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Kopp LHP, Søgaard-Hansen CM, Zachhau KM, Bastkjær RM, Andersen BV, Budtz-Jørgensen E, Byrne DV, Chaaban N, Holst JJ, Klindt TB, Magkos F, Ozenne B, Samkani A, Skytte MJ, Madsbad S, Krarup T, Thomsen MN. Effects of a carbohydrate-reduced high-protein diet delivered with meal kits to Danish people with type 2 diabetes: protocol for a 12-month randomised controlled trial. BMJ Open 2024; 14:e084686. [PMID: 39142677 PMCID: PMC11331900 DOI: 10.1136/bmjopen-2024-084686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 07/16/2024] [Indexed: 08/16/2024] Open
Abstract
INTRODUCTION The cornerstone in the management of type 2 diabetes (T2D) is lifestyle modification including a healthy diet, typically one in which carbohydrate provides 45%-60% of total energy intake (E%). Nevertheless, systematic reviews and meta-analyses of trials with low carbohydrate diets (which are increased in protein and/or fat) for T2D have found improved glycaemic control in the first months relative to comparator diets with higher carbohydrate content. Studies lasting ≥1 year are inconclusive, which could be due to decreased long-term dietary adherence. We hypothesise that glucometabolic benefits can be achieved following 12 months of carbohydrate-restricted dieting, by maximising dietary adherence through delivery of meal kits, containing fresh, high-quality ingredients for breakfast, dinner and snacks, combined with nutrition education and counselling. METHODS AND ANALYSIS This protocol describes a 12-month investigator-initiated randomised controlled, open-label, superiority trial with two parallel groups that will examine the effect of a carbohydrate-reduced high-protein (CRHP) diet compared with a conventional diabetes (CD) diet on glucometabolic control (change in glycated haemoglobin being the primary outcome) in 100 individuals with T2D and body mass index (BMI) >25 kg/m2. Participants will be randomised 1:1 to receive either the CRHP or the CD diet (comprised 30/50 E% from carbohydrate, 30/17 E% from protein and 40/33 E% from fat, respectively) for 12 months delivered as meal kits, containing foods covering more than two-thirds of the participants' estimated daily energy requirements for weight maintenance. Adherence to the allocated diets will be reinforced by monthly sessions of nutrition education and counselling from registered clinical dietitians. ETHICS AND DISSEMINATION The trial has been approved by the National Committee on Health Research Ethics of the Capital Region of Denmark. The trial will be conducted in accordance with the Declaration of Helsinki. Results will be submitted for publication in international peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER NCT05330247. PROTOCOL VERSION The trial protocol was approved on 9 March 2022 (study number: H-21057605). The latest version of the protocol, described in this manuscript, was approved on 23 June 2023.
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Affiliation(s)
- Luise H P Kopp
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | | | - Karen M Zachhau
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Rasmus M Bastkjær
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | | | | | - Derek V Byrne
- Department of Food Science, Aarhus University, Aarhus, Denmark
| | - Nora Chaaban
- Department of Food Science, Aarhus University, Aarhus, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Trine B Klindt
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Faidon Magkos
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Brice Ozenne
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
- Neurobiology Research Unit and BrainDrugs, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Amirsalar Samkani
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Mads J Skytte
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thure Krarup
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Mads N Thomsen
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
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Martín-Grau M, Pardo-Tendero M, Casanova P, Dromant M, Marrachelli VG, Morales JM, Borrás C, Pisoni S, Maestrini S, Di Blasio AM, Monleon D. Altered Lipid Moieties and Carbonyls in a Wistar Rat Dietary Model of Subclinical Fatty Liver: Potential Sex-Specific Biomarkers of Early Fatty Liver Disease? Antioxidants (Basel) 2023; 12:1808. [PMID: 37891887 PMCID: PMC10604774 DOI: 10.3390/antiox12101808] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is a condition in which excess fat builds up in the liver. To date, there is a lack of knowledge about the subtype of lipid structures affected in the early stages of NAFLD. The aim of this study was to analyze serum and liver lipid moieties, specifically unsaturations and carbonyls, by nuclear magnetic resonance (NMR) in a subclinical Wistar rat model of NAFLD for detecting early alterations and potential sex dimorphisms. Twelve weeks of a high-fat diet (HFD) induced fat accumulation in the liver to a similar extent in male and female Wistar rats. In addition to total liver fat accumulation, Wistar rats showed a shift in lipid subtype composition. HFD rats displayed increased lipid carbonyls in both liver and serum, and decreased in unsaturated fatty acids (UFAs) and polyunsaturated fatty acids (PUFAs), with a much stronger effect in male than female animals. Our results revealed that the change in fat was not only quantitative but also qualitative, with dramatic shifts in relevant lipid structures. Finally, we compared the results found in Wistar rats with an analysis in a human patient cohort of extreme obesity. For the first time to our knowledge, lipid carbonyl levels and lipoproteins profiles were analyzed in the context of subclinical NAFLD. The association found between lipid carbonyls and alanine aminotransferase (ALT) in a human cohort of extremely obese individuals further supports the potential role of lipid moieties as biomarkers of early NAFLD.
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Affiliation(s)
- María Martín-Grau
- Department of Pathology, University of Valencia, 46010 Valencia, Spain
- University Clinical Hospital of Valencia Research Foundation (INCLIVA), 46010 Valencia, Spain
| | - Mercedes Pardo-Tendero
- Department of Pathology, University of Valencia, 46010 Valencia, Spain
- University Clinical Hospital of Valencia Research Foundation (INCLIVA), 46010 Valencia, Spain
| | - Pilar Casanova
- Department of Pathology, University of Valencia, 46010 Valencia, Spain
- University Clinical Hospital of Valencia Research Foundation (INCLIVA), 46010 Valencia, Spain
| | - Mar Dromant
- University Clinical Hospital of Valencia Research Foundation (INCLIVA), 46010 Valencia, Spain
- Department of Physiology, University of Valencia, 46010 Valencia, Spain
| | - Vannina G Marrachelli
- University Clinical Hospital of Valencia Research Foundation (INCLIVA), 46010 Valencia, Spain
- Department of Physiology, University of Valencia, 46010 Valencia, Spain
| | - Jose Manuel Morales
- Department of Pathology, University of Valencia, 46010 Valencia, Spain
- University Clinical Hospital of Valencia Research Foundation (INCLIVA), 46010 Valencia, Spain
| | - Consuelo Borrás
- University Clinical Hospital of Valencia Research Foundation (INCLIVA), 46010 Valencia, Spain
- Department of Physiology, University of Valencia, 46010 Valencia, Spain
| | - Serena Pisoni
- Department of Physiology, University of Valencia, 46010 Valencia, Spain
| | - Sabrina Maestrini
- Laboratory of Molecular Genetics, Istituto Auxologico Italiano IRCCS, 20145 Milano, Italy
| | - Anna M Di Blasio
- Laboratory of Molecular Genetics, Istituto Auxologico Italiano IRCCS, 20145 Milano, Italy
| | - Daniel Monleon
- Department of Pathology, University of Valencia, 46010 Valencia, Spain
- University Clinical Hospital of Valencia Research Foundation (INCLIVA), 46010 Valencia, Spain
- CIBERFES_ISCIII, 46010 Valencia, Spain
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Cattaneo C, Mambrini SP, Gilardini L, Scacchi M, Pagliarini E, Bertoli S. Impact of 4-week of a restricted Mediterranean diet on taste perception, anthropometric, and blood parameters in subjects with severe obesity. Front Nutr 2023; 10:1196157. [PMID: 37693245 PMCID: PMC10485378 DOI: 10.3389/fnut.2023.1196157] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 08/07/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction The study of taste functionality and its relation to human health is receiving growing attention. Obesity has been reported to cause alterations in sensory perception regarding system functionality and preferences. However, a small body of research addresses tastes perception and its modification with the achievement of body mass reduction through surgical intervention. Much fewer efforts have been made to evaluate the impact of mild restrictive nutritional intervention on gustatory functions. Thus, the objectives of this study were to determine if a dietary intervention of 4 weeks following a restricted balanced Mediterranean diet would affect the sweet and salty taste thresholds of subjects with severe obesity and could influence their anthropometric and blood parameters. Methods Fifty-one patients with severe obesity (F: 31; age: 43.7 ± 12.5; BMI = 47.6 ± 1.0) were enrolled in the study. The recognition threshold for sweet and salty taste and anthropometric and blood parameters were assessed before and after the 4-week weight loss program. Results and Discussion The Mediterranean diet has proven to be an effective treatment, significantly improving all anthropometric and blood parameters (p < 0.05) after 4 weeks of intervention. Moreover, the hypo-sodium treatment associated with the diet significantly improved the salty threshold (p < 0.001). No changes were detected for the sweet threshold. Collectively, these data highlight that dietary treatment might impact taste perception differently. Therefore, a taste-oriented nutritional intervention could represent a novel approach to developing more individualized, taste-oriented follow-up interventions to maintain sustainable and long-term weight loss.
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Affiliation(s)
- Camilla Cattaneo
- Sensory & Consumer Science Lab (SCS_Lab), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
| | - Sara Paola Mambrini
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
- Istituto Auxologico Italiano, IRCCS, Laboratory of Metabolic Research, S. Giuseppe Hospital, Piancavallo, Italy
| | - Luisa Gilardini
- Istituto Auxologico Italiano, IRCCS, Obesity Unit – Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Milan, Italy
| | - Massimo Scacchi
- Istituto Auxologico Italiano, IRCCS, Laboratory of Metabolic Research, S. Giuseppe Hospital, Piancavallo, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Ella Pagliarini
- Sensory & Consumer Science Lab (SCS_Lab), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy
- Istituto Auxologico Italiano, IRCCS, Obesity Unit – Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Milan, Italy
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Wimmer R, Audétat A, Binggeli J, Schuetz P, Kaegi-Braun N. Association of Sociodemographic, Socioeconomic and Lifestyle Characteristics with Low Protein and Energy Intake in the Healthy Swiss Population. Nutrients 2023; 15:2200. [PMID: 37432324 DOI: 10.3390/nu15092200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 07/12/2023] Open
Abstract
A balanced diet has the goal of providing adequate amounts of different nutrients to promote and maintain physical and psychological health. Our aim was to study the association between different sociodemographic, socioeconomic and lifestyle factors and low energy or protein intake among the Swiss population. This is a cross-sectional cohort study based on the national nutritional survey "MenuCH", which is the first representative, detailed assessment of dietary habits in the adult Swiss population conducted in 2014/2015. We compared the mean protein and caloric intake based on two 24 h recall nutritional assessments with current recommendations based on resting metabolic rate calculation and DACH guidelines. A total of 1919 participants with a median age of 46 years and 53% females were included. Overall, 10.9% and 20.2% of participants had an energy and protein intake, respectively, below the dietary reference values. However, a high income (>9000 CHF per month) reduced the risk of low energy intake (OR 0.49 [0.26-0.94], p = 0.032), obesity (OR 6.55 [3.77-11.38], p < 0.01), and living in a household with children (OR 2.1 [1.15-3.85], p = 0.016) was associated with higher risk. Regarding low protein intake, the most important risk factors were an age group of 65-75 years (OR 2.94 [1.57-5.52], p = 0.001) and female gender (OR 1.73 [1.15-2.6], p = 0.008). Regular meat consumption reduced the risk of low protein intake (OR of 0.23 (0.1-0.53), p = 0.001). Within this survey, several socio-economic and lifestyle factors were associated with low energy and protein intake in the healthy Swiss population. A bunderstanding of these factors may help to reduce the risk of malnutrition.
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Affiliation(s)
- Roxana Wimmer
- Medical University Department, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Medical Faculty, University of Basel, 4056 Basel, Switzerland
| | - Andrea Audétat
- Medical Faculty, University of Basel, 4056 Basel, Switzerland
| | - Julia Binggeli
- Medical Faculty, University of Basel, 4056 Basel, Switzerland
| | - Philipp Schuetz
- Medical University Department, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Medical Faculty, University of Basel, 4056 Basel, Switzerland
| | - Nina Kaegi-Braun
- Medical University Department, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, 5001 Aarau, Switzerland
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Heusschen L, Berendsen AAM, Balvers MGJ, Deden LN, de Vries JHM, Hazebroek EJ. Relative validity of a short screener to assess diet quality in patients with severe obesity before and after bariatric surgery. Public Health Nutr 2022; 25:1-11. [PMID: 35786490 PMCID: PMC9991825 DOI: 10.1017/s1368980022001501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/12/2022] [Accepted: 06/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the relative validity and reproducibility of the Eetscore FFQ, a short screener for assessing diet quality, in patients with (severe) obesity before and after bariatric surgery (BS). DESIGN The Eetscore FFQ was evaluated against 3-d food records (3d-FR) before (T0) and 6 months after BS (T6) by comparing index scores of the Dutch Healthy Diet index 2015 (DHD2015-index). Relative validity was assessed using paired t tests, Kendall's tau-b correlation coefficients (τb), cross-classification by tertiles, weighted kappa values (k w ) and Bland-Altman plots. Reproducibility of the Eetscore FFQ was assessed using intraclass correlation coefficients (ICC). SETTING Regional hospital, the Netherlands. PARTICIPANTS Hundred and forty participants with obesity who were scheduled for BS. RESULTS At T0, mean total DHD2015-index score derived from the Eetscore FFQ was 10·2 points higher than the food record-derived score (P < 0·001) and showed an acceptable correlation (τb = 0·42, 95 % CI: 0·27, 0·55). There was a fair agreement with a correct classification of 50 % (k w = 0·37, 95 % CI: 0·25, 0·49). Correlation coefficients of the individual DHD components varied from 0·01-0·54. Similar results were observed at T6 (τb = 0·31, 95 % CI: 0·12, 0·48, correct classification of 43·7 %; k w = 0·25, 95 % CI: 0·11, 0·40). Reproducibility of the Eetscore FFQ was good (ICC = 0·78, 95 % CI: 0·69, 0·84). CONCLUSION The Eetscore FFQ showed to be acceptably correlated with the DHD2015-index derived from 3d-FR, but absolute agreement was poor. Considering the need for dietary assessment methods that reduce the burden for patients, practitioners and researchers, the Eetscore FFQ can be used for ranking according to diet quality and for monitoring changes over time.
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Affiliation(s)
- Laura Heusschen
- Vitalys Obesity Clinic, Part of Rijnstate Hospital, Arnhem, 6800 TA, The Netherlands
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Agnes AM Berendsen
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Michiel GJ Balvers
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Laura N Deden
- Vitalys Obesity Clinic, Part of Rijnstate Hospital, Arnhem, 6800 TA, The Netherlands
| | - Jeanne HM de Vries
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Eric J Hazebroek
- Vitalys Obesity Clinic, Part of Rijnstate Hospital, Arnhem, 6800 TA, The Netherlands
- Divison of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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Yao Z, Xie Y, Wang L, Yan C, Du H, Hu H, Li Z. A comparative study of indirect calorimetry and prediction equations in overweight and obese Chinese adults. NUTR CLIN METAB 2022. [DOI: 10.1016/j.nupar.2022.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Pisoni S, Marrachelli VG, Morales JM, Maestrini S, Di Blasio AM, Monleón D. Sex Dimorphism in the Metabolome of Metabolic Syndrome in Morbidly Obese Individuals. Metabolites 2022; 12:metabo12050419. [PMID: 35629923 PMCID: PMC9147578 DOI: 10.3390/metabo12050419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 12/10/2022] Open
Abstract
Adult morbid obesity is defined as abnormal or excessive fat accumulation, mostly resulting from a long-term unhealthy lifestyle. Between 10% and 30% of people with obesity exhibit low cardiometabolic risk. The metabolic syndrome has been suggested as an indicator of obesity-related metabolic dysregulation. Although the prevalence of obesity does not seem to be sex-related and metabolic syndrome occurs at all ages, in the last few years, sex-specific differences in the pathophysiology, diagnosis, and treatment of metabolic syndrome have received attention. The aim of this study was to determine the prevalence of metabolic syndrome and its components in different sex and age groups in people with metabolic unhealthy obesity and to compare them with people with metabolic healthy obesity. We analyzed the metabolome in 1350 well-phenotyped morbidly obese individuals and showed that there is a strong sex-dependent association of metabolic syndrome with circulating metabolites. Importantly, we demonstrated that metabolic dysregulation in women and men with severe obesity and metabolic syndrome is age-dependent. The metabolic profiles from our study showed age-dependent sex differences in the impact of MetS which are consistent with the cardiometabolic characterization. Although there is common ground for MetS in the metabolome of severe obesity, men older than 54 are affected in a more extensive and intensive manner. These findings strongly argue for more studies aimed at unraveling the mechanisms that underlie this sex-specific metabolic dysregulation in severe obesity. Moreover, these findings suggest that women and men might benefit from differential sex and age specific interventions to prevent the adverse cardiometabolic effects of severe obesity.
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Affiliation(s)
- Serena Pisoni
- Department of Pathology, Medicine and Odontology Faculty, University of Valencia, 46010 Valencia, Spain; (S.P.); (J.M.M.)
| | - Vannina G. Marrachelli
- Department of Physiology, Medicine and Odontology Faculty, University of Valencia, 46010 Valencia, Spain;
- Clinical Hospital Research Foundation-INCLIVA and CIBERFES, 46010 Valencia, Spain
| | - Jose M. Morales
- Department of Pathology, Medicine and Odontology Faculty, University of Valencia, 46010 Valencia, Spain; (S.P.); (J.M.M.)
- Clinical Hospital Research Foundation-INCLIVA and CIBERFES, 46010 Valencia, Spain
| | - Sabrina Maestrini
- Laboratory of Molecular Genetics, Istituto Auxologico Italiano IRCCS, 20145 Milano, Italy; (S.M.); (A.M.D.B.)
| | - Anna M. Di Blasio
- Laboratory of Molecular Genetics, Istituto Auxologico Italiano IRCCS, 20145 Milano, Italy; (S.M.); (A.M.D.B.)
| | - Daniel Monleón
- Department of Pathology, Medicine and Odontology Faculty, University of Valencia, 46010 Valencia, Spain; (S.P.); (J.M.M.)
- Clinical Hospital Research Foundation-INCLIVA and CIBERFES, 46010 Valencia, Spain
- Correspondence:
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Griffith R, Shean R, Petersen CL, Al-Nimr RI, Gooding T, Roderka MN, Batsis JA. Validation of Resting Energy Expenditure Equations in Older Adults with Obesity. J Nutr Gerontol Geriatr 2022; 41:126-139. [PMID: 35502533 PMCID: PMC9761489 DOI: 10.1080/21551197.2022.2070320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
It is unclear which energy expenditure prediction equation should guide weight loss interventions in older adults with obesity. We ascertained the validity of four equations commonly used in practice in a series of weight loss studies of adults aged ≥65 with a body mass index ≥30kg/m2 using indirect calorimetry data. Diagnostic accuracy was defined as <10% discrepancy between predicted and measured resting metabolic rate (RMR). Mean was 73.4 years. RMR using the ReeVue was 1,643 kCal. With 59.0% accuracy, the WHO equation demonstrated the highest accuracy while the Harris-Benedict yielded 53.5% accuracy. The Owens equation demonstrated the least variability (21.5% overprediction, 27.8% underprediction) with 50.7% accuracy. A SECA bioimpedance analyzer noted the second lowest accuracy of 49.6%. Only 43.1% of measurements were within 10% of the gold-standard indirect calorimetry value using the Mifflin equation. All equations demonstrated <60% accuracy suggesting a great need for estimating energy needs.
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Affiliation(s)
- Rachel Griffith
- Department of Medicine, Dartmouth-Hitchcock, Lebanon, New Hampshire
| | - Ryan Shean
- Dartmouth College, Hanover, New Hampshire
| | - Curtis L. Petersen
- The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH
| | - Rima I. Al-Nimr
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Tyler Gooding
- Department of Medicine, Dartmouth-Hitchcock, Lebanon, New Hampshire
| | | | - John A. Batsis
- Department of Medicine, Dartmouth-Hitchcock, Lebanon, New Hampshire
- Dartmouth College, Hanover, New Hampshire
- The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, NH
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- Division of Geriatric Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC
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Sprowls M, Victor S, Mora SJ, Osorio O, Pyznar G, Destaillats H, Wheatley-Guy C, Johnson B, Kulick D, Forzani E. A Smart System for the Contactless Measurement of Energy Expenditure. SENSORS (BASEL, SWITZERLAND) 2022; 22:1355. [PMID: 35214262 PMCID: PMC8963031 DOI: 10.3390/s22041355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/15/2022] [Accepted: 01/30/2022] [Indexed: 12/04/2022]
Abstract
Energy Expenditure (EE) (kcal/day), a key element to guide obesity treatment, is measured from CO2 production, VCO2 (mL/min), and/or O2 consumption, VO2 (mL/min). Current technologies are limited due to the requirement of wearable facial accessories. A novel system, the Smart Pad, which measures EE via VCO2 from a room's ambient CO2 concentration transients was evaluated. Resting EE (REE) and exercise VCO2 measurements were recorded using Smart Pad and a reference instrument to study measurement duration's influence on accuracy. The Smart Pad displayed 90% accuracy (±1 SD) for 14-19 min of REE measurement and for 4.8-7.0 min of exercise, using known room's air exchange rate. Additionally, the Smart Pad was validated measuring subjects with a wide range of body mass indexes (BMI = 18.8 to 31.4 kg/m2), successfully validating the system accuracy across REE's measures of ~1200 to ~3000 kcal/day. Furthermore, high correlation between subjects' VCO2 and λ for CO2 accumulation was observed (p < 0.00001, R = 0.785) in a 14.0 m3 sized room. This finding led to development of a new model for REE measurement from ambient CO2 without λ calibration using a reference instrument. The model correlated in nearly 100% agreement with reference instrument measures (y = 1.06x, R = 0.937) using an independent dataset (N = 56).
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Affiliation(s)
- Mark Sprowls
- School of Engineering for Matter, Transport and Energy, Arizona State University, Tempe, AZ 85281, USA; (M.S.); (S.V.)
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85281, USA; (S.J.M.); (O.O.); (G.P.)
| | - Shaun Victor
- School of Engineering for Matter, Transport and Energy, Arizona State University, Tempe, AZ 85281, USA; (M.S.); (S.V.)
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85281, USA; (S.J.M.); (O.O.); (G.P.)
| | - Sabrina Jimena Mora
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85281, USA; (S.J.M.); (O.O.); (G.P.)
| | - Oscar Osorio
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85281, USA; (S.J.M.); (O.O.); (G.P.)
| | - Gabriel Pyznar
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85281, USA; (S.J.M.); (O.O.); (G.P.)
| | - Hugo Destaillats
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA;
| | | | - Bruce Johnson
- Mayo Clinic, Scottsdale, AZ 85289, USA; (C.W.-G.); (B.J.); (D.K.)
| | - Doina Kulick
- Mayo Clinic, Scottsdale, AZ 85289, USA; (C.W.-G.); (B.J.); (D.K.)
| | - Erica Forzani
- School of Engineering for Matter, Transport and Energy, Arizona State University, Tempe, AZ 85281, USA; (M.S.); (S.V.)
- Center for Bioelectronics and Biosensors, Biodesign Institute, Arizona State University, Tempe, AZ 85281, USA; (S.J.M.); (O.O.); (G.P.)
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Mora SJ, Sprowls M, Tipparaju VV, Wheatley-Guy CM, Kulick D, Johnson B, Xiaojun X, Forzani E. Comparative study of a novel portable indirect calorimeter to a reference breath-by-breath instrument and its use in telemedicine settings. Clin Nutr ESPEN 2021; 46:361-366. [PMID: 34857221 DOI: 10.1016/j.clnesp.2021.09.731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/18/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND & AIMS Resting Energy Expenditure (REE) quantitatively describes the calories used to support body function (e.g. breathing, blood circulation, etc.) at resting condition. Assessment of the REE is essential for successful weight management and the understanding of metabolic health. REE is typically determined via indirect calorimetry. Current biomedical indirect calorimetry technologies, utilizing assessment of oxygen consumption (VO2) and carbon dioxide production (VCO2) rates (which are typically in the form factor of a metabolic cart) are bulky and require on-site calibration and/or trained professionals to operate. We introduce a novel wearable medical device with FDA clearance to determine REE accurately, portable, and user-friendly format, which can be used both by health professionals in a clinical environment and by the patient at home. Previously, we have reported the validation of Breezing Med (also named as Breezing Pro™) through Douglas Bag Method, a gold standard for gas exchange measurement, and excellent agreement has been found between the two methods for the determination of REE, VO2, and VCO2 rates (Mora et al., 2020). Now we present the validation of Breezing Med against Medical Graphics (MGC) CPX Ultima™, a FDA 510 k cleared metabolic cart, which principle is based on breath-by-breath analysis. In addition, we present Breezing Med as a tool for daily measurement of metabolic rate by the lay person at home. METHODS A) The validation study was executed via parallel measurement of 20 healthy participants under resting conditions using both the Breezing Med and the MGC Ultima CPX™ (10 min test). B) Breezing Med measurements were carried out by six subjects at home during stay-at-home order due to COVID-19 for 30 days. RESULTS A) The resulting measurements from both devices was compared with correlation slope's and R-squared coefficients close to 1. B) Results were recorded and analyzed for variability. The pilot study demonstrated the advantage of Breezing Med device to be easy-to-use at home by lay people, which make the valuable device for telemedicine applications related to weight management from home. CONCLUSIONS This result shows that the MGC Ultima CPX™ and Breezing Med are substantially equivalent for REE measurement; and an advantage of this device for metabolic assessment under the current COVID-19 pandemic situation, for people with impaired physical mobility, and for those who lives in rural areas or face impediments that limit physical access to care.
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Affiliation(s)
- S Jimena Mora
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States.
| | - Mark Sprowls
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States
| | - Vishal V Tipparaju
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States
| | | | - Doina Kulick
- Mayo Clinic, Scottsdale, Arizona, 85259, United States
| | - Bruce Johnson
- Mayo Clinic, Scottsdale, Arizona, 85259, United States
| | - Xian Xiaojun
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States
| | - Erica Forzani
- Center for Bioelectronics & Biosensors, The Biodesign Institute, Arizona State University, Tempe, Arizona, 85281, United States.
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Andrade-Mayorga O, Díaz E, Salazar LA. Effects of Four Lipid Metabolism-Related Polymorphisms on Body Composition Improvements After 12 Weeks of High-Intensity Interval Training and Dietary Energy Restriction in Overweight/Obese Adult Women: A Pilot Study. Front Physiol 2021; 12:712787. [PMID: 34539437 PMCID: PMC8440869 DOI: 10.3389/fphys.2021.712787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Polymorphisms in lipid metabolism-related genes have been associated with obesity and body composition, but these have been scarcely described concerning the magnitude of the response to exercise interventions in the overweight/obese population. Objective: To evaluate the association of perilipin 1 (PLIN1; rs1052700 and rs2304795), lipoprotein lipase (rs283), and adrenoceptor beta 3 (rs4994) polymorphisms with high and low responders (LoRes) to fat mass reduction after 12 weeks of high-intensity interval training (HIIT) and dietary energy restriction in overweight/obese adult women. In addition, we examined the effect of these genetic variants on body composition changes. Methods: Forty-three unrelated overweight/obese adult women were incorporated and genotyped, of which 30 women (age = 27.4 ± 7.9 years; BMI = 29.9 ± 3.3 kg/m2) successfully completed the 12-week supervised HIIT program plus an individually prescribed home hypocaloric diet. Results: An association was observed between the PLIN1 rs1052700 polymorphism with high and LoRes (χ2 = 8.138; 2 df; p = 0.01). Moreover, after the intervention, the carriers of TT genotype of PLIN1 rs1052700 as compared to AA and AT showed a greater reduction in absolute fat mass (Δ: −5.1 ± 1.8 vs. − 1.8 ± 1.4 vs. − 2.1 ± 2.3 kg; p = 0.04). The effect size of this fat mass reduction between TT and AT genotypes was a mean difference of −3.01 kg [95%IC − 4.88– − 1.1], and between TT and AA genotypes was −3.29 kg [95%IC − 4.86– − 1.65]. No differences were observed for other polymorphisms investigated. Conclusion: These results suggest that the rs1052700 (14995A>T) polymorphism of the PLIN1 gene is associated with a differential response to fat mass reduction after a 12-week intervention in overweight/obese adult women. In addition, women with the TT genotype of this genetic variant showed greater changes in fat mass than AA and AT genotypes. However, further studies are needed to confirm these findings.
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Affiliation(s)
- Omar Andrade-Mayorga
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile.,Department of Preclinical Sciences, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile.,Exercise, Movement and Health Research Group, Universidad de La Frontera, Temuco, Chile
| | - Erik Díaz
- Exercise, Movement and Health Research Group, Universidad de La Frontera, Temuco, Chile
| | - Luis A Salazar
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile
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14
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Andrade-Mayorga O, Martínez-Maturana N, Salazar LA, Díaz E. Physiological Effects and Inter-Individual Variability to 12 Weeks of High Intensity-Interval Training and Dietary Energy Restriction in Overweight/Obese Adult Women. Front Physiol 2021; 12:713016. [PMID: 34393829 PMCID: PMC8358598 DOI: 10.3389/fphys.2021.713016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Human adaptive response to exercise interventions is often described as group average and SD to represent the typical response for most individuals, but studies reporting individual responses to exercise show a wide range of responses. Objective: To characterize the physiological effects and inter-individual variability on fat mass and other health-related and physical performance outcomes after 12 weeks of high-intensity interval training (HIIT) and dietary energy restriction in overweight/obese adult women. Methods: Thirty untrained adult overweight and obese women (age = 27.4 ± 7.9 years; BMI = 29.9 ± 3.3 kg/m2) successfully completed a 12-week supervised HIIT program and an individually prescribed home hypocaloric diet (75% of daily energy requirements) throughout the whole intervention. High and low responders to the intervention were those individuals who were able to lose ≥ 10 and < 10% of initial absolute fat mass (i.e., kilograms), respectively. Results: The prevalence for high and low responders was 33% (n = 11) and 66% (n = 19), respectively. At the whole group level, the intervention was effective to reduce the absolute fat mass (30.9 ± 7.2 vs. 28.5 ± 7.2 kg; p < 0.0001), body fat percentage (39.8 ± 4.3 vs. 37.8 ± 4.9%; p < 0.0001), and total body mass (76.7 ± 10.1 vs. 74.4 ± 9.9 kg; p < 0.0001). In addition, there were improvements in systolic blood pressure (SBP; Δ% = −5.1%), diastolic blood pressure (DBP; Δ% = −6.4%), absolute VO2peak (Δ% = +14.0%), relative VO2peak (Δ% = +13.8%), peak power output (PPO; Δ% = +19.8%), anaerobic threshold (AT; Δ% = +16.7%), maximal ventilation (VE; Δ% = +14.1%), and peak oxygen pulse (O2 pulse; Δ% = +10.4%). However, at the individual level, a wide range of effects were appreciated on all variables, and the magnitude of the fat mass changes did not correlate with baseline body mass or fat mass. Conclusion: A 12-week supervised HIIT program added to a slight dietary energy restriction effectively improved fat mass, body mass, blood pressure, and cardiorespiratory fitness (CRF). However, a wide range of inter-individual variability was observed in the adaptative response to the intervention. Furthermore, subjects classified as low responders for fat mass reduction could be high responders (HiRes) in many other health-related and physical performance outcomes. Thus, the beneficial effects of exercise in obese and overweight women go further beyond the adaptive response to a single outcome variable such as fat mass or total body mass reduction.
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Affiliation(s)
- Omar Andrade-Mayorga
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile.,Department of Preclinical Sciences, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile.,Exercise, Movement, and Health Research Group, Universidad de La Frontera, Temuco, Chile
| | | | - Luis A Salazar
- Center of Molecular Biology and Pharmacogenetics, Scientific and Technological Bioresource Nucleus (BIOREN), Universidad de La Frontera, Temuco, Chile
| | - Erik Díaz
- Exercise, Movement, and Health Research Group, Universidad de La Frontera, Temuco, Chile
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15
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Common variants in the CD36 gene are associated with dietary fat intake, high-fat food consumption and serum triglycerides in a cohort of Quebec adults. Int J Obes (Lond) 2021; 45:1193-1202. [PMID: 33574567 DOI: 10.1038/s41366-021-00766-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/03/2020] [Accepted: 01/20/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND The CD36 gene is a candidate for sensory detection of fatty acids and has been associated with individual differences in fat preferences and consumption. Excess adiposity may compromise sensory detection, but few studies have examined whether associations between CD36 variants and fat consumption differ between underweight/normal weight (UW/NW) and overweight/obese (OW/OB) individuals. METHODS Diet (assessed by food frequency questionnaire), genetic (nine variants), body mass index (BMI), lifestyle and biomarker data were obtained from the CARTaGENE biobank (n = 12,065), a Quebec cohort of middle-aged adults. Primary outcome variables included intakes (%kcal/day) of total, saturated (SFA), monounsaturated (MUFA) and polyunsaturated (PUFA) fatty acids. Secondary outcome variables included consumption (servings/day) of four food categories with high-fat content (added fats and oils, high-fat foods, desserts and MUFA- and PUFA-rich foods) and biomarkers of chronic disease. Multivariable regression models stratified by BMI category were used to assess associations between CD36 variants and outcome variables. RESULTS Among UW/NW, rs1049654 and rs10499859 were associated with higher intakes of total fat, MUFA and PUFA (all P < 0.05), while rs1527483 and rs3211956 were associated with higher SFA (P = 0.0278) and lower PUFA (P = 0.0466) intake, respectively. Rs1527483 and rs3211956 were also associated with higher consumption of high-fat foods and desserts (all P < 0.05). Among OW, rs1054516 and rs3173798 were associated with higher SFA intake (both P < 0.05), and rs1054516 was also associated with higher serum triglycerides (P = 0.0065). CONCLUSIONS CD36 variants are associated with habitual fat consumption, which may play a role in subsequent associations with chronic-disease biomarkers. Associations differ by BMI status and dietary fat type.
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Tamini S, Cicolini S, Caroli D, Sartorio A. Effects of a 3-Week In-Hospital Multidisciplinary Body Weight Reduction Program in Obese Females: Is Measured Resting Energy Expenditure Essential for Tailoring Adequately the Amount of Energy Intake? Front Nutr 2021; 8:678788. [PMID: 34055863 PMCID: PMC8149587 DOI: 10.3389/fnut.2021.678788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/14/2021] [Indexed: 11/13/2022] Open
Abstract
In the obese population, the prescription of a proper diet plan is essential to ensure an appropriate and gradual weight loss, reduce the risk of weight cycling and favor an overall improvement of health conditions. Energy needs are commonly estimated using predictive equations, even if their accuracy is still debated, especially in severely obese subjects. In the present study, 850 severely obese females admitted to our hospital for a multidisciplinary body weight reduction program (BWRP) were divided into three subgroups, “hypo-,” “normo-,” and “hyper-metabolic,” based on the comparison between estimated resting energy expenditure (eREE, using the Mifflin equation) and measured REE (mREE, using indirect calorimetry). The majority of this study population was considered normo-metabolic (59.4%, mREE between 90 and 110% of eREE), 32.6% was hyper-metabolic (mREE > 110% of eREE) and only 8% was hypo-metabolic (mREE < 90% of eREE). The three subgroups were evaluated before and after a 3-week BWRP, entailing energy restricted diet, adapted physical activity, psychological counseling and nutritional education. Since the diet plan during the BWRP consisted of a 30% reduction of total energy expenditure (obtained by multiplying mREE by the physical activity level), each subgroup responded positively to the BWRP independently from the difference between mREE and eREE, the extent of BMI reduction and clinical, metabolic and physical amelioration being comparable among the three subgroups. By contrast, the restriction of the energy intake based on eREE during the BWRP would have determined a slighter caloric restriction in the hypo-metabolic subgroup, thus determining a smaller body weight reduction, and, by contrast, a more marked caloric restriction in the hyper-metabolic subgroup, probably difficult to be tolerated and maintained for prolonged period. In conclusion, the percentage of subjects with “slow metabolism” in a Caucasian female obese population seeking hospitalization for a BWRP is actually lower than expected, finding controverting the common notion that obesity is mostly due to reduced REE. The high percentage (40%) of inadequate eREE in these female obese populations further underlines the absolute need to include the measurement of REE in the clinical practice for the correct prescription of energy intake in severely obese populations.
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Affiliation(s)
- Sofia Tamini
- Istituto Auxologico Italiano, Experimental Laboratory for Auxo-Endocrinological Research, Verbania and Milan, Italy
| | - Sabrina Cicolini
- Istituto Auxologico Italiano, Experimental Laboratory for Auxo-Endocrinological Research, Verbania and Milan, Italy
| | - Diana Caroli
- Istituto Auxologico Italiano, Experimental Laboratory for Auxo-Endocrinological Research, Verbania and Milan, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Experimental Laboratory for Auxo-Endocrinological Research, Verbania and Milan, Italy.,Istituto Auxologico Italiano, Division of Auxology and Metabolic Diseases, Verbania, Italy
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17
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Pereira AZ, Gonçalves SEA, Rodrigues M, Hamerschlak N, Flowers ME. Challenging and Practical Aspects of Nutrition in Chronic Graft-versus-Host Disease. Biol Blood Marrow Transplant 2020; 26:e265-e270. [PMID: 32784069 DOI: 10.1016/j.bbmt.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/24/2020] [Accepted: 08/02/2020] [Indexed: 01/22/2023]
Abstract
There is a paucity of information about nutrition in chronic graft-versus-host disease (GVHD). The role of nutrition is important because malnutrition is strongly associated with severe chronic GVHD manifestations. There is a high prevalence of metabolic syndrome and osteoporosis in this setting. Here we review the literature, describe main aspects of nutrition and discuss macronutrients (ie, vitamins), micronutrients (ie, Mg, Zn, Ca, and K) and supplements (probiotics and omega 3 fatty acids). A search was carried out in March 2020 using PubMed. Databases were screened for searching terms in titles and abstracts referring to chronic GVHD, nutrition intervention, protein, and body composition. Data were extracted for the following outcomes: nutrition, nutrition intervention, chronic GVHD, nutrition deficiencies, diet, vitamin, dry eye, probiotic, protein, and body composition. In this report, we summarize interventional nutrition studies reported in oncology and metabolic syndrome settings and describe our nutritional clinical practice in hematopoietic cell transplantation and chronic GVHD. The impact of nutrition evaluation and intervention on muscle mass loss, dry eye, dysgeusia, metabolic syndrome, osteoporosis, and comorbidities associated with chronic GVHD need to be studied prospectively.
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Affiliation(s)
- Andrea Z Pereira
- Oncology and Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil.
| | - Sandra Elisa Adami Gonçalves
- Oncology and Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil; Clinical Nutrition Department, Prevent Senior Center, São Paulo, Brazil
| | - Morgani Rodrigues
- Oncology and Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Nelson Hamerschlak
- Oncology and Hematology Department, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Mary E Flowers
- Division of Clinical Research, Fred Hutchinson Cancer Research Center and University of Washington School of Medicine, Seattle, Washington
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18
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Validation of predictive equations for resting energy expenditure in treatment-seeking adults with overweight and obesity: Measured versus estimated. JOURNAL OF POPULATION THERAPEUTICS AND CLINICAL PHARMACOLOGY 2020; 27:e32-e47. [PMID: 31971355 DOI: 10.15586/jptcp.v27i1.653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/31/2019] [Indexed: 01/04/2023]
Abstract
The quantification of resting energy expenditure (REE) in patients with obesity is an important measure. We aimed to evaluate the validity of predictive equations in estimating REE compared with indirect calorimetry (IC) in treatment-seeking Arab adults with overweight or obesity. Twenty-three predictive equations were compared with REE values measured by IC (Vmax Encore 229) in 89 adult participants with overweight or obesity (mean age = 40.62 ± 15.96 years and mean body mass index [BMI] = 35.02 ± 4.60 kg/m2) referred to the Department of Nutrition and Dietetics of Beirut Arab University (Lebanon). The accuracy of the predictive equations was evaluated on the basis of whether the percentage prediction was within 10% of the measured REE, and the mean difference between predicted and measured values (bias). The Bland-Altman method was used to assess the agreement between the predicted and measured values. The equations that demonstrated the closest agreement with IC were the De La Cruz equation in males (accurate predictions: 68.2%; bias: -19.52 kcal/day) and the Mifflin equation in females (accurate prediction: 61.2%; bias: -36.43 kcal/day). In conclusion, we suggest that these two equations produce the least biased estimations for REE in this population.
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19
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Martin-Rincon M, Perez-Valera M, Morales-Alamo D, Perez-Suarez I, Dorado C, Gonzalez-Henriquez JJ, Juan-Habib JW, Quintana-Garcia C, Galvan-Alvarez V, Pedrianes-Martin PB, Acosta C, Curtelin D, Calbet JA, de Pablos-Velasco P. Resting Energy Expenditure and Body Composition in Overweight Men and Women Living in a Temperate Climate. J Clin Med 2020; 9:jcm9010203. [PMID: 31940840 PMCID: PMC7020055 DOI: 10.3390/jcm9010203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 12/27/2019] [Accepted: 01/06/2020] [Indexed: 11/16/2022] Open
Abstract
This study aimed to determine whether the measured resting energy expenditure (REE) in overweight and obese patients living in a temperate climate is lower than the predicted REE; and to ascertain which equation should be used in patients living in a temperate climate. REE (indirect calorimetry) and body composition (DXA) were measured in 174 patients (88 men and 86 women; 20-68 years old) with overweight or obesity (BMI 27-45 kg m-2). All volunteers were residents in Gran Canaria (monthly temperatures: 18-24 °C). REE was lower than predicted by most equations in our population. Age and BMI were similar in both sexes. In the whole population, the equations of Mifflin, Henry and Rees, Livingston and Owen, had similar levels of accuracy (non-significant bias of 0.7%, 1.1%, 0.6%, and -2.2%, respectively). The best equation to predict resting energy expenditure in overweight and moderately obese men and women living in a temperate climate all year round is the Mifflin equation. In men, the equations by Henry and Rees, Livingston, and by Owen had predictive accuracies comparable to that of Mifflin. The body composition-based equation of Johnston was slightly more accurate than Mifflin's in men. In women, none of the body composition-based equations outperformed Mifflin's.
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Affiliation(s)
- Marcos Martin-Rincon
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Mario Perez-Valera
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - David Morales-Alamo
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Ismael Perez-Suarez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Cecilia Dorado
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Juan J. Gonzalez-Henriquez
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Mathematics, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Julian W. Juan-Habib
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
| | - Cristian Quintana-Garcia
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
| | - Victor Galvan-Alvarez
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Pablo B. Pedrianes-Martin
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Calle Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Canary Islands, Spain
| | - Carmen Acosta
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Calle Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Canary Islands, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
| | - Jose A.L. Calbet
- Department of Physical Education, University of Las Palmas de Gran Canaria, Campus Universitario de Tafira, s/n, 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (M.M.-R.); (M.P.-V.); (D.M.-A.); (I.P.-S.); (C.D.); (J.W.J.-H.); (C.Q.-G.); (V.G.-A.)
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Physical Performance, The Norwegian School of Sport Sciences, Postboks, 4014 Ulleval Stadion, 0806 Oslo, Norway
- Correspondence: (J.A.L.C.); (P.d.P.-V.)
| | - Pedro de Pablos-Velasco
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Paseo Blas Cabrera Felipe “Físico” (s/n), 35017 Las Palmas de Gran Canaria, Canary Islands, Spain; (J.J.G.-H.); (P.B.P.-M.); (C.A.); (D.C.)
- Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Calle Plaza Barranco de la Ballena, s/n, 35010 Las Palmas de Gran Canaria, Canary Islands, Spain
- Correspondence: (J.A.L.C.); (P.d.P.-V.)
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El Masri D, Itani L, Kreidieh D, Tannir H, El Ghoch M. Predictive Equations Based on Body Composition for Resting Energy Expenditure Estimation in Adults with Obesity. Curr Diabetes Rev 2020; 16:381-386. [PMID: 31663845 DOI: 10.2174/1573399815666191030085915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/19/2019] [Accepted: 10/28/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIM An accurate estimation of Resting Energy Expenditure (REE) in patients with obesity is crucial. Therefore, our aim was to assess the validity of REE predictive equations based on body composition variables in treatment-seeking Arab adults with obesity. METHODS Body composition and REE were measured by Tanita BC-418 bioimpedance and Vmax Encore 229 IC, respectively, and predictive equations based on fat mass and fat-free mass were used in REE estimations among 87 adults of both genders, in the Outpatient Clinic in the Department of Nutrition and Dietetics at Beirut Arab University (Lebanon). The mean differences between the measured and estimated REE values were calculated to assess the accuracy, and the Bland-Altman method was used to assess the level of agreement. RESULTS Ten predictive equations were included. In males, all the predictive equations gave significantly different estimates of REE when compared to that measured by IC. On the other hand, in females, the mean difference between the REE value estimated by Huang and Horie-Waitzberg equations and that measured using IC was not significant, and the agreement was confirmed using Bland-Altman plots. CONCLUSION Huang and Horie-Waitzberg equations are suggested for accurate REE estimation in females; however, new validated REE estimation equations for males in this population are still needed.
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Affiliation(s)
- Dana El Masri
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
| | - Marwan El Ghoch
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, P.O. Box 11-5020 Riad El Solh, Beirut, Lebanon
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Mele C, Tagliaferri MA, Pagano L, Soranna D, Scacchi M, Aimaretti G, Biondi B, Marzullo P. Levothyroxine Replacement in Obese Adults: The Role of Metabolic Variables and Aging on Thyroid Testing Abnormalities. J Clin Endocrinol Metab 2019; 104:6265-6274. [PMID: 31265068 DOI: 10.1210/jc.2019-00773] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/26/2019] [Indexed: 02/13/2023]
Abstract
CONTEXT General rates of over- and underreplacement in levothyroxine (LT4) users with primary hypothyroidism are variably high. No information on LT4 adequacy exists in obesity. OBJECTIVE We explored rates and factors relating to LT4 adequacy in obese patients with primary hypothyroidism. SETTING Tertiary care center. DESIGN Among 4954 consecutive obese patients admitted between 2011 and 2014, 691 hypothyroid patients receiving LT4 therapy and 691 body mass index (BMI)-, age-, and sex-matched euthyroid controls underwent analysis of thyroid function, glucolipid profile, body composition, and indirect calorimetry. LT4 users were classified into low TSH (<0.27 mU/L), euthyroid (0.27 to 4.2 mU/L), and high TSH (>4.2 mU/L). RESULTS LT4 users constituted 13.9% of the incident population. TSH was low in 7.5%, high in 17.2%, and normal in 75.2% of LT4 users. Overtreatment decreased with aging and more LT4 users ≥65 years of age had normal TSH than those <65 years of age (P < 0.05). Compared with the euthyroid obese group, LT4 users showed higher adiposity, similar insulin resistance, but a healthier lipid profile. In multivariable analyses, LT4 dose was predicted by fat-free mass, hypothyroidism cause, and sex (P < 0.0001 to < 0.05). Risk of LT4 overreplacement increased with younger age (OR 0.96; 95% CI 0.94 to 0.99), higher LT4 dose (OR 2.98; 95% CI 1.44 to 6.14), and lower BMI (OR 0.93; 95% CI 0.88 to 0.99). Male sex increased the likelihood of LT4 underreplacement (OR 2.37; 95% CI 1.10 to 5.11). CONCLUSIONS Obesity is associated with milder rates of inadequate LT4 treatment compared with nonobese populations. LT4 adequacy increases with aging. Age, body composition, and sex are main determinants of LT4 requirements in obesity.
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Affiliation(s)
- Chiara Mele
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Division of General Medicine, Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo, Verbania, Italy
| | - Maria Antonella Tagliaferri
- Division of General Medicine, Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo, Verbania, Italy
| | - Loredana Pagano
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Davide Soranna
- Statistics Unit, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Massimo Scacchi
- Division of General Medicine, Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo, Verbania, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gianluca Aimaretti
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Bernadette Biondi
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Paolo Marzullo
- Division of Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Division of General Medicine, Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Piancavallo, Verbania, Italy
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Indirect Calorimetry in Clinical Practice. J Clin Med 2019; 8:jcm8091387. [PMID: 31491883 PMCID: PMC6780066 DOI: 10.3390/jcm8091387] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 12/14/2022] Open
Abstract
Indirect calorimetry (IC) is considered as the gold standard to determine energy expenditure, by measuring pulmonary gas exchanges. It is a non-invasive technique that allows clinicians to personalize the prescription of nutrition support to the metabolic needs and promote a better clinical outcome. Recent technical developments allow accurate and easy IC measurements in spontaneously breathing patients as well as in those on mechanical ventilation. The implementation of IC in clinical routine should be promoted in order to optimize the cost–benefit balance of nutrition therapy. This review aims at summarizing the latest innovations of IC as well as the clinical indications, benefits, and limitations.
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