The Clinical and Metabolic Effects of Rapid Weight Loss in Obese Pet Cats and the Influence of Supplemental Oral L-Carnitine

Assessment of the potential effects of l-carnitine and cinnamon supplementation on weight loss and body composition

OBJECTIVE

Aim: To assess efficacy of L-carnitine and cinnamon alone and in combination on body composition parameters in addition to compare between them.

PATIENTS AND METHODS

Materials and Methods: Sample of 28 obese and overweight adults in Babylon city, sample collection includes patients in places, or by internet, where interview take place according to specialize questionnaire height, weight, and body mass index were measured.

RESULTS

Results: A significant differences P<0.05 among gender distribution between male and female. A significant difference between (150-160 cm, 160-170 cm) as compared with (170-180 cm, 180-190 cm). A significant difference between 170-180 cm as compared with 180-190 cm but non-significant differences between 150-160 cm as compared with 160-170 cm. A significant difference between 26-35 as compared with 36-45, 46-55, but non-significant differences between 36-45 as compared with 46-55. A significant difference between body weight, body fat, water content, skeletal muscle, and body mass index after treatment, but non-significant differences between protein, and inorganic salt after treatment and at baseline. A significant difference between body weight, water content, skeletal muscle, and body mass index in group treated with cinnamon as compared with negative control group, but non-significant differences between body fat, protein, and inorganic salt as compared with negative control group.

CONCLUSION

Conclusions: The prevalence of overweight and obesity within accepted range of that reported in Iraq, important relationship was reported between several life style risk factor, as soon as diagnose increase in weight and education health program for behavior of life style were high recommended.

Biomedical role of L-carnitine in several organ systems, cellular tissues, and COVID-19

Carnitine is a conditionally necessary vitamin that aids in energy creation and fatty acid metabolism. Its bioavailability is higher in vegetarians than in meat-eaters. Deficits in carnitine transporters occur because of genetic mutations or in conjunction with other illnesses. Carnitine shortage can arise in health issues and diseases-including hypoglycaemia, heart disease, starvation, cirrhosis, and ageing-because of abnormalities in carnitine control. The physiologically active form of L-carnitine supports immunological function in diabetic patients. Carnitine has been demonstrated to be effective in the treatment of Alzheimer's disease, several painful neuropathies, and other conditions. It has been used as a dietary supplement for the treatment of heart disease, and it also aids in the treatment of obesity and reduces blood glucose levels. Therefore, L-carnitine shows the potential to eliminate the influences of fatigue in COVID-19, and its consumption is recommended in future clinical trials to estimate its efficacy and safety. This review focused on carnitine and its effect on tissues, covering the biosynthesis, metabolism, bioavailability, biological actions, and its effects on various body systems and COVID-19.

Effects of a high-protein, high-fiber diet rich in antioxidants and L-carnitine on body weight, body composition, metabolic status, and physical activity levels of cats after spay surgery

Spay and neuter surgeries are useful in controlling pet populations, but increase obesity risk due to increased appetite, decreased metabolic rate and decreased energy expenditure. Dietary management may help limit post-spay weight gain, but few research studies have been conducted in cats. Therefore, the objective of this study was to evaluate the effects of a high-protein, high-fiber diet (HPHF) compared to a moderate-protein, moderate-fiber diet (MPMF) in female cats following spay surgery. Twenty healthy female cats (9.5±0.1 mo) were used. After a 4-wk baseline phase with cats fed MPMF to maintain body weight (BW), 16 cats were spayed and allotted to MPMF (n=8) or HPHF (n=8), with the remaining cats being sham-operated and fed MPMF (n=4). Cats were fed to maintain BW for 12 wk, then allowed to eat up to twice that amount for another 12 wk. Daily food intake, twice weekly BW and twice weekly body condition scores (BCS) were assessed. Back fat thickness (BF) using ultrasound, body composition using dual-energy X-ray absorptiometry (DEXA), feline body mass index (fBMI), body fat percentage estimates using zoometry measurements, serum metabolites, and voluntary physical activity levels were measured prior to spay (wk 0) and every 6 wk post-spay. A treatment*time effect was observed for food intake (g/d), but not caloric intake (kcal ME/d). Caloric intake was affected by time and treatment, being reduced over the first 12 wk and reduced at higher amounts in HPHF and MPMF cats vs. sham cats. BW, BCS and body fat percentage were affected over time. Treatment*time effects were observed for blood urea nitrogen, alkaline phosphatase, and fructosamine, while blood triglycerides, total cholesterol, creatinine, total protein, phosphorus, and bicarbonate were affected by time. Physical activity was reduced over time. Our results demonstrate that spay surgery affects food intake, BW, metabolism, and physical activity of cats. Dietary intervention in this study, however, led to minor changes.

Successful treatment of local anaesthetic toxicity using intralipid 20% emulsion following intrathoracic bupivacaine overdose in a cat

Case summary

An 8.75-year-old male neutered Burmese cat was referred for treatment of pyothorax. The cat was responsive, cardiovascularly stable and tachypnoeic (40 breaths/min) on arrival. Medical management of pyothorax was initiated, bilateral thoracic drains were placed and thoracic lavage using aliquots of saline 0.9% was performed every 4 h. Regional analgesia was provided using 1 mg/kg of intrapleural bupivacaine divided equally between the left and right hemithoraxes every 6 h. On the second day of hospitalisation, the cat developed hypersalivation, mydriasis and tonic–clonic seizure activity 25 mins after accidental intrapleural administration of a 10 mg/kg bupivacaine overdose. Cardiovascular compromise was also noted; the cat became bradycardic (120 beats/min) and blood pressure decreased to 110 mmHg. Clinical signs resolved after administration of intravenous lipid emulsion (ILE) as an intravenous (IV) bolus (1.5 ml/kg over 5 mins), followed by a continuous rate infusion (0.25 ml/kg/min over 25 mins). Local anaesthetic intrapleural anaesthesia was discontinued. There was recrudescence of clinical signs 10 h post-overdose and repeat ILE 20% infusion was required. The cat was discharged with no ongoing complications.

Relevance and novel information

Treatment of IV local anaesthetic systemic toxicity with ILE has been reported in cats. To our knowledge, this is the first reported case of intrapleural bupivacaine overdose with initial response and resolution of clinical signs followed by recrudescence and subsequent successful treatment using ILE.

How do chain lengths of acyl-l-carnitines affect their surface adsorption and solution aggregation?

HYPOTHESIS

l-carnitines in our body systems can be readily converted into acyl-l-carnitines which have a prominent place in cellular energy generation by supporting the transport of long-chain fatty acids into mitochondria. As biocompatible surfactants, acyl-l-carnitines have potential to be useful in technical, personal care and healthcare applications. However, the lack of understanding of the effects of their molecular structures on their physical properties has constrained their potential use.

EXPERIMENTS

This work reports the study of the influence of the acyl chain lengths of acyl-l-carnitines (C_nLC) on solubility, surface adsorption and aggregation. Critical micellar concentrations (CMCs) of C_nLC were determined by surface tension measurements. Neutron reflection (NR) was used to further examine the structure and composition of the adsorbed C_nLC layer. The structural changes of the micellar aggregates under different concentrations of C_nLC, pH and ionic strength were determined by dynamic light scattering (DLS) and small angle neutron scattering (SANS).

FINDINGS

C₁₂LC is fully soluble over a wide temperature and concentration range. There is however a strong decline of solubility with increasing acyl chain length. The adsorption and aggregation behavior of C₁₄LC was therefore studied at 30 °C and C₁₆LC at 45 °C. The solubility boundaries displayed distinct hysteresis with respect to heating and cooling. The CMCs of C₁₂LC, C₁₄LC and C₁₆LC at pH 7 were 1.1 ± 0.1, 0.10 ± 0.02 and 0.010 ± 0.005 mM, respectively, with the limiting values of the area per molecule at the CMC being 45.4 ± 2, 47.5 ± 2 and 48.8 ± 2 Å² and the thicknesses of the adsorbed C_nLC layers at the air/water interface increasing from 21.5 ± 2 to 22.6 ± 2 to 24.2 ± 2 Å, respectively. All three surfactants formed core-shell spherical micelles with comparable dimensional parameters apart from an increase in core radius with acyl chain length. This study outlines the effects of acyl chain length on the physicochemical properties of C_nLCs under different environmental conditions, serving as a useful basis for developing their potential applications.

Acetyl-L-Carnitine Ameliorates Metabolic and Endocrine Alterations in Women with PCOS: A Double-Blind Randomized Clinical Trial

INTRODUCTION

Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder and the main cause of infertility in women of reproductive age. Affected women suffer from insulin resistance and present with an intense stress response. Treatment with insulin sensitizers alone and in combination is used to ameliorate the signs and symptoms associated with the disease. This study was designed to compare the endocrine and metabolic parameters as well as subjective and objective measures of stress in women with PCOS before and after treatment with acetyl-L-carnitine (ALC) and metformin plus pioglitazone.

METHODS

A total of 147 women with PCOS were randomly assigned into two groups: the combo group (n = 72) received a combination of metformin, pioglitazone, and ALC (500 mg, 15 mg, and 1500 mg, respectively), twice daily; the Met + Pio group (n = 75) received metformin plus pioglitazone (500 mg, 15 mg, respectively) and placebo (citric acid plus calcium carbonate), twice daily for 12 weeks. Medications were discontinued when pregnancy was confirmed. The Perceived Stress Scale (PSS14) and Profile of Mood States (POMS) were employed as subjective measures of stress. The endocrine and metabolic functions of women with PCOS were assessed by measuring insulin, leutinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and adiponectin levels in fasting blood samples. Insulin resistance was calculated by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR).

RESULTS

Women at baseline had significantly elevated circulating concentration of insulin and low level of adiponectin. Treatment decreased insulin in both groups; however, the combo group showed a significant decrease (p = 0.001). Serum adiponectin level was raised significantly after treatment in both groups (p < 0.001). HOMA-IR also decreased in both groups (both p < 0.001). Testosterone, FSH, and LH significantly improved in both groups. LH also decreased in both groups; however, the change was significant only in the combo (metformin plus pioglitazone plus ALC) group (p = 0.013). Interestingly, there was a significant improvement in body circumference (p < 0.001) in the combo group. The PSS scores of the patients improved significantly (p < 0.001) in the combo group. Interestingly, regular menstrual cycles were found (97.2%) in the carnitine group, but in only 12.9% of the other group.

CONCLUSION

We conclude that addition of ALC therapy is superior to metformin plus pioglitazone in ameliorating insulin resistance, polycystic ovaries, menstrual irregularities, and hypoadiponectinemia in women with PCOS.

TRIAL REGISTRATION

Trial registration: clinicalTrial.gov NCT04113889. Registered 3 October, 2019. https://clinicaltrials.gov/ct2/show/NCT04113889 .

Effect of raw and encapsulated policosanol on lipid profiles, blood biochemistry, activity, energy expenditure and macronutrient metabolism of adult cats

Objectives

The objective of this study was to verify the safety of policosanol supplementation for domestic cats. The effects of raw and encapsulated policosanol were compared with positive (L-carnitine) and negative (no supplementation) controls on outcomes of complete blood count, serum biochemistry, energy expenditure, respiratory quotient and physical activity in healthy young adult cats.

Methods

The study was a replicated 4 × 4 complete Latin square design. Eight cats (four castrated males, four spayed females; mean age 3.0 ± 1.0 years; mean weight 4.36 ± 1.08 kg; mean body condition score 5.4 ± 1.4) were blocked by sex and body weight then randomized to treatment groups: raw policosanol (10 mg/kg body weight), encapsulated policosanol (50 mg/kg body weight), L-carnitine (200 mg/kg body weight) or no supplementation. Treatments were supplemented to a basal diet for 28 days with a 1-week washout between periods. Food was distributed equally between two offerings to ensure complete supplement consumption (first offering) and measure consumption time (second offering). Blood collection (lipid profile, complete blood count, serum biochemistry) and indirect calorimetry (energy expenditure, respiratory quotient) were conducted at days 0, 14 and 28 of each period. Activity monitors were worn 7 days prior to indirect calorimetry and blood collection. Data were analyzed using a repeated measures mixed model (SAS, v.9.4).

Results

Food intake and body weight were similar among treatments. There was no effect of treatment on lipid profile, serum biochemistry, activity, energy expenditure or respiratory quotient (P >0.05); however, time to consume a second meal was greatest in cats fed raw policosanol (P <0.05).

Conclusions and relevance

These data suggest that policosanol is safe for feline consumption. Further studies with cats demonstrating cardiometabolic risk factors are warranted to confirm whether policosanol therapy is an efficacious treatment for hyperlipidemia and obesity.

Amino Acids in the Nutrition, Metabolism, and Health of Domestic Cats

Domestic cats (carnivores) require high amounts of dietary amino acids (AAs) for normal growth, development, and reproduction. Amino acids had been traditionally categorised as nutritionally essential (EAAs) or nonessential (NEAAs), depending on whether they are synthesized de novo in the body. This review will focus on AA nutrition and metabolism in cats. Like other mammals, cats do not synthesize the carbon skeletons of twelve proteinogenic AAs: Arg, Cys, His, Ile, Leu, Lys, Met, Phe, Thr, Trp, Tyr, and Val. Like other feline carnivores but unlike many mammals, cats do not synthesize citrulline and have a very limited ability to produce taurine from Cys. Except for Leu and Lys that are strictly ketogenic AAs, most EAAs are both glucogenic and ketogenic AAs. All the EAAs (including taurine) must be provided in diets for cats. These animals are sensitive to dietary deficiencies of Arg and taurine, which rapidly result in life-threatening hyperammonemia and retinal damage, respectively. Although the National Research Council (NCR, Nutrient requirements of dogs and cats. National Academies Press, Washington, DC, 2006) does not recommend dietary requirements of cats for NEAAs, much attention should be directed to this critical issue of nutrition. Cats can synthesize de novo eight proteinogenic AAs: Ala, Asn, Asp, Gln, Glu, Gly, Pro, and Ser, as well as some nonproteinogenic AAs, such as γ-aminobutyrate, ornithine, and β-alanine with important physiological functions. Some of these AAs (e.g., Gln, Glu, Pro, and Gly) are crucial for intestinal integrity and health. Except for Gln, AAs in the arterial blood of cats may not be available to the mucosa of the small intestine. Plant-source foodstuffs lack taurine and generally contain inadequate Met and Cys and, therefore, should not be fed to cats in any age group. Besides meat, animal-source foodstuffs (including ruminant meat & bone meal, poultry by-product meal, porcine mucosal protein, and chicken visceral digest) are good sources of proteinogenic AAs and taurine for cats. Meeting dietary requirements for both EAAs and NEAAs in proper amounts and balances is crucial for improving the health, wellbeing, longevity, and reproduction of cats.

Concentrations of leptin, adiponectin, and resistin in the serum of obese cats during weight loss

We monitored changes in serum leptin, adiponectin, and resistin concentrations in obese cats during weight loss. Six naturally developed obese cats were fed low-fat, high-fiber dry food during a 9-week experimental period. Serum leptin, adiponectin, and resistin concentrations were measured at week 0, 4, 8, and 9. Body weight became significantly lower week 4 onward than that at week 0 (P<0.05 or 0.01). At week 9, serum leptin concentrations were significantly lower than those at week 0 (P<0.05). Contrarily, serum adiponectin and resistin concentrations did not significantly differ within the 9 weeks. While serum leptin levels were strongly positively correlated with body weight (r=0.923, P<0.001), serum adiponectin levels were moderately negatively correlated with it (r=−0.529, P<0.01), with serum resistin having a no correlation with body weight. Serum leptin levels might be more closely related with pathogenesis of adiposity than serum adiponectin or resistin in cats.

An international multi-centre cohort study of weight loss in overweight cats: Differences in outcome in different geographical locations

Introduction

Feline obesity is a worldwide concern which has recently been formally classified as a disease by the veterinary community. Management involves invoking controlled weight loss by feeding a purpose-formulated food in restricted quantities and altering physical activity. Most weight loss studies conducted in cats have been undertaken in research cat colonies from single geographic locations. The aim of this multi-centre cohort study was to determine the efficacy of a short-term dietary weight loss intervention in overweight pet cats across a range of geographical locations globally.

Materials and methods

A 3-month (median 13 weeks, inter-quartile range [IQR] 12–15 weeks) weight loss programme was conducted at 188 veterinary practices in 22 countries, and involving 730 cats, 413 of which completed the programme and had complete data available. All were fed commercially available dry or wet weight loss diets, and median energy intake was 53 kcal/kg BW^0.711/day. The Royal Canin Ethics Committee approved the study, and owners gave informed consent. Owners completed behavioural questionnaires assessing begging, physical activity and quality of life (QOL). Linear mixed models were used to assess the respective influence of time, age, and initial body condition score (BCS) on weight loss and behavioural observations.

Results

At baseline, median age was 72 months (range 12–200 months) and median BCS was 8 (range 7–9). In all, 402/413 cats (97%) lost weight (mean 10.6±6.3%) during the programme at a rate of 0.8 ±0.50%/week. Based upon owner questionnaires, activity and QOL improved (both P<0.001), while begging behaviour decreased (P<0.001) during weight loss. The main factor influencing percentage weight loss was geographical location (P<0.001), with cats in North America losing less weight (median 7.2%, IQR: 4.4–10.4%) than those in both Europe (10.7%, 6-8-15.4%) and South America (10.0%, 6.2–15.4%). Differences in weight loss were also observed amongst countries (P<0.001), with cats in Argentina, Germany, and Italy losing more weight than cats in the USA, and cats in Germany also losing more weight than cats in Portugal.

Discussion/conclusion

Most of the overweight cats enrolled in this international multi-centre study successfully lost weight. The reason for the differences in percentage weight loss amongst geographical locations requires further study.

Feline Hepatic Lipidosis

Feline hepatic lipidosis (FHL) is a common and potentially fatal liver disorder. Although the pathophysiologic mechanisms of FHL remain elusive, there is an imbalance between the influx of fatty acids from peripheral fat stores into the liver, de novo liposynthesis, and the rate of hepatic oxidation and dispersal of hepatic TAG via excretion of very-low density lipoproteins. The diagnosis of FHL is based on anamnestic, clinical, and clinicopathologic findings, associated with diagnostic imaging of the liver, and cytology, or histological examination of liver biopsies. Fluid therapy, electrolyte correction and adequate early nutrition are essential components of the therapy for FHL.

Effectiveness of a new dietetic weight management food to achieve weight loss in client-owned obese cats

OBJECTIVES

The aim of the study was to evaluate weight loss and maintenance parameters in cats fed a novel weight management food and to assess the owner's perception of the cat's quality of life.

METHODS

This study was designed as a prospective, uncontrolled/unmasked clinical trial. One hundred and thirty-two overweight/obese, otherwise healthy, client-owned cats were enrolled. Initial evaluation included physical examination, nutritional assessment, ideal body weight determination and weight-loss feeding guidelines development. Follow-up evaluations (monthly for 6 months) encompassed determination of body weight, body condition score, body fat index, muscle condition score and feeding practices. Quality of life assessment by owners included the cat's level of energy, happiness, appetite, begging behavior, flatulence, stool volume and fecal score.

RESULTS

Eighty-three percent of the cats lost weight, with an average ± SEM weight loss of 11.0 ± 1.8% over 6 months and an average ± SE weekly weight loss rate of 0.45 ± 0.02%. The mean ± SEM duration of weight loss was 134.0 ± 4.8 days. Fourteen percent of cats achieved an ideal body weight. Seventy-nine percent of cats ate more calories from novel weight management food than the recommended daily energy requirement for weight loss, and the majority of these cats still lost weight. Body condition score and body fat index decreased over time compared with baseline from weeks 12-24 and from weeks 8-24, respectively. Owners perceived an increase in energy and happiness (>week 12) in the cats that lost weight, without changes in appetite or begging behavior.

CONCLUSIONS AND RELEVANCE

This study confirmed the effectiveness of the novel weight management food in achieving weight loss in overweight/obese client-owned cats. Owners reported significant improvements in their cat's quality of life without negative side effects.

Cats in Positive Energy Balance Have Lower Rates of Adipose Gain When Fed Diets Containing 188 versus 121 ppm L-Carnitine

L-carnitine (LC) is included in select adult feline diets for weight management. This study investigated whether feeding adult cats with diets containing either 188 ppm of LC (LC188) or 121 ppm of LC (LC121) and feeding them 120% of maintenance energy requirement (MER) resulted in differences in total energy expenditure (EE), metabolic fuel selection, BW, body composition, and behavior. Cats (n = 20, 4 ± 1.2 yrs) were stratified for BCS and randomly assigned to one of two dietary treatments and fed for 16 weeks. BW was measured weekly, and indirect calorimetry, body composition, physical activity, play motivation, and cognition were measured at baseline and throughout the study. A mixed, repeated measures, ANCOVA model was used. Cats in both treatments gained BW (P < 0.05) throughout the study, with no differences between treatments at any time point (P > 0.05). There were no differences in body composition between groups at baseline; however, body fat (g) and body fat : lean mass ratio were greater in cats fed LC121 in contrast to cats fed LC188 (P < 0.05) on week 16. No other outcomes differed between treatments (P > 0.05). Supplying dietary LC at a dose of at least 188 ppm may be beneficial for the health and well-being of cats fed above MER.

Current Topics in Canine and Feline Obesity

The domestication and urbanization of dogs and cats has dramatically altered their environment and behavior. Human and pet obesity is a global concern, particularly in developed countries. An increased incidence of chronic disease is associated with obesity secondary to low-grade systemic inflammation. This article reviews current research into the genetic, dietary, and physiologic factors associated with obesity, along with use of "omics" technology to better understand and characterize this disease.

Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial

OBJECTIVE

Limited data are available for evaluating the effects of oral carnitine supplementation on weight loss and metabolic profiles of women with polycystic ovary syndrome (PCOS). This study was designed to determine the effects of oral carnitine supplementation on weight loss, and glycaemic and lipid profiles in women with PCOS.

DESIGN, PATIENTS AND MEASUREMENTS

In a prospective, randomized, double-blind, placebo-controlled trial, 60 overweight patients diagnosed with PCOS were randomized to receive either 250 mg carnitine supplements (n = 30) or placebo (n = 30) for 12 weeks. Fasting blood samples were obtained at the beginning and the end of the study to quantify parameters of glucose homoeostasis and lipid concentrations.

RESULTS

At the end of the 12 weeks, taking carnitine supplements resulted in a significant reduction in weight (-2·7 ± 1·5 vs +0·1 ± 1·8 kg, P < 0·001), BMI (-1·1 ± 0·6 vs +0·1 ± 0·7 kg/m(2) , P < 0·001), waist circumference (WC) (-2·0 ± 1·3 vs -0·3 ± 2·0 cm, P < 0·001) and hip circumference (HC) (-2·5 ± 1·5 vs -0·3 ± 1·8 cm, P < 0·001) compared with placebo. In addition, compared with placebo, carnitine administration in women with PCOS led to a significant reduction in fasting plasma glucose (-0·38 ± 0·36 vs +0·11 ± 0·97 mmol/l, P = 0·01), serum insulin levels (-14·39 ± 25·80 vs +3·01 ± 37·25 pmol/l, P = 0·04), homoeostasis model of assessment-insulin resistance (-0·61 ± 1·03 vs +0·11 ± 1·43, P = 0·04) and dehydroepiandrosterone sulphate (-3·64 ± 7·00 vs -0·59 ± 3·20 μmol/l, P = 0·03).

CONCLUSIONS

Overall, 12 weeks of carnitine administration in PCOS women resulted in reductions in weight, BMI, WC and HC, and beneficial effects on glycaemic control; however, it did not affect lipid profiles or free testosterone.

L-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled study

Background

The present study aimed to determine that whether L-carnitine infusion could ameliorate fasting-induced adverse effects and improve outcomes.

Method

In this 7-day, randomized, single-blind, placebo-controlled, pilot study, 15 metabolic syndrome (MetS) patients (11/4 F/M; age 46.9 ± 9.14 years; body mass index [BMI] 28.2 ± 1.8 kg/m²) were in the L-carnitine group (LC) and 15 (10/5 F/M; age 46.8 ± 10.9 years; BMI 27.1 ± 2.3 kg/m²) were in the control group (CT). All participants underwent a 5-day modified fasting therapy introduced with 2-day moderate calorie restriction. Patients in the LC group received 4 g/day of intravenous L-carnitine, while patients in the CT group were injected with saline. Blood pressure (BP), anthropometric characteristics, markers of liver function, metabolic indices (plasma glucose, lipid profiles, uric acid, free fatty acid and insulin) and hypersensitivity C-reactive protein were measured. Perceived hunger was recorded daily by self-rating visual analogue scales. Fatigue was evaluated by Wessely and Powell scores.

Results

In contrast to the CT group, total cholesterol, alanine aminotransferase, systolic and diastolic BP did not change significantly in the LC group after prolonged fasting. There were significant differences in weight loss (LC −4.6 ± 0.9 vs. CT −3.2 ± 1.1 kg, P = 0.03), and waist circumference (LC −5.0 ± 2.2 vs. CT −1.7 ± 1.16 cm, P < 0.001), waist hip ratio (LC −0.023 ± 0.017 vs. CT 0.012 ± 0.01, P < 0.001), insulin concentration (LC −9.9 ± 3.58 vs. CT −6.32 ± 3.44 µU/mL, P = 0.046), and γ-glutamyltransferase concentration (LC −7.07 ± 6.82 vs. CT −2.07 ± 4.18, P = 0.024). Perceived hunger scores were significantly increased (P < 0.05) in the CT group during starvation, which was alleviated with L-carnitine administration in the LC group. Physical fatigue (LC −3.2 ± 3.17 vs. CT 1.8 ± 2.04, P < 0.001) and fatigue severity (LC −11.6 ± 8.38 vs. CT 8.18 ± 7.32, P < 0.001) were significantly reduced in the LC group but were aggravated in the CT group.

Conclusion

Intravenous L-carnitine can ameliorate fasting-induced hunger, fatigue, cholesterol abnormalities and hepatic metabolic changes and facilitate fasting-induced weight loss in MetS patients.

Trial registration

ChiCTR-TNRC-12002835.

Influence of dietary protein level on body composition and energy expenditure in calorically restricted overweight cats

High-protein (HP) diets help prevent loss of lean mass in calorie-restricted (CR) cats. However, it is not entirely known whether these diets also induce changes of energy expenditure during periods of CR. To investigate this issue, sixteen overweight cats were fed either a high-protein [(HP), 54.2% of metabolizable energy (ME)] or a moderate-protein [(MP), 31.5% of ME] diet at 70% of their maintenance energy intakes for 8 weeks, and energy expenditure, energy intake, body weight and composition, and serum metabolites and hormones were measured. While both groups of cats lost weight at a similar rate, only cats eating the HP diet maintained lean mass during weight loss. Indirect respiration calorimetry measurements revealed that both total and resting energy expenditure (kcal/d) significantly decreased during weight loss for both treatment groups. However, only cats eating the MP diet exhibited significant decreases of total and resting energy expenditures after energy expenditure was normalized for body weight or lean mass. Results from this study suggest that in addition to sparing the loss of lean mass, feeding HP diets to overweight cats in restricted amounts may be beneficial for preventing or minimizing decreases of mass-adjusted energy expenditure during weight loss.

Acute effect on satiety, resting energy expenditure, respiratory quotient, glucagon-like peptide-1, free fatty acids, and glycerol following consumption of a combination of bioactive food ingredients in overweight subjects

OBJECTIVE

A combination of bioactive food ingredients (capsaicinoids, epigallocatechin gallate, piperin, and l-carnitine, CBFI) may promote satiety and thermogenesis. The study was conducted in order to assess whether there is any effect on satiety, resting energy expenditure (REE), respiratory quotient, glucagon-like peptide-1 (GLP-1), free fatty acids (FFA) and glycerol release, following a standardized mixed meal with or without single consumption of a CBFI.

DESIGN

An 8-week randomized double-blind placebo-controlled trial.

SETTING

Dietetic and Metabolic Unit, Azienda di Servizi alla Persona, University of Pavia and "Villa delle Querce" Clinical Rehabilitation Institute, Rome, Italy.

PARTICIPANTS

Thirty-seven overweight adults (body mass index [BMI]: 25-35).

INTERVENTION

Nineteen overweight subjects were included in the supplemented group (14 women, 5 men; age 46.4 ± 6.4; BMI: 30.5 ± 3.3) and 18 in the placebo group (13 women, 5 men; age 40.8 ± 11.5; BMI: 30.1 ± 2.6). Satiety was assessed using 100-mm visual analogue scales (VAS) and the area under the curve was calculated.

RESULTS

All measured parameters increased significantly in comparison with baseline in response to meal, both with CBFI and with placebo. However, throughout the study day, the supplemented group experienced a significantly greater increase than the placebo group in their sensation of satiety following acute administration of the supplement.

CONCLUSION

CBFI may therefore be of great value in the treatment of overweight patients by increasing satiety and stimulating thermogenesis.

Improvement in insulin resistance and favourable changes in plasma inflammatory adipokines after weight loss associated with two months' consumption of a combination of bioactive food ingredients in overweight subjects

This randomized, double blind, placebo-controlled, 8 week trial assessed the efficacy on metabolic changes produced by a consumption of a combination of bioactive food ingredients (epigallocatechin gallate, capsaicins, piperine and L-carnitine) versus a placebo, as part of a therapeutic 'lifestyle change' diet, in 86 overweight subjects. Forty-one patients (2/14 F/M; age 43.7 ± 8.5; BMI 30.3 ± 3.5 kg/m(2)) were randomized to the supplemented group and 45 (29/16; age 40.7 ± 10.2; BMI 30.0 ± 2.7) to the control group. We observed that consumption of the dietary supplement was associated with a significantly greater decrease in insulin resistance, assessed by homostasis model assessment (p < 0.001), leptin/adiponectin ratio (p < 0.04), respiratory quotient (p < 0.008). LDL-cholesterol levels (p < 0.01). Moreover, statistically significant differences were recorded between the two groups in relation to urinary norepinephrine levels (p < 0.001). Leptin, ghrelin, C-reactive protein decreased and resting energy expenditure increased significantly in the supplemented group (p < 0.05, 0.03, 0.02 and 0,02 respectively), but not in the placebo group; adiponectin decreased significantly in the placebo group (0.001) but not in the supplemented group, although no statistical significance between the groups was elicited. BMI, fat mass (assessed by DXA) and vascular endothelial growth factor significantly decreased, whilst the resting energy expenditure/free fat mass significantly increased in both groups. In general, a greater change was recorded in the supplemented group compared to the placebo, although no statistically significant difference between the two groups was recorded. These results suggest that the combination of bioactive food ingredients studied might be useful for the treatment of obesity-related inflammatory metabolic dysfunctions.

The unravelling of metabolic dysfunctions linked to metal-associated diseases by blue native polyacrylamide gel electrophoresis

Gel electrophoresis is routinely used to separate and analyse macromolecules in biological systems. Although many of these electrophoretic techniques necessitate the denaturing of the analytes prior to their analysis, blue native polyacrylamide gel electrophoresis (BN-PAGE) permits the investigation of proteins/enzymes and their supramolecular structures such as the metabolon in native form. This attribute renders this analytical tool conducive to deciphering the metabolic perturbations invoked by metal toxicity. In this review, we elaborate on how BN-PAGE has led to the discovery of the dysfunctional metabolic pathways associated with disorders such as Alzheimer's disease, Parkinson's disease, and obesity that have been observed as a consequence of exposure to various metal toxicants.

Nutritional care for aging cats and dogs

Veterinarians need to be prepared to provide nutritional advice for healthy pets as well as for pets that are ill. Before instituting a dietary change in any patient, especially an older dog or cat, a nutritional evaluation should be completed. This should include an evaluation of the patient, the current diet, and feeding management. Diets should be appropriate to the unique needs of the individual patient. Many diseases in senior pets are “diet-sensitive” meaning that diet can play a role in managing the effects of the disease. Common examples discussed include cognitive dysfunction of aging, osteoarthritis, and obesity.

Companion Animals Symposium: Obesity in dogs and cats: What is wrong with being fat?

Few diseases in modern pets are diet induced. One possible exception to this is obesity, which is ultimately caused by consuming more calories than needed by the dog or cat. Although fat is the most concentrated and efficiently stored source of calories, and protein least so, an excess of calories from any source will contribute to adiposity. Obesity is an excess of body fat sufficient to result in impairment of health or body function. In people, this is generally recognized as 20 to 25% above ideal BW. This degree of excess is important in dogs as well. A lifelong study in dogs showed that even moderately overweight dogs were at greater risk for earlier morbidity; these dogs required medication for chronic health problems sooner than their lean-fed siblings. The average difference in BW between groups was approximately 25%. Obese cats also face increased health risks, including an increased risk of arthritis, diabetes mellitus, hepatic lipidosis, and early mortality. The risk for development of diabetes increases about 2-fold in overweight cats and about 4-fold [corrected] in obese cats. Altered adipokine secretion appears to be an important mechanism for the link between excess BW and many diseases. Once considered to be physiologically inert, adipose tissue is an active producer of hormones, such as leptin and resistin, and cytokines, including many inflammatory cytokines such as tumor necrosis factor-α, IL-1β and IL-6, and C-reactive protein. The persistent, low-grade inflammation secondary to obesity is thought to play a causal role in chronic diseases such as osteoarthritis, cardiovascular disease, diabetes mellitus, and others. For example, tumor necrosis factor-α alters insulin sensitivity by blocking activation of insulin receptors. In addition, obesity is associated with increased oxidative stress, which also may contribute to obesity-related diseases. Management of obesity involves nutritional modification as well as behavioral modification. Increased protein intake combined with reduced calorie intake facilitates loss of body fat while minimizing loss of lean body mass. Limiting treats to 10% of calorie intake and increasing exercise both aid in successful BW management.

Patient variation in veterinary medicine--part II--influence of physiological variables

In veterinary medicine, the characterization of a drug's pharmacokinetic properties is generally based upon data that are derived from studies that employ small groups of young healthy animals, often of a single breed. In Part I of the series, we focused on the potential influence of disease processes, stress, pregnancy and lactation on drug pharmacokinetics. In this Part II of the series, we consider other covariates, such as gender, heritable traits, age, body composition, and circadian rhythms. The impact of these factors with respect to predicting the relationship between dose and drug exposure characteristics within an animal population is illustrated through the use of Monte Carlo simulations. Ultimately, an appreciation of these potential influences will improve the prediction of situations when dose adjustments may be appropriate.

Novel dietary strategies can improve the outcome of weight loss programmes in obese client-owned cats

A randomised, single-blinded, positively controlled, field trial for weight loss in obese client-owned cats was undertaken to look at novel diets and dietary strategies that could improve owner compliance and, therefore, success of feline weight loss programmes. Three dietary strategies were evaluated: strategy A used a novel dry high fibre ration; strategy B used ready-prepared portions of dry and moist food; strategy C used an existing commercial dry high fibre ration fed with a measuring cup. Cats were assessed at weeks 4, 12 and 20, and adjustments to the energy allocation made if required. Mean weight loss at 20 weeks (A: 11.0+/-1.3%, B: 10.9+/-1.2%, C: 11.9+/-1.7%) and mean energy allocation (A: 31.0, B: 28.5 and C: 32.2 kcal/kg of target body weight/day) were similar amongst strategies. However, owners' subjective hunger score was significantly (P<0.001) higher with strategy C than with strategies A and B. Further, owner satisfaction was lowest with strategy C, and more owners also regarded food allowance as insufficient with this strategy. Novel diets and feeding strategies may improve outcome in feline weight loss programmes.

Energy restriction results in a mass-adjusted decrease in energy expenditure in cats that is maintained after weight regain

Dietary energy restriction (ER) is used to treat obesity in cats but it is often unsuccessful. The purpose of this study was to determine whether ER results in a sustained decrease in mass-adjusted energy expenditure (EE) that may oppose weight loss and promote weight regain. EE and body composition were measured in 10 adult neutered cats at 3 time points: baseline (obese cats), during weight loss (40% ER), and following weight regain. The cats started with a body weight (BW) of 6.1 +/- 0.30 kg, body condition score (BCS) of 7.6 +/- 0.14 (on a 9-point scale), and fat body mass (FM) of 38 +/- 1.0% of BW. After weight loss, BW was 5.0 +/- 0.19 kg, BCS was 5.5 +/- 0.07 kg, and FM was 31 +/- 1.6% (P < 0.01). After weight regain, BW was 6.2 +/- 0.30 kg, BCS was 7.7 +/- 0.16, and FM was 42 +/- 1.8% (P < 0.01). Total EE decreased from 1258 +/- 33.7 kJ/d to 1025 +/- 39.6 kJ/d during weight loss (P < 0.001). After weight regain, EE was still lower than baseline (1103 +/- 41.5 kJ/d, P < 0.001). Energy intake (EI) at baseline (1337 +/- 50.6 kJ/d) was higher than EI after weight loss and regain (1217 +/- 61.2 kJ/d), resulting in no differences in energy balance (78 +/- 30.4 and 104 +/- 35.4 kJ/d, respectively, P = 0.581). These results support the hypothesis that ER results in a mass-adjusted decrease in EE in cats that is maintained after weight regain.

Canine obesity: an overview

Canine patients are generally regarded as being clinically obese when their body weight is at least 15% above ideal. The incidence of obesity in dogs is thought to be in the range of 20-40% of the general population and, since obesity is known to predispose or exacerbate a range of serious medical conditions, its importance cannot be overstated. Management of obesity through dietary restriction and increased exercise is often difficult to achieve and dependent upon owner compliance. Until recently there has been no authorized therapeutic medication available for weight reduction in dogs, and drugs used in people have proved unsuitable. However, with the development of microsomal triglyceride transfer protein inhibitors for canine use, such as dirlotapide, the veterinarian has a novel method with which to augment traditional weight control programmes. This approach has the additional advantage that weight loss is achieved without dietary restriction or change in exercise regimen, providing encouragement for the owner to comply with subsequent dietary and exercise recommendations, thereby increasing the likelihood for long-term success.

L-Carnitine Stimulates Lipolysis via Induction of the Lipolytic Gene Expression and Suppression of the Adipogenic Gene Expression in 3T3-L1 Adipocytes

We investigated the lipolytic effects of L-carnitine in 3T3-L1 adipocytes. L-carnitine at 10-S100 nM suppressed lipid accumulation. The release of glycerol and free fatty acid into the medium was significantly increased by 1.5- and 1.7- fold, respectively, by the addition of 100 nM L-carnitine compared with the control (P < .05). The mRNA levels of hormone-sensitive lipase, carnitine palmitoyltransferase I-a, and acyl-coenzyme A oxidase, all of which participate in lipid catabolism, were increased in the presence of 100 nM L-carnitine by 2.8-, 2.2-, and 1.6-fold, respectively (P < .05). However, the expression of peroxisome proliferator-activated receptor-gamma and adipose-specific fatty acid-binding protein, which are involved in adipogenesis, were down-regulated by L-carnitine in 3T3-L1 adipocytes (P < .05). These results suggest an anti-obesity action of L-carnitine. L-carnitine may modulate lipid metabolism by stimulation of lipolysis and beta-oxidation accompanied by corresponding changes in gene expression and suppression of adipogenic gene expression.

Dietary Herbal Supplements with Phenylephrine for Weight Loss

This study was designed to evaluate the efficacy and safety of a dietary herbal supplement containing citrus aurantium and phenylephrine in the treatment of obesity. Two pilot studies enrolled healthy subjects with body mass indexes 25-40 kg/m(2) to similar 8-week weight loss programs. Safety was assessed by physical examination and laboratory tests at screening and 8 weeks. The first pilot study randomized eight subjects to citrus aurantium (herbal phenylephrine) or placebo. Body composition by DEXA scan, waist circumference, and resting metabolic rate (RMR) were measured at baseline and 8 weeks. Food intake and appetite ratings were measured at baseline and week 2. The second pilot study randomized 20 subjects to two 2-hour RMR tests a week apart after phenylephrine (20 mg) or placebo followed by phenylephrine (20 mg) three times a day for 8 weeks. In the first pilot study, the citrus aurantium group gained 1.13 +/- 0.27 (mean +/- SEM) kg compared with 0.09 +/- 0.28 kg in the placebo group (P < .04). RMR at baseline rose more in the citrus aurantium group, 144.5 +/- 15.7 kcal/24 hours, than the placebo group, 23.8 +/- 28.3 kcal/24 hours (P < .002), but not at 8 weeks. DEXA, waist circumference, food intake, and hunger ratings were not different. In the second pilot study, the phenylephrine group lost 0.8 +/- 3.4 kg in 8 weeks (not significant), and RMR increased more in the phenylephrine group (111.5 +/- 32.6 vs. 37.4 +/- 22.7 kcal/24 hours, P = .02). There were no significant safety issues in either study. Although no toxicity was seen, these pilot studies suggest phenylephrine is not efficacious for weight loss.

Understanding and Managing Obesity in Dogs and Cats

Treatment of diabetes mellitus (DM) is a common disease, and nutrition has become an integral part of management. This article focuses on the role of nutrition and dietary ingredients in OA, evaluating current evidence for obesity management, omega-3 fatty acids, and chondromodulating agents. Additionally, Keeping an animal in optimal to slightly lean body condition has been shown to decrease the risk of development of OA and to aid in management of dogs with OA.

Weight loss favorably modifies anthropometrics and reverses the metabolic syndrome in premenopausal women

OBJECTIVE

To determine the effects of a weight loss program, including dietary modifications, increased physical activity and dietary supplement (L-carnitine or placebo) on anthropometrics, leptin, insulin, the metabolic syndrome (MS) and insulin resistance in overweight /obese premenopausal women.

METHODS

Participants consumed a hypocaloric diet; 30% protein, 30% fat and 40% carbohydrate in addition to increasing number of steps/day. Carnitine supplementation followed a randomized double blind protocol. Protocol lasted for 10 weeks. Seventy subjects (35 in the control and 35 in the carnitine group) completed the intervention. Anthropometrics, plasma insulin and leptin concentrations and body composition were measured. The number of subjects with the MetSyn and insulin resistance, were assessed at baseline and post-intervention.

RESULTS

Because there were no significant differences between the carnitine and the placebo groups for all measured parameters, participants were grouped together for all analysis. Subjects decreased total energy (-26.6%, p < 0.01) and energy from carbohydrate (-17.3%, p < 0.01) and increased energy from protein by 67% (p < 0.01) and number of steps/day (42.6%, p < 0.01). Body weight (-4.6%, p < 0.001), body mass index (-4.5%, p < 0.01), waist circumference (-6.5%, p < 0.01), total fat mass (-1.7%, p < 0.01), trunk fat mass (-2.0%, p < 0.01), insulin (- 17.9%, p < 0.01) and leptin (-5.9%, p < 0.05) decreased after the intervention. Ten of 19 participants with insulin resistance became insulin sensitive and 7 of 8 participants with the MetSyn no longer had the syndrome after the intervention.

CONCLUSION

Moderate increases in physical activity and a hypocaloric/high protein diet resulted in multiple beneficial effects on body anthropometrics and insulin sensitivity. Realistic dietary and physical activity goals must be the focus of intervention strategies for overweight and obese individuals.

Weight loss associated with reduced intake of carbohydrate reduces the atherogenicity of LDL in premenopausal women

The effect of a 3-tier intervention including dietary modifications (ie, moderate energy restriction, decreased carbohydrate, increased protein), increased physical activity, and the use of carnitine as a dietary supplement was evaluated on plasma lipids and the atherogenicity of low-density lipoprotein (LDL) particles in a population of overweight and obese premenopausal (aged 20-45 years) women. Carnitine or a placebo (cellulose) was randomly assigned to the participants using a double-blind design. Carnitine supplementation was postulated to enhance fat oxidation resulting in lower concentrations of plasma triglycerides. Seventy women completed the 10-week protocol, which followed a reduction in their energy intake by 15% and a macronutrient energy distribution of 30% protein, 30% fat, and 40% carbohydrate. In addition, subjects increased the number of steps taken per day by 4500. As no differences were observed between the carnitine and placebo groups in all the measured parameters, all subjects were pooled together for statistical analysis. Participants decreased (P<.01) their caloric intake (between 4132.8 and 7770 kJ) and followed prescribed dietary modifications as assessed by dietary records. The average number of steps increased from 8950+/-3432 to 12764+/-4642 (P<.001). Body weight, plasma total cholesterol, LDL cholesterol, and triglyceride were decreased by 4.5%, 8.0%, 12.3%, and 19.2% (P<.0001), respectively, after the intervention. Likewise, apolipoproteins B and E decreased by 4.5% and 15% (P<.05) after 10 weeks. The LDL mean particle size was increased from 26.74 to 26.86 nm (P<.01), and the percent of the smaller LDL subfraction (P<.05) was decreased by 26.5% (P<.05) after 10 weeks. In addition, LDL lag time increased by 9.3% (P<.01), and LDL conjugated diene formation decreased by 23% (P<.01), indicating that the susceptibility of LDL to oxidation was decreased after the intervention. This study suggests that moderate weight loss (<5% of body weight) associated with reduced caloric intake, lower dietary carbohydrate, and increased physical activity impacts the atherogenicity of LDL.

Nutrition for Aging Cats and Dogs and the Importance of Body Condition

Before recommending a diet for a senior pet, a thorough nutritional evaluation should be completed. Although many middle-aged and older pets are overweight, a large percentage of geriatric cats and dogs have a low BCS. Approximately one third of cats older than 12 years of age may have a decreased ability to digest fat, whereas one in five may have a compromised ability to digest protein. Thus, appropriate diets for these two age groups may differ considerably. Mature (middle-aged) cats would likely benefit from a lower calorie food, whereas geriatric cats (>12 years of age) may need a highly digestible nutrient-dense diet. More than 40% of dogs between the ages of 5 and 10 years are overweight or obese. Such dogs may benefit from diets with lower fat and calories. Senior dogs also have an increased need for dietary protein, however. Therefore, healthy older dogs may benefit from diets with an increased protein-to-calorie ratio, providing a minimum of 25% of calories from protein. Common obesity-related conditions in dogs or cats include DM and OA. Diabetes differs between dogs and cats. Type I diabetes, common in dogs, seems to respond to fiber-enriched diets, whereas type II diabetes, common in cats, seems to benefit from high-protein and low-carbohydrate diets. OA, an inflammatory condition that occurs in approximately 20% of dogs, may benefit from weight management and nutrients that reduce the inflammatory responses, such as long-chain n-3 fatty acids.

Feline hepatic lipidosis

We have come a long way in understanding and managing the FHL syndrome since it was first described nearly 30 years ago. Increased sensitivity of clinicians for recognizing the syndrome has improved case outcome by arresting this metabolic syndrome in its earliest stages. Simply ensuring adequate intake of a complete and balanced feline diet can rescue cats just developing clinical signs; however, full metabolic support as described herein provides the best chance for recovery of cats demonstrating the most severe clinicopathologic features. It remains possible that adjustments in recommended micronutrient and vitamin intake for healthy cats may pivotally change feline susceptibility to FHL over the coming years.

Metabolic, antioxidant, nutraceutical, probiotic, and herbal therapies relating to the management of hepatobiliary disorders

Many nutraceuticals, conditionally essential nutrients, and botanical extracts have been proposed as useful in the management of liver disease. The most studied of these are addressed in terms of proposed mechanisms of action, benefits, hazards, and safe dosing recommendations allowed by current information. While this is an area of soft science, it is important to keep an open and tolerant mind, considering that many major treatment discoveries were in fact serendipitous accidents.