No effect of short-term testosterone manipulation on exercise substrate metabolism in men

Sex Differences in Energy Metabolism: A Female-Oriented Discussion

The purpose of this review is to delineate aspects of energy metabolism at rest and during exercise that may be subject to sex differences and the potential underlying mechanisms involved. It focuses on distinct aspects of female physiology with an oriented discussion following the reproductive life stages of healthy, eumenorrheic females, including premenopausal time frames, pregnancy, perimenopause, and menopause. Finally, this review aims to address methodological challenges surrounding sexual dimorphism in energy metabolism investigations and confounding factors in this field. During resting conditions, females tend to have higher rates of non-oxidative free fatty acid clearance, which could contribute to lower respiratory exchange ratio measures. At the same time, carbohydrate energy metabolism findings are mixed. In general, females favor lipid energy metabolism during moderate-intensity exercise, while men favor carbohydrate energy metabolism. Factors such as age, dietary intake, genetics, and methodological decisions confound study findings, including properly identifying and reporting the menstrual cycle phase when female subjects are eumenorrheic. Pregnancy presents a unique shift in physiological systems, including energy metabolism, which can be observed at rest and during exercise. Changes in body composition and hormonal levels during the post-menopausal period directly impact energy metabolism, specifically lipid metabolism. This change in physiological state factors into the evidence showing a reduction in our understanding of sex differences in lipid metabolism during exercise in older adults. This review reveals a need for a focused understanding of female energy metabolism that could help exercise and nutrition professionals optimize female health and performance across the lifespan.

The Biological Basis of Sex Differences in Athletic Performance: Consensus Statement for the American College of Sports Medicine

ABSTRACT

Biological sex is a primary determinant of athletic performance because of fundamental sex differences in anatomy and physiology dictated by sex chromosomes and sex hormones. Adult men are typically stronger, more powerful, and faster than women of similar age and training status. Thus, for athletic events and sports relying on endurance, muscle strength, speed, and power, males typically outperform females by 10%-30% depending on the requirements of the event. These sex differences in performance emerge with the onset of puberty and coincide with the increase in endogenous sex steroid hormones, in particular testosterone in males, which increases 30-fold by adulthood, but remains low in females. The primary goal of this consensus statement is to provide the latest scientific knowledge and mechanisms for the sex differences in athletic performance. This review highlights the differences in anatomy and physiology between males and females that are primary determinants of the sex differences in athletic performance and in response to exercise training, and the role of sex steroid hormones (particularly testosterone and estradiol). We also identify historical and nonphysiological factors that influence the sex differences in performance. Finally, we identify gaps in the knowledge of sex differences in athletic performance and the underlying mechanisms, providing substantial opportunities for high-impact studies. A major step toward closing the knowledge gap is to include more and equitable numbers of women to that of men in mechanistic studies that determine any of the sex differences in response to an acute bout of exercise, exercise training, and athletic performance.

Metabolic Adaptations and Substrate Oxidation are Unaffected by Exogenous Testosterone Administration during Energy Deficit in Men

INTRODUCTION/PURPOSE

The effects of testosterone on energy and substrate metabolism during energy deficit are unknown. The objective of this study was to determine the effects of weekly testosterone enanthate (TEST; 200 mg·wk -1 ) injections on energy expenditure, energy substrate oxidation, and related gene expression during 28 d of energy deficit compared with placebo (PLA).

METHODS

After a 14-d energy balance phase, healthy men were randomly assigned to TEST ( n = 24) or PLA ( n = 26) for a 28-d controlled diet- and exercise-induced energy deficit (55% below total energy needs by reducing energy intake and increasing physical activity). Whole-room indirect calorimetry and 24-h urine collections were used to measure energy expenditure and energy substrate oxidation during balance and deficit. Transcriptional regulation of energy and substrate metabolism was assessed using quantitative reverse transcription-polymerase chain reaction from rested/fasted muscle biopsy samples collected during balance and deficit.

RESULTS

Per protocol design, 24-h energy expenditure increased ( P < 0.05) and energy intake decreased ( P < 0.05) in TEST and PLA during deficit compared with balance. Carbohydrate oxidation decreased ( P < 0.05), whereas protein and fat oxidation increased ( P < 0.05) in TEST and PLA during deficit compared with balance. Change (∆; deficit minus balance) in 24-h energy expenditure was associated with ∆activity factor ( r = 0.595), but not ∆fat-free mass ( r = 0.147). Energy sensing (PRKAB1 and TP53), mitochondria (TFAM and COXIV), fatty acid metabolism (CD36/FAT, FABP, CPT1b, and ACOX1) and storage (FASN), and amino acid metabolism (BCAT2 and BCKHDA) genes were increased ( P < 0.05) during deficit compared with balance, independent of treatment.

CONCLUSIONS

These data demonstrate that increased physical activity and not exogenous testosterone administration is the primary determinate of whole-body and skeletal muscle metabolic adaptations during diet- and exercise-induced energy deficit.

Effects of short-term sex steroid suppression on dietary fat storage patterns in healthy males

Hypogonadism in males is associated with increased body fat and altered postprandial metabolism, but mechanisms remain poorly understood. Using a cross‐over study design, we investigated the effects of short‐term sex hormone suppression with or without testosterone add‐back on postprandial metabolism and the fate of dietary fat. Eleven healthy males (age: 29 ± 4.5 year; BMI: 26.3 ± 2.1 kg/m²) completed two 7‐day study phases during which hormone levels were altered pharmacologically to produce a low sex hormone condition (gonadotropin releasing hormone antagonist, aromatase inhibitor, and placebo gel) or a testosterone add‐back condition (testosterone gel). Following 7 days of therapy, subjects were administered an inpatient test meal containing 50 μCi of [1‐¹⁴C] oleic acid. Plasma samples were collected hourly for 5 h to assess postprandial responses. Energy metabolism (indirect calorimetry) and dietary fat oxidation (¹⁴CO₂ in breath) were assessed at 1, 3, 5, 13.5, and 24 h following the test meal. Abdominal and femoral adipose biopsies were taken 24 h after the test meal to determine uptake of the labeled lipid. Postprandial glucose, insulin, free‐fatty acid, and triglyceride responses were not different between conditions (P > 0.05). Whole‐body energy metabolism was also not different between conditions at any time point (P > 0.05). Dietary fat oxidation trended lower (P = 0.12) and the relative uptake of ¹⁴C labeled lipid into femoral adipose tissue was greater (P = 0.03) in the low hormone condition. Short‐term hormone suppression did not affect energy expenditure or postprandial metabolism, but contributed to greater relative storage of dietary fat in the femoral depot. ClinicalTrials.gov Identifier: NCT03289559.

Metabolic Effects of Testosterone Hormone Therapy in Normal and Orchiectomized Male Rats: From Indirect Calorimetry to Lipolytic Enzymes

BACKGROUND AND AIM

Changes in total energy expenditure (TEE) and substrate metabolism may help explain the metabolic actions of testosterone (T). This study measured respiratory quotient (RQ), TEE, ghrelin, insulin, and key lipolysis enzyme concentrations in relation to body weight (wt) and food intake (FI) in both normal and bilaterally orchiectomized rats with/without T treatment.

METHODS

In total, thirty-two male Wistar rats (300-400 g) were divided into four groups (n = 8/group), including (a) sham-operated and vehicle-injected group (Sham), (b) T-treated sham group (T-Sham) for which sham-operated rats were injected with IM testosterone undecanoate (100 mg/kg, for one week), (c) orchiectomy and vehicle-injected group (Orch), and (d) T-replaced orchiectomy group (T-Orch). After one week, FI and wt were automatically recorded, indirect calorimetry parameters were measured, and blood samples were collected to measure T, ghrelin, insulin, growth hormone (GH), glucose, hormone-sensitive lipase (HSL), adipocyte triglyceride lipase (ATGL), free fatty acids (FFA), and lipid profiles.

RESULTS

Orchiectomy decreased ghrelin, GH, and insulin levels, increased TEE and RQ, and lowered FI and wt. The T-Orch group exhibited increased levels of ghrelin (3-fold), insulin, GH, blood levels of lipolysis products, TEE, and FI in addition to reduced glucose levels (P < 0.05). This group demonstrated no significant changes in wt. In the T-Sham group, T increased ghrelin and insulin levels (P < 0.05) with strong positive correlations (r = 0.663 and 0.644, respectively, P < 0.05), increased ATGL levels, RQ toward carbohydrate utilization ranges, and TEE, and reduced HSL levels (P < 0.05) with insignificant changes in FI or wt.

CONCLUSIONS

T administration in orchiectomized rats significantly increased orexigenic mediators such as ghrelin and insulin without inducing any significant changes in wt. The mechanism for this finding might be the increased TEE and the stimulation of lipolysis through the ATGL enzyme. The associated rise of GH might help in interference with accumulation of lipid in adipose tissue. Apart from the effect on GH, T-Sham showed similar effects of T supplementation.

Ovarian hormones mediate running-induced changes in high fat diet choice patterns in female rats

Physical inactivity and increased consumption of energy dense, high fat (HF) foods often leads to a state of positive energy balance. Regular exercise can facilitate the maintenance of a healthy body weight and mediate changes in dietary selection. Past studies using a two-diet choice (chow vs. HF) and voluntary wheel running paradigm found that when a novel HF diet and wheel running are simultaneously introduced, male rats show complete and persistent HF diet avoidance whereas the majority of females show HF diet avoidance for a few days, but then revert to HF diet preference. Ovariectomy (OVX) appears to decrease preference for the HF diet bringing it closer to that of males. Given that estradiol but not progesterone mediates changes in food intake and energy balance, we hypothesized that estradiol signaling is required for the reversal of HF diet avoidance in female rats. Accordingly, Experiment 1 compared the persistency of running-induced HF diet avoidance in males, sham-operated females, and OVX rats with replacement of oil vehicle, estradiol benzoate (E), progesterone (P), or both (E + P). The number of wheel running rats that either avoided or preferred the HF diet varied with hormone treatment. The reversal of HF diet avoidance in running females and OVX E + P rats occurred more rapidly and frequently than male running rats. E + P but not E or P replaced OVX wheel running rats significantly reversed HF diet avoidance. OVX oil rats avoided HF diet to the same extent as male rats for the first 11 days of diet choice and then rapidly increased HF diet intake and began preferring it. This incomplete elimination of sex differences suggests that developmental factors or androgens might play a role in sustaining running-induced HF diet avoidance. Subsequently, Experiment 2 aimed to determine the role of androgens in the persistency of running-associated HF diet avoidance with sham-operated and orchiectomized (GDX) male rats. Both intact and GDX male running rats persistently avoided the HF diet to the same extent. Taken together, these results suggest that activational effects of ovarian hormones play a role in female specific running-induced changes in diet choice patterns. Furthermore, the activational effects of androgens are not required for the expression of HF diet avoidance in males.

Sex-based differences in endurance exercise muscle metabolism: impact on exercise and nutritional strategies to optimize health and performance in women

NEW FINDINGS

What is the topic of this review? The topic is how sex influences carbohydrate and fat metabolism during exercise and whether this influences adaptation to nutritional and exercise regimens aiming to improve health and performance. What advances does it highlight? Women respond differently to certain nutritional and training regimens aimed at improving health and performance. Few studies have included women in trials and thus we are unsure how women respond to nutritional and training strategies aimed at improving health and performance. Sex-based differences in substrate metabolism during moderate-intensity endurance exercise (END) have been well established. Specifically, during END of the same relative intensity women have a lower respiratory exchange ratio than men, indicative of a lesser reliance on carbohydrate oxidation to support fuel requirements for exercise. In fact, compared with men, women show a lesser reliance on both liver and muscle glycogen during END. Sex-based differences in intramyocellular lipid (IMCL) utilization during END are controversial. However, women have a larger depot of IMCL available to support END fuel needs and a greater percentage of IMCL in contact with mitochondria after a bout of END compared with men, suggestive of a greater capacity to use IMCL. These sex-based differences in metabolism during END are known to be mediated by oestrogen. Despite the well-recognized sexual dimorphisms in substrate metabolism during END, there is a paucity of research examining the effects of exercise and nutritional regimens aimed to enhance performance and/or health in women. Furthermore, the evidence that does exist is suggestive of discordance in the effectiveness of nutritional and exercise regimens between the sexes. The focus of this review is to provide an overview of the well-established sex-based differences in metabolism during END and how they relate to the physiological responses to nutritional and exercise strategies intended to improve exercise performance and/or health.

Gender dimorphic effects of voluntary running in laboratory rats depends on maturational status

This study examined the effect of 24 hr per day wheel access on running, body weight, and food intake for 30- or 50-day-old male and female rats under ad lib feeding conditions. Food intake and body weight were also monitored in a control group housed without access to running wheels. A dimorphic effect was observed after wheel introduction in 50-day-old but not 30-day-old rats: A temporary decline in food intake and a lasting decrease in body weight occurred for active male rats in comparison to their sedentary controls, and wheel access facilitated food intake and preserved body weight gain in female rats in comparison to their sedentary counterparts. Hyperphagia in adult females is interpreted in terms of the evolutionary acquired advantage linked to their reproductive function.

Effects of estrogen and testosterone on resting energy expenditure in older men

The mechanisms by which sex hormones cause changes in body composition are unclear. Sex steroid deficiency might directly reduce energy expenditure/fat oxidation and thereby predispose to increased body fat. Alternatively, sex steroid deficiency could result in lean tissue loss and thus reduced energy expenditure. Our objective was to examine the independent and combined effects of acute testosterone and estrogen withdrawal on respiratory exchange ratio (RER) and resting energy expenditure (REE) in men. The objective of the study was to examine the independent and combined effects of acute estrogen and testosterone withdrawal on RER and REE in men. A total of 54 men aged 50-80 years, BMI range of 17-35 kg/m(2) underwent a 3-week eugonadal run-in hormone-treatment period involving suppression of endogenous sex steroids using letrozole and leuprolide acetate (Lupron) while sex steroid concentrations were maintained with transdermal testosterone (T) and estradiol (E). A second Lupron injection was then given and participants were randomized to one of the following four 3-week treatment groups: group A (-T, -E), group B (-T, +E), group C (+T, -E), and group D (+T, +E). REE and RER were measured via indirect calorimetry before and after the 3-week treatment period. Three-week suppression and/or repletion of estrogen or testosterone did not produce changes in RER or REE within or between groups. We conclude that abrupt changes in sex steroids does not change resting substrate oxidation, indicating that changes that can be observed after more prolonged periods of deficiency are most likely due to direct effects of sex steroids on body composition.

Sex differences in exercise metabolism and the role of 17-beta estradiol

Women oxidize more lipid and less carbohydrate and protein compared with men during endurance exercise. The increase in fat oxidation is associated with higher intramyocellular lipid content and use as well as greater adipocyte lipolysis. Glucose rates of appearance and disappearance are lower for women than for men, with no change in basal muscle glycogen, and some evidence for muscle glycogen sparing during endurance exercise. Women oxidize less protein compared with men and show lower leucine oxidation during exercise. The consistent and robust finding of higher mRNA abundance for most components of fat-oxidation pathways in women compared with men is directionally consistent with the substrate-oxidation data. A lack of directional consistency between mRNA species involved in carbohydrate and protein metabolism and the known sex differences during exercise implies that fat oxidation is regulated and that carbohydrate and protein oxidation follow by metabolic demand. Administration of 17-beta-estradiol to men recapitulates most of the described sex differences in metabolism and mRNA content. The greater fat oxidation for women during submaximal endurance exercise compared with men seems to occur partly through a sex hormone-mediated enhancement of lipid-oxidation pathways.