1
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Lindgren O, Ahrén B. Consequences on islet and incretin hormone responses to dinner by omission of lunch in healthy men. Endocrinol Diabetes Metab 2020; 3:e00141. [PMID: 32704562 PMCID: PMC7375076 DOI: 10.1002/edm2.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/31/2020] [Accepted: 04/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Omission of breakfast results in higher glucose and lower insulin and incretin hormone levels after both lunch and dinner. Whether omission of lunch has a similar impact on the following meal is not known. AIM This study therefore explored whether omission of lunch ingestion affects glucose, islet and incretin hormones after dinner ingestion in healthy subjects. MATERIALS & METHODS Twelve male volunteers (mean age 22 years, BMI 22.5 kg/m2) underwent two test days in random order with standard breakfast and dinner on both days with provision or omission of standard lunch in between. RESULTS The results showed that throughout the 300 minutes study period, glucose, insulin, glucagon and GIP levels after dinner ingestion did not differ between the two tests. In contrast, C-peptide, and GLP-1 levels were 26%-35% higher at later time points after dinner ingestion when lunch had been omitted (P < .05). CONCLUSION We conclude that omission of lunch increases GLP-1 and insulin secretion and possibly also insulin clearance resulting in unchanged glucose and insulin levels after dinner ingestion.
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Affiliation(s)
- Ola Lindgren
- Department of Clinical Sciences LundLund UniversityLundSweden
| | - Bo Ahrén
- Department of Clinical Sciences LundLund UniversityLundSweden
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2
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Duan D, Gu C, Jun JC. Altered metabolism in pulmonary hypertension: fuelling the fire or just smoke? Eur Respir J 2020; 55:2000447. [PMID: 32273332 PMCID: PMC7573924 DOI: 10.1183/13993003.00447-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 02/29/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Daisy Duan
- Division of Endocrinology, Diabetes and Metabolism, Dept of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chenjuan Gu
- Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jonathan C Jun
- Division of Pulmonary and Critical Care Medicine, Dept of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Pratt K, Cotto J, Xu J, Watowicz R, Walston M, Eneli I. Adolescents' and Parents' Perspectives of a Revised Protein-Sparing Modified Fast (rPSMF) for Severe Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3385. [PMID: 31547451 PMCID: PMC6765859 DOI: 10.3390/ijerph16183385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 09/07/2019] [Accepted: 09/09/2019] [Indexed: 01/01/2023]
Abstract
The purpose of this pilot study was to assess the acceptability to adolescents (11-18 years old) and their parents using a revised protein-sparing modified fast (rPSMF) for 12 months as an intervention for severe obesity in a tertiary pediatric weight management clinic (PWMC). To assess acceptability (satisfaction, confidence) with the rPSMF protocol, surveys were completed by adolescents and parents at baseline, 1, 3, 6, and 12 months, with adolescent height and weight measured. Analyses were conducted to assess differences in satisfaction and confidence based on adolescent response (weight loss) and adherence to the rPSMF. Adolescents' adherence with the rPSMF was close to 50% in the first 3 months, but dropped to 14.7% at 6 months. Adolescents were most confident with choosing low carbohydrate foods at baseline. Over 12 months, adolescents and parents reported weight loss as "the most liked" part of the rPSMF. Adolescents who were adherent were more satisfied with their weight loss than their non-adherent peers. Parents and adolescents reported lack of food variety and difficulty following the protocol as challenges with the rPSMF. Adolescents and their parents were able to follow the rPSMF protocol, with weight loss, but with decreased adherence over time.
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Affiliation(s)
- Keeley Pratt
- Department of Human Sciences, The Ohio State University, 130 Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA.
- Department of Surgery, The Ohio State Wexner Medical Center, Columbus, OH 43210, USA.
| | - Jennifer Cotto
- Department of Human Sciences, The Ohio State University, 130 Campbell Hall, 1787 Neil Avenue, Columbus, OH 43210, USA
| | - Jinyu Xu
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH 43210, USA
| | - Rosanna Watowicz
- Department of Nutrition, Case Western University, Cleveland, OH 43210, USA
| | - Marnie Walston
- Department of Pediatrics, Akron Children's Hospital, Akron, OH 43210, USA
| | - Ihuoma Eneli
- Department of Nutrition, Case Western University, Cleveland, OH 43210, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
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4
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Eneli I, Watowicz R, Xu J, Tindall A, Walston M, Tanner K, Worthington J, Pratt K. Rationale and design of a pilot study to evaluate the acceptability and effectiveness of a revised protein sparing modified fast (rPSMF) for severe obesity in a pediatric tertiary care weight management clinic. Contemp Clin Trials Commun 2019; 15:100388. [PMID: 31431932 PMCID: PMC6580089 DOI: 10.1016/j.conctc.2019.100388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 05/21/2019] [Accepted: 05/27/2019] [Indexed: 02/05/2023] Open
Abstract
Aggressive dietary interventions may provide an accessible treatment option for children and adolescents with severe obesity who are not successful with traditional lifestyle behavioral interventions or do not want or qualify for weight loss surgery. One such intensive dietary option is the protein sparing modified fast (PSMF). The PSMF involves minimal carbohydrate intake to induce ketosis, while maintaining adequate or high protein intake to minimize catabolism. The PSMF, under medical supervision, can be an effective and safe intervention for children and adolescents, yet the PSMF diet is not regularly used in the treatment of pediatric severe obesity. This paper describes the rationale and design for a pilot study to evaluate the acceptability and effectiveness of a revised PSMF (rPSMF) implemented as a weight loss treatment option for children and adolescents with severe obesity in a pediatric tertiary care weight management clinic. The primary aim of the study is to evaluate the acceptability of the rPSMF as assessed by adherence, satisfaction with the intervention, and participation rate using quantitative and qualitative methods. The secondary aim is to investigate the effectiveness of the rPSMF on improving a) anthropometric measures (weight, body mass index [BMI], BMI z-score); b) metabolic measures (lipid profile, glycosylated hemoglobin, liver function tests); and c) quality of life. Results of this study will provide guidance for the standardization of a pediatric rPSMF protocol in a clinic setting, delineate which factors improve or hinder adherence and weight loss and provide preliminary data for a multicenter randomized controlled trial. CLINICALTRIALSGOV IDENTIFIER NCT03899311.
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Affiliation(s)
- I.U. Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - R.P. Watowicz
- Department of Nutrition, Case Western University, Cleveland, OH, USA
| | - J. Xu
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
| | - A. Tindall
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA
| | - M. Walston
- Department of Pediatrics, Akron Children's Hospital, Akron, OH, USA
| | - K. Tanner
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, OH, USA
| | - J. Worthington
- Division of Clinical Therapies, Nationwide Children's Hospital, Columbus, OH, USA
| | - K.J. Pratt
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
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5
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Andela S, Burrows TL, Baur LA, Coyle DH, Collins CE, Gow ML. Efficacy of very low-energy diet programs for weight loss: A systematic review with meta-analysis of intervention studies in children and adolescents with obesity. Obes Rev 2019; 20:871-882. [PMID: 30734459 DOI: 10.1111/obr.12830] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/04/2018] [Accepted: 12/04/2018] [Indexed: 11/29/2022]
Abstract
The objective of this review was to evaluate the efficacy and safety of very low-energy diet (VLED) programs for weight loss in children and adolescents with obesity. Six electronic databases were searched identifying 24 eligible studies (16 pre-post studies, four nonrandomized trials, two randomized controlled trials [RCTs], and two chart reviews) published up to October 2018. Studies were in English, implemented a VLED (≤3360 kJF/day [≤800 kcal/day] or <50% estimated energy requirements) in 5- to 18-year-olds with obesity, and reported at least one weight-related outcome. Weight-related outcomes significantly improved postintervention in all studies. Meta-analysis of 20 studies indicated a mean 10.1 kg (95% confidence interval [CI], 8.7-11.4 kg, P < 0.001; I2 = 92.3%) weight loss following interventions lasting 3 to 20 weeks. Moderator analysis indicated greater weight loss in adolescent-only studies (10-18 years) and formulated meal replacement interventions and inpatient settings. Meta-analysis of seven studies reporting weight at follow-up (5-14.5 months from baseline) indicated 5.3 kg mean weight loss (CI, 2.5-8.0 kg, P < 0.001; I2 = 50.6%). Details of adverse events were limited. VLED programs are effective for treating children and adolescents with obesity. However, conclusions on their safety cannot be drawn from the existing literature at this time. Future studies should include long-term follow-up with ongoing support and comprehensive monitoring of all adverse events.
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Affiliation(s)
- Sarah Andela
- The University of Sydney Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia
| | - Tracy L Burrows
- The Priority Research Centre in Physical Activity and Nutrition and School of Health Sciences, The Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia.,Cardiovascular Research Group, Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Louise A Baur
- The University of Sydney Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia.,Weight Management Services, The Children's Hospital at Westmead, Westmead, Australia
| | - Daisy H Coyle
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Clare E Collins
- The Priority Research Centre in Physical Activity and Nutrition and School of Health Sciences, The Faculty of Health and Medicine, The University of Newcastle, Callaghan, Australia.,Cardiovascular Research Group, Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Megan L Gow
- The University of Sydney Children's Hospital Westmead Clinical School, The University of Sydney, Westmead, Australia.,Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, Australia
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Semnani-Azad Z, Johnston LW, Lee C, Retnakaran R, Connelly PW, Harris SB, Zinman B, Hanley AJ. Determinants of longitudinal change in insulin clearance: the Prospective Metabolism and Islet Cell Evaluation cohort. BMJ Open Diabetes Res Care 2019; 7:e000825. [PMID: 31803485 PMCID: PMC6887510 DOI: 10.1136/bmjdrc-2019-000825] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/03/2019] [Accepted: 10/28/2019] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To evaluate multiple determinants of the longitudinal change in insulin clearance (IC) in subjects at high risk for type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS Adults (n=492) at risk for T2D in the Prospective Metabolism and Islet Cell Evaluation cohort, a longitudinal observational cohort, had four visits over 9 years. Values from oral glucose tolerance tests collected at each assessment were used to calculate the ratios of both fasting C peptide-to-insulin (ICFASTING) and areas under the curve of C peptide-to-insulin (ICAUC). Generalized estimating equations (GEE) evaluated multiple determinants of longitudinal changes in IC. RESULTS IC declined by 20% over the 9-year follow-up period (p<0.05). Primary GEE results indicated that non-European ethnicity, as well as increases in baseline measures of waist circumference, white cell count, and alanine aminotransferase, was associated with declines in ICFASTING and ICAUC over time (all p<0.05). There were no significant associations of IC with sex, age, physical activity, smoking, or family history of T2D. Both baseline and longitudinal IC were associated with incident dysglycemia. CONCLUSIONS Our findings suggest that non-European ethnicity and components of the metabolic syndrome, including central obesity, non-alcoholic fatty liver disease, and subclinical inflammation, may be related to longitudinal declines in IC.
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Affiliation(s)
- Zhila Semnani-Azad
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Luke W Johnston
- Department of Public Health, Aarhus Universitet, Aarhus, Denmark
| | - Christine Lee
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Ravi Retnakaran
- Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Philip W Connelly
- Keenan Research Centre for Biomedical Science, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Stewart B Harris
- Centre for Studies in Family Medicine, Western University, London, Ontario, Canada
| | - Bernard Zinman
- Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada
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Acute Exercise Improves Insulin Clearance and Increases the Expression of Insulin-Degrading Enzyme in the Liver and Skeletal Muscle of Swiss Mice. PLoS One 2016; 11:e0160239. [PMID: 27467214 PMCID: PMC4965115 DOI: 10.1371/journal.pone.0160239] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/15/2016] [Indexed: 11/19/2022] Open
Abstract
The effects of exercise on insulin clearance and IDE expression are not yet fully elucidated. Here, we have explored the effect of acute exercise on insulin clearance and IDE expression in lean mice. Male Swiss mice were subjected to a single bout of exercise on a speed/angle controlled treadmill for 3-h at approximately 60-70% of maximum oxygen consumption. As expected, acute exercise reduced glycemia and insulinemia, and increased insulin tolerance. The activity of AMPK-ACC, but not of IR-Akt, pathway was increased in the liver and skeletal muscle of trained mice. In an apparent contrast to the reduced insulinemia, glucose-stimulated insulin secretion was increased in isolated islets of these mice. However, insulin clearance was increased after acute exercise and was accompanied by increased expression of the insulin-degrading enzyme (IDE), in the liver and skeletal muscle. Finally, C2C12, but not HEPG2 cells, incubated at different concentrations of 5-aminoimidazole-4-carboxamide-1-β-d-ribofuranoside (AICAR) for 3-h, showed increased expression of IDE. In conclusion, acute exercise increases insulin clearance, probably due to an augmentation of IDE expression in the liver and skeletal muscle. The elevated IDE expression, in the skeletal muscle, seems to be mediated by activation of AMPK-ACC pathway, in response to exercise. We believe that the increase in the IDE expression, comprise a safety measure to maintain glycemia at or close to physiological levels, turning physical exercise more effective and safe.
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8
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Al-Share QY, DeAngelis AM, Lester SG, Bowman TA, Ramakrishnan SK, Abdallah SL, Russo L, Patel PR, Kaw MK, Raphael CK, Kim AJ, Heinrich G, Lee AD, Kim JK, Kulkarni RN, Philbrick WM, Najjar SM. Forced Hepatic Overexpression of CEACAM1 Curtails Diet-Induced Insulin Resistance. Diabetes 2015; 64:2780-90. [PMID: 25972571 PMCID: PMC4512217 DOI: 10.2337/db14-1772] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/16/2015] [Indexed: 12/18/2022]
Abstract
Carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1) regulates insulin sensitivity by promoting hepatic insulin clearance. Liver-specific inactivation or global null-mutation of Ceacam1 impairs hepatic insulin extraction to cause chronic hyperinsulinemia, resulting in insulin resistance and visceral obesity. In this study we investigated whether diet-induced insulin resistance implicates changes in hepatic CEACAM1. We report that feeding C57/BL6J mice a high-fat diet reduced hepatic CEACAM1 levels by >50% beginning at 21 days, causing hyperinsulinemia, insulin resistance, and elevation in hepatic triacylglycerol content. Conversely, liver-specific inducible CEACAM1 expression prevented hyperinsulinemia and markedly limited insulin resistance and hepatic lipid accumulation that were induced by prolonged high-fat intake. This was partly mediated by increased hepatic β-fatty acid oxidation and energy expenditure. The data demonstrate that the high-fat diet reduced hepatic CEACAM1 expression and that overexpressing CEACAM1 in liver curtailed diet-induced metabolic abnormalities by protecting hepatic insulin clearance.
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Affiliation(s)
- Qusai Y Al-Share
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Anthony M DeAngelis
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Sumona Ghosh Lester
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Thomas A Bowman
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Sadeesh K Ramakrishnan
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Simon L Abdallah
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Lucia Russo
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Payal R Patel
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Meenakshi K Kaw
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Christian K Raphael
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
| | - Andrea Jung Kim
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Rehabilitation Sciences, College of Health Sciences, The University of Toledo, Toledo, OH
| | - Garrett Heinrich
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Rehabilitation Sciences, College of Health Sciences, The University of Toledo, Toledo, OH
| | - Abraham D Lee
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Rehabilitation Sciences, College of Health Sciences, The University of Toledo, Toledo, OH
| | - Jason K Kim
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Rohit N Kulkarni
- Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, MA
| | - William M Philbrick
- Section of Endocrinology and Metabolism, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT
| | - Sonia M Najjar
- Center for Diabetes and Endocrine Research, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH Department of Physiology and Pharmacology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH
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9
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Benson AC, Torode ME, Fiatarone Singh MA. Effects of resistance training on metabolic fitness in children and adolescents: a systematic review. Obes Rev 2008; 9:43-66. [PMID: 18154602 DOI: 10.1111/j.1467-789x.2007.00388.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The majority of resistance training (RT) research with children to date has focused on pre-adolescents and the safety and efficacy of this type of training rather than the potential metabolic health benefits. Our objectives, using computerized databases, were (i) to systematically review studies utilizing RT interventions with children and adolescents <18 years; (ii) to investigate the metabolic health outcomes (adiposity, lipids, insulin, glucose) associated with RT; (iii) to provide recommendations for future investigations. A total of 12 studies met the review criteria. There is only a small amount of evidence that children and adolescents may derive metabolic health-related adaptations from supervised RT. However, methodological limitations within the body of this literature make it difficult to determine the optimal RT prescription for metabolic fitness in children and adolescents, and the extent and duration of such benefits. More robustly designed single modality randomized controlled trials utilizing standardized reporting and precise outcome assessments are required to determine the extent of health outcomes attributable solely to RT and to enable the development of evidence-based obesity prevention and treatment strategies in this cohort.
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Affiliation(s)
- A C Benson
- School of Medical Sciences, Discipline of Exercise Science, RMIT University, Melbourne, Vic. 3083, Australia.
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10
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Systematic review of interventions in the management of overweight and obese children which include a dietary component. INT J EVID-BASED HEA 2007. [DOI: 10.1097/01258363-200703000-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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11
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Roemmich JN, Liu EY, Rogol AD, Epstein LH, Quattrin T. Diminished Insulin Resistance with Weight Loss in Severely Overweight Youth. Metab Syndr Relat Disord 2004; 2:160-8. [DOI: 10.1089/met.2004.2.160] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- James N. Roemmich
- Department of Pediatrics, University at Buffalo, Buffalo, New York
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
| | - Emily Y. Liu
- Department of Pediatrics, University at Buffalo, Buffalo, New York
| | - Alan D. Rogol
- Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Leonard H. Epstein
- Department of Pediatrics, University at Buffalo, Buffalo, New York
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, New York
- Department of Social and Preventive Medicine, University at Buffalo, Buffalo, New York
| | - Teresa Quattrin
- Department of Pediatrics, University at Buffalo, Buffalo, New York
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12
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LeMura LM, Maziekas MT. Factors that alter body fat, body mass, and fat-free mass in pediatric obesity. Med Sci Sports Exerc 2002; 34:487-96. [PMID: 11880814 DOI: 10.1097/00005768-200203000-00016] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to quantify the effects of exercise treatment programs on changes in body mass, fat-free mass, and body fat in obese children and adolescents. METHODS By using the meta-analytic approach, studies that met the following criteria were included in our analyses: 1) at least six subjects per group; 2) subject groups consisting of children in the 5- to 17-yr age range; 3) pretest and posttest values for either body mass, percent body fat, or fat-free mass (FFM); 4) used exercise as a mode of treatment (e.g., walking, jogging, cycle ergometry, high-repetition resistance exercise, and combinations); 6) training programs >or= 3 wk; 7) full-length publications (not conference proceedings); 8) apparently "healthy" children (i.e., free from endocrine diseases and disorders); and 9) published studies in English language journals only. RESULTS A total of 120 investigations were located that addressed the issue of exercise as a method of treatment in pediatric obesity. Of those, 30 met our criteria for inclusion. Across all designs and categories, fixed-effects modeling yielded significant decreases in the following dependent variables: 1) percent body fat (mean = 0.70 +/- 0.35; 95% CI = 0.21 to 1.1); 2) FFM (mean = 0.50 +/- 0.38; 95% CI = 0.03 to 0.57); 3) body mass (mean = 0.34 +/- 0.18; 95% CI = 0.01 to 0.46); 4) BMI (mean = 0.76 +/- 0.55; 95% CI = 4.24 to 1.7), and 5) VO2max (mean = 0.52 +/- 0.16; 95% CI = 0.18 to 0.89), respectively. Significant differences were found as a function of the type intervention groups (exercise vs exercise + behavioral modification; P < 0.04); body composition assessment methods (skinfold vs hydrostatic weighing, DEXA, and total body water; P < 0.006); exercise intensity (60-65%, vs >or= 71% VO2max; P < 0.01); duration (<or= 30 min vs > 30 min; P < 0.03); and mode (aerobic vs aerobic + resistance training; P < 0.02). Stepwise linear regression suggested that initial body fat levels (or body mass), type of treatment intervention, exercise intensity, and exercise mode accounted for most of the variance associated with changes in body composition after training. CONCLUSIONS Exercise is efficacious for reducing selected body composition variables in children and adolescents. The most favorable alterations in body composition occurred with 1) low-intensity, long-duration exercise; 2) aerobic exercise combined with high-repetition resistance training; and 3) exercise programs combined with a behavioral-modification component.
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Affiliation(s)
- Linda M LeMura
- Exercise Physiology Laboratory, Graduate Program in Exercise Science, Bloomsburg University of Pennsylvania, Bloomsburg, PA 17815, USA.
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13
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Paquot N, Scheen AJ, Dirlewanger M, Lefèbvre PJ, Tappy L. Hepatic insulin resistance in obese non-diabetic subjects and in type 2 diabetic patients. OBESITY RESEARCH 2002; 10:129-34. [PMID: 11886934 DOI: 10.1038/oby.2002.21] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Obese non-diabetic patients are characterized by an extra-hepatic insulin resistance. Whether obese patients also have decreased hepatic insulin sensitivity remains controversial. RESEARCH METHODS AND PROCEDURES To estimate their hepatic insulin sensitivity, we measured the rate of exogenous insulin infusion required to maintain mildly elevated glycemia in obese patients with type 2 diabetes, obese non-diabetic patients, and lean control subjects during constant infusions of somatostatin and physiological low-glucagon replacement infusions. To account for differences in insulin concentrations among the three groups of subjects, an additional protocol was also performed in healthy lean subjects with higher insulin infusion rates and exogenous dextrose infusion. RESULTS The insulin infusion rate required to maintain glycemia at 8.5 mM was increased 4-fold in obese patients with type 2 diabetes and 1.5-fold in obese non-diabetic patients. The net endogenous glucose production (measured with 6,6-(2)H(2)-glucose) and total glucose output (measured with 2-(2)H(1)-glucose) were approximately 30% lower in the patients than in the lean subjects. Net endogenous glucose production and total glucose output were both markedly increased in both groups of obese patients compared with lean control subjects during hyperinsulinemia. DISCUSSION Our data indicate that both obese non-diabetic and obese type 2 diabetic patients have a blunted suppressive action of insulin on glucose production, indicating hepatic and renal insulin resistance.
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Affiliation(s)
- Nicolas Paquot
- Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU Sart-Tilman, Liège, Belgium
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