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Hengist A, Davies RG, Walhin JP, Buniam J, Merrell LH, Rogers L, Bradshaw L, Moreno-Cabañas A, Rogers PJ, Brunstrom JM, Hodson L, van Loon LJC, Barton W, O'Donovan C, Crispie F, O'Sullivan O, Cotter PD, Proctor K, Betts JA, Koumanov F, Thompson D, Gonzalez JT. Ketogenic diet but not free-sugar restriction alters glucose tolerance, lipid metabolism, peripheral tissue phenotype, and gut microbiome: RCT. Cell Rep Med 2024; 5:101667. [PMID: 39106867 PMCID: PMC11384946 DOI: 10.1016/j.xcrm.2024.101667] [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: 02/02/2024] [Revised: 04/01/2024] [Accepted: 07/09/2024] [Indexed: 08/09/2024]
Abstract
Restricted sugar and ketogenic diets can alter energy balance/metabolism, but decreased energy intake may be compensated by reduced expenditure. In healthy adults, randomization to restricting free sugars or overall carbohydrates (ketogenic diet) for 12 weeks reduces fat mass without changing energy expenditure versus control. Free-sugar restriction minimally affects metabolism or gut microbiome but decreases low-density lipoprotein cholesterol (LDL-C). In contrast, a ketogenic diet decreases glucose tolerance, increases skeletal muscle PDK4, and reduces AMPK and GLUT4 levels. By week 4, the ketogenic diet reduces fasting glucose and increases apolipoprotein B, C-reactive protein, and postprandial glycerol concentrations. However, despite sustained ketosis, these effects are no longer apparent by week 12, when gut microbial beta diversity is altered, possibly reflective of longer-term adjustments to the ketogenic diet and/or energy balance. These data demonstrate that restricting free sugars or overall carbohydrates reduces energy intake without altering physical activity, but with divergent effects on glucose tolerance, lipoprotein profiles, and gut microbiome.
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Affiliation(s)
| | | | | | - Jariya Buniam
- University of Bath, Bath, UK; Chulabhorn Royal Academy, Bangkok, Thailand
| | | | | | | | | | | | | | - Leanne Hodson
- University of Oxford and National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospital Trusts, Oxford, UK
| | | | - Wiley Barton
- Teagasc Food Research Centre, Moorepark, Cork, Ireland; APC Microbiome Ireland, Cork, Ireland; VistaMilk, Cork, Ireland
| | - Ciara O'Donovan
- Teagasc Food Research Centre, Moorepark, Cork, Ireland; APC Microbiome Ireland, Cork, Ireland
| | - Fiona Crispie
- Teagasc Food Research Centre, Moorepark, Cork, Ireland; APC Microbiome Ireland, Cork, Ireland
| | - Orla O'Sullivan
- Teagasc Food Research Centre, Moorepark, Cork, Ireland; APC Microbiome Ireland, Cork, Ireland; VistaMilk, Cork, Ireland
| | - Paul D Cotter
- Teagasc Food Research Centre, Moorepark, Cork, Ireland; APC Microbiome Ireland, Cork, Ireland; VistaMilk, Cork, Ireland
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2
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Ho DKN, Liao YC, Mayasari NR, Chien MM, Chung M, Bai CH, Huang YL, Chen YC, Tseng SH, Chang CC, Chiu WC, Sangopas P, Tseng HT, Kao JW, Ngu YJ, Chang JS. The effects of dietary macronutrient composition on resting energy expenditure following active weight loss: A systematic review and meta-analysis. Obes Rev 2024; 25:e13760. [PMID: 38697953 DOI: 10.1111/obr.13760] [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: 11/26/2022] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 05/05/2024]
Abstract
A systematic review and meta-analysis was conducted to evaluate the relative effectiveness of different dietary macronutrient patterns on changes in resting energy expenditure (REE) in relation to weight loss, categorized as minimal (<5%) and moderate to high (>5%). Changes in REE were assessed using a DerSimonian and Laird random-effects meta-analysis. A diet lower in carbohydrates (CHO) or higher in fat and protein was associated with smaller reductions in REE, with these trends being more pronounced among participants who experienced moderate to high weight loss. Adjusted meta-regression analysis indicated that, within the participants who experienced moderate to high weight loss, each 1% increase in CHO intake was associated with a reduction of 2.30 kcal/day in REE (95% CI: -4.11 to -0.47, p = 0.013). In contrast, a 1% increase in protein and fat intake was correlated with an increase in REE by 3.00 (95% confidence interval [CI] [1.02, 5.07], p = 0.003) and 0.5 (95% CI [-2.43, 3.41], p = 0.740) kcal/day, respectively. No significant associations were found among participants who experienced minimal weight loss. These findings indicate that, under a caloric deficit, the impact of dietary macronutrient composition on REE may vary depending on the degree of weight loss and individual metabolic responses.
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Affiliation(s)
- Dang Khanh Ngan Ho
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yu Chi Liao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Noor Rohmah Mayasari
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Department of Nutrition, Faculty of Engineering, Universitas Negeri Surabaya, Surabaya, Indonesia
| | - Mu-Ming Chien
- Department of Pediatrics, Taipei Medical University Hospital, Taipei, Taiwan
| | - Mei Chung
- School of Medicine, Tufts University, Boston, Massachusetts, USA
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Chyi-Huey Bai
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ya-Li Huang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yang-Ching Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Sung-Hui Tseng
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chun-Chao Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wan-Chun Chiu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Department of Nutrition, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Patchara Sangopas
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Hsiang-Tung Tseng
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Jing Wen Kao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yi Jing Ngu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei, Taiwan
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3
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Sciarrillo CM, Guo J, Hengist A, Darcey VL, Hall KD. Flawed reanalysis fails to support the carbohydrate-insulin model of obesity. J Nutr 2024; 154:1058-1060. [PMID: 38286396 PMCID: PMC10997902 DOI: 10.1016/j.tjnut.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024] Open
Affiliation(s)
- Christina M Sciarrillo
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Juen Guo
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Aaron Hengist
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Valerie L Darcey
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
| | - Kevin D Hall
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.
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4
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Li Z, Zhang X. Assessing human internal exposure to chemicals at different physical activity levels: A physiologically based kinetic (PBK) model incorporating metabolic equivalent of task (MET). ENVIRONMENT INTERNATIONAL 2023; 182:108312. [PMID: 37956621 DOI: 10.1016/j.envint.2023.108312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/27/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023]
Abstract
Physical activity levels have the potential to impact human internal exposure to environmental chemicals. However, the current lack of simple modeling approaches hinders the high-throughput screening of chemical exposure at different physical activity levels. To address this gap, this study proposes a straightforward model for assessing human internal exposure to chemicals. Our approach is based on the physiologically based kinetic (PBK) model and utilizes the metabolic equivalent of task (MET) to characterize internal exposure to chemicals at varying activity levels. To facilitate the application of this model, we have developed an Excel-based operation tool, allowing users to easily modify the MET value and generate simulation results for different physical activity levels. The simulation results demonstrate that as physical activity levels increase, the biotransfer factors (BTFs) of chemicals decrease, suggesting that higher physical activity levels reduce the bioaccumulation potential of chemicals. The intensified physical activity enhances the overall elimination kinetics of chemicals from the human body. However, the simulated concentrations of chemicals in the human body increase with higher physical activity levels, due to the significantly increased external exposure to chemicals, such as through inhalation. Our proposed modeling approach, along with the operational tool, enables high-throughput simulation of human chronic internal exposure to chemicals at different physical activity levels, where the findings can assist in screening chemicals for further health risk assessment. To accomplish this, the model incorporates certain assumptions and utilizes generic model input values. However, due to the intricate nature of the interaction between external and internal exposures at different physical activity levels, validating the simulation through experimental studies becomes challenging and is not performed in this study. For future studies, we recommend incorporating more MET-related physiological input variables, improving energy balance estimates, comprehending external exposure estimates, and conducting cohort studies to enhance and validate the proposed modeling approach.
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Affiliation(s)
- Zijian Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong 518107, China.
| | - Xiaoyu Zhang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, Guangdong 518107, China
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5
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Flanagan EW, Spann R, Berry SE, Berthoud HR, Broyles S, Foster GD, Krakoff J, Loos RJF, Lowe MR, Ostendorf DM, Powell-Wiley TM, Redman LM, Rosenbaum M, Schauer PR, Seeley RJ, Swinburn BA, Hall K, Ravussin E. New insights in the mechanisms of weight-loss maintenance: Summary from a Pennington symposium. Obesity (Silver Spring) 2023; 31:2895-2908. [PMID: 37845825 PMCID: PMC10915908 DOI: 10.1002/oby.23905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/18/2023] [Accepted: 08/04/2023] [Indexed: 10/18/2023]
Abstract
Obesity is a chronic disease that affects more than 650 million adults worldwide. Obesity not only is a significant health concern on its own, but predisposes to cardiometabolic comorbidities, including coronary heart disease, dyslipidemia, hypertension, type 2 diabetes, and some cancers. Lifestyle interventions effectively promote weight loss of 5% to 10%, and pharmacological and surgical interventions even more, with some novel approved drugs inducing up to an average of 25% weight loss. Yet, maintaining weight loss over the long-term remains extremely challenging, and subsequent weight gain is typical. The mechanisms underlying weight regain remain to be fully elucidated. The purpose of this Pennington Biomedical Scientific Symposium was to review and highlight the complex interplay between the physiological, behavioral, and environmental systems controlling energy intake and expenditure. Each of these contributions were further discussed in the context of weight-loss maintenance, and systems-level viewpoints were highlighted to interpret gaps in current approaches. The invited speakers built upon the science of obesity and weight loss to collectively propose future research directions that will aid in revealing the complicated mechanisms involved in the weight-reduced state.
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Affiliation(s)
| | - Redin Spann
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Sarah E. Berry
- Department of Nutritional Sciences, King’s College London, London, UK
| | | | | | - Gary D. Foster
- WW International, New York, New York, USA
- Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology & Clinical Research Branch, NIDDK-Phoenix, Phoenix, Arizona, USA
| | - Ruth J. F. Loos
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Danielle M. Ostendorf
- Department of Medicine, Anschutz Health and Wellness Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tiffany M. Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Leanne M. Redman
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Michael Rosenbaum
- Division of Molecular Genetics and Irving Center for Clinical and Translational Research, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Randy J. Seeley
- Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Boyd A. Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Kevin Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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6
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Fernández-Verdejo R, Mey JT, Ravussin E. Effects of ketone bodies on energy expenditure, substrate utilization, and energy intake in humans. J Lipid Res 2023; 64:100442. [PMID: 37703994 PMCID: PMC10570604 DOI: 10.1016/j.jlr.2023.100442] [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: 07/12/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023] Open
Abstract
The potential of ketogenic approaches to regulate energy balance has recently gained attention since ketones may influence both energy expenditure and energy intake. In this narrative review, we summarized the most relevant evidence about the role of ketosis on energy expenditure, substrate utilization, and energy intake in humans. We considered different strategies to induce ketosis, such as fasting, dietary manipulation, and exogenous ketone sources. In general, ketosis does not have a major influence on energy expenditure but promotes a shift in substrate utilization towards ketone body oxidation. The strategies to induce ketosis by reduction of dietary carbohydrate availability (e.g., ketogenic diets) do not independently influence energy intake, being thus equally effective for weight loss as diets with higher carbohydrate content. In contrast, the intake of medium-chain triglycerides and ketone esters induces ketosis and appears to increase energy expenditure and reduce energy intake in the context of high carbohydrate availability. These latter strategies lead to slightly enhanced weight loss. Unfortunately, distinguishing the effects of the various ketogenic strategies per se from the effects of other physiological responses is not possible with the available human data. Highly controlled, inpatient studies using targeted strategies to isolate the independent effects of ketones are required to adequately address this knowledge gap.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA; Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - Jacob T Mey
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
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7
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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: 11] [Impact Index Per Article: 11.0] [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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8
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Thomas DM, Kleinberg S, Brown AW, Crow M, Bastian ND, Reisweber N, Lasater R, Kendall T, Shafto P, Blaine R, Smith S, Ruiz D, Morrell C, Clark N. Machine learning modeling practices to support the principles of AI and ethics in nutrition research. Nutr Diabetes 2022; 12:48. [PMID: 36456550 PMCID: PMC9715415 DOI: 10.1038/s41387-022-00226-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 10/28/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Nutrition research is relying more on artificial intelligence and machine learning models to understand, diagnose, predict, and explain data. While artificial intelligence and machine learning models provide powerful modeling tools, failure to use careful and well-thought-out modeling processes can lead to misleading conclusions and concerns surrounding ethics and bias. METHODS Based on our experience as reviewers and journal editors in nutrition and obesity, we identified the most frequently omitted best practices from statistical modeling and how these same practices extend to machine learning models. We next addressed areas required for implementation of machine learning that are not included in commercial software packages. RESULTS Here, we provide a tutorial on best artificial intelligence and machine learning modeling practices that can reduce potential ethical problems with a checklist and guiding principles to aid nutrition researchers in developing, evaluating, and implementing artificial intelligence and machine learning models in nutrition research. CONCLUSION The quality of AI/ML modeling in nutrition research requires iterative and tailored processes to mitigate against potential ethical problems or to predict conclusions that are free of bias.
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Affiliation(s)
- Diana M. Thomas
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
| | - Samantha Kleinberg
- grid.217309.e0000 0001 2180 0654Department of Computer Science, Stevens Institute of Technology, Hoboken, NJ 07030 USA
| | - Andrew W. Brown
- grid.241054.60000 0004 4687 1637Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR 72205 USA ,grid.488749.eArkansas Children’s Research Institute, Little Rock, AR 72202 USA
| | - Mason Crow
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
| | - Nathaniel D. Bastian
- grid.419884.80000 0001 2287 2270Army Cyber Institute, United States Military Academy, West Point, NY 10996 USA
| | - Nicholas Reisweber
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
| | - Robert Lasater
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
| | - Thomas Kendall
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
| | - Patrick Shafto
- grid.430387.b0000 0004 1936 8796Department of Mathematics and Computer Science, Rutgers University, Newark, NJ 07102 USA
| | - Raymond Blaine
- grid.419884.80000 0001 2287 2270Department of Electrical Engineering and Computer Science, United States Military Academy, West Point, NY 10996 USA
| | - Sarah Smith
- grid.419884.80000 0001 2287 2270Department of Electrical Engineering and Computer Science, United States Military Academy, West Point, NY 10996 USA
| | - Daniel Ruiz
- grid.419884.80000 0001 2287 2270Department of Electrical Engineering and Computer Science, United States Military Academy, West Point, NY 10996 USA
| | - Christopher Morrell
- grid.419884.80000 0001 2287 2270Department of Electrical Engineering and Computer Science, United States Military Academy, West Point, NY 10996 USA
| | - Nicholas Clark
- grid.419884.80000 0001 2287 2270Department of Mathematical Sciences, United States Military Academy, West Point, NY 10996 USA
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9
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Issues related to the assessment of energy balance during short-term over-, under- and refeeding in normal weight men. Eur J Clin Nutr 2022; 77:538-545. [PMID: 36076069 DOI: 10.1038/s41430-022-01208-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND In humans, it is unclear how different estimates of energy balance (EB) compare with each other and whether the resulting changes in body weight (bw) and body composition (BC) are predictable and reproducible. METHODS This is a secondary data analysis of effects of sequential 7d over- (OF), 21d under- (UF) and 14d refeeding (RF) on EB. Energy intake (EI) was controlled at +/- 50% of energy needs in a 32 normal weight men (see Am J Clin Nutr. 2015; 102:807-819). EB was calculated (i) directly from the difference between EI and energy expenditure (EE) and (ii) indirectly from changes in BC. Changes in fat mass (FM) were compared with predicted changes according to Hall et al. (Lancet 2011; 378:826-37). Finally, within-subject reproducibility of changes in bw and BC was tested in a subgroup. RESULTS There were interindividual and day-by-day variabilities in changes in bw and BC. During OF and RF, the two estimates of EB were similar while with UF the indirect approach underestimated the direct estimate by 10593 ± 7506 kcal/21d (p < 0.001). Considerable differences became evident between measured and predicted changes in FM. Adjusting measured for predicted values did not reduce their interindividual variance. During UF, changes in bw and BC were reproducible, while corresponding changes during OF were not. CONCLUSION During hypercaloric nutrition the direct estimate of EB corresponded to the indirect estimate whereas this was not true during UF. Changes in bw and BC in response to OF were not reproducible while they were during UF.
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Perez-Montilla JJ, Cuevas-Cervera M, Gonzalez-Muñoz A, Garcia-Rios MC, Navarro-Ledesma S. Efficacy of Nutritional Strategies on the Improvement of the Performance and Health of the Athlete: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074240. [PMID: 35409921 PMCID: PMC8998415 DOI: 10.3390/ijerph19074240] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/28/2022] [Accepted: 03/31/2022] [Indexed: 02/04/2023]
Abstract
Evidence shows that the use of food strategies can impact health, but a clear consensus about how the effects of different food strategies impact improvement in the athlete’s performance and health remain unclear. This study evaluated how food strategies, specifically intermittent fasting and a ketogenic diet affect health and performance in healthy athletes. Study selection for this review was based on clinical trial studies analyzing changes in performance and health in athletes. The Pubmed, Web of Science, PEDro, Dialnet, Scopus, CINAHL, ProQuest, Medline and Cochrane databases were searched. The Physiotherapy Evidence Database (PEDro) scale, PEDro Internal Validity Scale (IVS) and Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a variety of fields (QUALSYT) checklists were used to evaluate the risk of bias of the included studies. Articles were selected based on criteria concerning the effectiveness of nutritional strategies on athletes’ performance; articles should be randomized clinical trials (RCTs) or uncontrolled clinical trials; they should be human studies and they should have been published less than 7 years ago. A total of 15 articles were evaluated, 8 randomised clinical trials and 7 non-randomized clinical studies, with 411 participants who satisfied our inclusion criteria and were included in this review. The results of the study showed intermittent fasting and time-restricted feeding as strategies that produce health benefits. On the other hand, the ketogenic diet did not reach an appropriate consensus. The articles presented a medium level of methodological quality in the PEDro scale, low quality in IVS scale and high quality in QUALSYT scale. Despite the lack of studies analyzing changes in the performance and health of athletes after the use of different nutritional strategies, intermittent fasting and time-restricted feeding should be considered since they seem to be effective, and further studies are necessary.
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Affiliation(s)
- J. Javier Perez-Montilla
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain; (J.J.P.-M.); (M.C.-C.)
| | - Maria Cuevas-Cervera
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain; (J.J.P.-M.); (M.C.-C.)
| | - Ana Gonzalez-Muñoz
- Clínica Ana González, Avenida Hernan Nuñez de Toledo 6, 29018 Malaga, Spain
- Correspondence: (A.G.-M.); (S.N.-L.)
| | - Maria Carmen Garcia-Rios
- Department of Physiotherapy, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
| | - Santiago Navarro-Ledesma
- Department of Physiotherapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Querol Street, 5, 52004 Melilla, Spain; (J.J.P.-M.); (M.C.-C.)
- Correspondence: (A.G.-M.); (S.N.-L.)
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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: 56] [Impact Index Per Article: 28.0] [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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12
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Energy Imbalance Gap, Anthropometric Measures, Lifestyle, and Sociodemographic Correlates in Latin American Adults-Results from the ELANS Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031129. [PMID: 35162152 PMCID: PMC8835004 DOI: 10.3390/ijerph19031129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/16/2022]
Abstract
Overweight and obesity are often explained by an imbalance between energy intake and expenditure. This, in addition to metabolic effects, makes it difficult to assess the real state of individual energy balance. This study aims to analyze the energy gaps between intake and expenditure in the adult population of Latin America, as well as its relationships with sociodemographic variables and nutrition status, to draw an epidemiological perspective based on the trends observed. The energy imbalance gap was used to this end. The difference between energy intake and expenditure can be applied as a reference to explain whether weight equilibrium can prevent weight gain. Moreover, the energy imbalance gap allows for a better understanding of the design of public health policies. Using data from the Latin American Study of Nutrition and Health, the energy imbalance gap in adult population from eight Latin-American countries was assessed in 5994 subjects aged from 19-65. Usual dietary intake was measured using two non-consecutive 24 h dietary recalls. The sociodemographic questionnaire was supplemented by anthropometric measurements. Physical activity was measured through the long International Physical Activity Questionnaire. Energy expenditure was obtained using the basal metabolic rate. For the overall sample, the mean energy intake was 1939.1 kcal (95% CI: 1926.9; 1951.3), the mean of energy expenditure was 1915.7 kcal (95% CI: 1906.4; 1924.9), and the mean of energy imbalance gap was 23.4 kcal (95% CI: 11.9; 35.0). Results show that energy intake and expenditure were higher in men. Moreover, subjects aged 19-34, of high socioeconomic level, who completed high school, were mestizos and were of normal weight consumed the highest number of calories. Overall, a positive energy imbalance gap was observed. Overweight and obese from Argentina, Costa Rica, Ecuador, Peru, and Venezuela showed a significantly lower energy imbalance gap than underweight subjects. These findings confirm the high variability of energy imbalance gap and the accompanying correlates of energy intake and expenditure. Further research is needed to specifically address interventions in low and middle-income countries such as many in Latin America, to help reduce the prevalence of obesity and eradicate undernutrition.
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13
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Modeling Energy Expenditure Estimation in Occupational Context by Actigraphy: A Multi Regression Mixed-Effects Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910419. [PMID: 34639718 PMCID: PMC8508338 DOI: 10.3390/ijerph181910419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 11/17/2022]
Abstract
The accurate prediction of energy requirements for healthy individuals has many useful applications. The occupational perspective has also been proven to be of great utility for improving workers' ergonomics, safety, and health. This work proposes a statistical regression model based on actigraphy and personal characteristics to estimate energy expenditure and cross-validate the results with reference standardized methods. The model was developed by hierarchical mixed-effects regression modeling based on the multitask protocol data. Measurements combined actigraphy, indirect calorimetry, and other personal and lifestyle information from healthy individuals (n = 50) within the age of 29.8 ± 5 years old. Results showed a significant influence of the variables related to movements, heart rate and anthropometric variables of body composition for energy expenditure estimation. Overall, the proposed model showed good agreement with energy expenditure measured by indirect calorimetry and evidenced a better performance than the methods presented in the international guidelines for metabolic rate assessment proving to be a reliable alternative to normative guidelines. Furthermore, a statistically significant relationship was found between daily activity and energy expenditure, which raised the possibility of further studies including other variables, namely those related to the subject's lifestyle.
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14
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Landry MJ, Crimarco A, Gardner CD. Benefits of Low Carbohydrate Diets: a Settled Question or Still Controversial? Curr Obes Rep 2021; 10:409-422. [PMID: 34297345 PMCID: PMC9621749 DOI: 10.1007/s13679-021-00451-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review was to provide an update on the available data on the benefits of low-carbohydrate (low-carb) diets for weight management and type 2 diabetes (T2DM) and determine if low-carb diets were a settled question or still controversial. RECENT FINDINGS Most of the recent published literature in this area consists of reviews of past trials, with a relatively smaller number of recent trials. Low-carb is most commonly compared to low-fat, with problematically inconsistent definitions of both. There are numerous challenges in trying to draw clear conclusions about efficacy and effectiveness. Short-term vs. long-term effects can differ, which is likely impacted by adherence. Adherence is very different between metabolic chamber or feeding studies vs. free-living. Body weight alone is a crude measure that fails to capture potentially important differences in lean-mass, fat-mass, and body water. Benefits for glycemic control need to be balanced with impacts on non-glycemic outcomes such as LDL-cholesterol, the microbiome, and inflammation. It is important to differentiate between low-carb and very-low carbohydrate diets (VLCD). To date no large-scale long-term clinical trials have been conducted testing whether low-carb diets can prevent T2DM. Many issues regarding benefits and risks of low-carb diets remain controversial or unresolved, particularly for VLCD. Some of the recent, better studies highlighted in this review suggest strategies for resolving these controversies.
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Affiliation(s)
- Matthew J Landry
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Anthony Crimarco
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Christopher D Gardner
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, USA.
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Minderis P, Fokin A, Dirmontas M, Kvedaras M, Ratkevicius A. Caloric Restriction per se Rather Than Dietary Macronutrient Distribution Plays a Primary Role in Metabolic Health and Body Composition Improvements in Obese Mice. Nutrients 2021; 13:3004. [PMID: 34578880 PMCID: PMC8466799 DOI: 10.3390/nu13093004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022] Open
Abstract
Caloric restriction (CR) is of key importance in combating obesity and its associated diseases. We aimed to examine effects of dietary macronutrient distribution on weight loss and metabolic health in obese mice exposed to CR. Male C57BL/6J mice underwent diet-induced obesity for 18 weeks. Thereafter mice were exposed to a 6-week CR for up to 40% on either low-fat diet (LFD; 20, 60, 20% kcal from protein, carbohydrate, fat), low-carb diet (LCD; 20, 20, 60% kcal, respectively) or high-pro diet (HPD; 35, 35, 30% kcal, respectively) (n = 16 each). Ten mice on the obesogenic diet served as age-matched controls. Body composition was evaluated by tissue dissections. Glucose tolerance, bloods lipids and energy metabolism were measured. CR-induced weight loss was similar for LFD and LCD while HPD was associated with a greater weight loss than LCD. The diet groups did not differ from obese controls in hindlimb muscle mass, but showed a substantial decrease in body fat without differences between them. Glucose tolerance and blood total cholesterol were weight-loss dependent and mostly improved in LFD and HPD groups during CR. Blood triacylglycerol was lowered only in LCD group compared to obese controls. Thus, CR rather than macronutrient distribution in the diet plays the major role for improvements in body composition and glucose control in obese mice. Low-carbohydrate-high-fat diet more successfully reduces triacylglycerol but not cholesterol levels compared to isocaloric high-carbohydrate-low-fat weight loss diets.
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Affiliation(s)
- Petras Minderis
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (A.F.); (M.K.); (A.R.)
| | - Andrej Fokin
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (A.F.); (M.K.); (A.R.)
| | - Mantas Dirmontas
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, 44221 Kaunas, Lithuania;
| | - Mindaugas Kvedaras
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (A.F.); (M.K.); (A.R.)
| | - Aivaras Ratkevicius
- Institute of Sport Science and Innovations, Lithuanian Sports University, 44221 Kaunas, Lithuania; (A.F.); (M.K.); (A.R.)
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, 44221 Kaunas, Lithuania;
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16
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Guyenet SJ, Hall KD. Overestimated Impact of Lower-Carbohydrate Diets on Total Energy Expenditure. J Nutr 2021; 151:2496-2497. [PMID: 34363484 PMCID: PMC8491863 DOI: 10.1093/jn/nxab213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
| | - Kevin D Hall
- Intramural Research Program, Integrative Physiology Section, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MA, USA
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17
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Kaiyala KJ. Review of Measuring Metabolic Rates: A Manual for Scientists. Physiol Biochem Zool 2021. [DOI: 10.1086/714603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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18
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Silveira SL, Jeng B, Gower BA, Motl RW. Feasibility, Acceptability, and Preliminary Validity of Self-Report Dietary Assessment in Adults with Multiple Sclerosis: Comparison with Doubly Labeled Water Measured Total Energy Expenditure. Nutrients 2021; 13:1198. [PMID: 33916406 PMCID: PMC8066556 DOI: 10.3390/nu13041198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/30/2021] [Accepted: 04/01/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Diet is a modifiable behavior of interest in multiple sclerosis (MS); however, measures of diet in persons with MS have not been vetted for feasibility, acceptability, and validity. METHODS This cross-sectional study examined the Automated Self-Administered 24-H (ASA24) Dietary Assessment Tool in 30 persons with MS and 15 healthy control (HC) participants. Participants were prompted to complete six ASA24 recalls and undergo a standard doubly labeled water (DLW) protocol. Acceptability of ASA24 was assessed using an online questionnaire. Total energy expenditure (TEE) from DLW was compared with ASA24-reported energy intake for assessing validity. RESULTS All participants completed four or more ASA24 recalls, indicating feasibility of ASA24. Regarding acceptability, the hardest part of completing the ASA24 was remembering everything eaten the previous day. Pearson correlation coefficients between DLW TEE and ASA24 kcal/day were not significant among HC (r = 0.40; p = 0.14) or MS (r = 0.26; p = 0.16) participants. The absolute mean error between DLW TEE and ASA24 among HC participants was 694.96 ± 506.25 mean kcal/day and among MS participants was 585.37 ± 529.02 mean kcal/day; this represents a mean difference of 30 and 25%, respectively. CONCLUSION This study established the feasibility and acceptability of ASA24 in persons with MS and provides a foundation regarding the need for further validation research examining appropriate outcomes for supporting dietary interventions.
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Affiliation(s)
- Stephanie L. Silveira
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL 35209, USA; (B.J.); (R.W.M.)
- Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, 1155 Union Circle #310769, Denton, TX 76203, USA
| | - Brenda Jeng
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL 35209, USA; (B.J.); (R.W.M.)
| | - Barbara A. Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, 1675 University Blvd, Birmingham, AL 35233, USA;
| | - Robert W. Motl
- Department of Physical Therapy, University of Alabama at Birmingham, 3810 Ridgeway Drive, Birmingham, AL 35209, USA; (B.J.); (R.W.M.)
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19
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Schutz Y, Montani JP, Dulloo AG. Low-carbohydrate ketogenic diets in body weight control: A recurrent plaguing issue of fad diets? Obes Rev 2021; 22 Suppl 2:e13195. [PMID: 33471427 DOI: 10.1111/obr.13195] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 01/02/2023]
Abstract
The most appropriate type of diets to maintain or lose body weight over the medium to long term has been a matter of controversy and debates for more than half a century. Both voluntarily and coercive food restriction, resulting in negative energy and macronutrient balance and hence weight loss, have not been designed to be maintained for the long term. By contrast, when a classical and traditional type of alimentation is consumed in ad lib conditions (e.g., the Mediterranean "diet"), it generally provides an appropriate nutritional density of essential macronutrients and micronutrients; it is hence appropriate for long-term use, and it provides several benefits for health if the compliance of the individuals is maintained over time. In this short review, we focus on four specific aspects: first, the need to agree on a clear definition of what is "low" versus "high" in terms of total carbohydrate intake and total fat intakes, both generally inversely related, in a representative individual with a certain lifestyle and a certain body morphology; second, the importance of discussing the duration over which it could be prescribed, that is, acute versus chronic conditions, focusing on the comparison between the fashion and often ephemeral low-carbohydrate diet (acute) with the well-recognized traditional Mediterranean type of alimentation (chronic), which includes lifestyle changes; third, the particular metabolic characteristics induced by the low-carbohydrate (high fat) diet, namely, the scramble up of ketone bodies production. The recent debate on ketogenic diets concern whether or not, in iso-energetic conditions, low-carbohydrate diets would significantly enhance energy expenditure. This is an issue that is more "academic" than practical, on the ground that the putative difference of 100-150 kcal/day or so (in the recent studies) is not negligible but within the inherent error of the methodology used to track total energy expenditure in free living conditions by the doubly labeled water technique. Fourth, the potential medical risks and shortcomings of ingesting (over the long term) low-carbohydrate ketogenic diets could exacerbate underlying renal dysfunction, consecutive to the joint combination of high-fat, high-protein diets, particularly in individuals with obesity. This particular diet promotes metabolic acidosis and renal hyperfiltration, which ultimately may contribute to a significant reduction in life expectancy in middle-age people.
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Affiliation(s)
- Yves Schutz
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Jean-Pierre Montani
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Abdul G Dulloo
- Department of Endocrinology, Metabolism and Cardiovascular System, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
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Hall KD, Guo J, Courville AB, Boring J, Brychta R, Chen KY, Darcey V, Forde CG, Gharib AM, Gallagher I, Howard R, Joseph PV, Milley L, Ouwerkerk R, Raisinger K, Rozga I, Schick A, Stagliano M, Torres S, Walter M, Walter P, Yang S, Chung ST. Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake. Nat Med 2021; 27:344-353. [PMID: 33479499 DOI: 10.1038/s41591-020-01209-1] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/10/2020] [Indexed: 01/29/2023]
Abstract
The carbohydrate-insulin model of obesity posits that high-carbohydrate diets lead to excess insulin secretion, thereby promoting fat accumulation and increasing energy intake. Thus, low-carbohydrate diets are predicted to reduce ad libitum energy intake as compared to low-fat, high-carbohydrate diets. To test this hypothesis, 20 adults aged 29.9 ± 1.4 (mean ± s.e.m.) years with body mass index of 27.8 ± 1.3 kg m-2 were admitted as inpatients to the National Institutes of Health Clinical Center and randomized to consume ad libitum either a minimally processed, plant-based, low-fat diet (10.3% fat, 75.2% carbohydrate) with high glycemic load (85 g 1,000 kcal-1) or a minimally processed, animal-based, ketogenic, low-carbohydrate diet (75.8% fat, 10.0% carbohydrate) with low glycemic load (6 g 1,000 kcal-1) for 2 weeks followed immediately by the alternate diet for 2 weeks. One participant withdrew due to hypoglycemia during the low-carbohydrate diet. The primary outcomes compared mean daily ad libitum energy intake between each 2-week diet period as well as between the final week of each diet. We found that the low-fat diet led to 689 ± 73 kcal d-1 less energy intake than the low-carbohydrate diet over 2 weeks (P < 0.0001) and 544 ± 68 kcal d-1 less over the final week (P < 0.0001). Therefore, the predictions of the carbohydrate-insulin model were inconsistent with our observations. This study was registered on ClinicalTrials.gov as NCT03878108 .
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Affiliation(s)
- Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.
| | - Juen Guo
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Amber B Courville
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - James Boring
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Robert Brychta
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Kong Y Chen
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Valerie Darcey
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Ciaran G Forde
- Singapore Institute for Food and Biotechnology Innovation, Singapore, Singapore
| | - Ahmed M Gharib
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Isabelle Gallagher
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Rebecca Howard
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Paule V Joseph
- National Institute of Nursing Research, Bethesda, MD, USA
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Lauren Milley
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Ronald Ouwerkerk
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | | | - Irene Rozga
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Alex Schick
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Michael Stagliano
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Stephan Torres
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Mary Walter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Peter Walter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Shanna Yang
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Stephanie T Chung
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
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21
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Ludwig DS, Dickinson SL, Henschel B, Ebbeling CB, Allison DB. Do Lower-Carbohydrate Diets Increase Total Energy Expenditure? An Updated and Reanalyzed Meta-Analysis of 29 Controlled-Feeding Studies. J Nutr 2020; 151:482-490. [PMID: 33274750 PMCID: PMC7948201 DOI: 10.1093/jn/nxaa350] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/29/2020] [Accepted: 10/12/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The effect of macronutrient composition on total energy expenditure (TEE) remains controversial, with divergent findings among studies. One source of heterogeneity may be study duration, as physiological adaptation to lower carbohydrate intake may require 2 to 3 wk. OBJECTIVE We tested the hypothesis that the effects of carbohydrate [expressed as % of energy intake (EI)] on TEE vary with time. METHODS The sample included trials from a previous meta-analysis and new trials identified in a PubMed search through 9 March 2020 comparing lower- and higher-carbohydrate diets, controlled for EI or body weight. Three reviewers independently extracted data and reconciled discrepancies. Effects on TEE were pooled using inverse-variance-weighted meta-analysis, with between-study heterogeneity assessed using the I2 statistic. Meta-regression was used to quantify the influence of study duration, dichotomized at 2.5 wk. RESULTS The 29 trials ranged in duration from 1 to 140 d (median: 4 d) and included 617 participants. Difference in carbohydrate between intervention arms ranged from 8% to 77% EI (median: 30%). Compared with reported findings in the prior analysis (I2 = 32.2%), we found greater heterogeneity (I2 = 90.9% in the reanalysis, 81.6% in the updated analysis). Study duration modified the diet effect on TEE (P < 0.001). Among 23 shorter trials, TEE was reduced on lower-carbohydrate diets (-50.0 kcal/d; 95% CI: -77.4, -22.6 kcal/d) with substantial heterogeneity (I2 = 69.8). Among 6 longer trials, TEE was increased on low-carbohydrate diets (135.4 kcal/d; 95% CI: 72.0, 198.7 kcal/d) with low heterogeneity (I2 = 26.4). Expressed per 10% decrease in carbohydrate as %EI, the TEE effects in shorter and longer trials were -14.5 kcal/d and 50.4 kcal/d, respectively. Findings were materially unchanged in sensitivity analyses. CONCLUSIONS Lower-carbohydrate diets transiently reduce TEE, with a larger increase after ∼2.5 wk. These findings highlight the importance of longer trials to understand chronic macronutrient effects and suggest a mechanism whereby lower-carbohydrate diets may facilitate weight loss.
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Affiliation(s)
| | | | - Beate Henschel
- Indiana University School of Public Health–Bloomington, Bloomington, IN, USA
| | - Cara B Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - David B Allison
- Indiana University School of Public Health–Bloomington, Bloomington, IN, USA
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Sanchez-Delgado G, Ravussin E. Assessment of energy expenditure: are calories measured differently for different diets? Curr Opin Clin Nutr Metab Care 2020; 23:312-318. [PMID: 32657792 PMCID: PMC9583681 DOI: 10.1097/mco.0000000000000680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW The prevalence and burden of obesity has reached alarming levels. The assessment of human energy expenditure enables the identification of obesity-prone and obesity-resistant individuals and helps to explain the short and long-term success of weight loss treatments. In this review, we describe the state-of-the-art methods used in the assessment of human energy expenditure and the impact of dietary intake on the interpretation of the data. RECENT FINDINGS The reference techniques to assess energy expenditure in humans have not significantly changed during the last century. Today, indirect calorimetry, either using a metabolic chamber or a metabolic cart, is the favored method to assess human energy expenditure and is the only method enabling the assessment of macronutrient oxidation. The doubly labeled water method however provides accurate assessment of human energy expenditure under free living conditions. SUMMARY Although energy expenditure and macronutrient oxidation can be assessed by simple calculations from oxygen consumption and carbon dioxide production, these calculations can provide erroneous results or require corrections and/or more complex interpretation when several biochemical pathways are simultaneously engaged. Such physiological mechanisms are often elicited by dietary interventions including, among other, gluconeogenesis, lipogenesis, ketogenesis, alcohol oxidation and under or overfeeding.
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Minderis P, Fokin A, Dirmontas M, Ratkevicius A. Hypocaloric Low-Carbohydrate and Low-Fat Diets with Fixed Protein Lead to Similar Health Outcomes in Obese Mice. Obesity (Silver Spring) 2020; 28:1494-1502. [PMID: 32639096 DOI: 10.1002/oby.22872] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE It is controversial whether low-carbohydrate diets are better suited for weight control and metabolic health than high-carbohydrate diets. This study examined whether these diets induce different improvements in body composition and glucose tolerance in obese mice during caloric restriction (CR). METHODS Male C57BL/6J mice were fed an obesogenic diet ad libitum for 18 weeks and then subjected to 6-week progressive CR of up to 40%, using either a low-fat or low-carbohydrate diet with equal protein content. Mice fed a regular chow diet ad libitum served as controls. Body mass, hindlimb muscle mass, fat mass, energy expenditure, and glucose tolerance were compared between the groups. RESULTS Initially low-fat and low-carbohydrate groups had similar body mass, which was 30% greater compared with controls. CR induced similar weight loss in low-fat and low-carbohydrate groups. This weight loss was mainly due to fat loss in both groups. Energy expenditure of freely moving mice did not differ between the groups. Glucose tolerance improved compared with the values before CR and in controls but did not differ between the diets. CONCLUSIONS Dietary carbohydrate or fat content does not affect improvements in body composition and metabolic health in obese mice exposed to CR with fixed energy and protein intake.
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Affiliation(s)
- Petras Minderis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Andrej Fokin
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Mantas Dirmontas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Aivaras Ratkevicius
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
- Department of Health Promotion and Rehabilitation, Lithuanian Sports University, Kaunas, Lithuania
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24
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Ebbeling CB, Bielak L, Lakin PR, Klein GL, Wong JMW, Luoto PK, Wong WW, Ludwig DS. Energy Requirement Is Higher During Weight-Loss Maintenance in Adults Consuming a Low- Compared with High-Carbohydrate Diet. J Nutr 2020; 150:2009-2015. [PMID: 32470981 PMCID: PMC7398766 DOI: 10.1093/jn/nxaa150] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/18/2019] [Accepted: 05/04/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Longer-term feeding studies suggest that a low-carbohydrate diet increases energy expenditure, consistent with the carbohydrate-insulin model of obesity. However, the validity of methodology utilized in these studies, involving doubly labeled water (DLW), has been questioned. OBJECTIVE The aim of this study was to determine whether dietary energy requirement for weight-loss maintenance is higher on a low- compared with high-carbohydrate diet. METHODS The study reports secondary outcomes from a feeding study in which the primary outcome was total energy expenditure (TEE). After attaining a mean Run-in weight loss of 10.5%, 164 adults (BMI ≥25 kg/m2; 70.1% women) were randomly assigned to Low-Carbohydrate (percentage of total energy from carbohydrate, fat, protein: 20/60/20), Moderate-Carbohydrate (40/40/20), or High-Carbohydrate (60/20/20) Test diets for 20 wk. Calorie content was adjusted to maintain individual body weight within ± 2 kg of the postweight-loss value. In analyses by intention-to-treat (ITT, completers, n = 148) and per protocol (PP, completers also achieving weight-loss maintenance, n = 110), we compared the estimated energy requirement (EER) from 10 to 20 wk of the Test diets using ANCOVA. RESULTS Mean EER was higher in the Low- versus High-Carbohydrate group in models of varying covariate structure involving ITT [ranging from 181 (95% CI: 8-353) to 246 (64-427) kcal/d; P ≤0.04] and PP [ranging from 245 (43-446) to 323 (122-525) kcal/d; P ≤0.02]. This difference remained significant in sensitivity analyses accounting for change in adiposity and possible nonadherence. CONCLUSIONS Energy requirement was higher on a low- versus high-carbohydrate diet during weight-loss maintenance in adults, commensurate with TEE. These data are consistent with the carbohydrate-insulin model and lend qualified support for the validity of the DLW method with diets varying in macronutrient composition. This trial was registered at clinicaltrials.gov as NCT02068885.
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Affiliation(s)
- Cara B Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston, MA, USA
| | - Lisa Bielak
- New Balance Foundation Obesity Prevention Center, Boston, MA, USA
| | - Paul R Lakin
- Institutional Centers for Clinical and Translational Research; Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Gloria L Klein
- New Balance Foundation Obesity Prevention Center, Boston, MA, USA
| | - Julia M W Wong
- New Balance Foundation Obesity Prevention Center, Boston, MA, USA
| | - Patricia K Luoto
- Department of Food and Nutrition, Framingham State University, Framingham, MA, USA
| | - William W Wong
- USDA/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine,Houston, TX, USA
| | - David S Ludwig
- New Balance Foundation Obesity Prevention Center, Boston, MA, USA
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25
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Ramuth H, Schutz Y, Calonne J, Joonas N, Dulloo AG. Total energy expenditure assessed by doubly labeled water technique and estimates of physical activity in Mauritian children: analysis by gender and ethnicity. Eur J Clin Nutr 2020; 74:445-453. [PMID: 31358885 PMCID: PMC7062628 DOI: 10.1038/s41430-019-0477-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/05/2019] [Accepted: 07/09/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES In the tropical island of Mauritius, the rise in obesity has accelerated in the past decades, and could be contributed by low physical activity and increased sedentary behavior. The study objectives were to generate the first dataset of total energy expenditure (TEE), to estimate physical activity in Mauritian children, and to explore differences due to gender and ethnicity. SUBJECTS/METHODS The doubly labeled water (DLW) technique was used to evaluate TEE over 14 days in 56 Mauritian school children (aged 7-11 years) belonging to the two main ethnic groups: Indian (South Asian descent) and Creole (African/Malagasy descent). Physical activity level (PAL) was calculated as the ratio of TEE and resting energy expenditure (using Schofield equations), and daily step counts were measured by accelerometry. Anthropometry and body composition were also assessed. RESULTS TEE measured by DLW was lower in Mauritian children (by ~155 kcal/d) than that predicted using FAO/WHO/UNU equations for children of the same sex, age, and body size. Furthermore, TEE, as well as PAL and step counts, also differed according to gender (lower in girls than in boys) and to ethnicity (lower in Indians than in Creoles) even after adjusting for differences in body weight and body composition. CONCLUSION These results in Mauritian children provide the first dataset of objectively measured TEE, from which physical activity is estimated as PAL, and complemented by step counts measurements. They suggest potential gender and ethnic differences in TEE and physical activity that need consideration in developing strategies to counter sedentary behavior and obesity.
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Affiliation(s)
- Harris Ramuth
- Victoria Hospital, Central Health Laboratory, Ministry of Health & Quality of Life, Port Louis, Mauritius
- Department of Endocrinology, Metabolism & Cardiovascular system, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Yves Schutz
- Department of Endocrinology, Metabolism & Cardiovascular system, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Julie Calonne
- Department of Endocrinology, Metabolism & Cardiovascular system, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland
| | - Noorjehan Joonas
- Victoria Hospital, Central Health Laboratory, Ministry of Health & Quality of Life, Port Louis, Mauritius
| | - Abdul G Dulloo
- Department of Endocrinology, Metabolism & Cardiovascular system, Faculty of Science & Medicine, University of Fribourg, Fribourg, Switzerland.
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26
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Friedman MI, Appel S. Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men: A secondary analysis of energy expenditure and physical activity. PLoS One 2019; 14:e0222971. [PMID: 31815933 PMCID: PMC6901216 DOI: 10.1371/journal.pone.0222971] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/09/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A previously published pilot study assessed energy expenditure (EE) of participants with overweight and obesity after they were switched from a baseline high-carbohydrate diet (BD) to an isocaloric low-carbohydrate ketogenic diet (KD). EE measured using metabolic chambers increased transiently by what was considered a relatively small extent after the switch to the KD, whereas EE measured using doubly labeled water (EEDLW) increased to a greater degree after the response in the chambers had waned. Using a publicly available dataset, we examined the effect of housing conditions on the magnitude of the increase in EEDLW after the switch to the KD and the role of physical activity in that response. METHODS The 14-day EEDLW measurement period included 4 days when subjects were confined to chambers instead of living in wards. To determine the effect on EEDLW only for the days subjects were living in the wards, we calculated non-chamber EE (EEnonchamber). To assess the role of physical activity in the response to the KD, we analyzed chamber and non-chamber accelerometer data for the BD and KD EEDLW measurement periods. RESULTS In comparison with the increase in average 14-day EEDLW of 151 kcal/d ± 63 (P = 0.03) after the switch to the KD, EEnonchamber increased by 203 ± 89 kcal/d (P = 0.04) or 283 ± 116 kcal/d (P = 0.03) depending on the analytical approach. Hip accelerometer counts decreased significantly (P = 0.01) after the switch to the KD, whereas wrist and ankle accelerometer counts did not change. CONCLUSIONS Switching from the BD to the KD substantially increased EEDLW, but apparently only on days subjects were living in the ward outside the metabolic chamber. Increased physical activity as measured by accelerometry did not appear to account for this effect.
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Affiliation(s)
- Mark I. Friedman
- Nutrition Science Initiative, San Diego, California, United States of America
| | - Scott Appel
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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27
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Hall KD. Mystery or method? Evaluating claims of increased energy expenditure during a ketogenic diet. PLoS One 2019; 14:e0225944. [PMID: 31815947 PMCID: PMC6901214 DOI: 10.1371/journal.pone.0225944] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/14/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Kevin D. Hall
- Laboratory of Biological Modeling, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States of America
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28
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Müller MJ, Bosy-Westphal A. Effect of Over- and Underfeeding on Body Composition and Related Metabolic Functions in Humans. Curr Diab Rep 2019; 19:108. [PMID: 31686224 DOI: 10.1007/s11892-019-1221-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Methodological limitations of body composition methods limit the validity of changes in body composition that are used to interpret metabolic outcome parameters of weight loss and weight gain. RECENT FINDINGS Direct assessment of energy balance is necessary for the assessment of early weight changes (i.e., within the 1st week of weight change), whereas body composition analysis with a high accuracy and a low minimal detectable change is recommended to assess ongoing changes. The sequence of underfeeding and overfeeding impacts the method inherent assumptions, and the considerable day-to-day and inter-individual variance in body composition changes is a challenge to the precision of methods. Weight loss-associated changes in body composition do not resemble their changes with subsequent hypercaloric re-feeding. Individual body components are related to specific metabolic functions where the structure-function relationships change with changes in energy balance. Analysis of structure-function relationships in response to weight changes needs to address (a) the validity, precision, and different outcome parameters of body composition methods and (b) the variance of results taking into account study protocols and the dynamics of weight changes. As for future studies, repeated measurements of body weight, body composition, and metabolic functions are needed before, during, and after weight changes focusing on the intra- and interindividual variances of weight change rather than on mean data only.
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Affiliation(s)
- Manfred James Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17-19, D-24105, Kiel, Germany.
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17-19, D-24105, Kiel, Germany
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29
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Hall KD, Guo J, Chen KY, Leibel RL, Reitman ML, Rosenbaum M, Smith SR, Ravussin E. Reply to DS Ludwig et al. Am J Clin Nutr 2019; 110:1255-1256. [PMID: 31667517 PMCID: PMC7307317 DOI: 10.1093/ajcn/nqz157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Kevin D Hall
- From the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD,Address correspondence to KDH, e-mail:
| | - Juen Guo
- From the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - Kong Y Chen
- From the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | | | - Marc L Reitman
- From the National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | | | - Steven R Smith
- The Translational Research Institute for Metabolism and Diabetes, Baton Rouge, LA
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30
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Ludwig DS, Ebbeling CB, Wong JMW, Wolfe RR, Wong WW. Methodological error in measurement of energy expenditure by the doubly labeled water method: much ado about nothing? Am J Clin Nutr 2019; 110:1253-1254. [PMID: 31667511 DOI: 10.1093/ajcn/nqz156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- David S Ludwig
- From the New Balance Foundation Obesity Prevention Center, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Cara B Ebbeling
- From the New Balance Foundation Obesity Prevention Center, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Julia M W Wong
- From the New Balance Foundation Obesity Prevention Center, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Robert R Wolfe
- University of Arkansas for Medical Sciences, Little Rock, AR
| | - William W Wong
- USDA Agricultural Research Service, Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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31
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Davy KP, Davy BM. Advances in Nutrition Science and Integrative Physiology: Insights From Controlled Feeding Studies. Front Physiol 2019; 10:1341. [PMID: 31736774 PMCID: PMC6828816 DOI: 10.3389/fphys.2019.01341] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/08/2019] [Indexed: 12/29/2022] Open
Abstract
Nutrition science is a highly impactful but contentious area of biomedical science. Establishing cause and effect relationships between the nutrients and/or diets we consume and the avoidance of or risk of disease is extremely challenging. As such, evidence-based nutrition is best served by considering the totality of evidence across multiple study types including nutritional epidemiological studies, randomized controlled trials of behavioral interventions, and controlled feeding studies. The purpose of the present review is to provide an overview for those conducting research outside of clinical nutrition on how controlled feeding studies can be used to gain insight into integrative physiology/metabolism as well as to inform dietary guidelines. We discuss the rationale, basic elements, and complexities of conducting controlled feeding studies and provide examples of contributions of controlled feeding studies to advances in nutrition science and integrative physiology. Our goal is to provide a resource for those wishing to leverage the experimental advantage provided by controlled feeding studies in their own research programs.
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Affiliation(s)
- Kevin P. Davy
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, United States
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32
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Do low-carbohydrate diets increase energy expenditure? Int J Obes (Lond) 2019; 43:2350-2354. [PMID: 31548574 PMCID: PMC8076039 DOI: 10.1038/s41366-019-0456-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/31/2019] [Accepted: 06/30/2019] [Indexed: 01/15/2023]
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33
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Hall KD, Ayuketah A, Brychta R, Cai H, Cassimatis T, Chen KY, Chung ST, Costa E, Courville A, Darcey V, Fletcher LA, Forde CG, Gharib AM, Guo J, Howard R, Joseph PV, McGehee S, Ouwerkerk R, Raisinger K, Rozga I, Stagliano M, Walter M, Walter PJ, Yang S, Zhou M. Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metab 2019; 30:67-77.e3. [PMID: 31105044 PMCID: PMC7946062 DOI: 10.1016/j.cmet.2019.05.008] [Citation(s) in RCA: 776] [Impact Index Per Article: 155.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/05/2019] [Accepted: 05/02/2019] [Indexed: 12/13/2022]
Abstract
We investigated whether ultra-processed foods affect energy intake in 20 weight-stable adults, aged (mean ± SE) 31.2 ± 1.6 years and BMI = 27 ± 1.5 kg/m2. Subjects were admitted to the NIH Clinical Center and randomized to receive either ultra-processed or unprocessed diets for 2 weeks immediately followed by the alternate diet for 2 weeks. Meals were designed to be matched for presented calories, energy density, macronutrients, sugar, sodium, and fiber. Subjects were instructed to consume as much or as little as desired. Energy intake was greater during the ultra-processed diet (508 ± 106 kcal/day; p = 0.0001), with increased consumption of carbohydrate (280 ± 54 kcal/day; p < 0.0001) and fat (230 ± 53 kcal/day; p = 0.0004), but not protein (-2 ± 12 kcal/day; p = 0.85). Weight changes were highly correlated with energy intake (r = 0.8, p < 0.0001), with participants gaining 0.9 ± 0.3 kg (p = 0.009) during the ultra-processed diet and losing 0.9 ± 0.3 kg (p = 0.007) during the unprocessed diet. Limiting consumption of ultra-processed foods may be an effective strategy for obesity prevention and treatment.
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Affiliation(s)
- Kevin D Hall
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA.
| | - Alexis Ayuketah
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Robert Brychta
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Hongyi Cai
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Thomas Cassimatis
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Kong Y Chen
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Stephanie T Chung
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Elise Costa
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Amber Courville
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Valerie Darcey
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Laura A Fletcher
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Ciaran G Forde
- Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - Ahmed M Gharib
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Juen Guo
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Rebecca Howard
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Paule V Joseph
- National Institute of Nursing Research, Bethesda, MD, USA
| | - Suzanne McGehee
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Ronald Ouwerkerk
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | | | - Irene Rozga
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Michael Stagliano
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Mary Walter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Peter J Walter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
| | - Shanna Yang
- National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Megan Zhou
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA
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Bistrian BR. Some Musings About Differential Energy Metabolism With Ketogenic Diets. JPEN J Parenter Enteral Nutr 2019; 43:578-582. [PMID: 31168839 DOI: 10.1002/jpen.1665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 05/22/2019] [Indexed: 12/24/2022]
Abstract
Ketogenic states are of 3 major types: total starvation and those resulting from the consumption of semistarvation, ketogenic diets, and eucaloric ketogenic diets. All are characterized by little or no dietary carbohydrate, resulting in a fat-based metabolism with sustained ketonemia of varying degrees in each state. The latter 2 diets are clinically useful with important impacts on both aspects of the energy balance equation with increased satiety and less hunger on the intake side and probably increased energy expenditure on the output side; both may have important implications for the successful long-term management of obesity. Consideration of older research regarding the hormonal response to carbohydrate-free dieting and recent findings on hepatic glycogen status that occurs with sustained ketonemia support the likelihood that there are profound differences in 24-hour gluconeogenesis rates between ketogenic diets and balanced diets containing substantial carbohydrate. This metabolic distinction could have a meaningful impact to increase the thermic effect of feeding and daily energy expenditure amounting to 100 kcal/d or more with each of the ketogenic diets.
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Affiliation(s)
- Bruce R Bistrian
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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35
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Ludwig DS, Lakin PR, Wong WW, Ebbeling CB. Scientific discourse in the era of open science: a response to Hall et al. regarding the Carbohydrate-Insulin Model. Int J Obes (Lond) 2019; 43:2355-2360. [PMID: 31586125 PMCID: PMC6892734 DOI: 10.1038/s41366-019-0466-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 12/14/2022]
Affiliation(s)
- David S. Ludwig
- 000000041936754Xgrid.38142.3cNew Balance Foundation Obesity Prevention Center, Boston Children’s Hospital and Harvard Medical School, Boston, MA USA
| | - Paul R. Lakin
- 0000 0004 0378 8438grid.2515.3Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA USA
| | - William W. Wong
- 0000 0001 2160 926Xgrid.39382.33USDA/Agricultural Research Service, Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX USA
| | - Cara B. Ebbeling
- 000000041936754Xgrid.38142.3cNew Balance Foundation Obesity Prevention Center, Boston Children’s Hospital and Harvard Medical School, Boston, MA USA
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