Herhaus B, Pässler S, Runst S, Berth H, Wolff-Stephan S, Petrowski K. Cortisol reactivity in patients with anorexia nervosa after stress induction. Transl Psychiatry 2020; 10:275. [PMID: 32778654 PMCID: PMC7417562 DOI: 10.1038/s41398-020-00955-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 12/15/2022] Open
Abstract
There is a need of experimental studies on biomarkers in patients with anorexia nervosa (PAN), especially in the context of stress, in order to foster understanding in illness maintenance. To this end, the cortisol response to an acute stressor was investigated in n = 26 PAN (BMI: 19.3 ± 3.4 kg/m2), age, and gender matched to n = 26 healthy controls (HC; BMI: 23.08 ± 3.3 kg/m2). For this purpose, salivary cortisol parameters were assessed in two experimental conditions: (1) rest/no intervention and (2) stress intervention (TSST; Trier Social Stress Test). In addition, psychological indicators of stress were assessed (Primary Appraisal Secondary Appraisal, Visual Analogue Scale, and Trier Inventory for the assessment of Chronic Stress), as well as psychological distress, depression, and eating disorder (ED) symptoms. A 2 × 2 × 8 ANOVA demonstrated elevated cortisol levels in PAN in the resting condition. In the stress intervention no significant group effect in terms of cortisol (F (1, 50) = 0.69; p = 0.410; [Formula: see text]). A significant condition (F (1, 50) = 20.50; p = 0.000; [Formula: see text]) and time effect (F(2.71, 135.44) = 11.27; p = 0.000; [Formula: see text]) were revealed, as well as two significant interaction effects. First: Condition × group (F (1, 50) = 4.17, p = 0.046; [Formula: see text]) and second: Condition × time (F (2.71, 135.44) = 16.07, p = 0.000, [Formula: see text]). In terms of AUCG, no significant differences between both groups were exhibited. Regardless, significant results were evinced in terms of an increase (AUCi: F(1, 50) = 20.66, p = 0.015, [Formula: see text]), baseline to peak (+20 min post-TSST: t5 = 16.51 (9.02), p = 0.029) and reactivity (MPAN = 0.73 vs. MHC = 4.25, p = 0.036). In addition, a significant correlation between AUCG and BMI: r (24) = -0.42, p = 0.027 was demonstrated, but not between AUCi and BMI (r (24) = -0.26, p = 0.20). Psychological indices suggested higher levels of chronic and perceived stress in PAN relative to HC. However, stress perception in the stress condition (VAS) was comparable. Additional analyses demonstrated that ED-symptoms are highly correlated with psychological distress and depression, but not with BMI. In addition, it could be demonstrated that reactivity is rather related to ED-symptoms and psychological burden than to BMI. In conclusion, PAN showed elevated basal cortisol levels at rest and exhibited a blunted cortisol reactivity to the TSST as evinced by salivary cortisol parameters. Further, it was shown that weight recovery influences reversibility of hypercortisolemia, i.e., cortisol levels normalize with weight gain. However, HPAA (hypothalamus-pituitary-adrenal axis) irregularities in terms of reactivity persist even at a BMI ≤ 19.3 (±3.4). Our data suggest that pronounced psychological burden in PAN, have a greater impact on the HPAA functionality (secondary to the ED) than BMI itself.
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Affiliation(s)
- Ileana Schmalbach
- Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany. .,Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Dresden, Germany.
| | - Benedict Herhaus
- grid.5802.f0000 0001 1941 7111Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Sebastian Pässler
- grid.412282.f0000 0001 1091 2917University Hospital Carl Gustav Carus Dresden, Department of Psychotherapy and Psychosomatic Medicine, Dresden, Germany
| | - Sarah Runst
- grid.412282.f0000 0001 1091 2917University Hospital Carl Gustav Carus Dresden, Department of Psychotherapy and Psychosomatic Medicine, Dresden, Germany
| | - Hendrik Berth
- grid.4488.00000 0001 2111 7257Technische Universität Dresden, Carl Gustav Carus Faculty of Medicine, Division of Psychological and Social Medicine and Developmental Neurosciences, Research Group Applied Medical Psychology and Medical Sociology, Dresden, Germany
| | - Silvia Wolff-Stephan
- grid.412282.f0000 0001 1091 2917University Hospital Carl Gustav Carus Dresden, Department of Psychotherapy and Psychosomatic Medicine, Dresden, Germany
| | - Katja Petrowski
- grid.5802.f0000 0001 1941 7111Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany ,grid.412282.f0000 0001 1091 2917University Hospital Carl Gustav Carus Dresden, Department of Psychotherapy and Psychosomatic Medicine, Dresden, Germany
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10
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A review of the short- and long-term impact of weight loss on appetite in youth: what do we know and where to from here? Proc Nutr Soc 2020; 79:357-366. [PMID: 32517831 DOI: 10.1017/s0029665120007028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This review seeks to synthesise our knowledge about changes in hunger and satiety that occur during diet-induced weight loss and during weight loss maintenance, with a particular focus on youth with obesity. Mechanisms of appetite responses to weight loss rely heavily on the adult literature. Physiological mechanisms that control appetite and satiety via the gut-brain axis have been elucidated but we have an incomplete picture of changes in gut hormones and peptides in youth with obesity. In adolescents, the role of the brain in long-term sensing of body composition and modifying appetite and satiety changes is easily over-ridden by hedonic influences for the reward of highly palatable sweet foods and encourages over-consumption. Accordingly, reward cues and hyper-responsiveness to palatable foods lead to a pattern of food choices. Different reward systems are necessary that are substantial enough to reward the continued individual effort required to sustain new behaviours, that need to be adopted to support a reduced body weight. Periods of growth and development during childhood provide windows of opportunity for interventions to influence body weight trajectory but long-term studies are lacking. More emphasis needs to be placed on anticipatory guidance on how to manage powerful hedonic influences of food choice, essential to cope with living in our obesogenic environment and managing hunger which comes with the stronger desire to eat after weight has been lost.
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Abstract
Obesity and type 2 diabetes are the most frequent metabolic disorders, but their causes remain largely unclear. Insulin resistance, the common underlying abnormality, results from imbalance between energy intake and expenditure favouring nutrient-storage pathways, which evolved to maximize energy utilization and preserve adequate substrate supply to the brain. Initially, dysfunction of white adipose tissue and circulating metabolites modulate tissue communication and insulin signalling. However, when the energy imbalance is chronic, mechanisms such as inflammatory pathways accelerate these abnormalities. Here we summarize recent studies providing insights into insulin resistance and increased hepatic gluconeogenesis associated with obesity and type 2 diabetes, focusing on data from humans and relevant animal models.
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12
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Palau-Rodriguez M, Garcia-Aloy M, Miñarro A, Bernal-Lopez MR, Brunius C, Gómez-Huelgas R, Landberg R, Tinahones FJ, Andres-Lacueva C. Effects of a long-term lifestyle intervention on metabolically healthy women with obesity: Metabolite profiles according to weight loss response. Clin Nutr 2019; 39:215-224. [PMID: 30862367 DOI: 10.1016/j.clnu.2019.01.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/13/2019] [Accepted: 01/15/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS The benefits of weight loss in subjects with metabolically healthy obesity (MHO) are still a matter of controversy. We aimed to identify metabolic fingerprints and their associated pathways that discriminate women with MHO with high or low weight loss response after a lifestyle intervention, based on a hypocaloric Mediterranean diet (MedDiet) and physical activity. METHODS A UPLC-Q-Exactive-MS/MS metabolomics workflow was applied to plasma samples from 27 women with MHO before and after 12 months of a hypocaloric weight loss intervention with a MedDiet and increased physical activity. The subjects were stratified into two age-matched groups according to weight loss: <10% (low weight loss group, LWL) and >10% (high weight loss group, HWL). Random forest analysis was performed to identify metabolites discriminating between the LWL and the HWL as well as within-status effects. Modulated pathways and associations between metabolites and anthropometric and biochemical variables were also investigated. RESULTS Thirteen metabolites discriminated between the LWL and the HWL, including 1,5-anhydroglucitol, carotenediol, 3-(4-hydroxyphenyl)lactic acid, N-acetylaspartate and several lipid species (steroids, a plasmalogen, sphingomyelins, a bile acid and long-chain acylcarnitines). 1,5-anhydroglucitol, 3-(4-hydroxyphenyl)lactic acid and sphingomyelins were positively associated with weight variables whereas N-acetylaspartate and the plasmalogen correlated negatively with them. Changes in very long-chain acylcarnitines and hydroxyphenyllactic levels were observed in the HWL and positively correlated with fasting glucose, and changes in levels of the plasmalogen negatively correlated with insulin resistance. Additionally, the cholesterol profile was positively associated with changes in acid hydroxyphenyllactic, sphingolipids and 1,5-AG. CONCLUSIONS Higher weight loss after a hypocaloric MedDiet and increased physical activity for 12 months is associated with changes in the plasma metabolome in women with MHO. These findings are associated with changes in biochemical variables and may suggest an improvement of the cardiometabolic risk profile in those patients that lose greater weight. Further studies are needed to investigate whether the response of those subjects with MHO to this intervention differs from those with unhealthy obesity.
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Affiliation(s)
- Magali Palau-Rodriguez
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Mar Garcia-Aloy
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028, Barcelona, Spain
| | - Antonio Miñarro
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029, Madrid, Spain; Genetics, Microbiology and Statistics Department, Biology Faculty, University of Barcelona, Barcelona, 08028, Spain
| | - M Rosa Bernal-Lopez
- Internal Medicine Department, Biomedical Institute of Malaga (IBIMA), Regional University Hospital of Malaga (Carlos Haya Hospital), 29010, Malaga, Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Carl Brunius
- Department of Biology and Biological Engineering, Chalmers University of Technology, 412 58, Göteborg, Sweden
| | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Biomedical Institute of Malaga (IBIMA), Regional University Hospital of Malaga (Carlos Haya Hospital), 29010, Malaga, Spain; Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Rikard Landberg
- Department of Biology and Biological Engineering, Chalmers University of Technology, 412 58, Göteborg, Sweden
| | - Francisco J Tinahones
- Ciber Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029, Madrid, Spain; Endocrinology and Nutrition Department, Biomedical Institute of Malaga (IBIMA), Regional University Hospital of Malaga (Virgen de la Victoria Hospital), 29010, Malaga, Spain
| | - Cristina Andres-Lacueva
- Biomarkers and Nutrimetabolomics Laboratory, Department of Nutrition, Food Sciences and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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13
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Metabolic adaptations during negative energy balance and their potential impact on appetite and food intake. Proc Nutr Soc 2019; 78:279-289. [DOI: 10.1017/s0029665118002811] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This review examines the metabolic adaptations that occur in response to negative energy balance and their potential putative or functional impact on appetite and food intake. Sustained negative energy balance will result in weight loss, with body composition changes similar for different dietary interventions if total energy and protein intake are equated. During periods of underfeeding, compensatory metabolic and behavioural responses occur that attenuate the prescribed energy deficit. While losses of metabolically active tissue during energy deficit result in reduced energy expenditure, an additional down-regulation in expenditure has been noted that cannot be explained by changes in body tissue (e.g. adaptive thermogenesis). Sustained negative energy balance is also associated with an increase in orexigenic drive and changes in appetite-related peptides during weight loss that may act as cues for increased hunger and food intake. It has also been suggested that losses of fat-free mass (FFM) could also act as an orexigenic signal during weight loss, but more data are needed to support these findings and the signalling pathways linking FFM and energy intake remain unclear. Taken together, these metabolic and behavioural responses to weight loss point to a highly complex and dynamic energy balance system in which perturbations to individual components can cause co-ordinated and inter-related compensatory responses elsewhere. The strength of these compensatory responses is individually subtle, and early identification of this variability may help identify individuals that respond well or poorly to an intervention.
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14
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Effects of 2-day calorie restriction on cardiovascular autonomic response, mood, and cognitive and motor functions in obese young adult women. Exp Brain Res 2018; 236:2299-2308. [DOI: 10.1007/s00221-018-5305-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/01/2018] [Indexed: 12/19/2022]
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15
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Beeler JA, Mourra D. To Do or Not to Do: Dopamine, Affordability and the Economics of Opportunity. Front Integr Neurosci 2018; 12:6. [PMID: 29487508 PMCID: PMC5816947 DOI: 10.3389/fnint.2018.00006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 01/26/2018] [Indexed: 12/21/2022] Open
Abstract
Five years ago, we introduced the thrift hypothesis of dopamine (DA), suggesting that the primary role of DA in adaptive behavior is regulating behavioral energy expenditure to match the prevailing economic conditions of the environment. Here we elaborate that hypothesis with several new ideas. First, we introduce the concept of affordability, suggesting that costs must necessarily be evaluated with respect to the availability of resources to the organism, which computes a value not only for the potential reward opportunity, but also the value of resources expended. Placing both costs and benefits within the context of the larger economy in which the animal is functioning requires consideration of the different timescales against which to compute resource availability, or average reward rate. Appropriate windows of computation for tracking resources requires corresponding neural substrates that operate on these different timescales. In discussing temporal patterns of DA signaling, we focus on a neglected form of DA plasticity and adaptation, changes in the physical substrate of the DA system itself, such as up- and down-regulation of receptors or release probability. We argue that changes in the DA substrate itself fundamentally alter its computational function, which we propose mediates adaptations to longer temporal horizons and economic conditions. In developing our hypothesis, we focus on DA D2 receptors (D2R), arguing that D2R implements a form of “cost control” in response to the environmental economy, serving as the “brain’s comptroller”. We propose that the balance between the direct and indirect pathway, regulated by relative expression of D1 and D2 DA receptors, implements affordability. Finally, as we review data, we discuss limitations in current approaches that impede fully investigating the proposed hypothesis and highlight alternative, more semi-naturalistic strategies more conducive to neuroeconomic investigations on the role of DA in adaptive behavior.
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Affiliation(s)
- Jeff A Beeler
- Department of Psychology, Queens College, City University of New York, New York, NY, United States.,CUNY Neuroscience Consortium, The Graduate Center, City University of New York, New York, NY, United States
| | - Devry Mourra
- Department of Psychology, Queens College, City University of New York, New York, NY, United States.,CUNY Neuroscience Consortium, The Graduate Center, City University of New York, New York, NY, United States
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Perry RJ, Wang Y, Cline GW, Rabin-Court A, Song JD, Dufour S, Zhang XM, Petersen KF, Shulman GI. Leptin Mediates a Glucose-Fatty Acid Cycle to Maintain Glucose Homeostasis in Starvation. Cell 2018; 172:234-248.e17. [PMID: 29307489 PMCID: PMC5766366 DOI: 10.1016/j.cell.2017.12.001] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 09/09/2017] [Accepted: 11/29/2017] [Indexed: 02/02/2023]
Abstract
The transition from the fed to the fasted state necessitates a shift from carbohydrate to fat metabolism that is thought to be mostly orchestrated by reductions in plasma insulin concentrations. Here, we show in awake rats that insulinopenia per se does not cause this transition but that both hypoleptinemia and insulinopenia are necessary. Furthermore, we show that hypoleptinemia mediates a glucose-fatty acid cycle through activation of the hypothalamic-pituitary-adrenal axis, resulting in increased white adipose tissue (WAT) lipolysis rates and increased hepatic acetyl-coenzyme A (CoA) content, which are essential to maintain gluconeogenesis during starvation. We also show that in prolonged starvation, substrate limitation due to reduced rates of glucose-alanine cycling lowers rates of hepatic mitochondrial anaplerosis, oxidation, and gluconeogenesis. Taken together, these data identify a leptin-mediated glucose-fatty acid cycle that integrates responses of the muscle, WAT, and liver to promote a shift from carbohydrate to fat oxidation and maintain glucose homeostasis during starvation.
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Affiliation(s)
- Rachel J Perry
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Yongliang Wang
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Gary W Cline
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Aviva Rabin-Court
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Joongyu D Song
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Sylvie Dufour
- Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Xian Man Zhang
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Kitt Falk Petersen
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Gerald I Shulman
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520, USA; Department of Cellular & Molecular Physiology, Yale University School of Medicine, New Haven, CT 06520, USA; Howard Hughes Medical Institute, Yale University School of Medicine, New Haven, CT 06520, USA.
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17
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Hopkins M, Beaulieu K, Myers A, Gibbons C, Blundell JE. Mechanisms responsible for homeostatic appetite control: theoretical advances and practical implications. Expert Rev Endocrinol Metab 2017; 12:401-415. [PMID: 30063436 DOI: 10.1080/17446651.2017.1395693] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Homeostatic appetite control is part of a psychobiological system that has evolved to maintain an adequate supply of nutrients for growth and maintenance. The system links the physiological needs for energy with the behaviour that satisfies these needs (feeding), and is shaped by excitatory and inhibitory signals. Owing to rapid shifts in the food environment, homeostatic appetite control is not well adapted for modern-day human functioning. Areas covered: Homeostatic appetite control has two divisions. Tonic processes exert stable and enduring influences, with signals arising from bodily tissues and metabolism. Episodic processes fluctuate rapidly and are related to nutrient ingestion and the composition of foods consumed. Research in these areas incorporates potent endocrine signals that can influence behaviour. Expert commentary: The regulation of adipose tissue, and its impact on appetite (energy) homeostasis, has been heavily researched. More recently however, it has been demonstrated that fat-free mass has the potential to act as a tonic driver of food intake. A challenging issue is to determine how the post-prandial action of episodic satiety hormones and gastrointestinal mechanisms can effectively brake the metabolic drive to eat, in order to keep food intake under control and prevent a positive energy balance and fat accumulation.
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Affiliation(s)
- Mark Hopkins
- a School of Food Science and Nutrition, Faculty of Mathematics and Physical Sciences , University of Leeds , Leeds , UK
| | - Kristine Beaulieu
- b School of Psychology, Faculty of Medicine and Health , University of Leeds , Leeds , UK
| | - Anna Myers
- b School of Psychology, Faculty of Medicine and Health , University of Leeds , Leeds , UK
| | - Catherine Gibbons
- b School of Psychology, Faculty of Medicine and Health , University of Leeds , Leeds , UK
| | - John E Blundell
- b School of Psychology, Faculty of Medicine and Health , University of Leeds , Leeds , UK
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18
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Timeline of changes in appetite during weight loss with a ketogenic diet. Int J Obes (Lond) 2017; 41:1224-1231. [PMID: 28439092 PMCID: PMC5550564 DOI: 10.1038/ijo.2017.96] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/22/2017] [Accepted: 04/02/2017] [Indexed: 12/25/2022]
Abstract
Background/objective: Diet-induced weight loss (WL) leads to increased hunger and reduced fullness feelings, increased ghrelin and reduced satiety peptides concentration (glucagon-like peptide-1 (GLP-1), cholecystokinin (CCK) and peptide YY (PYY)). Ketogenic diets seem to minimise or supress some of these responses. The aim of this study was to determine the timeline over which changes in appetite occur during progressive WL with a ketogenic very-low-energy diet (VLED). Subjects/methods: Thirty-one sedentary adults (18 men), with obesity (body mass index: 37±4.5 kg m−2) underwent 8 weeks (wks) of a VLED followed by 4 wks of weight maintenance. Body weight and composition, subjective feelings of appetite and appetite-related hormones (insulin, active ghrelin (AG), active GLP-1, total PYY and CCK) were measured in fasting and postprandially, at baseline, on day 3 of the diet, 5 and 10% WL, and at wks 9 and 13. Data are shown as mean±s.d. Results: A significant increase in fasting hunger was observed by day 3 (2±1% WL), (P<0.01), 5% WL (12±8 days) (P<0.05) and wk 13 (17±2% WL) (P<0.05). Increased desire to eat was observed by day 3 (P<0.01) and 5% WL (P<0.05). Postprandial prospective food consumption was significantly reduced at wk 9 (16±2% WL) (P<0.01). Basal total PYY was significantly reduced at 10% WL (32±8 days) (P<0.05). Postprandial active GLP-1 was increased at 5% WL (P<0.01) and CCK reduced at 5 and 10% WL (P<0.01, for both) and wk 9 (P<0.001). Basal and postprandial AG were significantly increased at wk 13 (P<0.001, both). Conclusions: WL with a ketogenic VLED transiently increases the drive to eat up to 3 weeks (5% WL). After that, and while participants are ketotic, a 10–17% WL is not associated with increased appetite. However, hunger feelings and AG concentrations increase significantly from baseline, once refeeding occurs.
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19
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Clayton DJ, Burrell K, Mynott G, Creese M, Skidmore N, Stensel DJ, James LJ. Effect of 24-h severe energy restriction on appetite regulation and ad libitum energy intake in lean men and women. Am J Clin Nutr 2016; 104:1545-1553. [PMID: 27806971 DOI: 10.3945/ajcn.116.136937] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/03/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Intermittent severe energy restriction (SER) can induce substantial weight loss, but the appetite regulatory responses to SER are unknown and may dictate long-term dietary adherence. OBJECTIVE We determined the effect of 24-h SER on appetite regulation, metabolism, and energy intake. DESIGN Eighteen lean men and women completed two 3-d trials in randomized, counterbalanced order. On day 1 subjects consumed standardized diets containing 100% (mean ± SD: 9.3 ± 1.3 MJ; energy balance) or 25% [2.3 ± 0.3 MJ; energy restriction (ER)] of energy requirements. On day 2, a standardized breakfast was consumed, with plasma concentrations of acylated ghrelin, glucagon-like peptide 1, insulin, glucose, and nonesterified fatty acids determined for 4 h. Ad libitum energy intake was assessed at lunch and dinner with subjective appetite and resting metabolism assessed throughout. On day 3, ad libitum energy intake was assessed at breakfast and by weighed food records. RESULTS Energy intake was 7% greater on day 2 (P < 0.05) during ER but not significantly different on day 3 (P = 0.557). Subjective appetite was greater during ER on the morning of day 2 (P < 0.05) but was not significantly different thereafter (P > 0.145). During ER, postprandial concentrations of acylated ghrelin were lower (P < 0.05), whereas glucose (P < 0.05) and nonesterified fatty acids (P < 0.0001) were higher. Postprandial glucagon-like peptide 17-36 (P = 0.784) and insulin (P = 0.06) concentrations were not significantly different between trials. Energy expenditure was lower during ER in the morning (P < 0.01). CONCLUSIONS In lean young adults, 24-h SER transiently elevated subjective appetite and marginally increased energy intake, but hormonal appetite markers did not respond in a manner indicative of hyperphagia. These results suggest that intermittent SER might be useful to attenuate energy intake and control body weight in this population. This trial was registered at www.clinicaltrials.gov.uk as NCT02696772.
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Affiliation(s)
- David J Clayton
- School of Sport, Exercise and Health Science, Loughborough University, Loughborough, United Kingdom
| | - Kirsty Burrell
- School of Sport, Exercise and Health Science, Loughborough University, Loughborough, United Kingdom
| | - Georgina Mynott
- School of Sport, Exercise and Health Science, Loughborough University, Loughborough, United Kingdom
| | - Mark Creese
- School of Sport, Exercise and Health Science, Loughborough University, Loughborough, United Kingdom
| | - Nicola Skidmore
- School of Sport, Exercise and Health Science, Loughborough University, Loughborough, United Kingdom
| | - David J Stensel
- School of Sport, Exercise and Health Science, Loughborough University, Loughborough, United Kingdom
| | - Lewis J James
- School of Sport, Exercise and Health Science, Loughborough University, Loughborough, United Kingdom
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20
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Smith TJ, Wilson MA, Karl JP, Austin K, Bukhari A, Pasiakos SM, O’Connor KL, Lieberman HR. Interstitial glucose concentrations and hypoglycemia during 2 days of caloric deficit and sustained exercise: a double-blind, placebo-controlled trial. J Appl Physiol (1985) 2016; 121:1208-1216. [DOI: 10.1152/japplphysiol.00432.2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 09/06/2016] [Accepted: 09/26/2016] [Indexed: 11/22/2022] Open
Abstract
Military personnel and some athlete populations endure short-term energy deficits from reduced energy intake and/or increased energy expenditure (EE) that may degrade physical and cognitive performance due to severe hypoglycemia (<3.1 mmol/l). The extent to which energy deficits alter normoglycemia (3.9–7.8 mmol/l) in healthy individuals is not known, since prior studies measured glucose infrequently, not continuously. The purpose of this study was to characterize the glycemic response to acute, severe energy deficit compared with fully fed control condition, using continuous glucose monitoring (CGM). For 2 days during a double-blind, placebo-controlled, crossover study, 23 volunteers (17 men/6 women; age: 21.3 ± 3.0 yr; body mass index: 25 ± 3 kg/m) increased habitual daily EE [2,300 ± 450 kcal/day [means ± SD)] by 1,647 ± 345 kcal/day through prescribed exercise (~3 h/day; 40–65% peak O2 consumption), and consumed diets designed to maintain energy balance (FED) or induce 93% energy deficit (DEF). Interstitial glucose concentrations were measured continuously by CGM (Medtronic Minimed). Interstitial glucose concentrations were 1.0 ± 0.9 mmol/l lower during DEF vs. FED ( P < 0.0001). The percentage of time spent in mild (3.1–3.8 mmol/l) hypoglycemia was higher during DEF compared with FED [mean difference = 20.5%; 95% confidence interval (CI): 13.1%, 27.9%; P = 0.04], while time spent in severe (<3.1 mmol/l) hypoglycemia was not different between interventions (mean difference = 4.6%; 95% CI: −0.6%, 9.8%; P = 0.10). Three of 23 participants spontaneously reported symptoms (e.g., nausea) potentially related to hypoglycemia during DEF, and an additional participant reported symptoms during both interventions. These findings suggest that severe hypoglycemia rarely occurs in healthy individuals enduring severe, short-term energy deficit secondary to heavy exercise and inadequate energy intake.
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Affiliation(s)
- Tracey J. Smith
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Marques A. Wilson
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - J. Philip Karl
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Krista Austin
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Asma Bukhari
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Stefan M. Pasiakos
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Kristie L. O’Connor
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
| | - Harris R. Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, Natick, Massachusetts
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Clayton DJ, Creese M, Skidmore N, Stensel DJ, James LJ. No effect of 24 h severe energy restriction on appetite regulation and ad libitum energy intake in overweight and obese males. Int J Obes (Lond) 2016; 40:1662-1670. [PMID: 27339607 DOI: 10.1038/ijo.2016.106] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/14/2016] [Accepted: 05/02/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND/OBJECTIVES Long-term success of weight loss diets might depend on how the appetite regulatory system responds to energy restriction (ER). This study determined the effect of 24 h severe ER on subjective and hormonal appetite regulation, subsequent ad libitum energy intake and metabolism. SUBJECTS/METHODS In randomised order, eight overweight or obese males consumed a 24 h diet containing either 100% (12105 (1174 kJ; energy balance; EB) or 25% (3039 (295) kJ; ER) of estimated daily energy requirements (EER). An individualised standard breakfast containing 25% of EER (3216 (341) kJ) was consumed the following morning and resting energy expenditure, substrate utilisation and plasma concentrations of acylated ghrelin, glucagon-like peptide-1 (GLP-17-36), glucose-dependant insulinotropic peptide (GIP1-42), glucose, insulin and non-esterified fatty acid (NEFA) were determined for 4 h after breakfast. Ad libitum energy intake was assessed in the laboratory on day 2 and via food records on day 3. Subjective appetite was assessed throughout. RESULTS Energy intake was not different between trials for day 2 (EB: 14946 (1272) kJ; ER: 15251 (2114) kJ; P=0.623), day 3 (EB: 10580 (2457) kJ; 10812 (4357) kJ; P=0.832) or day 2 and 3 combined (P=0.693). Subjective appetite was increased during ER on day 1 (P<0.01), but was not different between trials on day 2 (P>0.381). Acylated ghrelin, GLP-17-36 and insulin were not different between trials (P>0.104). Post-breakfast area under the curve (AUC) for NEFA (P<0.05) and GIP1-42 (P<0.01) were greater during ER compared with EB. Fat oxidation was greater (P<0.01) and carbohydrate oxidation was lower (P<0.01) during ER, but energy expenditure was not different between trials (P=0.158). CONCLUSIONS These results suggest that 24 h severe ER does not affect appetite regulation or energy intake in the subsequent 48 h. This style of dieting may be conducive to maintenance of a negative EB by limiting compensatory eating behaviour, and therefore may assist with weight loss.
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Affiliation(s)
- D J Clayton
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - M Creese
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - N Skidmore
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - D J Stensel
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - L J James
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
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Karl JP, Smith TJ, Wilson MA, Bukhari AS, Pasiakos SM, McClung HL, McClung JP, Lieberman HR. Altered metabolic homeostasis is associated with appetite regulation during and following 48-h of severe energy deprivation in adults. Metabolism 2016; 65:416-27. [PMID: 26975533 DOI: 10.1016/j.metabol.2015.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/29/2015] [Accepted: 11/04/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Military personnel frequently endure intermittent periods of severe energy deficit which can compromise health and performance. Physiologic factors contributing to underconsumption, and the subsequent drive to overeat, are not fully characterized. This study aimed to identify associations between appetite, metabolic homeostasis and endocrine responses during and following severe, short-term energy deprivation. METHODS Twenty-three young adults (17M/6F, 21±3years, BMI 25±3kg/m(2)) participated in a randomized, controlled, crossover trial. During separate 48-h periods, participants increased habitual energy expenditure by 1647±345kcal/d (mean±SD) through prescribed exercise at 40-65% VO2peak, and consumed provided isovolumetric diets designed to maintain energy balance at the elevated energy expenditure (EB; 36±93kcal/d energy deficit) or to produce a severe energy deficit (ED; 3681±716kcal/d energy deficit). Appetite, markers of metabolic homeostasis and endocrine mediators of appetite and substrate availability were periodically measured. Ad libitum energy intake was measured over 36h following both experimental periods. RESULTS Appetite increased during ED and was greater than during EB despite maintenance of diet volume (P=0.004). Ad libitum energy intake was 907kcal/36h [95% CI: 321, 1493kcal/36h, P=0.004] higher following ED compared to following EB. Serum beta-hydroxybutyrate, free fatty acids, branched-chain amino acids, dehydroepiandrosterone-sulfate (DHEA-S) and cortisol concentrations were higher (P<0.001 for all), whereas whole-body protein balance was more negative (P<0.001), and serum glucose, insulin, and leptin concentrations were lower (P<0.001 for all) during ED relative to during EB. Cortisol concentrations, but not any other hormone or metabolic substrate, were inversely associated with satiety during EB (R(2)=0.23, P=0.04). In contrast, serum glucose and DHEA-S concentrations were inversely associated with satiety during ED (R(2)=0.68, P<0.001). No associations between physiologic variables measured during EB and ad libitum energy intake following EB were observed. However, serum leptin and net protein balance measured during ED were inversely associated with ad libitum energy intake following ED (R(2)=0.48, P=0.01). CONCLUSION These findings suggest that changes in metabolic homeostasis during energy deprivation modulate appetite independent of reductions in diet volume. Following energy deprivation, physiologic signals of adipose and lean tissue loss may drive restoration of energy balance. CLINICAL TRIALS REGISTRATION www.clinicaltrials.gov #NCT01603550.
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Affiliation(s)
- J Philip Karl
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760, USA.
| | - Tracey J Smith
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760, USA
| | - Marques A Wilson
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760, USA
| | - Asma S Bukhari
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760, USA
| | - Stefan M Pasiakos
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760, USA
| | - Holly L McClung
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760, USA
| | - James P McClung
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, US Army Research Institute of Environmental Medicine, 10 General Greene Ave, Bldg 42, Natick, MA 01760, USA
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Rogers NH, Walsh H, Alvarez-Garcia O, Park S, Gaylinn B, Thorner MO, Smith RG. Metabolic Benefit of Chronic Caloric Restriction and Activation of Hypothalamic AGRP/NPY Neurons in Male Mice Is Independent of Ghrelin. Endocrinology 2016; 157:1430-42. [PMID: 26812158 PMCID: PMC4816730 DOI: 10.1210/en.2015-1745] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Aging is associated with attenuated ghrelin signaling. During aging, chronic caloric restriction (CR) produces health benefits accompanied by enhanced ghrelin production. Ghrelin receptor (GH secretagogue receptor 1a) agonists administered to aging rodents and humans restore the young adult phenotype; therefore, we tested the hypothesis that the metabolic benefits of CR are mediated by endogenous ghrelin. Three month-old male mice lacking ghrelin (Ghrelin-/-) or ghrelin receptor (Ghsr-/-), and their wild-type (WT) littermates were randomly assigned to 2 groups: ad libitum (AL) fed and CR, where 40% food restriction was introduced gradually to allow Ghrelin-/- and Ghsr-/- mice to metabolically adapt and avoid severe hypoglycemia. Twelve months later, plasma ghrelin, metabolic parameters, ambulatory activity, hypothalamic and liver gene expression, as well as body composition were measured. CR increased plasma ghrelin and des-acyl ghrelin concentrations in WT and Ghsr-/- mice. CR of WT, Ghsr-/-, and Ghrelin-/- mice markedly improved metabolic flexibility, enhanced ambulatory activity, and reduced adiposity. Inactivation of Ghrelin or Ghsr had no effect on AL food intake or food anticipatory behavior. In contrast to the widely held belief that endogenous ghrelin regulates food intake, CR increased expression of hypothalamic Agrp and Npy, with reduced expression of Pomc across genotypes. In the AL context, ablation of ghrelin signaling markedly inhibited liver steatosis, which correlated with reduced Pparγ expression and enhanced Irs2 expression. Although CR and administration of GH secretagogue receptor 1a agonists both benefit the aging phenotype, we conclude the benefits of chronic CR are a consequence of enhanced metabolic flexibility independent of endogenous ghrelin or des-acyl ghrelin signaling.
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Affiliation(s)
- Nicole H Rogers
- Department of Metabolism and Aging (N.H.R., H.W., O.A.-G., S.P., R.G.S.), The Scripps Research Institute Florida, Jupiter, Florida 33458; and Division of Endocrinology and Metabolism (B.G., M.O.T.), Department of Medicine, University of Virginia, Charlottesville, Virginia 22908
| | - Heidi Walsh
- Department of Metabolism and Aging (N.H.R., H.W., O.A.-G., S.P., R.G.S.), The Scripps Research Institute Florida, Jupiter, Florida 33458; and Division of Endocrinology and Metabolism (B.G., M.O.T.), Department of Medicine, University of Virginia, Charlottesville, Virginia 22908
| | - Oscar Alvarez-Garcia
- Department of Metabolism and Aging (N.H.R., H.W., O.A.-G., S.P., R.G.S.), The Scripps Research Institute Florida, Jupiter, Florida 33458; and Division of Endocrinology and Metabolism (B.G., M.O.T.), Department of Medicine, University of Virginia, Charlottesville, Virginia 22908
| | - Seongjoon Park
- Department of Metabolism and Aging (N.H.R., H.W., O.A.-G., S.P., R.G.S.), The Scripps Research Institute Florida, Jupiter, Florida 33458; and Division of Endocrinology and Metabolism (B.G., M.O.T.), Department of Medicine, University of Virginia, Charlottesville, Virginia 22908
| | - Bruce Gaylinn
- Department of Metabolism and Aging (N.H.R., H.W., O.A.-G., S.P., R.G.S.), The Scripps Research Institute Florida, Jupiter, Florida 33458; and Division of Endocrinology and Metabolism (B.G., M.O.T.), Department of Medicine, University of Virginia, Charlottesville, Virginia 22908
| | - Michael O Thorner
- Department of Metabolism and Aging (N.H.R., H.W., O.A.-G., S.P., R.G.S.), The Scripps Research Institute Florida, Jupiter, Florida 33458; and Division of Endocrinology and Metabolism (B.G., M.O.T.), Department of Medicine, University of Virginia, Charlottesville, Virginia 22908
| | - Roy G Smith
- Department of Metabolism and Aging (N.H.R., H.W., O.A.-G., S.P., R.G.S.), The Scripps Research Institute Florida, Jupiter, Florida 33458; and Division of Endocrinology and Metabolism (B.G., M.O.T.), Department of Medicine, University of Virginia, Charlottesville, Virginia 22908
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24
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O'Connor KL, Scisco JL, Smith TJ, Young AJ, Montain SJ, Price LL, Lieberman HR, Karl JP. Altered Appetite-Mediating Hormone Concentrations Precede Compensatory Overeating After Severe, Short-Term Energy Deprivation in Healthy Adults. J Nutr 2016; 146:209-17. [PMID: 26740683 DOI: 10.3945/jn.115.217976] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 12/08/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Adaptive responses of appetite-mediating hormones to negative energy balance are thought to contribute to a counterregulatory response that drives weight regain, but they have not been studied while controlling for reduced diet volume. OBJECTIVE In this secondary analysis, we aimed to determine the effects of short-term, severe energy deprivation (ED) on appetite and appetite-mediating hormone concentrations. METHODS Twenty-one adults with a mean ± SD age of 21 ± 3 y and body mass index of 25 ± 3 kg/m(2) consumed isovolumetric diets provided over separate 48-h periods while increasing habitual energy expenditure by 1683 ± 329 kcal/d through light- and moderate-intensity exercise. Energy intake was matched to energy expenditure to maintain energy balance (EB) (-44 ± 92 kcal/d) or was <10% of energy expenditure to generate a -3696 ± 742-kcal/d energy deficit. Postprandial appetite, glucose, insulin, acyl ghrelin, peptide YY, pancreatic polypeptide (PP), and glucagon-like peptide-1 (GLP-1) responses and ad libitum energy intake were measured as secondary outcomes after both experimental periods. RESULTS Fasting insulin (-56% ± 42%) and acyl ghrelin (-60% ± 17%) concentrations decreased during ED but not during EB (condition-by-time interaction; P-interaction ≤ 0.01), whereas fasting leptin concentrations decreased more during ED compared with during EB (-47% ± 27% compared with -20% ± 27%; P-interaction = 0.05). Postprandial insulin (57% ± 63%; P < 0.001), GLP-1 (14% ± 28%; P = 0.04), and PP (54% ± 52%; P < 0.001) areas under the curve (AUCs) were higher, whereas the acyl ghrelin AUC was lower (-56% ± 13%; P < 0.001) after ED compared with after EB. After ED, self-rated appetite was greater, and ad libitum energy intake was 811 kcal/36 h (95% CI: 184, 1439 kcal/36 h) higher relative to after EB (P = 0.01). CONCLUSIONS Short-term, severe ED suppressed acyl ghrelin concentrations and increased postprandial anorexigenic hormone concentrations. These effects preceded compensatory overeating, suggesting that in adults without obesity, altered sensitivity to appetite-mediating hormones may contribute to an adaptive counterregulatory response during the initial stages of negative EB. This trial was registered at clinicaltrials.gov as NCT01603550.
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Affiliation(s)
- Kristie L O'Connor
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA; and
| | - Jenna L Scisco
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA; and
| | - Tracey J Smith
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA; and
| | - Andrew J Young
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA; and
| | - Scott J Montain
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA; and
| | - Lori Lyn Price
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center and Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA
| | - Harris R Lieberman
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA; and
| | - J Philip Karl
- US Army Research Institute of Environmental Medicine, Military Nutrition Division, Natick, MA; and
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Nakamura Y, Walker BR, Ikuta T. Systematic review and meta-analysis reveals acutely elevated plasma cortisol following fasting but not less severe calorie restriction. Stress 2016; 19:151-7. [PMID: 26586092 DOI: 10.3109/10253890.2015.1121984] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Elevated plasma cortisol has been reported following caloric restriction, and may contribute to adverse effects including stress-induced overeating, but results from published studies are inconsistent. To clarify the effects of caloric restriction on plasma cortisol, and to assess cortisol as an indicator of stress during caloric restriction, we conducted a systematic review and meta-analysis of published studies in which cortisol was measured following caloric restriction without other manipulations in humans. We further compared effects of fasting, very low calorie diet (VLCD), and other less intense low calorie diet (LCD), as well as the duration of caloric restriction by meta-regression. Overall, caloric restriction significantly increased serum cortisol level in 13 studies (357 total participants). Fasting showed a very strong effect in increasing serum cortisol, while VLCD and LCD did not show significant increases. The meta-regression analysis showed a negative association between the serum cortisol level and the duration of caloric restriction, indicating serum cortisol is increased in the initial period of caloric restriction but decreased to the baseline level after several weeks. These results suggest that severe caloric restriction causes activation of the hypothalamic-pituitary-adrenal axis, which may be transient, but results in elevated cortisol which could mediate effects of starvation on brain and metabolic function as well as ameliorate weight loss.
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Affiliation(s)
- Yuko Nakamura
- a The John B. Pierce Laboratory , New Haven, CT , USA
| | - Brian R Walker
- b BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh , Scotland , UK , and
| | - Toshikazu Ikuta
- c Department of Communication Sciences and Disorders, School of Applied Sciences , University of Mississippi, University , MS , USA
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26
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Purcell K, Sumithran P, Prendergast LA, Bouniu CJ, Delbridge E, Proietto J. The effect of rate of weight loss on long-term weight management: a randomised controlled trial. Lancet Diabetes Endocrinol 2014; 2:954-62. [PMID: 25459211 DOI: 10.1016/s2213-8587(14)70200-1] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Guidelines recommend gradual weight loss for the treatment of obesity, indicative of a widely held opinion that weight lost rapidly is more quickly regained. We aimed to investigate the effect of the rate of weight loss on the rate of regain in obese people. METHODS For this two phase, randomised, non-masked, dietary intervention trial in a Melbourne metropolitan hospital, we enrolled 204 participants (51 men and 153 women) aged 18–70 years with a BMI between 30 and 45 kg/m2. During phase 1, we randomly assigned (1:1) participants with a block design (block sizes of 2, 4, and 6) to account for sex, age, and BMI, to either a 12-week rapid weight loss or a 36-week gradual programme, both aimed at 15% weight loss. We placed participants who lost 12·5% or more weight during phase 1 on a weight maintenance diet for 144 weeks (phase 2). The primary outcome was mean weight loss maintained at week 144 of phase 2. We investigated the primary outcome by both completers only and intention-to-treat analyses. This study is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000190909. FINDINGS 200 participants were randomly assigned to the gradual weight loss (n=103) or rapid weight loss (n=97) programme between Aug 8, 2008, and March 9, 2010. After phase 1, 51 (50%) participants in the gradual weight loss group and 76 (81%) in the rapid weight loss group achieved 12·5% or more weight loss in the allocated time and started phase 2. At the end of phase 2, both gradual weight loss and rapid weight loss participants who completed the study (n=43 in gradual weight loss and n=61 in rapid weight loss) had regained most of their lost weight (gradual weight loss 71·2% regain, 95% CI 58·1–84·3 vs rapid weight loss 70·5%, 57·8–83·2). Intention-to-treat analysis showed similar results (gradual weight loss 76·3% regain, 95% CI 65·2–87·4 vs rapid weight loss 76·3%, 65·8–86·8). In phase 1, one participant in the rapid weight loss group developed cholecystitis, requiring cholecystectomy. In phase 2, two participants in the rapid weight loss group developed cancer. INTERPRETATION The rate of weight loss does not affect the proportion of weight regained within 144 weeks. These findings are not consistent with present dietary guidelines which recommend gradual over rapid weight loss, based on the belief that rapid weight loss is more quickly regained. FUNDING The Australian National Health and Medical Research Council and the Sir Edward Dunlop Medical Research Foundation.
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Affiliation(s)
- Katrina Purcell
- The University of Melbourne, Department of Medicine (Austin Health), Heidelberg, VIC, Australia
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27
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Glenn DE, Minor TR, Vervliet B, Craske MG. The effect of glucose on hippocampal-dependent contextual fear conditioning. Biol Psychiatry 2014; 75:847-54. [PMID: 24199667 DOI: 10.1016/j.biopsych.2013.09.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 09/17/2013] [Accepted: 09/20/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The metabolic challenge of trauma disrupts hippocampal functioning, which is necessary for processing the complex co-occurring elements comprising the traumatic context. Poor contextual memory of trauma may subsequently contribute to intrusive memories and overgeneralization of fear. Glucose consumption following trauma may be a means to protect hippocampal functioning and contextual fear learning. This study experimentally examined the effect of glucose on hippocampal-dependent contextual learning versus cued fear learning in humans. METHODS Forty-two male participants underwent cued conditioning with an unconditional stimulus (US) (shock) paired with a discrete conditional stimulus (geometric shape) and context conditioning (requiring hippocampal processing) with a US unpredictably paired with a background context (picture of room). Participants were then blindly randomized to consume either a 25 g glucose or sweet-tasting placebo drink and returned for a test phase 24 hours later. Measures included acoustic startle response, US expectancy, blood glucose levels, and arousal ratings. RESULTS The glucose group showed superior retention of hippocampal-dependent contextual learning at test relative to the placebo group, as demonstrated by acoustic startle response and US expectancy ratings. Glucose and placebo groups did not differ on any measure of cued fear learning at test. CONCLUSIONS This study provides experimental evidence that in mildly stressed humans postconditioning glucose consumption improves retention of hippocampal-dependent contextual learning but not cued learning. Ultimately, glucose consumption following trauma may be a means of improving learning about the traumatic context, thereby preventing subsequent development of symptoms of posttraumatic stress.
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Affiliation(s)
- Daniel E Glenn
- Department of Psychology, University of California, Los Angeles, California.
| | - Thomas R Minor
- Department of Psychology, University of California, Los Angeles, California
| | - Bram Vervliet
- Department of Psychology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, California
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Fu ZD, Klaassen CD. Increased bile acids in enterohepatic circulation by short-term calorie restriction in male mice. Toxicol Appl Pharmacol 2013; 273:680-90. [PMID: 24183703 DOI: 10.1016/j.taap.2013.10.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/16/2013] [Accepted: 10/20/2013] [Indexed: 12/15/2022]
Abstract
Previous studies showed glucose and insulin signaling can regulate bile acid (BA) metabolism during fasting or feeding. However, limited knowledge is available on the effect of calorie restriction (CR), a well-known anti-aging intervention, on BA homeostasis. To address this, the present study utilized a "dose-response" model of CR, where male C57BL/6 mice were fed 0, 15, 30, or 40% CR diets for one month, followed by BA profiling in various compartments of the enterohepatic circulation by UPLC-MS/MS technique. This study showed that 40% CR increased the BA pool size (162%) as well as total BAs in serum, gallbladder, and small intestinal contents. In addition, CR "dose-dependently" increased the concentrations of tauro-cholic acid (TCA) and many secondary BAs (produced by intestinal bacteria) in serum, such as tauro-deoxycholic acid (TDCA), DCA, lithocholic acid, ω-muricholic acid (ωMCA), and hyodeoxycholic acid. Notably, 40% CR increased TDCA by over 1000% (serum, liver, and gallbladder). Interestingly, 40% CR increased the proportion of 12α-hydroxylated BAs (CA and DCA), which correlated with improved glucose tolerance and lipid parameters. The CR-induced increase in BAs correlated with increased expression of BA-synthetic (Cyp7a1) and conjugating enzymes (BAL), and the ileal BA-binding protein (Ibabp). These results suggest that CR increases BAs in male mice possibly through orchestrated increases in BA synthesis and conjugation in liver as well as intracellular transport in ileum.
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Affiliation(s)
- Zidong Donna Fu
- Department of Pharmacology, Toxicology, and Therapeutics, University of Kansas Medical Center, Kansas City, KS, 66160, USA
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Henning PC, Scofield DE, Rarick KR, Pierce JR, Staab JS, Lieberman HR, Nindl BC. Effects of acute caloric restriction compared to caloric balance on the temporal response of the IGF-I system. Metabolism 2013; 62:179-87. [PMID: 22906764 DOI: 10.1016/j.metabol.2012.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/11/2012] [Accepted: 07/11/2012] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Insulin-like growth factor-I (IGF-I) is a key regulator of metabolism during altered energy states. The IGF-I system components respond to prolonged caloric restriction but it is not clear if this system responds similarly to acute caloric restriction. The purpose of this study was to characterize the IGF-I system response to acute caloric restriction with a secondary purpose of determining if two isocaloric diets with different ratios of carbohydrate to fat alter the IGF-I system under conditions of caloric balance. MATERIALS/METHODS A double-blind, placebo-controlled crossover design was used in which 27 subjects underwent three, 48-h experimental treatments: 1) caloric restriction 2) carbohydrate and 3) carbohydrate/fat. Blood was sampled periodically (6 time points total) for IGF-I (total and free), IGFBPs1-4, insulin and glucose. ANOVAs were used with significance set at P<0.05. RESULTS Total IGF-I decreased 7% during CR (P=0.051) and remained stable during CHO and CHO/F. Free IGF-I decreased 43% during CR (P<0.05) and remained stable during CHO and CHO/F. IGFBP-1 increased by 445% during CR (P<0.05) compared to CHO and CHO/F with no changes for IGFBP-2, IGFBP-3 and IGFBP-4. There was no change in glucose or insulin during CR over the course of the study. Insulin and glucose increased (P<0.05) after a meal in both the CHO and CHO/F groups with no difference between these two groups. CONCLUSION Our findings indicate that free IGF-I decreases and IGFBP-1 increases during caloric restriction, but they are not altered with diets differing in carbohydrate and fat content. Changes in free IGF-I and IGFBP-1 are sensitive to caloric restriction, and their measurement may be valuable in monitoring the physiological response to refeeding in those consuming suboptimal calories.
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Affiliation(s)
- Paul C Henning
- Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA 01760, USA.
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Goto K, Shioda K, Uchida S. Effect of 2 days of intensive resistance training on appetite-related hormone and anabolic hormone responses. Clin Physiol Funct Imaging 2012; 33:131-6. [PMID: 23383691 DOI: 10.1111/cpf.12005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 09/18/2012] [Indexed: 01/31/2023]
Abstract
This study was designed to determine endocrine responses during 2 days of strenuous resistance training. Ten healthy men performed resistance training twice a day for two successive days to induce acute fatigue (excessive physical stress). The resistance training consisted of four exercises for the lower body in the morning and seven exercises for the upper body in the afternoon. Maximal isometric and isokinetic strengths were measured from day 1 (before the training period) to day 3 (after the training period). Fasting blood samples were taken on days 1-3. Maximal isometric and isokinetic strengths significantly decreased with two successive days of training (P<0·05), with significant increases in serum creatine phosphokinase and myoglobin concentrations (P<0·05). Significant reductions in the fasting concentrations of serum insulin-like growth factor-1, free testosterone, insulin and high-molecular-weight adiponectin were observed on day 3 (P<0·05), whereas there were no changes in the serum cortisol concentration or the free testosterone/cortisol ratio. Plasma active ghrelin and serum leptin concentrations decreased by -20·7 ± 2·8% and -29·6 ± 4·1%, respectively (P<0·05). Two days strenuous resistance training significantly affects the profiles of anabolic hormone and endocrine regulators of appetite and energy balance, such as ghrelin and leptin. The present findings suggest that decreased ghrelin and leptin concentrations might reflect excessive physical stress and may be early signs of accumulated fatigue.
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Affiliation(s)
- Kazushige Goto
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsushi, Shiga, Japan.
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