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Prentice RL, Aragaki AK, Zheng C, Manson JE, Tinker LF, Ravelli MN, Mossavar-Rahmani Y, Wallace RB, Tooze JA, Johnson KC, Lampe JW, Neuhouser ML, Schoeller DA. Biomarker-assessed total energy intake and its cohort study association with all-cause mortality in postmenopausal females. Am J Clin Nutr 2024; 119:1329-1337. [PMID: 38428741 PMCID: PMC11130702 DOI: 10.1016/j.ajcnut.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/20/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND The association of total energy intake (EI) with all-cause mortality is uncertain as are the dependencies of this association on age and weight change history. OBJECTIVES To identify an EI biomarker suitable for use in epidemiologic association studies and to study EI associations with total mortality in a Women's Health Initiative (WHI) cohort of postmenopausal United States females (1993-present). METHODS EI biomarkers were developed based on doubly labeled water (DLW) total energy expenditure (TEE) and weight variation during the 2-wk DLW protocol period using the energy balance method in an embedded feeding study (n = 153). This along with 2 earlier WHI nutrition biomarker studies having TEE assessments (n = 1131 total), with 14.6 y (median) follow-up, constituted a prospective cohort for the study of EI and all-cause mortality. RESULTS An empirical biomarker for log(EI) was developed that had a correlation of 0.73 with log(feeding study-consumed EI). The overall association between EI and mortality was nonsignificant. The association, however, depended on age (P = 0.009), with lower EI associated with lower mortality at younger ages, and also on preceding weight change history (P = 0.03). Among participants with stable or increasing weight, mortality hazard ratios (95% confidence intervals [CIs]) for a 12% lower EI were 0.66 (95% CI: 0.51, 0.87) at age 60, 0.84 (95% CI: 0.72, 0.98) at age 70, and 1.06 (95% CI: 0.87, 1.29) at age 80. Corresponding values for participants having preceding weight loss were 0.83 (95% CI: 0.61, 1.12) at age 60, 1.05 (95% CI: 0.87, 1.26) at age 70, and 1.33 (95% CI: 1.08, 1.63) at age 80. A previously considered EI biomarker, using a theoretical model for variation in body fat and fat-free mass components over time, gave similar results following rescaling. CONCLUSIONS Lower EI is associated with lower all-cause mortality among younger postmenopausal females with stable or increasing weight and with higher mortality among older females with weight loss. This study was registered with clinicaltrials.gov as NCT00000611.
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Affiliation(s)
- Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States.
| | - Aaron K Aragaki
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Michele N Ravelli
- Biotech Center and Neurology, University of Wisconsin, Madison, WI, United States
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Robert B Wallace
- College of Public Health, University of Iowa, Iowa City, IA, United States
| | - Janet A Tooze
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Center, Memphis TN, United States
| | - Johanna W Lampe
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States; School of Public Health, University of Washington, Seattle, WA, United States
| | - Dale A Schoeller
- Biotech Center and Nutritional Sciences, University of Wisconsin, Madison WI, United States
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Lau Y, Wong SH, Chee DGH, Ng BSP, Ang WW, Han CY, Cheng LJ. Technology-delivered personalized nutrition intervention on dietary outcomes among adults with overweight and obesity: A systematic review, meta-analysis, and meta-regression. Obes Rev 2024; 25:e13699. [PMID: 38296771 DOI: 10.1111/obr.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 01/01/2024] [Accepted: 01/02/2024] [Indexed: 02/02/2024]
Abstract
The prevalence of overweight and obesity has continued to increase globally, and one-size-fits-all dietary recommendations may not be suitable for different individual characteristics. A personalized nutrition intervention may be a potential solution. This review aims to evaluate the effects of the technology-delivered personalized nutrition intervention on energy, fat, vegetable, and fruit intakes among adults with overweight and obesity. A three-step comprehensive search strategy was performed from 10 databases and seven clinical registries in published and unpublished trials. A total of 46 randomized controlled trials (RCTs) involving 19,670 adults with overweight and obesity from 14 countries are included. Subgroup and meta-regression analyses were conducted. Meta-analyses showed a reduction of energy intake (-128.05, 95% CI: -197.08, -59.01) and fat intake (-1.81% energy/days, 95% CI: -3.38, -0.24, and -0.19 scores, 95% CI: -0.40, 0.02) in the intervention compared with the comparator. Significant improvements in vegetable and fruit intakes with 0.12-0.15 servings/day were observed in the intervention. Combined one- and two-way interactions had a greater effect on energy intake reduction compared with their counterparts. Meta-regression analyses revealed that no significant covariates were found. Given that the certainty of the evidence was rated as low or very low, further well-designed RCTs with long-term follow-up are warranted.
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Affiliation(s)
- Ying Lau
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | | | | | - Brenda Sok Peng Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Wei Ang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chad Yixian Han
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Ling Jie Cheng
- Health Systems and Behavioural Science Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Nunes CL, Jesus F, Oliveira MV, Thomas DM, Sardinha LB, Martins P, Minderico CS, Silva AM. The impact of body composition on the degree of misreporting of food diaries. Eur J Clin Nutr 2024; 78:209-216. [PMID: 38087045 DOI: 10.1038/s41430-023-01382-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 03/13/2024]
Abstract
BACKGROUND/OBJECTIVES Accurate assessments of energy intake (EI) are needed in lifestyle interventions to guarantee a negative energy balance (EB), thereby losing weight. This study aimed (1) to compare objectively measured and self-reported EI and (2) to determine the predictors of underreporting divided by sex, adiposity and BMI category. METHODS Seventy-three participants [mean (SD): 43.7 (9.2) years, BMI = 31.5 (4.5) kg/m2, 37% females] of the Champ4Life intervention were included in this study. EI was measured using the "intake-balance method" and self-reported through 3-day food records. Fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry. Bland-Altman analysis was performed to compare both EI assessments. RESULTS Self-reported EI was lower than measured EI during both neutral (-355 kcal/d) and negative EB (-570 kal/day). While no significant trends were observed for EI evaluation in either neutral (p = 0.315) or negative EB (p = 0.611), limits of agreement were wide (-1720 to 1010 and -1920 to 779 kcal/day, respectively). In females, the degree of misreporting (kcal/day and %) was predicted by weight (p = 0.032 and p = 0.039, respectively) and FM (p = 0.029 and p = 0.037, respectively). In males, only BMI (p = 0.036) was a predictor of misreporting (kcal/day). CONCLUSION Self-reported EI did not agree with measured EI. Our results show that larger body size was associated with higher levels of underestimation for EI (females only). Nevertheless, misreporting EI is a complex issue involving more associations than merely body composition. A deeper understanding could inform counseling for participants filling out food records in other to reduce misreporting and improve validity.
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
- Atlântica, Instituto Universitário, Fábrica da Pólvora de Barcarena, 2730-036, Barcarena, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Mariana V Oliveira
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, New York, NY, USA
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana da Universidade de Lisboa, 1499-002, Cruz-Quebrada, Portugal
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.
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Nunes CL, Jesus F, Rosa GB, Marianito M, Francisco R, Bosy-Westphal A, Minderico CS, Martins P, Sardinha LB, Silva AM. Interindividual variability in energy intake and expenditure during a weight loss intervention. Appetite 2024; 193:107162. [PMID: 38101517 DOI: 10.1016/j.appet.2023.107162] [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: 07/20/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023]
Abstract
INTRODUCTION Behavioral compensations may occur as a response to a negative energy balance. The aim of this study was to explore the associations between changes in energy intake (EI) and changes in physical activity (PA, min/day; kcal/d) as a response to a weight loss (WL) intervention and to understand if interindividual differences occur in EI and energy expenditure (EE). METHODS Eighty-one participants [mean (SD): age = 42.8 (9.4)y, BMI = 31.2 (4.4)kg/m2, 37% females] divided in intervention (IG, n = 43) and control group (CG, n = 38) were included. The IG underwent a moderate energy restriction (300-500 kcal/d). EI was measured through the intake-balance method. Non-exercise PA (NEPA) and exercise (through logbook) were assessed by accelerometery. The EE in NEPA (NEAT) and in exercise (EiEE) was calculated by applying the Freedson Combination'98 algorithm over the time spent in these activities. Pearson correlations were performed in IG to examine associations between EE components, EI and body composition. To understand if interindividual differences were observed, the SD of individual response (SDIR) and the smallest worthwhile change (SWC, SDbaselineCG×0.2) were calculated. RESULTS Changes in EI [Δ EI, (kcal/d)] was negatively associated with Δ exercise (min/d:r = -0.413, p = 0.045; %:r = -0.846, p = 0.008) and with Δ EiEE (kcal/d:r = -0.488, p = 0.016; %:r = -0.859, p = 0.006). A negative correlation was found between Δ sedentary time and Δ NEPA (min/d:r = -0.622, p = 0.002; %:r = -0.487, p = 0.018). An interindividual variability was found for EI(SDIR = 151.6, SWC = 72.3) and EE (SDIR = 165, SWC = 134). CONCLUSIONS Decreases in EI were not associated to compensatory responses such as decreases in PA and/or increases in sedentary time. Interindividual variability was found for EI and EE. Nevertheless, behavioral compensations and the interindividual variability should be considered when implementing WL interventions, to increase the likelihood of achieving sustainable results. (clinicaltrials.gov ID: NCT03031951).
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Affiliation(s)
- Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal; Atlântica, Instituto Universitário, Fábrica da Pólvora de Barcarena, Portugal
| | - Filipe Jesus
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Gil B Rosa
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Mariana Marianito
- Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz MB, 1649-028 Lisboa, Portugal
| | - Ruben Francisco
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
| | - Cláudia S Minderico
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Paulo Martins
- Laboratory of Sport Psychology, Faculdade de Motricidade Humana da Universidade de Lisboa, 1499-002 Cruz-Quebrada, Portugal
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal.
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Brummer J, Glasbrenner C, Hechenbichler Figueroa S, Koehler K, Höchsmann C. Continuous glucose monitoring for automatic real-time assessment of eating events and nutrition: a scoping review. Front Nutr 2024; 10:1308348. [PMID: 38264192 PMCID: PMC10804456 DOI: 10.3389/fnut.2023.1308348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Background Accurate dietary assessment remains a challenge, particularly in free-living settings. Continuous glucose monitoring (CGM) shows promise in optimizing the assessment and monitoring of ingestive activity (IA, i.e., consumption of calorie-containing foods/beverages), and it might enable administering dietary Just-In-Time Adaptive Interventions (JITAIs). Objective In a scoping review, we aimed to answer the following questions: (1) Which CGM approaches to automatically detect IA in (near-)real-time have been investigated? (2) How accurate are these approaches? (3) Can they be used in the context of JITAIs? Methods We systematically searched four databases until October 2023 and included publications in English or German that used CGM-based approaches for human (all ages) IA detection. Eligible publications included a ground-truth method as a comparator. We synthesized the evidence qualitatively and critically appraised publication quality. Results Of 1,561 potentially relevant publications identified, 19 publications (17 studies, total N = 311; for 2 studies, 2 publications each were relevant) were included. Most publications included individuals with diabetes, often using meal announcements and/or insulin boluses accompanying meals. Inpatient and free-living settings were used. CGM-only approaches and CGM combined with additional inputs were deployed. A broad range of algorithms was tested. Performance varied among the reviewed methods, ranging from unsatisfactory to excellent (e.g., 21% vs. 100% sensitivity). Detection times ranged from 9.0 to 45.0 min. Conclusion Several CGM-based approaches are promising for automatically detecting IA. However, response times need to be faster to enable JITAIs aimed at impacting acute IA. Methodological issues and overall heterogeneity among articles prevent recommending one single approach; specific cases will dictate the most suitable approach.
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Hibbing PR, Welk GJ, Ries D, Yeh HW, Shook RP. Criterion validity of wrist accelerometry for assessing energy intake via the intake-balance technique. Int J Behav Nutr Phys Act 2023; 20:115. [PMID: 37749645 PMCID: PMC10521469 DOI: 10.1186/s12966-023-01515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Intake-balance assessments measure energy intake (EI) by summing energy expenditure (EE) with concurrent change in energy storage (ΔES). Prior work has not examined the validity of such calculations when EE is estimated via open-source techniques for research-grade accelerometry devices. The purpose of this study was to test the criterion validity of accelerometry-based intake-balance methods for a wrist-worn ActiGraph device. METHODS Healthy adults (n = 24) completed two 14-day measurement periods while wearing an ActiGraph accelerometer on the non-dominant wrist. During each period, criterion values of EI were determined based on ΔES measured by dual X-ray absorptiometry and EE measured by doubly labeled water. A total of 11 prediction methods were tested, 8 derived from the accelerometer and 3 from non-accelerometry methods (e.g., diet recall; included for comparison). Group-level validity was assessed through mean bias, while individual-level validity was assessed through mean absolute error, mean absolute percentage error, and Bland-Altman analysis. RESULTS Mean bias for the three best accelerometry-based methods ranged from -167 to 124 kcal/day, versus -104 to 134 kcal/day for the non-accelerometry-based methods. The same three accelerometry-based methods had mean absolute error of 323-362 kcal/day and mean absolute percentage error of 18.1-19.3%, versus 353-464 kcal/day and 19.5-24.4% for the non-accelerometry-based methods. All 11 methods demonstrated systematic bias in the Bland-Altman analysis. CONCLUSIONS Accelerometry-based intake-balance methods have promise for advancing EI assessment, but ongoing refinement is necessary. We provide an R package to facilitate implementation and refinement of accelerometry-based methods in future research (see paulhibbing.com/IntakeBalance).
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Affiliation(s)
- Paul R Hibbing
- Department of Kinesiology and Nutrition, University of Illinois Chicago, 1919 W. Taylor St, Rm 650, Mail Code 517, Chicago, IL, 60612, USA.
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA.
| | - Gregory J Welk
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Daniel Ries
- Statistical Sciences Department, Sandia National Laboratories, Albuquerque, NM, USA
| | - Hung-Wen Yeh
- Biostatistics & Epidemiology Core, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, 64108, USA
| | - Robin P Shook
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO, 64108, USA
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Serra M, Alceste D, Hauser F, Hulshof PJM, Meijer HAJ, Thalheimer A, Steinert RE, Gerber PA, Spector AC, Gero D, Bueter M. Assessing daily energy intake in adult women: validity of a food-recognition mobile application compared to doubly labelled water. Front Nutr 2023; 10:1255499. [PMID: 37810925 PMCID: PMC10556674 DOI: 10.3389/fnut.2023.1255499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Accurate dietary assessment is crucial for nutrition and health research. Traditional methods, such as food records, food frequency questionnaires, and 24-hour dietary recalls (24HR), have limitations, such as the need for trained interviewers, time-consuming procedures, and inaccuracies in estimations. Novel technologies, such as image-based dietary assessment apps, have been developed to overcome these limitations. SNAQ is a novel image-based food-recognition app which, based on computer vision, assesses food type and volume, and provides nutritional information about dietary intake. This cross-sectional observational study aimed to investigate the validity of SNAQ as a dietary assessment tool for measuring energy and macronutrient intake in adult women with normal body weight (n = 30), compared to doubly labeled water (DLW), a reference method for total daily energy expenditure (TDEE). Energy intake was also estimated using a one-day 24HR for direct comparison. Bland-Altman plots, paired difference tests, and Pearson's correlation coefficient were used to assess agreement and relationships between the methods. SNAQ showed a slightly higher agreement (bias = -329.6 kcal/day) with DLW for total daily energy intake (TDEI) compared to 24HR (bias = -543.0 kcal/day). While both SNAQ and 24HR tended to underestimate TDEI, only 24HR significantly differed from DLW in this regard (p < 0.001). There was no significant relationship between estimated TDEI and TDEE using SNAQ (R2 = 27%, p = 0.50) or 24HR (R2 = 34%, p = 0.20) and there were no significant differences in energy and macronutrient intake estimates between SNAQ and 24HR (Δ = 213.4 kcal/day). In conclusion, these results indicate that SNAQ provides a closer representation of energy intake in adult women with normal body weight than 24HR when compared to DLW, but no relationship was found between the energy estimates of DLW and of the two dietary assessment tools. Further research is needed to determine the clinical relevance and support the implementation of SNAQ in research and clinical settings. Clinical trial registration: This study is registered on ClinicalTrials.gov with the unique identifier NCT04600596 (https://clinicaltrials.gov/ct2/show/NCT04600596).
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Affiliation(s)
- Michele Serra
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - Daniela Alceste
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - Florian Hauser
- Faculty of Medicine, University of Zurich (UZH), Zurich, Switzerland
| | - Paul J. M. Hulshof
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Harro A. J. Meijer
- Centre for Isotope Research (CIO), Energy and Sustainability Research Institute Groningen, University of Groningen, Groningen, Netherlands
| | - Andreas Thalheimer
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Robert E. Steinert
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Philipp A. Gerber
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland
| | - Alan C. Spector
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, United States
| | - Daniel Gero
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
| | - Marco Bueter
- Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
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Hibbing PR, Shook RP, Panda S, Manoogian EN, Mashek DG, Chow LS. Predicting energy intake with an accelerometer-based intake-balance method. Br J Nutr 2023; 130:344-352. [PMID: 36250527 PMCID: PMC10106530 DOI: 10.1017/s0007114522003312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Nutritional interventions often rely on subjective assessments of energy intake (EI), but these are susceptible to measurement error. To introduce an accelerometer-based intake-balance method for assessing EI using data from a time-restricted eating (TRE) trial. Nineteen participants with overweight/obesity (25-63 years old; 16 females) completed a 12-week intervention (NCT03129581) in a control group (unrestricted feeding; n 8) or TRE group (n 11). At the start and end of the intervention, body composition was assessed by dual-energy X-ray absorptiometry (DXA) and daily energy expenditure (EE) was assessed for 2 weeks via wrist-worn accelerometer. EI was back-calculated as the sum of net energy storage (from DXA) and EE (from accelerometer). Accelerometer-derived EI estimates were compared against estimates from the body weight planner of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Mean EI for the control group declined by 138 and 435 kJ/day for the accelerometer and NIDDK methods, respectively (both P ≥ 0·38), v. 1255 and 1469 kJ/day, respectively, for the TRE group (both P < 0·01). At follow-up, the accelerometer and NIDDK methods showed excellent group-level agreement (mean bias of -297 kJ/day across arms; standard error of estimate 1054 kJ/day) but high variability at the individual level (limits of agreement from -2414 to +1824 kJ/day). The accelerometer-based intake-balance method showed plausible sensitivity to change, and EI estimates were biologically and behaviourally plausible. The method may be a viable alternative to self-report EI measures. Future studies should assess criterion validity using doubly labelled water.
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Affiliation(s)
- Paul R. Hibbing
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, 610 E 22 St, Kansas City, MO 64108, USA
| | - Robin P. Shook
- Center for Children’s Healthy Lifestyles & Nutrition, Children’s Mercy Kansas City, 610 E 22 St, Kansas City, MO 64108, USA
- School of Medicine, University of MO-Kansas City, 2411 Holmes St, Kansas City, MO 64108, USA
| | - Satchidananda Panda
- Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Emily N.C. Manoogian
- Salk Institute for Biological Studies, 10010 N Torrey Pines Rd, La Jolla, CA 92037, USA
| | - Douglas G. Mashek
- Division of Diabetes, Endocrinology, and Metabolism; Department of Medicine, University of MN Medical School, 909 Fulton St SE, Minneapolis, MN 55455, USA
| | - Lisa S. Chow
- Division of Diabetes, Endocrinology, and Metabolism; Department of Medicine, University of MN Medical School, 909 Fulton St SE, Minneapolis, MN 55455, USA
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Laferrère B. Can we measure food intake in humans? Int J Obes (Lond) 2023; 47:391-392. [PMID: 36849596 DOI: 10.1038/s41366-023-01282-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 03/01/2023]
Affiliation(s)
- Blandine Laferrère
- Obesity Nutrition Research Center, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
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Tarnowski CA, Wardle SL, O’Leary TJ, Gifford RM, Greeves JP, Wallis GA. Measurement of Energy Intake Using the Principle of Energy Balance Overcomes a Critical Limitation in the Assessment of Energy Availability. SPORTS MEDICINE - OPEN 2023; 9:16. [PMID: 36811697 PMCID: PMC9947205 DOI: 10.1186/s40798-023-00558-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 02/04/2023] [Indexed: 02/24/2023]
Abstract
Prolonged low energy availability, which is the underpinning aetiology of the Relative Energy Deficiency in Sport and the Female and Male Athlete Triad frameworks, can have unfavourable impacts on both health and performance in athletes. Energy availability is calculated as energy intake minus exercise energy expenditure, expressed relative to fat free mass. The current measurement of energy intake is recognized as a major limitation for assessing energy availability due to its reliance on self-report methods, in addition to its short-term nature. This article introduces the application of the energy balance method for the measurement of energy intake, within the context of energy availability. The energy balance method requires quantification of the change in body energy stores over time, with concurrent measurement of total energy expenditure. This provides an objective calculation of energy intake, which can then be used for the assessment of energy availability. This approach, the Energy Availability - Energy Balance (EAEB) method, increases the reliance on objective measurements, provides an indication of energy availability status over longer periods and removes athlete burden to self-report energy intake. Implementation of the EAEB method could be used to objectively identify and detect low energy availability, with implications for the diagnosis and management of Relative Energy Deficiency in Sport and the Female and Male Athlete Triad.
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Affiliation(s)
- Caroline A. Tarnowski
- grid.6572.60000 0004 1936 7486School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT UK
| | - Sophie L. Wardle
- Army Health and Performance Research, Army Headquarters, Andover, UK ,grid.83440.3b0000000121901201Division of Surgery and Interventional Science, Department of Targeted Intervention, University College London, London, UK
| | - Thomas J. O’Leary
- Army Health and Performance Research, Army Headquarters, Andover, UK ,grid.83440.3b0000000121901201Division of Surgery and Interventional Science, Department of Targeted Intervention, University College London, London, UK
| | - Robert M. Gifford
- grid.511172.10000 0004 0613 128XBritish Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK ,grid.415490.d0000 0001 2177 007XResearch and Clinical Innovation, Royal Centre of Defence Medicine, Birmingham, UK
| | - Julie P. Greeves
- Army Health and Performance Research, Army Headquarters, Andover, UK ,grid.83440.3b0000000121901201Division of Surgery and Interventional Science, Department of Targeted Intervention, University College London, London, UK ,grid.8273.e0000 0001 1092 7967Norwich Medical School, University of East Anglia, Norwich, UK
| | - Gareth A. Wallis
- grid.6572.60000 0004 1936 7486School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT UK
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Corbin KD, Carnero EA, Allerton TD, Tillner J, Bock CP, Luyet PP, Göbel B, Hall KD, Parsons SA, Ravussin E, Smith SR. Glucagon-like peptide-1/glucagon receptor agonism associates with reduced metabolic adaptation and higher fat oxidation: A randomized trial. Obesity (Silver Spring) 2023; 31:350-362. [PMID: 36695055 PMCID: PMC9881753 DOI: 10.1002/oby.23633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/16/2022] [Accepted: 10/02/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE This study tested the hypothesis that treatment with the glucagon-like peptide-1/glucagon receptor agonist SAR425899 would lead to a smaller decrease in sleeping metabolic rate (SMR; kilocalories/day) than expected from the loss of lean and fat mass (metabolic adaptation). METHODS This Phase 1b, double-blind, randomized, placebo-controlled study was conducted at two centers in inpatient metabolic wards. Thirty-five healthy males and females with overweight and obesity (age = 36.5 ± 7.1 years) were randomized to a calorie-reduced diet (-1000 kcal/d) and escalating doses (0.06-0.2 mg/d) of SAR425899 (n = 17) or placebo (n = 18) for 19 days. SMR was measured by whole-room calorimetry. RESULTS Both groups lost weight (-3.68 ± 1.37 kg placebo; -4.83 ± 1.44 kg SAR425899). Those treated with SAR425899 lost more weight, fat mass, and fat free mass (p < 0.05) owing to a greater achieved energy deficit than planned. The SAR425899 group had a smaller reduction in body composition-adjusted SMR (p = 0.002) as compared with placebo, but not 24-hour energy expenditure. Fat oxidation and ketogenesis increased in both groups, with significantly greater increases with SAR425899 (p < 0.05). CONCLUSIONS SAR425899 led to reduced selective metabolic adaptation and increased lipid oxidation, which are believed to be beneficial for weight loss and weight-loss maintenance.
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Affiliation(s)
- Karen D Corbin
- AdventHealth Translational Research Institute, Orlando, Florida, USA
| | - Elvis A Carnero
- AdventHealth Translational Research Institute, Orlando, Florida, USA
| | | | | | | | | | | | - Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | | | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Steven R Smith
- AdventHealth Translational Research Institute, Orlando, Florida, USA
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12
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Shivakumar N, Thomas T, Devi S, Jahoor F, Kurpad AV. Free living total energy expenditure in young South Indian children at risk of environmental enteric dysfunction and its relation to faltered linear growth. Eur J Clin Nutr 2023; 77:532-537. [PMID: 36720933 DOI: 10.1038/s41430-023-01268-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND/OBJECTIVES Chronic immune activation in Environmental Enteric Dysfunction (EED) could lead to increased fed-state metabolic rate (MR) or total energy expenditure (TEE) and limit the energy available for optimal linear growth. In a secondary analysis, MR and TEE were compared in young Indian children from urban slums, with and without stunting or EED. SUBJECTS/METHODS Children (18-24 months, n = 69) were classified into non-stunted (LAZ ≥ -2) and stunted (LAZ < -2), and no-EED (lactulose rhamnose ratio, LRR < 0.068) and EED (LRR ≥ 0.068) groups. Associations between MR and TEE (kcal per kg bodyweight [BW] or fat free mass [FFM]) with stunting and EED were examined using logistic regression. RESULTS Median TEE was significantly higher in the stunted compared to non-stunted group (76.8 versus 92.0 kcal/kg BW/day, p = <0.01). The adjusted (for sex, FFM, EED) odds ratio (AOR) for stunting with TEE (kcal/day) was 1.01 (95% CI: 1.00, 1.01), but importantly, there was no interaction between EED and TEE. The median TEE was also significantly higher in the EED compared to the no-EED group (89.1 vs 76.8 kcal/kg BW/day, p = 0.02), and the AOR (adjusted for sex and TEE) for stunting with EED was 3.56 (95% CI:1.09, 11.63). MR (per kg BW or FFM) was not associated with stunting or EED. CONCLUSION Higher TEE and presence of EED were independently and positively associated with stunting. Children with EED also had higher TEE but not MR. Energetically, the higher TEE in stunted children may not specifically be linked to the presence of EED, although the latter independently had higher odds of stunting.
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Affiliation(s)
- Nirupama Shivakumar
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Tinku Thomas
- Department of Biostatistics, St. John's Medical College, St. John's National Academy of Health Sciences, Bangalore, India
| | - Sarita Devi
- Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India
| | - Farook Jahoor
- USDA/Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Anura V Kurpad
- Department of Physiology, St. John's Medical College, St. John's National Academy of Health Sciences, Bangalore, India.
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Santos-Báez LS, Garbarini A, Shaw D, Cheng B, Popp CJ, Manoogian ENC, Panda S, Laferrère B. Time-restricted eating to improve cardiometabolic health: The New York Time-Restricted EATing randomized clinical trial - Protocol overview. Contemp Clin Trials 2022; 120:106872. [PMID: 35934281 PMCID: PMC10031768 DOI: 10.1016/j.cct.2022.106872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 11/20/2022]
Abstract
Re-aligning eating patterns with biological rhythm can reduce the burden of metabolic syndrome in older adults with overweight or obesity. Time-restricted eating (TRE) has been shown to result in weight loss and improved cardiometabolic health while being less challenging than counting calories. The New York Time-Restricted EATing study (NY-TREAT) is a two-arm, randomized clinical trial (RCT) that aims to examine the efficacy and sustainability of TRE (eating window ≤10 h/day) vs. a habitual prolonged eating window (HABIT, ≥14 h/day) in metabolically unhealthy midlife adults (50-75 years) with overweight or obesity and prediabetes or type 2 diabetes (T2D). Our primary hypothesis is that the TRE will result in greater weight loss compared to HABIT at 3 months. The efficacy of the TRE intervention on body weight, fat mass, energy expenditure, and glucose is tested at 3 months, and the sustainability of its effect is measured at 12 months, with ambulatory assessments of sleep and physical activity (ActiGraph), eating pattern (smartphone application), and interstitial glucose (continuous glucose monitoring). The RCT also includes state-of-the-art measurements of body fat (quantitative magnetic resonance), total energy expenditure (doubly-labelled water), insulin secretion, insulin resistance, and glucose tolerance. Adherence to self-monitoring and reduced eating window are monitored remotely in real-time. This RCT will provide further insight into the effects of TRE on cardiometabolic health in individuals with high metabolic risk. Sixty-two participants will be enrolled, and with estimated 30% attrition, 42 participants will return at 12 months. This protocol describes the design, interventions, methods, and expected outcomes. Clinical trial registration:NCT04465721 IRB: AAAS7791.
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Affiliation(s)
- Leinys S Santos-Báez
- Columbia University Irving Medical Center, Department of Medicine, Division of Endocrinology, Diabetes Research Center, New York, NY, United States of America
| | - Alison Garbarini
- Columbia University Irving Medical Center, Department of Medicine, Division of Endocrinology, Diabetes Research Center, New York, NY, United States of America
| | - Delaney Shaw
- Columbia University Irving Medical Center, Department of Medicine, Division of Endocrinology, Diabetes Research Center, New York, NY, United States of America
| | - Bin Cheng
- Mailman School of Public Health, Department of Biostatistics, Columbia University, New York, NY, United States of America
| | - Collin J Popp
- New York Langone Health, Department of Population Health, New York, NY, United States of America
| | - Emily N C Manoogian
- Salk Institute for Biological Studies, La Jolla, CA, United States of America
| | - Satchidananda Panda
- Salk Institute for Biological Studies, La Jolla, CA, United States of America
| | - Blandine Laferrère
- Columbia University Irving Medical Center, Department of Medicine, Division of Endocrinology, Diabetes Research Center, New York, NY, United States of America.
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Tasali E, Wroblewski K, Kahn E, Kilkus J, Schoeller DA. Effect of Sleep Extension on Objectively Assessed Energy Intake Among Adults With Overweight in Real-life Settings: A Randomized Clinical Trial. JAMA Intern Med 2022; 182:365-374. [PMID: 35129580 PMCID: PMC8822469 DOI: 10.1001/jamainternmed.2021.8098] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Short sleep duration has been recognized as a risk factor for obesity. Whether extending sleep duration may mitigate this risk remains unknown. OBJECTIVE To determine the effects of a sleep extension intervention on objectively assessed energy intake, energy expenditure, and body weight in real-life settings among adults with overweight who habitually curtailed their sleep duration. DESIGN, SETTING, AND PARTICIPANTS This single-center, randomized clinical trial was conducted from November 1, 2014, to October 30, 2020. Participants were adults aged 21 to 40 years with a body mass index (calculated as weight in kilograms divided by height in meters squared) between 25.0 and 29.9 and had habitual sleep duration of less than 6.5 hours per night. Data were analyzed according to the intention-to-treat principle. INTERVENTIONS After a 2-week habitual sleep period at baseline, participants were randomized to either an individualized sleep hygiene counseling session that was intended to extend their bedtime to 8.5 hours (sleep extension group) or to continue their habitual sleep (control group). All participants were instructed to continue daily routine activities at home without any prescribed diet or physical activity. MAIN OUTCOMES AND MEASURES The primary outcome was change in energy intake from baseline, which was objectively assessed as the sum of total energy expenditure and change in body energy stores. Total energy expenditure was measured by the doubly labeled water method. Change in body energy stores was computed using regression of daily home weights and body composition changes from dual-energy x-ray absorptiometry. Sleep duration was monitored by actigraphy. Changes from baseline were compared between the 2 groups using intention-to-treat analysis. RESULTS Data from 80 randomized participants (mean [SD] age, 29.8 [5.1] years; 41 men [51.3%]) were analyzed. Sleep duration was increased by approximately 1.2 hours per night (95% CI, 1.0 to 1.4 hours; P < .001) in the sleep extension group vs the control group. The sleep extension group had a significant decrease in energy intake compared with the control group (-270 kcal/d; 95% CI, -393 to -147 kcal/d; P < .001). The change in sleep duration was inversely correlated with the change in energy intake (r = -0.41; 95% CI, -0.59 to -0.20; P < .001). No significant treatment effect in total energy expenditure was found, resulting in weight reduction in the sleep extension group vs the control group. CONCLUSIONS AND RELEVANCE This trial found that sleep extension reduced energy intake and resulted in a negative energy balance in real-life settings among adults with overweight who habitually curtailed their sleep duration. Improving and maintaining healthy sleep duration over longer periods could be part of obesity prevention and weight loss programs. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02253368.
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Affiliation(s)
- Esra Tasali
- Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Kristen Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois
| | - Eva Kahn
- Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Jennifer Kilkus
- Department of Medicine, The University of Chicago, Chicago, Illinois
| | - Dale A Schoeller
- Biotechnology Center, Department of Nutritional Sciences, University of Wisconsin-Madison, Madison
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Waterworth SP, Kerr CJ, McManus CJ, Costello R, Sandercock GRH. Obese individuals do not underreport dietary intake to a greater extent than nonobese individuals when data are allometrically‐scaled. Am J Hum Biol 2022; 34:e23743. [PMID: 35257435 PMCID: PMC9286371 DOI: 10.1002/ajhb.23743] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/21/2022] [Accepted: 02/27/2022] [Indexed: 01/25/2023] Open
Abstract
Objective The aim of this study was to assess the extent of misreporting in obese and nonobese adults on an absolute, ratio‐scaled, and allometrically‐scaled basis. Method Self‐reported daily energy intake (EI) was compared with total energy expenditure (TEE) in 221 adults (106 male, 115 female; age 53 ± 17 years, stature 1.68 ± 0.09 m, mass 79.8 ± 17.2 kg) who participated in a doubly‐labeled water (DLW) subsection of 2013–2015 National Diet and Nutrition Survey. Data were log transformed and expressed as absolute values, according to simple ratio‐standards (per kg body mass) and adjusted for body mass allometrically. Absolute and ratio‐scaled misreporting were examined using full‐factorial General Linear Models with repeated measures of the natural logarithms of TEE or EI as the within‐subjects factor. The natural logarithm of body mass was included as a covariate in the allometric method. The categorical variables of gender, age, obesity, and physical activity level (PAL) were the between‐factor variables. Results On an absolute‐basis, self‐reported EI (2759 ± 590 kcal·d−1) was significantly lower than TEE measured by DLW (2759 ± 590 kcal·d−1: F1,205 = 598.81, p < .001, ηp2 =0.75). We identified significantly greater underreporting in individuals with an obese BMI (F1,205 = 29.01, p <.001, ηp2 =0.12), in more active individuals (PAL > 1.75; F1,205 = 34.15, p <.001, ηp2 =0.14) and in younger individuals (≤55 years; F1,205 = 14.82, p < .001, ηp2 =0.07), which are all categories with higher energy needs. Ratio‐scaling data reduced the effect sizes. Allometric‐scaling removed the effect of body mass (F1,205 =0.02, p = 0.887, ηp2 =0.00). Conclusion In weight‐stable adults, obese individuals do not underreport dietary intake to a greater extent than nonobese individuals. These results contradict previous research demonstrating that obesity is associated with a greater degree of underreporting.
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Affiliation(s)
- Sally P. Waterworth
- School of Sport, Rehabilitation, and Exercise Sciences University of Essex Essex UK
| | - Catherine J. Kerr
- School of Sport, Rehabilitation, and Exercise Sciences University of Essex Essex UK
| | | | - Rianne Costello
- Oxford Brookes Centre for Nutrition and Health Oxford Brookes University Oxford UK
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Effect of Resistance Exercise on the Lipolysis Pathway in Obese Pre- and Postmenopausal Women. J Pers Med 2021; 11:jpm11090874. [PMID: 34575649 PMCID: PMC8471631 DOI: 10.3390/jpm11090874] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/24/2022] Open
Abstract
Physical exercise may stimulate lipolytic activity within adipose tissue. Furthermore, resistance exercise may contribute to the more efficient reduction in adipose tissue mass and prevent the accumulation thereof in obese women. The purpose of this study was to examine the effects of regular resistance exercise for 12 weeks on the lipolysis pathway in women with obesity. Twenty-three pre- and postmenopausal women with body fat percentages of 30% or more were divided into the premenopausal group (n = 9) and the postmenopausal group (n = 14). All subjects participated in resistance exercise training for 12 weeks. Anthropometric and physical fitness tests were performed on all participants. Protein analyses were performed on extracted subcutaneous fatty tissue, and changes in the relevant protein levels in the samples were analyzed by Western blotting. All serum samples were submitted for enzyme-linked immunosorbent assay measurements of adipocyte factors. After 12 weeks, the adipose triglyceride lipase, monoacylglycerol lipase, and perilipin1 protein levels were significantly lower in the postmenopausal group than in the premenopausal group. The hormone-sensitive lipase protein levels were significantly higher in the postmenopausal group than in the premenopausal group. In addition, leptin concentrations were significantly decreased after resistance exercise in the postmenopausal group. Adiponectin concentrations were significantly increased after resistance exercise in both groups. These findings indicate that regular resistance exercise is effective in reducing the weight and body fat of obese premenopausal women, and in the secretion of adiponectin. On the other hand, postmenopausal women were found to have redeced weight and body fat, and were found to be positive for the secretion of adipokine factors. In addition, positive changes in lipolysis pathway factors in adipose tissue promote lipid degradation and reduce fat mass. Thus, regular resistance exercise shows positive changes in the lipolysis pathway more effectively in weight and body fat reduction in postmenopausal women than in premenopausal women.
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