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

Reproducibility of the energy metabolism response to an oral glucose tolerance test: influence of a postcalorimetric correction procedure

PURPOSE

Metabolic flexibility (MetF), which is a surrogate of metabolic health, can be assessed by the change in the respiratory exchange ratio (RER) in response to an oral glucose tolerance test (OGTT). We aimed to determine the day-to-day reproducibility of the energy expenditure (EE) and RER response to an OGTT, and whether a simulation-based postcalorimetric correction of metabolic cart readouts improves day-to-day reproducibility.

METHODS

The EE was assessed (12 young adults, 6 women, 27 ± 2 years old) using an Omnical metabolic cart (Maastricht Instruments, Maastricht, The Netherlands) after an overnight fast (12 h) and after a 75-g oral glucose dose on 2 separate days (48 h). On both days, we assessed EE in 7 periods (one 30-min baseline and six 15-min postprandial). The ICcE was performed immediately after each recording period, and capillary glucose concentration (using a digital glucometer) was determined.

RESULTS

We observed a high day-to-day reproducibility for the assessed RER (coefficients of variation [CV] < 4%) and EE (CVs < 9%) in the 7 different periods. In contrast, the RER and EE areas under the curve showed a low day-to-day reproducibility (CV = 22% and 56%, respectively). Contrary to our expectations, the postcalorimetric correction procedure did not influence the day-to-day reproducibility of the energy metabolism response, possibly because the Omnical's accuracy was ~ 100%.

CONCLUSION

Our study demonstrates that the energy metabolism response to an OGTT is poorly reproducible (CVs > 20%) even using a very accurate metabolic cart. Furthermore, the postcalorimetric correction procedure did not influence the day-to-day reproducibility. Trial registration NCT04320433; March 25, 2020.

Comparing acute effects of extra virgin coconut oil and extra virgin olive oil consumption on appetite and food intake in normal-weight and obese male subjects

Objectives

The aim of this study is to compare acute effects of consuming extra virgin coconut oil (EVCO) as a source of medium chain fatty acids and extra virgin olive oil (EVOO) as a source of long chain fatty acids in normal weight and obese subjects.

Design

Randomised, crossover design.

Participants

Metabolically healthy twenty male subjects (10 normal weight; 10 obese) aged 19–40 years.

Intervention

Subjects consumed breakfast meals containing skimmed milk, fat-free white cheese, bread and EVCO (25 g) or EVOO (25 g).

Outcome measures

Visual analog scale evaluations, resting metabolic rate measurements and selected blood parameters analysis (glucose, triglyceride, insulin and plasma peptide YY) were performed before and after the test breakfast meals. In addition, energy intakes were evaluated by ad libitum lunch meal at 180 min.

Results

Visual analogue scale values of hunger and desire to eat decreased significantly after EVCO consumption than EVOO consumption in normal weight subjects at 180 min. There was an increase trend in plasma PYY at 30 and 180 min after EVCO breakfast compared to EVOO breakfast. Ad libitum energy intakes after EVCO and EVOO consumption in normal weight subjects were 924 ± 302; 845 ± 158 kcal (p = 0.272), respectively whereas in obese subjects were 859 ± 238; 994 ± 265 kcal (p = 0.069) respectively.

Conclusion

The results of this study shows that consumption of EVCO compared to EVOO may have suppressive effect on hunger and desire to eat, may affect postprandial PYY levels differently and have no effect on postprandial energy expenditure.

Trial registration

Clinical Trials NCT04738929.

Hibiscus sabdariffa tea affects diet-induced thermogenesis and subjective satiety responses in healthy men, but not in women: a randomized crossover trial

The aim of this study was to investigate the effect of Hibiscus sabdariffa tea on energy expenditure, satiety response and food intake. This is an open-label, crossover, randomized clinical trial (RBR-5HZ86T), including 21 subjects (11 women, 10 men). The individuals were evaluated at acute moments (fasting and after eating standardized breakfast accompanied by water or Hibiscus sabdariffa tea). Resting energy expenditure was measured by indirect calorimetry, subjective satiety responses were evaluated with a visual analogue scale and food intake was assessed by using food records. The volunteers who drank the Hibiscus sabdariffa tea had lower perception of hunger (p=0.002) and greater feeling of satiety (p=0.010) and fullness (p=0.009) compared to control. Men who ingested the Hibiscus sabdariffa tea had an increase in nitrogen energy expenditure (water: 1501±290.7kcal, Hibiscus sabdariffa tea: 1619±288.9kcal; p=0.029). In comparison to control, men presented less perception of hunger (p=0.003) and desire to eat (p=0.016), increased satiety (p=0.021) and fullness (p=0.010), and women oxidized more fat (p=0.034) when they drank Hibiscus sabdariffa tea. There was no difference between treatments regarding the energy and macronutrient intake from the first meal and throughout the day (p>0.050) for all participants. The Hibiscus sabdariffa tea only affected energy expenditure and satiety responses in men. Clinical trial registry: ReBEC Platform of the Brazilian Clinical Trials Registry - RBR-5HZ86T Novelty bullets • Hibiscus sabdariffa tea promoted an increase in energy expenditure and caused less perception of hunger/desire to eat in men. • Hibiscus sabdariffa tea intake increased postprandial fat oxidation in women.

Effects of coconut oil consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat

PURPOSE

Virgin coconut oil (VCO) is a medium-chain fatty acid source with popularly attributed benefits on obesity management. However, its role on obesity requires elucidation due to its saturated nature. In the study herein, we investigated acute effects of VCO consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat.

METHODS

Fifteen adult women with excess body fat (37.43 ± 0.83%) participated in this randomized, crossover, controlled study. Two isocaloric mixed breakfasts containing 25 mL of VCO or control (extra-virgin olive oil-C) were evaluated. Resting energy expenditure (REE), fat oxidation rate (FOR), diet induced thermogenesis (DIT) and appetitive subjective responses were assessed at fasting and postprandial periods (up to 240 min). Cardiometabolic risk markers were assessed at fasting and up to 180 min postprandially.

RESULTS

VCO did not affect REE, FOR, and DIT compared to C. In addition, VCO did not cause deleterious change in triglycerides, total cholesterol, HDL-c, LDL-c, triglycerides/HDL-c ratio, uric acid, glucose and Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR) (P _{time×treatment} > 0.05). However, VCO suppressed less hunger (P _{time×treatment} = 0.003), total satiety (P _iAUC = 0.021) and total fullness (P _iAUC = 0.035) responses than C.

CONCLUSIONS

VCO consumption did not acutely change energy metabolism and cardiometabolic risk markers when added to a mixed breakfast but promoted less appetitive responses.

The Energy Content and Composition of Meals Consumed after an Overnight Fast and Their Effects on Diet Induced Thermogenesis: A Systematic Review, Meta-Analyses and Meta-Regressions

This systematic review investigated the effects of differing energy intakes, macronutrient compositions, and eating patterns of meals consumed after an overnight fast on Diet Induced Thermogenesis (DIT). The initial search identified 2482 records; 26 papers remained once duplicates were removed and inclusion criteria were applied. Studies (n = 27) in the analyses were randomized crossover designs comparing the effects of two or more eating events on DIT. Higher energy intake increased DIT; in a mixed model meta-regression, for every 100 kJ increase in energy intake, DIT increased by 1.1 kJ/h (p < 0.001). Meals with a high protein or carbohydrate content had a higher DIT than high fat, although this effect was not always significant. Meals with medium chain triglycerides had a significantly higher DIT than long chain triglycerides (meta-analysis, p = 0.002). Consuming the same meal as a single bolus eating event compared to multiple small meals or snacks was associated with a significantly higher DIT (meta-analysis, p = 0.02). Unclear or inconsistent findings were found by comparing the consumption of meals quickly or slowly, and palatability was not significantly associated with DIT. These findings indicate that the magnitude of the increase in DIT is influenced by the energy intake, macronutrient composition, and eating pattern of the meal.

Methodological considerations for meal-induced thermogenesis: measurement duration and reproducibility

Meal-induced thermogenesis (MIT) research findings have been highly inconsistent, in part, due to the variety of durations and protocols used to measure MIT. In the present study, we aimed to determine the following: (1) the proportion of a 6 h MIT response completed at 3, 4 and 5 h; (2) the associations between the shorter durations and the 6 h measures; (3) whether shorter durations improved the reproducibility of the measurement. MIT was measured in response to a 2410 kJ mixed composition meal in ten individuals (five males and five females) on two occasions. Energy expenditure was measured continuously for 6 h post-meal using indirect calorimetry, and MIT was calculated as the increase in energy expenditure above the pre-meal RMR. On average, 76, 89 and 96 % of the 6 h MIT response was completed within 3, 4 and 5 h, respectively, and MIT at each of these time points was strongly correlated with the 6 h MIT response (range for correlations, r 0·990-0·998; P< 0·01). The between-day CV for the 6 h measurement was 33 %, but it was significantly lower after 3 h of measurement (CV 26 %; P= 0·02). Despite variability in the total MIT between days, the proportion of MIT that was completed at 3, 4 and 5 h was reproducible (mean CV: 5 %). While 6 h are typically required to measure the complete MIT response, the 3 h measures provide sufficient information about the magnitude of the MIT response and may be applicable for testing individuals on repeated occasions.

Reduced postprandial energy expenditure and increased exogenous fat oxidation in young woman after ingestion of test meals with a low protein content

BACKGROUND

Macronutrient composition of diets can influence energy balance in humans. We tested the hypothesis whether low protein content in single meals may induce lower values of energy expenditure (EE) and fat oxidation (FO) as compared to adequate protein content.

METHODS

Indirect calorimetry was combined with a breath test using naturally 13C-enriched corn oil to differentiate between postprandial exogenous and endogenous FO. Young women ingested single meals containing either 3.9% (low protein, LP) or 11.4% (adequate protein, AP) of total energy (~3100 kJ) as protein.

RESULTS

Postprandial EE was 160 kJ/6 h lower (p < 0.01) after LP meals and diet induced thermogenesis (DIT) increased less (p < 0.001) as compared to AP meals. Total postprandial FO was not significantly different between meals (~17 g/6 h). However, exogenous postprandial FO was significantly (p < 0.01) higher (4.28 +/- 1.57 g/6 h) after exposure to LP meals as compared to AP meals (1.87 +/- 1.00 g/6 h). Less than 10% of ingested fat (50 g) was oxidized in the postprandial phase. The overall postprandial fat balance was approximately + 33 g.

CONCLUSION

Breath tests using naturally 13C-labeled corn oil mirror exogenous FO. Low protein meals resulted in reduced postprandial EE and increased exogenous FO as compared to adequate protein meals without differences in total FO.

The acute effects of different sources of dietary calcium on postprandial energy metabolism

Dairy Ca intake has been shown to be superior to elemental Ca in increasing the loss of body fat during energy restriction. We questioned whether the mechanisms involved an increase in postprandial energy expenditure, fat oxidation and/or a greater lipolysis. The acute effects of different sources of Ca were examined in eight subjects, aged 47-66 years and BMI 27.6-36.1 kg/m2, in a three-way cross-over study. Subjects were randomly provided breakfast meals either low in dairy Ca and vitamin D (LD; control), high in non-dairy Ca (calcium citrate) but low in vitamin D (HC) or high in dairy Ca and vitamin D (HD). Diet-induced thermogenesis, fat oxidation rates (FOR), carbohydrate oxidation rates (COR), insulin, glucose, NEFA and glycerol were measured hourly over a 6 h postprandial period. Postprandial data were calculated as a change (Delta) from the fasting value. Results showed that DeltaNEFA was significantly different between meals (LD -1.50 (sem 0.26), HC -1.22 (sem 0.32), HD -0.94 (sem 0.27) mmol/l x 6 h; P = 0.035), with a lesser suppression following both high-Ca meals. DeltaFOR was significantly higher following the two high-Ca meals (LD -6.5 (sem 2.2), HC 2.93 (sem 2.34), HD 3.3 (sem 2.5) g x 6 h; P = 0.005), while reciprocally DeltaCOR was significantly lower. DeltaGlycerol was less suppressed following the high-Ca meals but statistical significance was not achieved. No differences in diet-induced thermogenesis, insulin or glucose were observed. Regardless of source, Ca intake acutely stimulated postprandial fat oxidation; and there was a lesser suppression of NEFA following these meals.

Variability in energy expenditure and its components

PURPOSE OF REVIEW

To review factors contributing to variation in total daily energy expenditure and its primary components: (1) resting metabolic rate; (2) diet-induced thermogenesis; and (3) activity thermogenesis, including exercise energy expenditure and nonexercise activity. For each component, the expected magnitude of intra-individual variability is also considered. We also reviewed studies that quantified the variability in 24 h energy expenditure.

RECENT FINDINGS

In humans, the coefficient of variation in the components of total daily energy expenditure is around 5-8% for resting metabolic rate, 1-2% for exercise energy expenditure, and around 20% for diet-induced thermogenesis. The coefficient of variance for 24 h energy expenditure measured using a room calorimeter for resting metabolic rate is around 5-10%. Thus, these measures are all rather reproducible. Total daily energy expenditure varies several-fold in humans, not due to variation in resting metabolic rate, diet-induced thermogenesis, or exercise thermogenesis, but rather, due to variations in nonexercise activity. A variety of factors impact nonexercise activity, including occupation, environment, education, genetics, age, gender, and body composition, but little is known about the magnitude of effect.

SUMMARY

Resting metabolic rate, diet-induced thermogenesis, exercise energy expenditure, and 24 h energy expenditure are highly reproducible. Coefficient of variation is smallest for exercise energy expenditure, followed by resting metabolic rate, 24 h energy expenditure, and diet-induced thermogenesis. There is considerable variability in total daily energy expenditure, largely due to variations in nonexercise activity. Although the factors that impact upon nonexercise activity are understood, their contribution to variation in total daily energy expenditure is unclear.

The acute effects of olive oil v. cream on postprandial thermogenesis and substrate oxidation in postmenopausal women

The influence of the source of dietary fat on postprandial thermogenesis and substrate oxidation rates, was examined in twelve postmenopausal women aged 57-73 years, with BMI 21.9-38.3 kg/m(2). A single blind, randomised, paired comparison of two high-fat, isoenergetic, mixed test meals was conducted. The major source of fat was either cream (CREAM) or extra virgin olive oil (EVOO). RMR, diet-induced thermogenesis (DIT) and substrate oxidation rates over 5 h were measured by indirect calorimetry. There were no differences in body weight, RMR, fasting carbohydrate or fat oxidation rates between the two occasions. DIT (EVOO 97 (SD 46) v. CREAM 76 (SD 69) kJ/5 h and EVOO 5.2 (SD 2.5) v. CREAM 4.1 (SD 3.7)% energy) did not differ between the two test meals. The postprandial increase in carbohydrate oxidation rates, relative to their respective fasting values (DeltaCOX), was significantly lower following the EVOO meal (EVOO 10.6 (SD 8.3) v. CREAM 17.5 (SD 10) g/5 h; paired t test, P=0.023), while postprandial fat oxidation rates (DeltaFOX) were significantly higher (EVOO 0.0 (SD 4.4) v. CREAM -3.6 (sd 4.0) g/5 h; P=0.028). In the eight obese subjects, however, DIT was significantly higher following the EVOO meal (EVOO 5.1 (SD 2.0) v. CREAM 2.5 (sd 2.9) %; P=0.01). This was accompanied by a significantly lower DeltaCOX (EVOO 10.9 (SD 9.9) v. CREAM 17.3 (SD 10.5) g/5 h; P=0.03) and significantly higher DeltaFOX (EVOO 0.11 (SD 4.4) v. CREAM -4.1 (SD 4.5) g/5 h, P=0.034). The present study showed that olive oil significantly promoted postprandial fat oxidation and stimulated DIT in abdominally obese postmenopausal women.

Total energy expenditure and physical activity in children treated with home parenteral nutrition

Determining total energy expenditure (TEE) and its components in children treated with home parenteral nutrition (CHPN) under free-living conditions is an important consideration in the assessment of energy requirements and the maintenance of health. The aim of this study was to assess TEE and physical activity in CHPN. Eleven CHPN (three girls and eight boys; median age, 6.0 y; range, 4.5-15.0 y) were compared with 11 healthy children (three girls and eight boys; median age, 6.0 y, range, 4.5-14.0 y) after pairing for sex, age, and weight. Underlying diseases included chronic intractable diarrhea (n = 5), short bowel syndrome (n = 3), and intestinal dysmotility (n = 3). None of these children had inflammatory disease or recent infection when studied. Fat-free mass (FFM), measured by body impedance analysis, fat mass (FM), measured by skinfold thickness, and energy intake were similar between the two groups, suggesting that CHPN had normal body composition and energy intake. Resting energy expenditure (REE), measured by indirect calorimetry, and TEE, assessed by a technique using 24-h heart-rate monitoring calibrated against indirect calorimetry and physical activity using a triaxial accelerometer, were simultaneously recorded and were also similar in the two groups. Sleeping energy expenditure (SEE), expressed per kilogram of FFM, was significantly greater in the CHPN group (median, 0.15; range, 0.10-0.23 kJ/min/kg FFM versus median, 0.12; range, 0.09-0.21 kJ/min/kg FFM for controls; p < 0.05, Wilcoxon rank test). These findings were explained by the high correlation between the energy flow infused by parenteral nutrition and sleeping energy expenditure (p < 0.05, Spearman test) and also-diet induced thermogenesis (p < 0.05 Spearman test). These results suggest that the energy requirements of children on long-term home parenteral nutrition programs do not differ from controls and that cyclic parenteral nutrition does not interfere with physical activity.

The influence of the type of dietary fat on postprandial fat oxidation rates: monounsaturated (olive oil) vs saturated fat (cream)

OBJECTIVE

To compare postprandial whole-body fat oxidation rates in humans, following high-fat (43% of total energy) mixed breakfast meals, of fixed energy and macronutrient composition, rich in either monounsaturated fat (MUFA) from extra virgin olive oil or saturated fat (SFA) from cream.

DESIGN

Paired comparison of resting metabolic rate (RMR), thermic effect of a meal and substrate oxidation rates following consumption of isocaloric breakfast meals, differing only in the type of fat, administered in random order 1-2 weeks apart.

SUBJECTS

Fourteen male volunteers, body mass index (BMI) in the range 20-32 kg/m(2), aged 24-49 y and resident in Melbourne, Australia, were recruited by advertisement in the local media or by personal contact.

MEASUREMENTS

Body size and composition was determined by anthropometry and dual energy X-ray absorptiometry (DEXA). Indirect calorimetry was used to measure RMR, thermic effect of a meal, post-meal total energy expenditure and substrate oxidation rate. Blood pressure and pulse rates were measured with an automated oscillometric system. Fasting and 2 h postprandial glucose and insulin concentrations and the fasting lipid profile were also determined.

RESULTS

In the 5 h following the MUFA breakfast, there was a significantly greater postprandial fat oxidation rate (3.08+/-4.58 g/5 h, P=0.017), and lower postprandial carbohydrate oxidation rate (P=0.025), than after the SFA breakfast. Thermic effect of a meal was significantly higher (55 kJ/5 h, P=0.034) after the MUFA breakfast, in subjects with a high waist circumference (HWC > or = 99 cm) than those with a low waist circumference (LWC<99 cm). This difference was not detected following the SFA breakfast (P=0.910).

CONCLUSION

If postprandial fat oxidation rates are higher after high MUFA, rather than SFA meals, then a simple change to the type of dietary fat consumed might have beneficial effects in curbing weight gain in men consuming a relatively high-fat diet. This may be particularly evident in men with a large waist circumference.

Increased thermogenic response to food and fat oxidation in female athletes: relationship with VO(2 max)

The thermogenic response to food (TRF) and substrate oxidation were studied in 12 endurance-trained and 13 untrained female subjects. Energy expenditure and substrate oxidation were calculated by indirect calorimetry before and for 6 h after an oral test meal and after the same meal given intragastrically on a separate occasion. The TRF was calculated after the oral meal, the obligatory component after the intragastric meal (OTRF), and the facultative component from the difference between the two. VO(2 max) was measured on a treadmill and body composition by underwater weighing. The TRF and OTRF were significantly higher in trained than in untrained subjects: 223 +/- 63 vs. 185 +/- 50 kJ/6 h (P < 0.03) and 174 +/- 38 vs. 131 +/- 37 kJ/6 h (P < 0.01) for the TRF and OTRF in trained vs. untrained subjects, respectively. Multiple regression analysis showed that maximum O(2) consumption (VO(2 max)), but not percentage of body fat, was significantly related to OTRF (r =0.68, P < 0.01). Trained subjects had higher fatty acid oxidation than untrained subjects before (0.6 vs. 0.4 mg. kg(-1). min(-1), P < 0.05) and after the oral meal (13 +/- 6 vs. 8 +/- 4 g/6 h P < 0.05). These results demonstrate that 1) TRF is higher in trained than in untrained women; 2) this is due to a higher cost of nutrient digestion, absorption and storage; 3) the difference is related to higher VO(2 max); and 4) fatty acid oxidation is greater in trained women in both the postabsorptive and postprandial states. These observations suggest that endurance training induces metabolic changes that favor leanness.

Resting metabolic rate and thermic effects of a sucrose-sweetened soft drink during the menstrual cycle in young Chinese women

The resting metabolic rate (RMR) and thermic effects (TEF) of a sucrose-sweetened soft drink in a group (n = 19) of ovulating young Chinese women were determined by indirect calorimetry in the midfollicular and midluteal phases of the menstrual cycle. Urinary luteinizing hormone surge was used to confirm ovulation. The RMR was measured twice in each phase and found to be similar (F(1,18) = 0.863) across the follicular (5018 kJ/24 h) and the luteal (5098 kJ/24 h) phases. Within each phase and on separate days, subjects were given water (280 mL) or sucrose-sweetened soft drink (539 kJ). Soft drink, but not water, consumption increased energy expenditure over a period of 45 min. Compared with the follicular phase, a small but significant increase in TEF (kJ/45 min) was observed in the luteal phase (t = 2.434, p < 0.05). Energy expenditure after drinking the soft drink, however, was similar in the two phases. RMR was positively correlated with TEF (r = 0.613, p < 0.01) and net TEF (r = 0.648, p < 0.005) in the luteal but not the follicular phase. In ovulating women, the thermic effect of sucrose is influenced by the phase of the menstrual cycle.Key words: menstrual cycle, resting metabolic rate, thermic effect of food, sucrose, Chinese women.

The thermic effect of food and obesity: a critical review

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

Metabolic responses to isoenergetic meals containing different proportions of carbohydrate and fat

The purpose of the present study was to investigate the interrelationship between carbohydrate and fat metabolism at rest after isoenergetic meals of varying proportions of carbohydrate and fat. Eight physically-active subjects (BMI 18.1-23.4 kg/m2) were studied at rest on three occasions after an overnight fast. In a balanced design they were given meals containing carbohydrate, protein and fat in the following amounts respectively (g/70 kg body weight): meal 1 121, 16, 48; meal 2 70, 16, 70; meal 3 50, 14, 80. All meals were isoenergetic, containing 4.0 MJ/70 kg body weight, and were of similar appearance. In addition, on a fourth occasion five of the eight subjects consumed meal 4 (g/70 kg body weight): carbohydrate 0, protein 0, fat 108. Blood samples were taken before eating the meal and at intervals following the meal to determine metabolic and hormonal responses. Energy expenditure and substrate oxidation were measured by indirect calorimetry and balance was calculated over the 5 h postprandial period. The incremental areas under the time curves for fat oxidation were greatest after meals 3 and 4 (P < 0.05), whereas incremental areas under the carbohydrate oxidation v. time curves were relatively reduced after these two meals (P < 0.05). This was accompanied by lesser suppression of plasma non-esterified fatty acid concentrations (P < 0.001) and reduced plasma insulin concentrations (P < 0.001) following these meals. Energy balance was almost identical after the three isoenergetic meals. In contrast, there was an inverse relationship between carbohydrate and fat balance following these meals, with carbohydrate balance decreasing as carbohydrate intake decreased and fat balance increasing as fat intake increased. We conclude that there is a close interrelationship between carbohydrate and fat metabolism following isoenergetic meals in resting subjects.

Role of the autonomic nervous system in the thermogenic response to food in lean individuals

The aim of this study was to determine the role of the autonomic nervous system (ANS) in obligatory and facultative components of the thermogenic response to food (TRF). Nineteen lean, healthy subjects participated in this study, which comprised two protocols, each exploring one component of the ANS. In the first experimental group, propranolol (prime: 80 micrograms/kg; continuous: 1 microgram.kg-1.min-1) was infused intravenously to inhibit sympathetic nervous activity (SNA), whereas in the second group atropine (prime: 5 micrograms/kg; continuous: 5 micrograms.kg-1.min-1) was used to inhibit parasympathetic nervous activity (PNA). The TRF was measured on four occasions: 1) after oral ingestion of a breakfast, during 0.9% NaCl perfusion, 2) after oral ingestion of the same breakfast, during the perfusion of one of the drugs, 3) after intragastric injection of a pureed form of the same meal as in part 1, during 0.9% NaCl perfusion, and 4) after intragastric feeding, during the administration of one of the drugs. Energy expenditure was measured by indirect calorimetry for 30 min before and 6 h after ingestion of the meal. Facultative TRF was defined as the difference between oral and intragastric TRF. Intragastric feeding significantly reduced TRF in both studies: 6.6 +/- 1.0 vs. 8.7 +/- 0.8% of the ingested energy in the SNA study and 5.5 +/- 1.6 vs. 7.4 +/- 3.1% in the PNA study. During propranolol infusion, TRF was significantly lower than it was during saline infusion after oral feeding (6.9 +/- 1.0% vs. 8.7 +/- 0.8% of ingested energy) but not after intragastric feeding. During atropine administration, TRF was reduced after both oral and intragastric feeding, although statistical significance was not reached in the latter. Atropine administration decreased gastric emptying (measured with an isotopic method) 2 h postingestion by 50%. These results show that the SNA is necessary for the facultative component of TRF to occur in humans. The role of the PNA appears to be related to its action on gastric emptying.

Effects of RU 486 on energy expenditure and meal tolerance in normal men

OBJECTIVE

To evaluate the possible actions of glucocorticoids on resting energy expenditure and the thermogenic response to food in man.

METHODS

The morning after administration of RU 486 or placebo, resting metabolic rate (RMR) and the thermogenic response to food (TRF), were measured after the ingestion of a standardized meal in 12 healthy male volunteers. Plasma glucose (PG) and insulin (PI) concentrations were also measured at regular intervals.

RESULTS

1) After RU 486 administration, plasma cortisol was elevated throughout the test comparatively to placebo. 2) Fraction and concentration of free cortisol were also higher after RU 486 than after placebo. 3) Corticosteroid-binding-globulin (CBG) was similar in both experimentations. 4) RMR was not different after RU 486 (1656 +/- 144 kcal/day) or after placebo (1632 +/- 120 kcal/day). 5) TRF was not different after RU 486 or placebo (54 +/- 12 kcal vs 59 +/- 13 kcal over a 6 hour period for RU 486 and placebo, respectively). 6) Baseline glucose concentrations were similar at baseline but PG was higher 90 minutes postprandial with RU 486: 5.3 +/- 1.7 mmol/L vs 3.7 +/- 0.8 mmol/L for placebo. 7) Plasma insulin was similar at baseline but it was significantly higher at 90 minutes postprandial after RU 486 (347 +/- 143 vs 241 +/- 73 pmol/L for RU 486 and placebo, respectively).

CONCLUSIONS

This study shows that acute inhibition of glucocorticoid action does not alter RMR and TRF in healthy men and that a mild deterioration of glucose tolerance follows the ingestion of RU 486.

No substantial reduction of the thermic effect of a meal during pregnancy in well-nourished Dutch women

To investigate changes in the thermic effect of a meal (TEM) during pregnancy, metabolic rate was measured in the fasting state and during the first 180 min after consumption of a standardized test meal in twenty-seven women before, and in each trimester of pregnancy. Resting metabolic rate (RMR) showed a steady increase over pregnancy: values in weeks 24 and 35 of pregnancy were significantly higher than the prepregnancy baseline (Tukey's studentized range test). The pattern of changes of postprandial metabolic rate (PPMR) was similar to that of RMR. Consequently TEM, calculated as PPMR minus RMR, did not change over pregnancy; mean TEM values (kJ/180 min) before and in weeks 13, 24 and 35 of pregnancy were 117.3 (SD 19.4), 116.4 (SD 23.7), 111.6 (SD 24.4) and 111.5 (SD 26.7) respectively. We consider changes in TEM of less than 15% to be of little importance physiologically. If true changes in TEM over pregnancy are 15% or more we would have had a 90% chance of observing significant changes in TEM in the present study, given the number of subjects and the methods used. Therefore, we conclude that no substantial reduction in TEM occurs during pregnancy.

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

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

Thermic effect of a meal. 3. Effect of dietary supplementation in chronically undernourished human subjects

Five apparently healthy, chronically undernourished (UN) male volunteers aged between 18 and 30 years were studied before and after 12 weeks of dietary supplementation. The thermic effect of a meal (TEM) was measured over a period of 6 h using a ventilated-hood system. Results indicated a significant increase in body-weight after supplementation due to increases in body fat and fat-free mass (FFM) in the proportion of 69% and 31% respectively. The basal metabolic rates (BMR) measured post supplementation were significantly higher in absolute terms, with a trend towards higher values when adjusted for the changes in FFM. TEM responses measured after 12 weeks of supplementation were significantly lower when expressed either in absolute terms (presupplementation 227.0 kJ v. post supplementation 193.5 kJ), or as a percentage of the energy density of the meal (9.1% v. 7.7%). This lower TEM was reciprocal to the changes in the BMR (r -0.86). The post-meal total energy output (PMTEO) was, however, not significantly different after 12 weeks of dietary supplementation. The unchanged PMTEO would indicate an unaltered 'thermogenic capacity', following supplementation, in these chronically undernourished subjects. These results confirm our earlier conclusion that, in chronic undernutrition, the thermic response to a meal may not contribute to any energy saving.