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Gupta A, Nicholas R, McGing JJ, Nixon AV, Mallinson JE, McKeever TM, Bradley CR, Piasecki M, Cox EF, Bonnington J, Lord JM, Brightling CE, Evans RA, Hall IP, Francis ST, Greenhaff PL, Bolton CE. DYNamic Assessment of Multi-Organ level dysfunction in patients recovering from COVID-19: DYNAMO COVID-19. Exp Physiol 2024; 109:1274-1291. [PMID: 38923603 PMCID: PMC11291868 DOI: 10.1113/ep091590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 05/22/2024] [Indexed: 06/28/2024]
Abstract
We evaluated the impacts of COVID-19 on multi-organ and metabolic function in patients following severe hospitalised infection compared to controls. Patients (n = 21) without previous diabetes, cardiovascular or cerebrovascular disease were recruited 5-7 months post-discharge alongside controls (n = 10) with similar age, sex and body mass. Perceived fatigue was estimated (Fatigue Severity Scale) and the following were conducted: oral glucose tolerance (OGTT) alongside whole-body fuel oxidation, validated magnetic resonance imaging and spectroscopy during resting and supine controlled exercise, dual-energy X-ray absorptiometry, short physical performance battery (SPPB), intra-muscular electromyography, quadriceps strength and fatigability, and daily step-count. There was a greater insulin response (incremental area under the curve, median (inter-quartile range)) during the OGTT in patients [18,289 (12,497-27,448) mIU/min/L] versus controls [8655 (7948-11,040) mIU/min/L], P < 0.001. Blood glucose response and fasting and post-prandial fuel oxidation rates were not different. This greater insulin resistance was not explained by differences in systemic inflammation or whole-body/regional adiposity, but step-count (P = 0.07) and SPPB scores (P = 0.004) were lower in patients. Liver volume was 28% greater in patients than controls, and fat fraction adjusted liver T1, a measure of inflammation, was raised in patients. Patients displayed greater perceived fatigue scores, though leg muscle volume, strength, force-loss, motor unit properties and post-exercise muscle phosphocreatine resynthesis were comparable. Further, cardiac and cerebral architecture and function (at rest and on exercise) were not different. In this cross-sectional study, individuals without known previous morbidity who survived severe COVID-19 exhibited greater insulin resistance, pointing to a need for physical function intervention in recovery.
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Affiliation(s)
- Ayushman Gupta
- NIHR Nottingham Biomedical Research CentreNottinghamUK
- Centre for Respiratory Research, Translational Medical Sciences, School of MedicineUniversity of NottinghamNottinghamUK
- Nottingham University Hospitals NHS TrustNottinghamUK
| | - Rosemary Nicholas
- Sir Peter Mansfield Imaging Centre, School of Physics & AstronomyUniversity of NottinghamNottinghamUK
| | - Jordan J. McGing
- David Greenfield Human Physiology Unit, School of Life SciencesUniversity of NottinghamNottinghamUK
| | - Aline V. Nixon
- David Greenfield Human Physiology Unit, School of Life SciencesUniversity of NottinghamNottinghamUK
| | - Joanne E. Mallinson
- David Greenfield Human Physiology Unit, School of Life SciencesUniversity of NottinghamNottinghamUK
| | - Tricia M. McKeever
- NIHR Nottingham Biomedical Research CentreNottinghamUK
- Centre for Respiratory Research, Translational Medical Sciences, School of MedicineUniversity of NottinghamNottinghamUK
| | - Christopher R. Bradley
- Sir Peter Mansfield Imaging Centre, School of Physics & AstronomyUniversity of NottinghamNottinghamUK
| | - Mathew Piasecki
- NIHR Nottingham Biomedical Research CentreNottinghamUK
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of NottinghamNottinghamUK
| | - Eleanor F. Cox
- Sir Peter Mansfield Imaging Centre, School of Physics & AstronomyUniversity of NottinghamNottinghamUK
| | | | - Janet M. Lord
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of BirminghamBirminghamUK
- NIHR Birmingham Biomedical Research CentreUniversity of BirminghamBirminghamUK
| | | | - Rachael A. Evans
- NIHR Leicester Biomedical Research CentreUniversity of LeicesterLeicesterUK
| | - Ian P. Hall
- NIHR Nottingham Biomedical Research CentreNottinghamUK
- Centre for Respiratory Research, Translational Medical Sciences, School of MedicineUniversity of NottinghamNottinghamUK
- Nottingham University Hospitals NHS TrustNottinghamUK
| | - Susan T. Francis
- NIHR Nottingham Biomedical Research CentreNottinghamUK
- Sir Peter Mansfield Imaging Centre, School of Physics & AstronomyUniversity of NottinghamNottinghamUK
| | - Paul L. Greenhaff
- NIHR Nottingham Biomedical Research CentreNottinghamUK
- David Greenfield Human Physiology Unit, School of Life SciencesUniversity of NottinghamNottinghamUK
- MRC‐Versus Arthritis Centre for Musculoskeletal Ageing ResearchUniversity of NottinghamNottinghamUK
| | - Charlotte E. Bolton
- NIHR Nottingham Biomedical Research CentreNottinghamUK
- Centre for Respiratory Research, Translational Medical Sciences, School of MedicineUniversity of NottinghamNottinghamUK
- Nottingham University Hospitals NHS TrustNottinghamUK
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Alcantara JMA, Galgani JE. Association of metabolic flexibility indexes after an oral glucose tolerance test with cardiometabolic risk factors. Eur J Clin Nutr 2024; 78:180-186. [PMID: 38110728 DOI: 10.1038/s41430-023-01373-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND & AIMS Metabolic flexibility (MetF) is considered a metabolic health biomarker, as excess body weight is associated with lower MetF. We aimed to identify whether MetF indexes were associated with cardiometabolic risk factors before and after adjustment for body size-related factors (body weight, fat-free mass, and resting metabolic rate). METHODS We studied 51 participants (55% women; 33.6 ± 8.7 years; 26.3 ± 3.8 kg/m²) who consumed a 75-g glucose load. We measured gas exchange before (fasting) and for 3 h after glucose ingestion. MetF indexes were assessed, including the change after each hour and the 3-hour incremental area under the curve (iAUC) in respiratory exchange ratio (RER). These indexes were then related to cardiometabolic risk factors before and after adjusting for body size-related factors. RESULTS MetF indexes correlated with each other (r ≥ 0.51; P < 0.001) and related to body weight (adjusted R2 ≥ 0.09; P < 0.03). A similar pattern was noted for fat-free mass and resting metabolic rate. MetF, regardless of the index, was not related to cardiometabolic risk factors except to BMI and high-density lipoprotein-cholesterol (HDL-C). The association between BMI and MetF disappeared after adjusting for body size-related factors. Similar adjustments did not modify the association between HDL-C and MetF, especially when approached by the change in RER after the first hour (adjusted R2 = 0.20-0.22; all P < 0.02). CONCLUSIONS Inter-individual body size differences fully accounted for the associations between BMI and MetF. However, variability in body size-related factors appeared less relevant in affecting the associations of other cardiometabolic risk factors with MetF.
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Affiliation(s)
- J M A Alcantara
- Institute for Innovation & Sustainable Food Chain Development, Department of Health Sciences, Public University of Navarre, Campus Arrosadía, s/n, 31006, Pamplona, Spain.
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain.
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.
| | - J E Galgani
- Department of Health Sciences, Nutrition and Dietetics Career, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Department of Nutrition, Diabetes and Metabolism, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
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Malo-Vintimilla L, Aguirre C, Vergara A, Fernández-Verdejo R, Galgani JE. Resting energy metabolism and sweet taste preference during the menstrual cycle in healthy women. Br J Nutr 2024; 131:384-390. [PMID: 37641942 PMCID: PMC10784125 DOI: 10.1017/s0007114523001927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
Differences in blood concentration of sex hormones in the follicular (FP) and luteal (LP) phases may influence energy metabolism in women. We compared fasting energy metabolism and sweet taste preference on a representative day of the FP and LP in twenty healthy women (25·3 (sd 5·1) years, BMI: 22·2 (sd 2·2) kg/m2) with regular self-reported menses and without the use of hormonal contraceptives. From the self-reported duration of the three prior menstrual cycles, the predicted FP and LP visits were scheduled for days 5-12 and 20-25 after menses, respectively. The order of the FP and LP visits was randomly assigned. On each visit, RMR and RQ by indirect calorimetry, sweet taste preference by the Monell two-series forced-choice tracking procedure, serum fibroblast growth factor 21 by a commercial ELISA (FGF21, a liver-derived protein with action in energy balance, fuel oxidation and sugar preference) and dietary food intake by a 24-h dietary recall were determined. Serum progesterone and oestradiol concentrations displayed the expected differences between phases. RMR was lower in the FP v. LP (5042 (sd 460) v. 5197 (sd 490) kJ/d, respectively; P = 0·04; Cohen effect size, d rm = 0·33), while RQ showed borderline significant higher values (0·84 (sd 0·05) v. 0·81 (sd 0·05), respectively; P = 0·07; d rm = 0·62). Also, in the FP v. LP, sweet taste preference was lower (12 (sd 8) v. 16 (sd 9) %; P = 0·04; d rm = 0·47) concomitant with higher serum FGF21 concentration (294 (sd 164) v. 197 (sd 104) pg/ml; P < 0·01; d rm = 0·66). The menstrual cycle is associated with changes in energy expenditure, sweet taste preference and oxidative fuel partitioning.
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Affiliation(s)
- Lorena Malo-Vintimilla
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Aguirre
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Angie Vergara
- División de Obstetricia y Ginecología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Fernández-Verdejo
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Jose E. Galgani
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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McCue MD. CO 2 scrubbing, zero gases, Keeling plots, and a mathematical approach to ameliorate the deleterious effects of ambient CO 2 during 13 C breath testing in humans and animals. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2023; 37:e9639. [PMID: 37817343 DOI: 10.1002/rcm.9639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/17/2023] [Accepted: 08/26/2023] [Indexed: 10/12/2023]
Abstract
13 C breath testing is increasingly used in physiology and ecology research because of what it reveals about the different fuels that animals oxidize to meet their energetic demands. Here I review the practice of 13 C breath testing in humans and other animals and describe the impact that contamination by ambient/background CO2 in the air can have on the accuracy of 13 C breath measurements. I briefly discuss physical methods to avoid sample contamination as well as the Keeling plot approach that researchers have been using for the past two decades to estimate δ13 C from breath samples mixed with ambient CO2 . Unfortunately, Keeling plots are not suited for 13 C breath testing in common situations where (1) a subject's VCO2 is dynamic, (2) ambient [CO2 ] may change, (3) a subject is sensitive to hypercapnia, or (4) in any flow-through indirect calorimetry system. As such, I present a mathematical solution that addresses these issues by using information about the instantaneous [CO2 ] and the δ13 CO2 of ambient air as well as the diluted breath sample to back-calculate the δ13 CO2 in the CO2 exhaled by the animal. I validate this approach by titrating a sample of 13 C-enriched gas into an air stream and demonstrate its ability to provide accurate values across a wide range of breath and air mixtures. This approach allows researchers to instantaneously calculate the δ13 C of exhaled gas of humans or other animals in real time without having to scrub ambient CO2 or rely on estimated values.
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Leal-Martín J, Mañas A, Alfaro-Acha A, García-García FJ, Ara I. Optimization of VO 2 and VCO 2 outputs for the calculation of resting metabolic rate using a portable indirect calorimeter. Scand J Med Sci Sports 2023; 33:1648-1660. [PMID: 37300247 DOI: 10.1111/sms.14425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/24/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023]
Abstract
This study aimed to compare the Cosmed K5 portable indirect calorimeter, using the mixing chamber mode and face mask, with a stationary metabolic cart when measuring the resting metabolic rate (RMR) and to derive fitting equations if discrepancies are observed. Forty-three adults (18-84 years) were assessed for their RMR for two 30-min consecutive and counterbalanced periods using a Cosmed K5 and an Oxycon Pro. Differences among devices were tested using paired sample Student's t-tests, and correlation and agreement were assessed using Pearson's correlation coefficients, intraclass correlation coefficient and Bland-Altman plots. Forward stepwise multiple linear regression models were performed to develop fitting equations for estimating differences among devices when assessing oxygen uptake (VO2 diff , mL·min-1 ) and carbon dioxide production (VCO2 diff , mL·min-1 ). Furthermore, the Oxycon Pro was tested before being confirmed as a reference device. Significant differences between devices were found in most metabolic and ventilatory parameters, including the primary outcomes of VO2 and VCO2 . These differences showed an overestimation of the Cosmed K5 in all metabolic outcomes, except for Fat, when compared to the Oxycon Pro. When derived fitting equations were applied (VO2 diff - 139.210 + 0.786 [weight, kg] + 1.761 [height, cm] - 0.941 [Cosmed K5 VO2 , mL·min-1 ]; VCO2 diff - 86.569 + 0.548 [weight, kg] + 0.915 [height, cm] - 0.728 [Cosmed K5 VCO2 , mL·min-1 ]), differences were minimized, and agreement was maximized. This study provides fitting equations which allow the use of the Cosmed K5 for reasonably optimal RMR determinations.
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Affiliation(s)
- Javier Leal-Martín
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Castilla-La Mancha, Spain
| | - Asier Mañas
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Castilla-La Mancha, Spain
- Center UCM-ISCIII for Human Evolution and Behavior, Madrid, Spain
- Faculty of Education, Complutense University of Madrid, Madrid, Spain
| | - Ana Alfaro-Acha
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Castilla-La Mancha, Spain
- Geriatric Department, Hospital Virgen del Valle, Complejo Hospital Universitario de Toledo, Toledo, Spain
| | - Francisco José García-García
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Castilla-La Mancha, Spain
- Geriatric Department, Hospital Virgen del Valle, Complejo Hospital Universitario de Toledo, Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, Universidad de Castilla-La Mancha, Toledo, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Castilla-La Mancha, Spain
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Reproducibility of the energy metabolism response to an oral glucose tolerance test: influence of a postcalorimetric correction procedure. Eur J Nutr 2023; 62:351-361. [PMID: 36006468 PMCID: PMC9899729 DOI: 10.1007/s00394-022-02986-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/03/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Metabolic flexibility (MetF), which is a surrogate of metabolic health, can be assessed by the change in the respiratory exchange ratio (RER) in response to an oral glucose tolerance test (OGTT). We aimed to determine the day-to-day reproducibility of the energy expenditure (EE) and RER response to an OGTT, and whether a simulation-based postcalorimetric correction of metabolic cart readouts improves day-to-day reproducibility. METHODS The EE was assessed (12 young adults, 6 women, 27 ± 2 years old) using an Omnical metabolic cart (Maastricht Instruments, Maastricht, The Netherlands) after an overnight fast (12 h) and after a 75-g oral glucose dose on 2 separate days (48 h). On both days, we assessed EE in 7 periods (one 30-min baseline and six 15-min postprandial). The ICcE was performed immediately after each recording period, and capillary glucose concentration (using a digital glucometer) was determined. RESULTS We observed a high day-to-day reproducibility for the assessed RER (coefficients of variation [CV] < 4%) and EE (CVs < 9%) in the 7 different periods. In contrast, the RER and EE areas under the curve showed a low day-to-day reproducibility (CV = 22% and 56%, respectively). Contrary to our expectations, the postcalorimetric correction procedure did not influence the day-to-day reproducibility of the energy metabolism response, possibly because the Omnical's accuracy was ~ 100%. CONCLUSION Our study demonstrates that the energy metabolism response to an OGTT is poorly reproducible (CVs > 20%) even using a very accurate metabolic cart. Furthermore, the postcalorimetric correction procedure did not influence the day-to-day reproducibility. Trial registration NCT04320433; March 25, 2020.
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Bailey A, Eltawil M, Gohel S, Byham-Gray L. Machine learning models using non-linear techniques improve the prediction of resting energy expenditure in individuals receiving hemodialysis. Ann Med 2023; 55:2238182. [PMID: 37505893 PMCID: PMC10392315 DOI: 10.1080/07853890.2023.2238182] [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: 01/12/2023] [Revised: 05/23/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
PURPOSE Approximately 700,000 people in the USA have chronic kidney disease requiring dialysis. Protein-energy wasting (PEW), a condition of advanced catabolism, contributes to three-year survival rates of 50%. PEW occurs at all levels of Body Mass Index (BMI) but is devastating for those people at the extremes. Treatment for PEW depends on an accurate understanding of energy expenditure. Previous research established that current methods of identifying PEW and assessing adequate treatments are imprecise. This includes disease-specific equations for estimated resting energy expenditure (eREE). In this study, we applied machine learning (ML) modelling techniques to a clinical database of dialysis patients. We assessed the precision of the ML algorithms relative to the best-performing traditional equation, the MHDE. METHODS This was a secondary analysis of the Rutgers Nutrition and Kidney Database. To build the ML models we divided the population into test and validation sets. Eleven ML models were run and optimized, with the best three selected by the lowest root mean squared error (RMSE) from measured REE. Values for eREE were generated for each ML model and for the MHDE. We compared precision using Bland-Altman plots. RESULTS Individuals were 41.4% female and 82.0% African American. The mean age was 56.4 ± 11.1 years, and the median BMI was 28.8 (IQR = 24.8 - 34.0) kg/m2. The best ML models were SVR, Linear Regression and Elastic net with RMSE of 103.6 kcal, 119.0 kcal and 121.1 kcal respectively. The SVR demonstrated the greatest precision, with 91.2% of values falling within acceptable limits. This compared to 47.1% for the MHDE. The models using non-linear techniques were precise across extremes of BMI. CONCLUSION ML improves precision in calculating eREE for dialysis patients, including those most vulnerable for PEW. Further development for clinical use is a priority.
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Affiliation(s)
- Alainn Bailey
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, New Brunswick, NJ, USA
| | - Mohamed Eltawil
- Department of Health Informatics, School of Health Professions, Rutgers University, New Brunswick, NJ, USA
| | - Suril Gohel
- Department of Health Informatics, School of Health Professions, Rutgers University, New Brunswick, NJ, USA
| | - Laura Byham-Gray
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, New Brunswick, NJ, USA
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Sarabhai T, Mastrototaro L, Kahl S, Bönhof GJ, Jonuscheit M, Bobrov P, Katsuyama H, Guthoff R, Wolkersdorfer M, Herder C, Meuth SG, Dreyer S, Roden M. Hyperbaric oxygen rapidly improves tissue-specific insulin sensitivity and mitochondrial capacity in humans with type 2 diabetes: a randomised placebo-controlled crossover trial. Diabetologia 2023; 66:57-69. [PMID: 36178534 PMCID: PMC9729133 DOI: 10.1007/s00125-022-05797-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/28/2022] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS Hyperbaric oxygen (HBO) therapy may improve hyperglycaemia in humans with type 2 diabetes, but underlying mechanisms are unclear. Our objective was to examine the glucometabolic effects of HBO on whole-body glucose disposal in humans with type 2 diabetes. METHODS In a randomised placebo-controlled crossover trial located at the German Diabetes Center, 12 male individuals with type 2 diabetes (age 18-75 years, BMI <35 kg/m2, HbA1c 42-75 mmol/mol [6-9%]), randomly allocated by one person, underwent 2-h HBO, once with 100% (240 kPa; HBO) and once with 21% oxygen (240 kPa; control, CON). Insulin sensitivity was assessed by hyperinsulinaemic-euglycaemic clamps with D-[6,6-2H2]glucose, hepatic and skeletal muscle energy metabolism were assessed by 1H/31P-magnetic resonance spectroscopy, while high-resolution respirometry measured skeletal muscle and white adipose tissue (WAT) mitochondrial capacity. All participants and people assessing the outcomes were blinded. RESULTS HBO decreased fasting blood glucose by 19% and increased whole-body, hepatic and WAT insulin sensitivity about one-third (p<0.05 vs CON). Upon HBO, hepatic γ-ATP concentrations doubled, mitochondrial respiratory control doubled in skeletal muscle and tripled in WAT (p<0.05 vs CON). HBO increased myocellular insulin-stimulated serine-473/threonine-308 phosphorylation of Akt but decreased basal inhibitory serine-1101 phosphorylation of IRS-1 and endoplasmic reticulum stress (p<0.05 vs CON). CONCLUSIONS/INTERPRETATION HBO-mediated improvement of insulin sensitivity likely results from decreased endoplasmic reticulum stress and increased mitochondrial capacity, possibly leading to low-dose reactive oxygen species-mediated mitohormesis in humans with type 2 diabetes. TRIAL REGISTRATION ClinicalTrials.gov NCT04219215 FUNDING: German Federal Ministry of Health, German Federal Ministry of Education and Research, North-Rhine Westfalia Ministry of Culture and Science, European-Regional-Development-Fund, German-Research-Foundation (DFG), Schmutzler Stiftung.
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Affiliation(s)
- Theresia Sarabhai
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Lucia Mastrototaro
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Sabine Kahl
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Gidon J Bönhof
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Marc Jonuscheit
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Pavel Bobrov
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
| | - Hisayuki Katsuyama
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Rainer Guthoff
- Department of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Martin Wolkersdorfer
- Department of Production, Hospital Pharmacy, Landesapotheke Salzburg, Salzburg, Austria
| | - Christian Herder
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany
| | - Sven G Meuth
- Department of Neurology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Sven Dreyer
- Clinic for Orthopedics and Trauma Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Michael Roden
- Department of Endocrinology and Diabetology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.
- Institute for Clinical Diabetology, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research at Heinrich-Heine-University, Düsseldorf, Germany.
- German Center for Diabetes Research (DZD), Partner Düsseldorf, München-Neuherberg, Germany.
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Bailey A, Brody R, Sackey J, Parrott JS, Peters E, Byham-Gray L. Current methods for developing predictive energy equations in maintenance dialysis are imprecise. Ann Med 2022; 54:909-920. [PMID: 35356849 PMCID: PMC8979515 DOI: 10.1080/07853890.2022.2057581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE For individuals receiving maintenance dialysis, estimating accurate resting energy expenditure (REE) is essential for achieving energy balance, and preventing protein-energy wasting. Dialysis-specific, predictive energy equations (PEEs) offer a practical way to calculate REE. Three PEEs have been formulated via similar methods in different demographic samples; the Maintenance Haemodialysis Equation (MHDE REE), Vilar et al. Equation (Vilar REE) and the Fernandes et al. Equation (Cuppari REE). We compared them in a US cohort and assessed precision relative to measured REE (mREE) from indirect calorimetry. Because of expected imprecision at the extremes of the weight distribution, we also assessed the PEEs stratified by body mass index (BMI) subgroups. METHODS This analysis comprised of 113 individuals from the Rutgers Nutrition and Kidney Database. Estimated REE (eREE) was calculated for each PEE, and agreement with mREE was set at > 50% of values within the limits of ±10%. Reliability and accuracy were determined using intraclass correlation (ICC) and a Bland Altman plot, which analysed the percentage difference of eREE form mREE. RESULTS Participants were 58.4% male and 81.4% African American. Mean age was 55.8 ± 12.2 years, and the median BMI was 28.9 (IQR = 25.3 - 34.4) kg/m2. The MHDE REE achieved 58.4% of values within ±10% from mREE; Cuppari REE achieved 47.8% and Vilar REE achieved 46.0% agreement. Reliability was good for the MHDE REE (ICC = 0.826) and Cuppari REE (ICC = 0.801), and moderate for the Vilar REE (ICC = 0.642) (p < .001 for all). The equations performed poorly at the lowest and highest BMI categories. CONCLUSION Dialysis-specific energy equations showed variable accuracy. When categorized by BMI, the equations performed poorly at the extremes, where individuals are most vulnerable. Innovation is needed to understand these variances and correct the imprecision in PEEs for clinical practice.KEY MESSAGESPotentially impacting over millions of patients worldwide, our long-term goal is to understand energy expenditure (EE) across the spectrum of CKD (stages 1-5) in adults and children being treated with dialysis or transplantation, with the intent of providing tools for the health professional that will improve the delivery of quality care.Our research has identified and focussed on disease-specific factors which account for 60% of the variance in predicting EE in patients on MHD, but significant gaps remain.Thus, our central hypotheses are that (1) there are unique disease-specific determinants of EE and (2) prediction of EE for individuals diagnosed with CKD can be vastly improved with a model that combines these factors with more sophisticated approaches.
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Affiliation(s)
- Alainn Bailey
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - Rebecca Brody
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - Joachim Sackey
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - J Scott Parrott
- Department of Interdisciplinary Studies, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - Emily Peters
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - Laura Byham-Gray
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions, Rutgers University, Newark, NJ, USA
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10
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Vujović N, Piron MJ, Qian J, Chellappa SL, Nedeltcheva A, Barr D, Heng SW, Kerlin K, Srivastav S, Wang W, Shoji B, Garaulet M, Brady MJ, Scheer FAJL. Late isocaloric eating increases hunger, decreases energy expenditure, and modifies metabolic pathways in adults with overweight and obesity. Cell Metab 2022; 34:1486-1498.e7. [PMID: 36198293 PMCID: PMC10184753 DOI: 10.1016/j.cmet.2022.09.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/28/2022] [Accepted: 09/12/2022] [Indexed: 01/10/2023]
Abstract
Late eating has been linked to obesity risk. It is unclear whether this is caused by changes in hunger and appetite, energy expenditure, or both, and whether molecular pathways in adipose tissues are involved. Therefore, we conducted a randomized, controlled, crossover trial (ClinicalTrials.gov NCT02298790) to determine the effects of late versus early eating while rigorously controlling for nutrient intake, physical activity, sleep, and light exposure. Late eating increased hunger (p < 0.0001) and altered appetite-regulating hormones, increasing waketime and 24-h ghrelin:leptin ratio (p < 0.0001 and p = 0.006, respectively). Furthermore, late eating decreased waketime energy expenditure (p = 0.002) and 24-h core body temperature (p = 0.019). Adipose tissue gene expression analyses showed that late eating altered pathways involved in lipid metabolism, e.g., p38 MAPK signaling, TGF-β signaling, modulation of receptor tyrosine kinases, and autophagy, in a direction consistent with decreased lipolysis/increased adipogenesis. These findings show converging mechanisms by which late eating may result in positive energy balance and increased obesity risk.
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Affiliation(s)
- Nina Vujović
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA.
| | - Matthew J Piron
- Department of Medicine, Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, The University of Chicago, Chicago, IL, USA
| | - Jingyi Qian
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Sarah L Chellappa
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA; Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Arlet Nedeltcheva
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - David Barr
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Su Wei Heng
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Kayla Kerlin
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Suhina Srivastav
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Wei Wang
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Brent Shoji
- Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Marta Garaulet
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Department of Physiology, Regional Campus of International Excellence, University of Murcia, 30100 Murcia, Spain; Biomedical Research Institute of Murcia, IMIB-Arrixaca-UMU, University Clinical Hospital, 30120 Murcia, Spain
| | - Matthew J Brady
- Department of Medicine, Section of Adult and Pediatric Endocrinology, Diabetes and Metabolism, The University of Chicago, Chicago, IL, USA
| | - Frank A J L Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA.
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11
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Fernández-Verdejo R, Galgani JE. Predictive equations for energy expenditure in adult humans: From resting to free-living conditions. Obesity (Silver Spring) 2022; 30:1537-1548. [PMID: 35854398 DOI: 10.1002/oby.23469] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/06/2022]
Abstract
Humans acquire energy from the environment for survival. A central question for nutritional sciences is how much energy is required to sustain cellular work while maintaining an adequate body mass. Because human energy balance is not exempt from thermodynamic principles, the energy requirement can be approached from the energy expenditure. Conceptual and technological advances have allowed understanding of the physiological determinants of energy expenditure. Body mass, sex, and age are the main factors determining energy expenditure. These factors constitute the basis for predictive equations for resting (REE) and total (TEE) energy expenditure in healthy adults. These equations yield predictions that differ up to ~400 kcal/d for REE and ~550 kcal/d for TEE. Identifying additional factors accounting for such variability and the most valid equations appears relevant. This review used novel approaches based on mathematical modeling of REE and analyses of the data from which REE predictive equations were generated. As for TEE, R2 and SE were considered because only a few predictive equations are available. From these analyses, Oxford's and Plucker's equations appear valid for predicting REE and TEE in adults, respectively.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratorio de Fisiología del Ejercicio y Metabolismo (LABFEM), Escuela de Kinesiología, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
| | - José E Galgani
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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12
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Yu X, Hussein S, Li L, Liu Q, Ban Z, Jiang H. Effect of Dihydroquercetin on Energy Metabolism in LPS-Induced Inflammatory Mice. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6491771. [PMID: 35832840 PMCID: PMC9273438 DOI: 10.1155/2022/6491771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 12/04/2022]
Abstract
This study investigated the effects and alterations of dihydroquercetin on the growth performance, nutriment metabolism, antioxidant and immune function, and energy substrate utilization in lipopolysaccharide-challenged mice. A total of 0, 50, and 200 mg/kg of dihydroquercetin were intragastrically administered once a day for 21 days. After the pretreatment with dihydroquercetin, each group was subjected to a lipopolysaccharide challenge (except for the control group). After lipopolysaccharide injection, food intake, body weight, metabolic indexes of blood and liver nutrients, blood inflammatory factors, and liver oxidative stress indexes were measured at 6, 12, 24, and 48 h, respectively. Indirect calorimetry analysis was performed by respiratory gas analysis for 48 h to calculate the energy substrate metabolism of carbohydrate, fat, and protein. Urinary nitrogen excretion was measured to evaluate the urinary protein metabolism to calculate the substrate utilization. The results showed that dihydroquercetin pretreatment can significantly increase the weight gain and average food intake and decrease the mortality rate in lipopolysaccharide-induced inflammation mice. Furthermore, dihydroquercetin pretreatment can alleviate the negative effects of lipopolysaccharides by increasing levels of superoxide dismutase and glutathione peroxidase and by decreasing the malondialdehyde and serum inflammatory cytokines (interleukin-1β, nuclear factor κB, and interleukin-6). Dihydroquercetin pretreatment also can relieve nutrient metabolic disorder by increasing blood glucose, serum total protein, and liver glycogen levels and reducing serum and liver triglycerides, serum cholesterol, serum lactate dehydrogenase, and serum urea nitrogen levels. Meanwhile, it increases the relative utilization of carbohydrate, reducing relative utilization of protein and lipid, alleviating the change in energy metabolism pattern from glucose-predominant to lipid-predominant caused by lipopolysaccharide stimulation. In addition, the degree of metabolic pattern transformation depends on the dose of dihydroquercetin supplement. Finally, according to principal component analysis, we found that the inflammation was strongest in the mice at 24 h and was subsequently relieved in the LPS-stimulated group, whereas in the dihydroquercetin-pretreated group, the inflammation was initially relieved. To summarize, dihydroquercetin pretreatment can improve energy metabolism disorder and attenuate the negative effects of lipopolysaccharide challenge in mice from the initial stage of inflammation.
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Affiliation(s)
- Xiaoying Yu
- Department of Animal Science and Technology, Jilin Agricultural University, Jilin Province, Changchun, China 130118
| | - Saddam Hussein
- Department of Animal Science and Technology, Jilin Agricultural University, Jilin Province, Changchun, China 130118
| | - Lijia Li
- Jilin Academy of Agricultural Sciences, No. 1363 Shengtai Street, Changchun City, Jilin Province, China 1300119
| | - Qingyu Liu
- Jilin Academy of Agricultural Sciences, No. 1363 Shengtai Street, Changchun City, Jilin Province, China 1300119
| | - Zhibin Ban
- Jilin Academy of Agricultural Sciences, No. 1363 Shengtai Street, Changchun City, Jilin Province, China 1300119
| | - Hailong Jiang
- Department of Animal Science and Technology, Jilin Agricultural University, Jilin Province, Changchun, China 130118
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13
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Clinical Evaluation Of The New Indirect Calorimeter In Canopy And Face Mask Mode For Energy Expenditure Measurement In Spontaneously Breathing Patients. Clin Nutr 2022; 41:1591-1599. [DOI: 10.1016/j.clnu.2022.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 11/20/2022]
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14
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Brochu P, Ménard J, Haddad S. Cardiopulmonary parameters and organ blood flows for workers expressed in terms of VO2 for use in physiologically based toxicokinetic modeling. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2022; 85:307-335. [PMID: 34991435 DOI: 10.1080/15287394.2021.2006845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Minute ventilation rates (VE), alveolar ventilation rates (VA), cardiac outputs (Q), liver blood flow (LBF) and kidneys blood flows (KBF) for physiologically based toxicokinetic modeling and occupational health risk assessment in active workers have apparently not been determined. Minute energy expenditure rates (E) and oxygen consumption rates (VO2) in workers during exertions and their aggregate daytime activities are obtained by using open-circuit wearable devices for indirect calorimetry measurements and the doubly labeled water method respectively. Hundreds of E (in kcal/min) and VO2 (in L of O2/min) were previously reported for workers. The oxygen uptake factors of 0.2059 ± 0.0019 and 0.2057 ± 0.0018 L of O2/kcal during postprandial and fasting phases respectively enabled conversion of E into VO2. Equations determined in this study based upon more than 25 000 published measurements enable the calculation of 15 parameters in the same worker only by using the VO2 reflecting workload. These parameters, notably VE, VA, VE/VO2 VA/Q, Q, LBF and KBF were found to be interrelated. Altering one of these changes the order of magnitude of the others. Q, LBF and KBF decrease when supine adults at rest switch to an upright position. This effect of gravity diminished when VO2 increased. The fall in LBF and KBF during exertion might enhance muscle blood flow as reported previously. Taken together these equations and data may improve the accuracy of physiologically based toxicokinetic modeling as well as occupational health assessment studies in active workers exposed to xenobiotics.List of main abbreviations: AVOD: arterioveinous oxygen content difference.BMI: body mass index (in kg/m2).BSA: body surface area (in m2).BTPS: body temperature and saturated with water vapor.Bw: body weight (in kg).E: minute energy expenditure rate (in kcal/min).FGE: organ blood flow factor for the gravitational effect on blood circulation.H: oxygen uptake factor, volume of oxygen (at STPD) consumed to produce 1 kcal of energy expended.KBF: kidneys blood flow (in ml/min).LBF: liver blood flow (in ml/min).PBF: liver or kidneys blood flows expressed in terms of percentages (in %) of Qsup C values: namely PBF = (LBF or KBF/Qsup C) x 100.Q: cardiac output (in L/min or ml/min).Qsup C: cardiac output for the cohort of males or females in supination (in ml/min).STPD: standard temperature and pressure, dry air.sup: values measured when adults are in the supine position.up: values measured when adults are in the upright position.VDphys: physiological dead space at BTPS (in L).VT: tidal volume at BTPS (in L).VA: alveolar ventilation rate at BTPS (in L/min).VA/Q: ventilation-perfusion ratio (unitless).VE: minute ventilation rate at BTPS (in L/min).VO2: oxygen consumption rate (i.e. the oxygen uptake) at STPD (in L/min).VQ: ventilatory equivalent for VO2 (VE at BTPS /VO2 at STPD).
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Affiliation(s)
- Pierre Brochu
- Department of Environmental and Occupational Health, ESPUM, Université de Montréal, Montreal, QC, Canada
| | - Jessie Ménard
- Department of Environmental and Occupational Health, ESPUM, Université de Montréal, Montreal, QC, Canada
- Centre for Public Health Research (CReSP), Université de Montréal, Montréal, QC, Canada
| | - Sami Haddad
- Department of Environmental and Occupational Health, ESPUM, Université de Montréal, Montreal, QC, Canada
- Centre for Public Health Research (CReSP), Université de Montréal, Montréal, QC, Canada
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15
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Validity of four commercially available metabolic carts for assessing resting metabolic rate and respiratory exchange ratio in non-ventilated humans. Clin Nutr 2022; 41:746-754. [DOI: 10.1016/j.clnu.2022.01.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 01/21/2022] [Accepted: 01/31/2022] [Indexed: 11/21/2022]
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16
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Slow deep breathing modulates cardiac vagal activity but does not affect peripheral glucose metabolism in healthy men. Sci Rep 2021; 11:20306. [PMID: 34645853 PMCID: PMC8514507 DOI: 10.1038/s41598-021-99183-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/23/2021] [Indexed: 12/11/2022] Open
Abstract
Parasympathetic nervous system innervates peripheral organs including pancreas, hepatic portal system, and gastrointestinal tract. It thereby contributes to the regulation of whole-body glucose metabolism especially in the postprandial state when it promotes secretion of insulin and enhances its action in major target organs. We now aimed to evaluate the effect of parasympathetic modulation on human glucose metabolism. We used slow deep breathing maneuvers to activate the parasympathetic nervous system and tested for effects on metabolism during an oral glucose tolerance test in a randomized, controlled, cross-over trial in 15 healthy young men. We used projections towards the heart as a readout for parasympathetic activity. When analyzing heart rate variability, there was a significant increase of RMSSD (root mean square of successive differences) when participants performed slow deep breathing compared to the control condition, indicating a modulation of parasympathetic activity. However, no statistically significant effects on peripheral glucose metabolism or energy expenditure after the glucose tolerance test were detected. Of note, we detected a significant association between mean heart rate and serum insulin and C-peptide concentrations. While we did not find major effects of slow deep breathing on glucose metabolism, our correlational results suggest a link between the autonomic nervous system and insulin secretion after oral glucose intake. Future studies need to unravel involved mechanisms and develop potential novel treatment approaches for impaired insulin secretion in diabetes.
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17
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Development of a Portable Respiratory Gas Analyzer for Measuring Indirect Resting Energy Expenditure (REE). JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:8870749. [PMID: 33680417 PMCID: PMC7904359 DOI: 10.1155/2021/8870749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 01/22/2021] [Accepted: 02/04/2021] [Indexed: 11/17/2022]
Abstract
Objective A rapidly growing home healthcare market has resulted in the development of many portable or wearable products. Most of these products measure, estimate, or calculate physiologic signals or parameters, such as step counts, blood pressure, or electrocardiogram. One of the most important applications in home healthcare is monitoring one's metabolic state since the change of metabolic state could reveal minor or major changes in one's health condition. A simple and noninvasive way to measure metabolism is through breath monitoring. With breath monitoring by breath gas analysis, two important indicators like the respiratory quotient (RQ) and resting energy exposure (REE) can be calculated. Therefore, we developed a portable respiratory gas analyzer for breath monitoring to monitor metabolic state, and the performance of the developed device was tested in a clinical trial. Approach. The subjects consisted of 40 healthy men and women. Subjects begin to measure exhalation gas using Vmax 29 for 15 minutes. After that, subjects begin to measure exhalation gas via the developed respiratory gas analyzer. Finally, the recorded data on the volume of oxygen (VO2), volume of carbon dioxide (VCO2), RQ, and REE were used to validate correlations between Vmax 29 and the developed respiratory gas analyzer. Results The results showed that the root-mean-square errors (RMSE) values of VCO2, VO2, RQ, and REE are 0.0315, 0.0417, 0.504, and 0.127. Bland-Altman plots showed that most of the VCO2, VO2, RQ, and REE values are within 95% of the significance level. Conclusions We have successfully developed and tested a portable respiratory gas analyzer for home healthcare. However, there are limitations of the clinical trial; the number of subjects is small in size, and the age and race of subjects are confined. The developed portable respiratory gas analyzer is a cost-efficient method for measuring metabolic state and a new application of home healthcare.
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18
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Galgani JE, Fernández-Verdejo R. Pathophysiological role of metabolic flexibility on metabolic health. Obes Rev 2021; 22:e13131. [PMID: 32815226 DOI: 10.1111/obr.13131] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022]
Abstract
Glucose, fatty acids, and amino acids among others are oxidized to generate adenosine triphosphate (ATP). These fuels are supplied from the environment (through food intake) and internal depots (through lipolysis, glycogenolysis, and proteolysis) at different rates throughout the day. Complex adaptive systems permit to accommodate fuel oxidation according to fuel availability. This capacity of a cell, tissue, or organism to adapt fuel oxidation to fuel availability is defined as metabolic flexibility (MetF). There are conditions, such as insulin resistance, diabetes, and obesity, in which MetF seems to be impaired. The observation that those conditions are accompanied by mitochondrial dysfunction has set the basis to propose a link between mitochondrial dysfunction, metabolic inflexibility, and metabolic health. We here highlight the evidence about the notion that MetF influences metabolic health.
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Affiliation(s)
- Jose E Galgani
- Department of Health Sciences, Nutrition and Dietetics Career, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Department of Nutrition, Diabetes and Metabolism, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rodrigo Fernández-Verdejo
- Department of Health Sciences, Nutrition and Dietetics Career, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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19
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Vosseler A, Zhao D, Fritsche L, Lehmann R, Kantartzis K, Small DM, Peter A, Häring HU, Birkenfeld AL, Fritsche A, Wagner R, Preißl H, Kullmann S, Heni M. No modulation of postprandial metabolism by transcutaneous auricular vagus nerve stimulation: a cross-over study in 15 healthy men. Sci Rep 2020; 10:20466. [PMID: 33235256 PMCID: PMC7686306 DOI: 10.1038/s41598-020-77430-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/29/2020] [Indexed: 12/13/2022] Open
Abstract
Experimental evidence suggests a crucial role of the autonomic nervous system in whole body metabolism with major regulatory effects of the parasympathetic branch in postprandial adaptation. However, the relative contribution of this mechanism is still not fully clear in humans. We therefore compared the effects of transcutaneous auricular vagus nerve stimulation (taVNS, Cerbomed Nemos) with sham stimulation during an oral glucose tolerance test in a randomized, single-blind, cross-over design in 15 healthy lean men. Stimulation was performed for 150 min, 30 min before and during the entire oral glucose tolerance test with stimulation cycles of 30 s of on-phase and 30 s of off-phase and a 25 Hz impulse. Heart rate variability and plasma catecholamine levels were assessed as proxies of autonomic tone in the periphery. Neither analyzed heart rate variability parameters nor plasma catecholamine levels were significantly different between the two conditions. Plasma glucose, insulin sensitivity and insulin secretion were also comparable between conditions. Thus, the applied taVNS device or protocol was unable to achieve significant effects on autonomic innervation in peripheral organs. Accordingly, glucose metabolism remained unaltered. Therefore, alternative approaches are necessary to investigate the importance of the autonomic nervous system in postprandial human metabolism.
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Affiliation(s)
- Andreas Vosseler
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Dongxing Zhao
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - Louise Fritsche
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Rainer Lehmann
- Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Konstantinos Kantartzis
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Dana M Small
- Modern Diet and Physiology Research Center, Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Andreas Peter
- German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.,Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Hans-Ulrich Häring
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Andreas L Birkenfeld
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Andreas Fritsche
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Robert Wagner
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Hubert Preißl
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
| | - Martin Heni
- Department of Internal Medicine IV, Division of Diabetology, Endocrinology and Nephrology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. .,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany. .,German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany. .,Institute for Clinical Chemistry and Pathobiochemistry, Department for Diagnostic Laboratory Medicine, University Hospital Tübingen, Tübingen, Germany.
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20
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Thom G, Gerasimidis K, Rizou E, Alfheeaid H, Barwell N, Manthou E, Fatima S, Gill JMR, Lean MEJ, Malkova D. Validity of predictive equations to estimate RMR in females with varying BMI. J Nutr Sci 2020; 9:e17. [PMID: 32595965 PMCID: PMC7299486 DOI: 10.1017/jns.2020.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 01/15/2023] Open
Abstract
Estimation of RMR using prediction equations is the basis for calculating energy requirements. In the present study, RMR was predicted by Harris-Benedict, Schofield, Henry, Mifflin-St Jeor and Owen equations and measured by indirect calorimetry in 125 healthy adult women of varying BMI (17-44 kg/m2). Agreement between methods was assessed by Bland-Altman analyses and each equation was assessed for accuracy by calculating the percentage of individuals predicted within ± 10 % of measured RMR. Slopes and intercepts of bias as a function of average RMR (mean of predicted and measured RMR) were calculated by regression analyses. Predictors of equation bias were investigated using univariate and multivariate linear regression. At group level, bias (the difference between predicted and measured RMR) was not different from zero only for Mifflin-St Jeor (0 (sd 153) kcal/d (0 (sd 640) kJ/d)) and Henry (8 (sd 163) kcal/d (33 (sd 682) kJ/d)) equations. Mifflin-St Jeor and Henry equations were most accurate at the individual level and predicted RMR within 10 % of measured RMR in 71 and 66 % of participants, respectively. For all equations, limits of agreement were wide, slopes of bias were negative, and intercepts of bias were positive and significantly (P < 0⋅05) different from zero. Increasing age, height and BMI were associated with underestimation of RMR, but collectively these variables explained only 15 % of the variance in estimation bias. Overall accuracy of equations for prediction of RMR is low at the individual level, particularly in women with low and high RMR. The Mifflin-St Jeor equation was the most accurate for this dataset, but prediction errors were still observed in about one-third of participants.
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Affiliation(s)
- George Thom
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
| | - Konstantinos Gerasimidis
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
| | - Eleni Rizou
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
| | - Hani Alfheeaid
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
- Qassim University, Buraydah City, P. C. 51452, Saudi Arabia
| | - Nick Barwell
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
| | - Eirini Manthou
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
| | - Sadia Fatima
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
| | - Jason M. R. Gill
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, GlasgowG12 8TA, UK
| | - Michael E. J. Lean
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
| | - Dalia Malkova
- Human Nutrition, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, GlasgowG31 2ER, UK
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21
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Sarabhai T, Kahl S, Szendroedi J, Markgraf DF, Zaharia OP, Barosa C, Herder C, Wickrath F, Bobrov P, Hwang JH, Jones JG, Roden M. Monounsaturated fat rapidly induces hepatic gluconeogenesis and whole-body insulin resistance. JCI Insight 2020; 5:134520. [PMID: 32434996 DOI: 10.1172/jci.insight.134520] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/09/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUNDWhile saturated fat intake leads to insulin resistance and nonalcoholic fatty liver, Mediterranean-like diets enriched in monounsaturated fatty acids (MUFA) may have beneficial effects. This study examined effects of MUFA on tissue-specific insulin sensitivity and energy metabolism.METHODSA randomized placebo-controlled cross-over study enrolled 16 glucose-tolerant volunteers to receive either oil (OIL, ~1.18 g/kg), rich in MUFA, or vehicle (VCL, water) on 2 occasions. Insulin sensitivity was assessed during preclamp and hyperinsulinemic-euglycemic clamp conditions. Ingestion of 2H2O/acetaminophen was combined with [6,6-2H2]glucose infusion and in vivo 13C/31P/1H/ex vivo 2H-magnet resonance spectroscopy to quantify hepatic glucose and energy fluxes.RESULTSOIL increased plasma triglycerides and oleic acid concentrations by 44% and 66% compared with VCL. Upon OIL intervention, preclamp hepatic and whole-body insulin sensitivity markedly decreased by 28% and 27%, respectively, along with 61% higher rates of hepatic gluconeogenesis and 32% lower rates of net glycogenolysis, while hepatic triglyceride and ATP concentrations did not differ from VCL. During insulin stimulation hepatic and whole-body insulin sensitivity were reduced by 21% and 25%, respectively, after OIL ingestion compared with that in controls.CONCLUSIONA single MUFA-load suffices to induce insulin resistance but affects neither hepatic triglycerides nor energy-rich phosphates. These data indicate that amount of ingested fat, rather than its composition, primarily determines the development of acute insulin resistance.TRIAL REGISTRATIONClinicalTrials.gov NCT01736202.FUNDINGGerman Diabetes Center, German Federal Ministry of Health, Ministry of Culture and Science of the state of North Rhine-Westphalia, German Federal Ministry of Education and Research, German Diabetes Association, German Center for Diabetes Research, Portugal Foundation for Science and Technology, European Regional Development Fund, and Rede Nacional de Ressonancia Magnética Nuclear.
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Affiliation(s)
- Theresia Sarabhai
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Sabine Kahl
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Daniel F Markgraf
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Oana-Patricia Zaharia
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Cristina Barosa
- Centre for Neurosciences and Cell Biology, UC Biotech, Cantanhede, Portugal.,Portuguese Diabetes Association, Lisbon, Portugal
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Frithjof Wickrath
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - Pavel Bobrov
- German Center for Diabetes Research, München-Neuherberg, Germany.,Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Jong-Hee Hwang
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany
| | - John Griffith Jones
- Centre for Neurosciences and Cell Biology, UC Biotech, Cantanhede, Portugal.,Portuguese Diabetes Association, Lisbon, Portugal
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, München-Neuherberg, Germany.,Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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22
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Daniell B, Bernitt C, Walton SR, Malin SK, Resch JE. Changes in Metabolism and Caloric Intake after Sport Concussion: A Case Series. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2020. [DOI: 10.1249/tjx.0000000000000129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Fechner E, Bilet L, Peters HPF, Hiemstra H, Jacobs DM, Op 't Eyndt C, Kornips E, Mensink RP, Schrauwen P. Effects of a whole diet approach on metabolic flexibility, insulin sensitivity and postprandial glucose responses in overweight and obese adults - A randomized controlled trial. Clin Nutr 2019; 39:2734-2742. [PMID: 31899037 DOI: 10.1016/j.clnu.2019.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/13/2019] [Accepted: 12/06/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS Metabolic flexibility is the ability to adapt fuel oxidation to fuel availability. Metabolic inflexibility has been associated with obesity, the metabolic syndrome and insulin resistance, and can be improved by exercise or weight loss. Dietary changes can modulate metabolic flexibility; however, the effect of a whole diet approach on metabolic flexibility has never been studied. Therefore, our objective was to assess the effect of a healthy diet (HD), as compared to a typical Western diet (WD), on several fasting and postprandial markers of metabolic flexibility and insulin sensitivity. METHODS In this parallel randomized trial, overweight or obese men and women (50-70 years; BMI 25-35 kg/m2) consumed a healthy diet (HD; high in fruits and vegetables, pulses, fibers, nuts, fatty fish, and low in high-glycemic carbohydrates; n = 19) or a typical Western diet (WD; n = 21) for six weeks, following a two-week run-in period. The change in respiratory quotient upon insulin stimulation (ΔRQ), and insulin sensitivity, expressed as the M-value, were both determined with a hyperinsulinemic euglycemic clamp. Additionally, other fasting and postprandial markers of metabolic flexibility were assessed during a 5-h high-fat high-glycemic mixed meal challenge. RESULTS ΔRQ (p = 0.730) and insulin sensitivity (p = 0.802) were not significantly affected by diet. Postprandial RQ did also not show significant differences (p = 0.610), whereas postprandial glucose excursions were significantly higher in the HD group at T30 (p = 0.014) and T45 (p = 0.026) after mixed meal ingestion (p = 0.037). Fasting glucose (p = 0.530) and HbA1c (p = 0.124) remained unchanged, whereas decreases in fasting insulin (p = 0.038) and the HOMA-IR (p = 0.050) were significantly more pronounced with the HD. CONCLUSION A healthy diet for six weeks, without further life-style changes, did not improve metabolic flexibility and whole-body insulin sensitivity, when compared to a Western-style diet. It remains to be determined whether the short time increase in postprandial glucose is physiologically relevant or detrimental to metabolic health. This trial was registered at clinicaltrials.gov as NCT02519127.
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Affiliation(s)
- Eva Fechner
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - Lena Bilet
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | | | - Harry Hiemstra
- Unilever Food Innovation Center, Wageningen, the Netherlands
| | - Doris M Jacobs
- Unilever Food Innovation Center, Wageningen, the Netherlands
| | - Cara Op 't Eyndt
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Esther Kornips
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Patrick Schrauwen
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, the Netherlands.
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24
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Estimating resting energy expenditure of patients on dialysis: Development and validation of a predictive equation. Nutrition 2019; 67-68:110527. [DOI: 10.1016/j.nut.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/18/2019] [Accepted: 06/08/2019] [Indexed: 12/11/2022]
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25
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Delsoglio M, Dupertuis YM, Oshima T, van der Plas M, Pichard C. Evaluation of the accuracy and precision of a new generation indirect calorimeter in canopy dilution mode. Clin Nutr 2019; 39:1927-1934. [PMID: 31543335 DOI: 10.1016/j.clnu.2019.08.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 07/02/2019] [Accepted: 08/19/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND & AIMS Indirect calorimetry (IC) is the only way to measure in real time energy expenditure (EE) and to optimize nutrition support in acutely and chronically ill patients. Unfortunately, most of the commercially available indirect calorimeters are rather complex to use, expensive and poorly accurate and precise. Therefore, an innovative device (Q-NRG®, COSMED, Rome, Italy) that matches clinicians' needs has been developed as part of the multicenter ICALIC study supported by the two academic societies ESPEN and ESICM. The aim of this study was to evaluate the accuracy and intra- and inter-unit precision of this new device in canopy dilution mode in vitro and in spontaneously breathing adults. METHODS Accuracy and precision of oxygen consumption (VO2) and carbon dioxide production (VCO2) measurements were evaluated in vitro and in 15 spontaneously breathing healthy adults by interchanging three Q-NRG® units in a random order. In vitro validation was performed by gas exchange simulation using high-precision gas mixture and mass flow controller. Accuracy was calculated as error of measured values against expected ones based on volume of gas infused. Respiratory coefficient (RQ) accuracy was furthermore assessed using the ethanol-burning test. To evaluate the intra- and inter-unit precisions, the coefficient of variation (CV% = SD/Mean*100) was calculated, respectively, from the mean ± SD or the mean ± SD of the three mean values of VO2, VCO2, RQ and EE measured by each Q-NRG® units. In vivo accuracy measurement of the Q-NRG® was assessed by simultaneous comparison with mass spectrometry (MS) gas analysis, using Bland-Altman plot, Pearson correlation and paired t-test (significance level of p = 0.05). RESULTS In vitro evaluation of the Q-NRG® accuracy showed measurement errors <1% for VO2, VCO2 and EE and <1.5% for RQ. Evaluation of the intra- and inter-unit precision showed CV% ≤1% for VO2 and EE and CV% ≤1.5% for VCO2 and RQ measurements, except for one Q-NRG® unit where CV% was 2.3% for VO2 and 3% for RQ. Very good inter-unit precision was confirmed in vivo with CV% equal to 2.4%, 3%, 2.8% and 2.3% for VO2, VCCO2, RQ and EE, respectively. Comparison with MS showed correlation of 0.997, 0.987, 0.913 and 0.997 for VO2, VCO2, RQ and EE respectively (p ≤ 0.05). Mean deviation of paired differences was 1.6 ± 1.4% for VO2, -1.5 ± 2.5% for VCO2, -3.1 ± 2.6% for RQ and 0.9 ± 1.4% for EE. CONCLUSION Both in vitro and in vivo measurements of VO2, VCO2, RQ and EE on three Q-NRG® units showed minimal differences compared to expected values and MS and very low intra- and inter-unit variability. These results confirm the very good accuracy and precision of the Q-NRG® indirect calorimeter in canopy dilution mode in spontaneously breathing adults.
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Affiliation(s)
- Marta Delsoglio
- Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
| | | | - Taku Oshima
- Emergency and Critical Care Medicine, Chiba University Hospital, Chiba, Japan.
| | - Mart van der Plas
- Department of Respiratory Medicine, OLVG Hospital, Amsterdam, the Netherlands.
| | - Claude Pichard
- Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
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26
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Do we need race-specific resting metabolic rate prediction equations? Nutr Diabetes 2019; 9:21. [PMID: 31358726 PMCID: PMC6662665 DOI: 10.1038/s41387-019-0087-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 04/10/2019] [Accepted: 06/13/2019] [Indexed: 12/12/2022] Open
Abstract
Background Resting metabolic rate (RMR) is a key determinant of daily caloric needs. Respirometry, a form of indirect calorimetry (IC), is considered one of the most accurate methods to measure RMR in clinical and research settings. It is impractical to measure RMR by IC in routine clinical practice; therefore, several formulas are used to predict RMR. In this study, we sought to determine the accuracy of these formulas in determining RMR and assess additional factors that may determine RMR. Methods We measured RMR in 114 subjects (67% female, 30% African American [AA]) using IC. Along with standard anthropometrics, dual-energy X-ray absorptiometry was used to obtain fat-free mass(FFM) and total fat mass. Measured RMR (mRMR) by respirometry was compared with predicted RMR (pRMR) generated by Mifflin–St.Joer, Cunningham, and Harris–Benedict (HB) equations. Linear regression models were used to determine factors affecting mRMR. Results Mean age, BMI, and mRMR of subjects were 46 ± 16 years (mean ± SD), 35 ± 10 kg/m2, and 1658 ± 391 kcal/day, respectively. After adjusting for age, gender, and anthropometrics, the two largest predictors of mRMR were race (p < 0.0001) and FFM (p < 0.0001). For every kg increase in FFM, RMR increased by 28 kcal/day (p < 0.0001). AA race was associated with 144 kcal/day (p < 0.0001) decrease in mRMR. The impact of race on mRMR was mitigated by adding in truncal FFM to the model. When using only clinically measured variables to predict mRMR, we found race, hip circumference, age, gender, and weight to be significant predictors of mRMR (p < 0.005). Mifflin–St.Joer and HB equations that use just age, gender, height, and weight overestimated kcal expenditure in AA by 138 ± 148 and 242 ± 164 (p < 0.0001), respectively. Conclusion We found that formulas utilizing height, weight, gender, and age systematically overestimate mRMR and hence predict higher calorie needs among AA. The lower mRMR in AA could be related to truncal fat-free mass representing the activity of metabolically active intraabdominal organs.
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27
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Fernández-Verdejo R, Aguirre C, Galgani JE. Issues in Measuring and Interpreting Energy Balance and Its Contribution to Obesity. Curr Obes Rep 2019; 8:88-97. [PMID: 30903595 DOI: 10.1007/s13679-019-00339-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE OF REVIEW Obesogenic environment challenges individuals' ability to preserve energy homeostasis, leading to weight gain. To understand how this energy imbalance proceeds, several methods and analytical procedures to determine energy intake and expenditure are currently available. However, these methods and procedures are not exempt from issues that may lead to equivocal conclusions. Our purpose herein is to discuss major issues involved in energy balance assessment. RECENT FINDINGS Measurement of energy intake mostly relies on self-report methods that provide inaccurate data. In contrast, determination of energy expenditure is more accurate as long as methodological and analytical issues are correctly addressed. Accurate measurements of energy expenditure can be obtained with the current methods once issues in measuring and interpreting data are correctly addressed. However, development of new technologies to measure energy intake is imperative to further understand the small and chronic energy imbalance leading to obesity.
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Affiliation(s)
- Rodrigo Fernández-Verdejo
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Aguirre
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jose E Galgani
- Carrera de Nutrición y Dietética, Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avda. Libertador Bernardo O'Higgins 340, Santiago, Chile.
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Indirect Calorimetry Performance Using a Handheld Device Compared to the Metabolic Cart in Outpatients with Cirrhosis. Nutrients 2019; 11:nu11051030. [PMID: 31071956 PMCID: PMC6566822 DOI: 10.3390/nu11051030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/29/2019] [Accepted: 05/06/2019] [Indexed: 12/23/2022] Open
Abstract
Addressing malnutrition is important to improve health outcomes in outpatients with cirrhosis, yet assessing energy requirements in this population is challenging. Predictive equations of resting energy expenditure (REE) are thought to be unreliable, and traditional indirect calorimetry is expensive and infrequently available for clinical use. The accuracy of REE predictions using a MedGem® handheld indirect calorimeter, the Harris Benedict Equation (HBE), the Mifflin St. Jeor equation (MSJ), and the gold standard Vmax Encore® (Vmax) metabolic cart was compared. The REE of cirrhotic pre-liver transplant outpatients was analyzed using each of the four methods. Agreement between methods was calculated using Bland-Altman analysis. Fourteen patients with cirrhosis participated, and were primarily male (71%) and malnourished (subjective global assessment (SGA) B or C 64%). Lin's concordance coefficient (ρC) for MedGem® vs. Vmax demonstrated poor levels of precision and accuracy (ρC = 0.80, 95% confidence interval 0.55-0.92) between measures, as did the HBE compared to Vmax (ρC = 0.56, 95% confidence interval 0.19-0.79). Mean REE by MedGem® was similar to that measured by Vmax (-1.5%); however, only 21% of REE measures by MedGem® were within ±5% of Vmax measures. Wide variability limits the use of MedGem® at an individual level; a more accurate and feasible method for determination of REE in patients with cirrhosis and malnutrition is needed.
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Amaro-Gahete FJ, Sanchez-Delgado G, Jurado-Fasoli L, De-la-O A, Castillo MJ, Helge JW, Ruiz JR. Assessment of maximal fat oxidation during exercise: A systematic review. Scand J Med Sci Sports 2019; 29:910-921. [PMID: 30929281 DOI: 10.1111/sms.13424] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/06/2019] [Accepted: 03/20/2019] [Indexed: 11/27/2022]
Abstract
Maximal fat oxidation during exercise (MFO) and the exercise intensity eliciting MFO (Fatmax ) are considered biological markers of metabolic health and performance. A wide range of studies have been performed to increase our knowledge about their regulation by exercise and/or nutritional intervention. However, numerous data collection and analysis approaches have been applied, which may have affected the MFO and Fatmax estimation. We aimed to systematically review the available studies describing and/or comparing different data collection and analysis approach factors that could affect MFO and Fatmax estimation in healthy individuals and patients. Two independent researchers performed the search. We included all original studies in which MFO and/or Fatmax were estimated by indirect calorimetry through an incremental graded exercise protocol published from 2002 to 2019. This systematic review provides key information about the factors that could affect MFO and Fatmax estimation: ergometer type, metabolic cart used, warm-up duration and intensity, stage duration and intensities imposed in the graded exercise protocol, time interval selected for data analysis, stoichiometric equation selected to estimate fat oxidation, data analysis approach, time of the day when the test was performed, fasting time/previous meal before the test, and testing days for MFO/Fatmax and maximal oxygen uptake assessment. We suggest that researchers measuring MFO and Fatmax should take into account these key methodological issues that can considerably affect the accuracy, validity, and reliability of the measurement. Likewise, when comparing different studies, it is important to check whether the above-mentioned key methodological issues are similar in such studies to avoid ambiguous and unacceptable comparisons.
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Affiliation(s)
- Francisco J Amaro-Gahete
- EFFECTS-262, Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain.,PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Guillermo Sanchez-Delgado
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Lucas Jurado-Fasoli
- EFFECTS-262, Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Alejandro De-la-O
- EFFECTS-262, Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Manuel J Castillo
- EFFECTS-262, Department of Medical Physiology, School of Medicine, University of Granada, Granada, Spain
| | - Jørn W Helge
- Xlab, Center for Healthy Aging, Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jonatan R Ruiz
- PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Zitting KM, Vujovic N, Yuan RK, Isherwood CM, Medina JE, Wang W, Buxton OM, Williams JS, Czeisler CA, Duffy JF. Human Resting Energy Expenditure Varies with Circadian Phase. Curr Biol 2018; 28:3685-3690.e3. [PMID: 30416064 PMCID: PMC6300153 DOI: 10.1016/j.cub.2018.10.005] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/05/2018] [Accepted: 10/01/2018] [Indexed: 10/27/2022]
Abstract
There is emerging evidence that circadian misalignment may alter energy expenditure, leading to obesity risk among those with irregular schedules [1-5]. It has been reported that energy expenditure is affected by the timing of sleep, exercise, and meals [6]. However, it is unclear whether the circadian system also modulates energy expenditure, independent of behavioral state and food intake. Here, we used a forced desynchrony protocol to examine whether fasted resting energy expenditure (REE) varies with circadian phase in seven participants. This protocol allowed us to uncouple sleep-wake and activity-related effects from the endogenous circadian rhythm, demonstrating that REE varies by circadian phase. REE is lowest at circadian phase ∼0°, corresponding to the endogenous core body temperature (CBT) nadir in the late biological night, and highest at circadian phase ∼180° in the biological afternoon and evening. Furthermore, we found that respiratory quotient (RQ), reflecting macronutrient utilization, also varies by circadian phase. RQ is lowest at circadian phase ∼240° and highest at circadian phase ∼60°, which corresponds to biological morning. This is the first characterization of a circadian profile in fasted resting energy expenditure and fasted respiratory quotient (with rhythmic profiles in both carbohydrate and lipid oxidation), decoupled from effects of activity, sleep-wake cycle, and diet in humans. The rhythm in energy expenditure and macronutrient metabolism may contribute to greater weight gain in shift workers and others with irregular schedules.
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Affiliation(s)
- Kirsi-Marja Zitting
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Nina Vujovic
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Robin K Yuan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Cheryl M Isherwood
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Jacob E Medina
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Wei Wang
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Orfeu M Buxton
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA; Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802, USA
| | - Jonathan S Williams
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA
| | - Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue, Boston, MA 02115, USA.
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Resting energy expenditure and body composition: critical aspects for clinical nutrition. Eur J Clin Nutr 2018; 72:1208-1214. [DOI: 10.1038/s41430-018-0220-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/08/2022]
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Alcantara JMA, Sanchez-Delgado G, Martinez-Tellez B, Merchan-Ramirez E, Labayen I, Ruiz JR. Congruent validity and inter-day reliability of two breath by breath metabolic carts to measure resting metabolic rate in young adults. Nutr Metab Cardiovasc Dis 2018; 28:929-936. [PMID: 29739678 DOI: 10.1016/j.numecd.2018.03.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND & AIMS Achieving high inter-day reliability is a key factor to analyze the magnitude of change in RMR, for instance after an intervention. The aims of this study were: i) to determine the congruent validity of RMR and respiratory quotient (RQ) with two breath by breath commercially available metabolic carts [CCM Express (CCM) and Ultima CardiO2 (MGU)]; and ii) to analyze the inter-day reliability of RMR and RQ measurements. METHODS & RESULTS Seventeen young adults participated in the study. RMR measurements were performed during two consecutive 30-min periods, on two consecutive days with both metabolic carts. The 5-min period that met the steady state criteria [Coefficient of variance (CV) < 10% for VO2, VCO2, and VE, and CV<5% for RQ] and with the lowest CV average was included in further analysis. RMR values were higher with the MGU than with the CCM on both days (two-way ANOVA, P = 0.021), however, no differences were found on RQ values obtained by both metabolic carts (P = 0.642). Absolute inter-day RMR differences obtained with the MGU were higher than those obtained with the CCM (219 ± 185 vs. 158 ± 154 kcal/day, respectively, P = 0.002; 18.3 ± 17.2% vs. 13.5 ± 15.3%, respectively, P = 0.046). We observed a significant positive association of absolute inter-day differences in RMR obtained with both metabolic carts (β = 0.717; R2 = 0.743; P < 0.001). CONCLUSIONS The CCM metabolic cart provides lower RMR values and seems more reliable than the MGU in our sample of young adults. Our findings also suggest that a great part of inter-day variability is explained by the individuals.
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Affiliation(s)
- J M A Alcantara
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Ctra. de Alfacar s/n C.P, 18071, Spain.
| | - G Sanchez-Delgado
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Ctra. de Alfacar s/n C.P, 18071, Spain
| | - B Martinez-Tellez
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Ctra. de Alfacar s/n C.P, 18071, Spain; Department of Medicine, Division of Endocrinology, and Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Albinusdreef 2, 2333, Leiden, The Netherlands
| | - E Merchan-Ramirez
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Ctra. de Alfacar s/n C.P, 18071, Spain
| | - I Labayen
- Department of Health Sciences, Public University of Navarra, Avda. Barañain s/n, 31008, Pamplona, Spain
| | - J R Ruiz
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Ctra. de Alfacar s/n C.P, 18071, Spain
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Validity of predictive equations for resting metabolic rate in healthy humans. Clin Sci (Lond) 2018; 132:1741-1751. [DOI: 10.1042/cs20180317] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/27/2018] [Accepted: 07/02/2018] [Indexed: 11/17/2022]
Abstract
Background: There are several predictive equations for estimating resting metabolic rate (RMR) in healthy humans. Concordance of these equations against measured RMR is variable, and often dependent on the extent of RMR. Part of the discrepancy may be due to an insufficient accuracy of metabolic carts, but this accuracy can be improved via a correction procedure. Objective: To determine the validity of predictive RMR equations by comparing them against measured and corrected (i.e. the reference) RMR. Methods: RMR was measured, in 69 healthy volunteers (29 males/40 females; 32±8 years old; BMI 25.5±3.8 kg/m2) and then corrected by simulating gas exchange through pure gases and high-precision mass-flow regulators. RMR was predicted using 13 published equations. Bland–Altman analyses compared predicted vs. reference RMRs. Results: All equations correlated well with the reference RMR (r>0.67; P<0.0001), but on average, over-predicted the reference RMR (89–312 kcal/d; P<0.05). Based on Bland–Altman analyses, 12 equations showed a constant bias across RMR, but the bias was not different from zero for nine of them. Three equations stood out because the absolute difference between predicted and reference RMR was equal or lower than 200 kcal/d for >60% of individuals (the Mifflin, Oxford and Müller equations). From them, only the Oxford equations performed better in both males and females separately. Conclusion: The Oxford equations are a valid alternative to predict RMR in healthy adult humans. Gas-exchange correction appears to be a good practice for the reliable assessment of RMR.
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Seichter F, Tütüncü E, Hagemann LT, Vogt J, Wachter U, Gröger M, Kress S, Radermacher P, Mizaikoff B. Online monitoring of carbon dioxide and oxygen in exhaled mouse breath via substrate-integrated hollow waveguide Fourier-transform infrared-luminescence spectroscopy. J Breath Res 2018; 12:036018. [DOI: 10.1088/1752-7163/aabf98] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Integrative analysis of indirect calorimetry and metabolomics profiling reveals alterations in energy metabolism between fed and fasted pigs. J Anim Sci Biotechnol 2018; 9:41. [PMID: 29796254 PMCID: PMC5956531 DOI: 10.1186/s40104-018-0257-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/19/2018] [Indexed: 11/16/2022] Open
Abstract
Background Fasting is a simple metabolic strategy that is used to estimate the maintenance energy requirement where the energy supply for basic physiological functions is provided by the mobilization of body reserves. However, the underlying metabolic components of maintenance energy expenditure are not clear. This study investigated the differences in heat production (HP), respiratory quotient (RQ) and plasma metabolites in pigs in the fed and fasted state, using the techniques of indirect calorimetry and metabolomics. Methods Nine barrows (45.2 ± 1.7 kg BW) were fed corn-soybean based meal diets and were kept in metabolism crates for a period of 14 d. After 7 d adaptation, pigs were transferred to respiratory chambers to determine HP and RQ based on indirect calorimetry. Pigs were fed the diet at 2,400 kJ ME/(kg BW0.6·d) during d 8 to 12. The last 2 d were divided into 24 h fasting and 48 h fasting treatment, respectively. Plasma samples of each pig were collected from the anterior vena cava during the last 3 d (1 d while pigs were fed and 2 d during which they were fasted). The metabolites of plasma were determined by high-resolution mass spectrometry using a metabolomics approach. Results Indirect calorimetry analysis revealed that HP and RQ were no significant difference between 24 h fasting and 48 h fasting, which were lower than those of fed state (P < 0.01). The nitrogen concentration of urine tended to decrease with fasting (P = 0.054). Metabolomics analysis between the fed and fasted state revealed differences in 15 compounds, most of which were not significantly different between 24 h fasting and 48 h fasting. Identified compounds were enriched in metabolic pathways related to linoleic acid metabolism, amino acid metabolism, sphingolipid metabolism, and pantothenate and CoA biosynthesis. Conclusion These results suggest that the decreases in HP and RQ of growing pigs under fasting conditions were associated with the alterations of linoleic acid metabolism and amino acid metabolism. The integrative analysis also revealed that growing pigs under a 24-h fasting were more appropriate than a 48-h fasting to investigate the metabolic components of maintenance energy expenditure.
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Acosta FM, Martinez-Tellez B, Sanchez-Delgado G, A. Alcantara JM, Acosta-Manzano P, Morales-Artacho AJ, R. Ruiz J. Physiological responses to acute cold exposure in young lean men. PLoS One 2018; 13:e0196543. [PMID: 29734360 PMCID: PMC5937792 DOI: 10.1371/journal.pone.0196543] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 04/14/2018] [Indexed: 01/21/2023] Open
Abstract
The aim of this study was to comprehensively describe the physiological responses to an acute bout of mild cold in young lean men (n = 11, age: 23 ± 2 years, body mass index: 23.1 ± 1.2 kg/m2) to better understand the underlying mechanisms of non-shivering thermogenesis and how it is regulated. Resting energy expenditure, substrate metabolism, skin temperature, thermal comfort perception, superficial muscle activity, hemodynamics of the forearm and abdominal regions, and heart rate variability were measured under warm conditions (22.7 ± 0.2°C) and during an individualized cooling protocol (air-conditioning and water cooling vest) in a cold room (19.4 ± 0.1°C). The temperature of the cooling vest started at 16.6°C and decreased ~ 1.4°C every 10 minutes until participants shivered (93.5 ± 26.3 min). All measurements were analysed across 4 periods: warm period, at 31% and at 64% of individual´s cold exposure time until shivering occurred, and at the shivering threshold. Energy expenditure increased from warm period to 31% of cold exposure by 16.7% (P = 0.078) and to the shivering threshold by 31.7% (P = 0.023). Fat oxidation increased by 72.6% from warm period to 31% of cold exposure (P = 0.004), whereas no changes occurred in carbohydrates oxidation. As shivering came closer, the skin temperature and thermal comfort perception decreased (all P<0.05), except in the supraclavicular skin temperature, which did not change (P>0.05). Furthermore, the superficial muscle activation increased at the shivering threshold. It is noteworthy that the largest physiological changes occurred during the first 30 minutes of cold exposure, when the participants felt less discomfort.
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Affiliation(s)
- Francisco M. Acosta
- PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Borja Martinez-Tellez
- PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Medicine, Division of Endocrinology, Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Guillermo Sanchez-Delgado
- PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Juan M. A. Alcantara
- PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Antonio J. Morales-Artacho
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jonatan R. Ruiz
- PROFITH “PROmoting FITness and Health through physical activity” research group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Ballon JS, Pajvani UB, Mayer LES, Freyberg Z, Freyberg R, Contreras I, Rosenbaum M, Leibel RL, Lieberman JA. Pathophysiology of drug induced weight and metabolic effects: findings from an RCT in healthy volunteers treated with olanzapine, iloperidone, or placebo. J Psychopharmacol 2018; 32:533-540. [PMID: 29444618 PMCID: PMC6996198 DOI: 10.1177/0269881118754708] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Second generation antipsychotics are prescribed for an increasing number of psychiatric conditions, despite variable associations with weight gain, dyslipidemia, and impaired glucose tolerance. The mechanism(s) of the apparent causal relationships between these medications and metabolic effects have been inadequately defined and are potentially confounded by genetic risk of mental illness, attendant lifestyle, and concomitant medications. Therefore, we conducted a study in which 24 healthy volunteers were randomized to olanzapine (highly weight-gain liability), iloperidone (less weight-gain liability), or placebo treatment for 28 days under double-blind conditions. We hypothesized that antipsychotics induce weight gain primarily through increased caloric intake, which causes secondary dyslipidemia and insulin resistance. Subjects were phenotyped pre- and post-treatment for body weight, adiposity by dual energy X-ray absorptiometry, energy expenditure by indirect calorimetry, food intake, oral glucose tolerance, plasma lipids, glucose, insulin, and other hormones. We found significantly increased food intake and body weight but no change in energy expenditure in olanzapine-treated subjects, with associated trends towards lipid abnormalities and insulin resistance the extent of which were presumably limited by the duration of treatment. Iloperidone treatment led to modest non-significant and placebo no weightgain, lipid increases and alterations in insulin metabolism. We conclude that second generation antipsychotic drugs, as represented by olanzapine, produce their weight and metabolic effects, predominantly, by increasing food intake which leads to weight gain that in turn induces metabolic consequences, but also through other direct effects on lipid and glucose metabolism independant of food intake and weight gain.
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Affiliation(s)
- Jacob S Ballon
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Utpal B Pajvani
- Department of Medicine, College of Physicians & Surgeons, Columbia University, New York, USA
| | - Laurel ES Mayer
- Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York, USA
| | - Zachary Freyberg
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robin Freyberg
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ignacio Contreras
- Department of Medicine, College of Physicians & Surgeons, Columbia University, New York, USA
| | - Michael Rosenbaum
- Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, USA
| | - Rudolph L Leibel
- Department of Pediatrics, College of Physicians & Surgeons, Columbia University, New York, USA
| | - Jeffrey A Lieberman
- Department of Psychiatry, College of Physicians & Surgeons, Columbia University, New York, USA
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Normalizing resting energy expenditure across the life course in humans: challenges and hopes. Eur J Clin Nutr 2018; 72:628-637. [PMID: 29748655 DOI: 10.1038/s41430-018-0151-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 02/23/2018] [Accepted: 02/28/2018] [Indexed: 02/05/2023]
Abstract
Whole-body daily energy expenditure is primarily due to resting energy expenditure (REE). Since there is a high inter-individual variance in REE, a quantitative and predictive framework is needed to normalize the data. Complementing the assessment of REE with data normalization makes individuals of different sizes, age, and sex comparable. REE is closely correlated with body mass suggesting its near constancy for a given mass and, thus, a linearity of this association. Since body mass and its metabolic active components are the major determinants of REE, they have been implemented into allometric modeling to normalize REE for quantitative differences in body weight and/or body composition. Up to now, various size and allometric scale laws are used to adjust REE for body mass. In addition, the impact of the anatomical and physical properties of individual body components on REE has been quantified in large populations and for different age groups. More than 80% of the inter-individual variance in REE is explained by FFM and its composition. There is evidence that the impact of individual organs on REE varies between age groups with a higher contribution of brain and visceral organs in children/adolescents compared with adults where skeletal muscle mass contribution is greater than in children/adolescents. However, explaining REE variations by FFM and its composition has its own limitations (inter-correlations of organs/tissues). In future, this could be overcome by re-describing the organ-to-organ variation using principal components analysis and then using the scores on the components as predictors in a multiple regression analysis.
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Methods to validate the accuracy of an indirect calorimeter in the in-vitro setting. Clin Nutr ESPEN 2017; 22:71-75. [DOI: 10.1016/j.clnesp.2017.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/15/2017] [Indexed: 11/22/2022]
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Galgani JE, Castro-Sepulveda MA. Influence of a Gas Exchange Correction Procedure on Resting Metabolic Rate and Respiratory Quotient in Humans. Obesity (Silver Spring) 2017; 25:1941-1947. [PMID: 28924987 DOI: 10.1002/oby.21981] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/07/2017] [Accepted: 08/06/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this study was to determine the influence of a gas exchange correction protocol on resting metabolic rate (RMR) and respiratory quotient (RQ), assessed by a Vmax Encore 29n metabolic cart (SensorMedics Co., Yorba Linda, California) in overnight fasted and fed humans, and to assess the predictive power of body size for corrected and uncorrected RMR. METHODS Healthy participants (23 M/29 F; 34 ± 9 years old; 26.3 ± 3.7 kg/m2 ) ingested two 3-hour-apart glucose loads (75 g). Indirect calorimetry was conducted before and hourly over a 6-hour period. Immediately after indirect calorimetry assessment, gas exchange was simulated through high-precision mass-flow regulators, which permitted the correction of RMR and RQ values. RESULTS Uncorrected and corrected RMR and RQ were directly related at each time over the 6-hour period. However, uncorrected versus corrected RMR was 6.9% ± 0.5% higher (128 ± 7 kcal/d; P < 0.0001), while RQ was 14.0 ± 0.4% lower (-0.114 ± 0.003; P < 0.0001) when compared throughout the whole period. Body weight, sex, and age explained a larger fraction of the variance when corrected RMR was considered (adjusted R2 = 0.71; P < 0.0001) versus uncorrected RMR (adjusted R2 = 0.59; P < 0.0001). CONCLUSIONS Applying a protocol to correct gas exchange in humans over a 6-hour period is feasible and provides information of improved accuracy.
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Affiliation(s)
- Jose E Galgani
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Departamento de Ciencias de la Salud, Carrera de Nutrición y Dietética, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio A Castro-Sepulveda
- Departamento de Nutrición, Diabetes y Metabolismo, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Laboratorio de Ciencias del Ejercicio, Facultad de Medicina, Universidad Finis Terrae, Santiago, Chile
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Voss TS, Vendelbo MH, Kampmann U, Pedersen SB, Nielsen TS, Johannsen M, Svart MV, Jessen N, Møller N. Effects of insulin-induced hypoglycaemia on lipolysis rate, lipid oxidation and adipose tissue signalling in human volunteers: a randomised clinical study. Diabetologia 2017; 60:143-152. [PMID: 27734104 DOI: 10.1007/s00125-016-4126-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/14/2016] [Indexed: 10/20/2022]
Abstract
AIMS/HYPOTHESIS The aims of this study were to determine the role of lipolysis in hypoglycaemia and define the underlying intracellular mechanisms. METHODS Nine healthy volunteers were randomised to treatment order of three different treatments (crossover design). Treatments were: (1) saline control; (2) hyperinsulinaemic hypoglycaemia (HH; i.v. bolus of 0.1 U/kg insulin); and (3) hyperinsulinaemic euglycaemia (HE; i.v. bolus of 0.1 U/kg insulin and 20% glucose). Inclusion criteria were that volunteers were healthy, aged >18 years, had a BMI between 19 and 26 kg/m2, and provided both written and oral informed consent. Exclusion criteria were the presence of a known chronic disease (including diabetes mellitus, epilepsy, ischaemic heart disease and cardiac arrhythmias) and regular use of prescription medication. The data was collected at the medical research facilities at Aarhus University Hospital, Denmark. The primary outcome was palmitic acid flux. Participants were blinded to intervention order, but caregivers were not. RESULTS Adrenaline (epinephrine) and glucagon concentrations were higher during HH than during both HE and control treatments. NEFA levels and lipid oxidation rates (determined by indirect calorimetry) returned to control levels after 105 min. Palmitate flux was increased to control levels during HH (p = NS) and was more than twofold higher than during HE (overall mean difference between HH vs HE, 114 [95% CI 64, 165 μmol/min]; p < 0.001). In subcutaneous adipose tissue biopsies, we found elevated levels of hormone-sensitive lipase (HSL) and perilipin-1 phosphorylation 30 min after insulin injection during HH compared with both control and HE. There were no changes in the levels of adipose triglyceride lipase (ATGL), comparative gene identification-58 (CGI-58) or G0/G1 switch gene 2 (G0S2) proteins. Insulin-stimulated phosphorylation of Akt and mTOR were unaffected by hypoglycaemia. Expression of the G0S2 gene increased during HE and HH compared with control, without changes in ATGL (also known as PNPLA2) or CGI-58 (also known as ABHD5) mRNA levels. CONCLUSIONS/INTERPRETATION These findings suggest that NEFAs become a major fuel source during insulin-induced hypoglycaemia and that lipolysis may be an important component of the counter-regulatory response. These effects appear to be mediated by rapid stimulation of protein kinase A (PKA) and HSL, compatible with activation of the β-adrenergic catecholamine signalling pathway. TRIAL REGISTRATION ClinicalTrials.gov NCT01919788 FUNDING: : The study was funded by Aarhus University, the Novo Nordisk Foundation and the KETO Study Group/Danish Agency for Science Technology and Innovation (grant no. 0603-00479, to NM).
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Affiliation(s)
- Thomas S Voss
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark.
- Department of Endocrinology and Internal Medicine Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark.
| | - Mikkel H Vendelbo
- Department of Nuclear Medicine, Aarhus University Hospital, Aarhus C, Denmark
| | - Ulla Kampmann
- Department of Endocrinology and Internal Medicine Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark
| | - Steen B Pedersen
- Department of Endocrinology and Internal Medicine Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark
| | - Thomas S Nielsen
- Integrative Physiology Section, Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mogens Johannsen
- Section for Forensic Chemistry, Department of Forensic Medicine, Aarhus University, Aarhus C, Denmark
| | - Mads V Svart
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark
| | - Niels Jessen
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
- Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus C, Denmark
| | - Niels Møller
- Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
- Department of Endocrinology and Internal Medicine Aarhus University Hospital, Nørrebrogade 44, 8000, Aarhus C, Denmark
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Galgani JE, Gómez C, Mizgier ML, Gutierrez J, Santos JL, Olmos P, Mari A. Assessment of the Role of Metabolic Determinants on the Relationship between Insulin Sensitivity and Secretion. PLoS One 2016; 11:e0168352. [PMID: 28002466 PMCID: PMC5176173 DOI: 10.1371/journal.pone.0168352] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/30/2016] [Indexed: 12/21/2022] Open
Abstract
Background Insulin secretion correlates inversely with insulin sensitivity, which may suggest the existence of a crosstalk between peripheral organs and pancreas. Such interaction might be mediated through glucose oxidation that may drive the release of circulating factors with action on insulin secretion. Aim To evaluate the association between whole-body carbohydrate oxidation and circulating factors with insulin secretion to consecutive oral glucose loading in non-diabetic individuals. Methods Carbohydrate oxidation was measured after an overnight fast and for 6 hours after two 3-h apart 75-g oral glucose tolerance tests (OGTT) in 53 participants (24/29 males/females; 34±9 y; 27±4 kg/m2). Insulin secretion was estimated by deconvolution of serum C-peptide concentration, β cell function by mathematical modelling and insulin sensitivity from an OGTT. Circulating lactate, free-fatty acids (FFA) and candidate chemokines were assessed before and after OGTT. The effect of recombinant RANTES (regulated on activation, normal T cell expressed and secreted) and IL8 (interleukin 8) on insulin secretion from isolated mice islets was also measured. Results Carbohydrate oxidation assessed over the 6-h period did not relate with insulin secretion (r = -0.11; p = 0.45) or β cell function indexes. Circulating lactate and FFA showed no association with 6-h insulin secretion. Circulating chemokines concentration increased upon oral glucose stimulation. Insulin secretion associated with plasma IL6 (r = 0.35; p<0.05), RANTES (r = 0.30; p<0.05) and IL8 (r = 0.41; p<0.05) determined at 60 min OGTT. IL8 was independently associated with in vivo insulin secretion; however, it did not affect in vitro insulin secretion. Conclusion Whole-body carbohydrate oxidation appears to have no influence on insulin secretion or putative circulating mediators. IL8 may be a potential factor influencing insulin secretion.
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Affiliation(s)
- Jose E. Galgani
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- UDA-Ciencias de la Salud, Carrera de Nutrición y Dietética, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail:
| | - Carmen Gómez
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria L. Mizgier
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Gutierrez
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jose L. Santos
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Olmos
- Departamento de Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea Mari
- Istituto di Neuroscienze, Consiglio Nazionale delle Ricerche, Padova, Italy
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Dobak S, Rincon F. "Cool" Topic: Feeding During Moderate Hypothermia After Intracranial Hemorrhage. JPEN J Parenter Enteral Nutr 2016; 41:1125-1130. [PMID: 27323775 DOI: 10.1177/0148607116655448] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Therapeutic moderate hypothermia (MH; T core 33°C-34°C) is being studied for treatment of spontaneous intracerebral hemorrhage (ICH). Nutrition assessment begins with accurate basal metabolic rate (BMR) determination. Although early enteral nutrition (EN) is associated with improved outcomes, it is often deferred until rewarming. We sought to determine the accuracy of predictive BMR equations and the safety and tolerance of EN during MH after ICH. MATERIALS AND METHODS Patients were randomized to 72 hours of MH or normothermia (NT; T core 36°C-37°C). Harris-Benedict (BMR-HB) and Penn-State equation (BMR-PS) calculations were compared with indirect calorimetry (IC) at day (D) 0 and D1-3. Patients with MH received trophic semi-elemental gastric EN. Occurrences of feeding intolerance, gastrointestinal (GI)-related adverse events, and ventilator-associated pneumonia (VAP) were analyzed with a double-sided matched pairs t test. RESULTS Thirteen patients with ICH participated (6 MH, 7 NT). Mean time to initiate EN: 29.9 (MH) vs 18.4 (NT) hours ( P = .046). Average daily EN calories received D0-3: 398 (MH) vs 1006 (NT) ( P < .01). Three patients with MH experienced high gastric residuals prior to prokinetic agents, 1 had mild ileus, and 1 patient with NT vomited. No GI-related adverse events were reported. One patient with MH and 1 patient with NT had VAP. Two patients with MH received IC, and from D0 to D1-3, BMR-HB remained stable (1331 kcal), BMR-PS decreased (1511 vs 1145 kcal, P = .5), and IC decreased (1413 vs 985 kcal, P = .2). CONCLUSIONS In patients with ICH undergoing MH, resting energy expenditure is decreased and predictive equations overestimate BMR. EN is feasible, although delayed EN initiation, high gastric residuals, and less EN provision are common. Future studies should focus on EN initiation within 24 hours, advanced EN rates, and postpyloric feeds during hypothermia.
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Affiliation(s)
- Stephanie Dobak
- 1 Department of Nutrition and Dietetics, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Fred Rincon
- 2 Division of Critical Care and Neurotrauma, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Szendroedi J, Saxena A, Weber KS, Strassburger K, Herder C, Burkart V, Nowotny B, Icks A, Kuss O, Ziegler D, Al-Hasani H, Müssig K, Roden M. Cohort profile: the German Diabetes Study (GDS). Cardiovasc Diabetol 2016; 15:59. [PMID: 27053136 PMCID: PMC4823856 DOI: 10.1186/s12933-016-0374-9] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/24/2016] [Indexed: 12/16/2022] Open
Abstract
Background The German Diabetes Study (GDS) is a prospective longitudinal cohort study describing the impact of subphenotypes on the course of the disease. GDS aims at identifying prognostic factors and mechanisms underlying the development of related comorbidities. Study design and methods The study comprises intensive phenotyping within 12 months after clinical diagnosis, at 5-year intervals for 20 years and annual telephone interviews in between. Dynamic tests, including glucagon, mixed meal, intravenous glucose tolerance and hyperinsulinemic clamp tests, serve to assess beta-cell function and tissue-specific insulin sensitivity. Magnetic resonance imaging and multinuclei spectroscopy allow quantifying whole-body fat distribution, tissue-specific lipid deposition and energy metabolism. Comprehensive analyses of microvascular (nerve, eye, kidney) and macrovascular (endothelial, cardiorespiratory) morphology and function enable identification and monitoring of comorbidities. The GDS biobank stores specimens from blood, stool, skeletal muscle, subcutaneous adipose tissue and skin for future analyses including multiomics, expression profiles and histology. Repeated questionnaires on socioeconomic conditions, patient-reported outcomes as quality of life, health-related behavior as physical activity and nutritional habits are a specific asset of GDS. This study will recruit 3000 patients and a group of humans without familiy history of diabetes. 237 type 1 and 456 type 2 diabetes patients have been already included. Electronic supplementary material The online version of this article (doi:10.1186/s12933-016-0374-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julia Szendroedi
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Aaruni Saxena
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Katharina S Weber
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Klaus Strassburger
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Institute for Biometrics and Epidemiology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Volker Burkart
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Bettina Nowotny
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Andrea Icks
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Institute for Biometrics and Epidemiology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,Public Health Unit, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Oliver Kuss
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Institute for Biometrics and Epidemiology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany
| | - Dan Ziegler
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Hadi Al-Hasani
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Institute for Clinical Biochemistry and Pathobiochemistry German Diabetes Center, Leibniz Institute for Diabetes Research, Düsseldorf, Germany
| | - Karsten Müssig
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany.,German Center for Diabetes Research (DZD), München-Neuherberg, Germany.,Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, Leibniz Institute for Diabetes Research, German Diabetes Center at Heinrich Heine University, Düsseldorf, Germany. .,German Center for Diabetes Research (DZD), München-Neuherberg, Germany. .,Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany.
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Hamada Y, Miyaji A, Hayashi N. Effect of postprandial gum chewing on diet-induced thermogenesis. Obesity (Silver Spring) 2016; 24:878-85. [PMID: 26887536 DOI: 10.1002/oby.21421] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/09/2015] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To examine the effect of postprandial gum chewing on diet-induced thermogenesis (DIT). METHODS Twelve healthy normal-weight males completed four trials on four different days. They chewed a 621-kcal test meal for as long as possible and as many times as possible in the slow-eating trials, while they consumed the same meal as rapidly as possible in the rapid-eating trials. In the gum-chewing trials, they chewed a 3-kcal gum for 15 min after the meal. In the non-gum-chewing trials, they consumed 3 kcal of sugar with the test meal instead of chewing the gum. DIT was calculated based on the oxygen uptake, body mass, and postprandial increments in energy expenditure above the baseline as measured before each trial. RESULTS DIT was significantly greater in the gum-chewing trials than in the non-gum-chewing trials for both rapid-eating and slow-eating trials. The difference in DIT between rapid-eating and slow-eating trials was greater than that between non-gum-chewing and gum-chewing trials. CONCLUSIONS Postprandial gum chewing enhanced DIT, but the effect of gum chewing on DIT did not exceed that of slow eating when consuming a meal.
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Affiliation(s)
- Yuka Hamada
- Graduate School of Decision Science and Technology, Tokyo Institute of Technology, Tokyo, Japan
| | - Akane Miyaji
- Graduate School of Decision Science and Technology, Tokyo Institute of Technology, Tokyo, Japan
| | - Naoyuki Hayashi
- Graduate School of Decision Science and Technology, Tokyo Institute of Technology, Tokyo, Japan
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Minimum Time to Achieve the Steady State and Optimum Abbreviated Period to Estimate the Resting Energy Expenditure by Indirect Calorimetry in Healthy Young Adults. Nutr Clin Pract 2016; 31:349-54. [DOI: 10.1177/0884533615627268] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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47
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Rising R, Whyte K, Albu J, Pi-Sunyer X. Evaluation of a new whole room indirect calorimeter specific for measurement of resting metabolic rate. Nutr Metab (Lond) 2015; 12:46. [PMID: 26594229 PMCID: PMC4653920 DOI: 10.1186/s12986-015-0043-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/16/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The most common methods for obtaining human resting metabolic rate (RMR) use either a ventilated hood connected to a metabolic cart (VH_MC) or calculation by many prediction equations utilizing the person's height and weight. These methods may be inherently inaccurate. The objective of this study is to compare the accuracy for the measurement of RMR by three methods: a new whole room indirect calorimeter specific for this purpose (RMR_WRIC), VH_MC and calculation by the Mifflin equation (ME). First, the VH_MC (Vmax Encore 2900, Carefusion Inc, San Diego, CA) and RMR_WRIC (Promethion GA-6/FG-1, Sable Systems Intl, Las Vegas, NV) were subjected to 10, one-hour ethanol (99.8 % purity) and propane (99.5 % purity) combustion tests, respectively, for simulated metabolic measurements. Thereafter, 40 healthy adults (22 M/18 F, 78.0 ± 24.5 kg, BMI = 25.6 ± 4.8, age 36.6 ± 13.4 years) had one-hour RMR (kcal), ventilation (liters) rates of oxygen (VO2), carbon dioxide (VCO2) and RQ (VCO2/VO2) measured after a 12-h fast with both the VH_ MC and the RMR_WRIC in a randomized fashion. The resting state was documented by heart rate. The RMR was also calculated using the ME, which was compared to both the RMR_WRIC and the VH_MC. All simulated and human metabolic data were extrapolated to 24-h and analyzed (SPSS, Ver. 22). RESULTS Comparing stoichiometry to actual combustion, the VH_MC underestimated simulated RMR (p < 0.05), VO2 (p < 0.05), VCO2 (p < 0.05) and the RQ. Similarly the RMR_WRIC underestimated simulated RMR (p < 0.05) and VO2 while overestimating VCO2 and the RQ. There was much greater variability in the simulated metabolic data between combustion and the VH_MC as compared to that of the RMR_WRIC. With regards to the volunteers, the RMR, RQ, VO2 and VCO2 determined by the VH_MC tended to be lower in comparison to these measurements determined by the RMR_WRIC. Finally, RMR calculated utilizing the ME was significantly (p < 0.05) less than the RMR_WRIC but similar to that obtained by the VH_MC. CONCLUSION The RMR_WRIC was more accurate and precise than either the VH_MC or ME, which has implications for determining energy requirements for individuals participating in weight loss or nutrition rehabilitation programs.
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Affiliation(s)
- Russell Rising
- />New York Obesity Research Center, Department of Medicine, Columbia University, 1150 St. Nicholas Ave, 1st Floor, Suite 121, New York, NY 10032 USA
| | - Kathryn Whyte
- />46 Meadowbrook Drive, Apt 121, Slingerlands, NY 12159 USA
| | - Jeanine Albu
- />Icahn School of Medicine at Mount Sinai, 1111 Amsterdam Avenue, New York, NY 10025 USA
| | - Xavier Pi-Sunyer
- />New York Obesity Research Center, Department of Medicine, Columbia University, 1150 St. Nicholas Ave, 1st Floor, Suite 121, New York, NY 10032 USA
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48
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Fritsch M, Koliaki C, Livingstone R, Phielix E, Bierwagen A, Meisinger M, Jelenik T, Strassburger K, Zimmermann S, Brockmann K, Wolff C, Hwang JH, Szendroedi J, Roden M. Time course of postprandial hepatic phosphorus metabolites in lean, obese, and type 2 diabetes patients. Am J Clin Nutr 2015; 102:1051-8. [PMID: 26423389 DOI: 10.3945/ajcn.115.107599] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 08/26/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Impaired energy metabolism is a possible mechanism that contributes to insulin resistance and ectopic fat storage. OBJECTIVE We examined whether meal ingestion differently affects hepatic phosphorus metabolites in insulin-sensitive and insulin-resistant humans. DESIGN Young, lean, insulin-sensitive humans (CONs) [mean ± SD body mass index (BMI; in kg/m(2)): 23.2 ± 1.5]; insulin-resistant, glucose-tolerant, obese humans (OBEs) (BMI: 34.3 ± 1.7); and type 2 diabetes patients (T2Ds) (BMI: 32.0 ± 2.4) were studied (n = 10/group). T2Ds (61 ± 7 y old) were older (P < 0.001) than were OBEs (31 ± 7 y old) and CONs (28 ± 3 y old). We quantified hepatic γATP, inorganic phosphate (Pi), and the fat content [hepatocellular lipids (HCLs)] with the use of (31)P/(1)H magnetic resonance spectroscopy before and at 160 and 240 min after a high-caloric mixed meal. In a subset of volunteers, we measured the skeletal muscle oxidative capacity with the use of high-resolution respirometry. Whole-body insulin sensitivity (M value) was assessed with the use of hyperinsulinemic-euglycemic clamps. RESULTS OBEs and T2Ds were similarly insulin resistant (M value: 3.5 ± 1.4 and 1.9 ± 2.5 mg · kg(-1) · min(-1), respectively; P = 0.9) and had 12-fold (P = 0.01) and 17-fold (P = 0.002) higher HCLs, respectively, than those of lean persons. Despite comparable fasting hepatic γATP concentrations, the maximum postprandial increase of γATP was 6-fold higher in OBEs (0.7 ± 0.2 mmol/L; P = 0.03) but only tended to be higher in T2Ds (0.6 ± 0.2 mmol/L; P = 0.09) than in CONs (0.1 ± 0.1 mmol/L). However, in the fasted state, muscle complex I activity was 53% lower (P = 0.01) in T2Ds but not in OBEs (P = 0.15) than in CONs. CONCLUSIONS Young, obese, nondiabetic humans exhibit augmented postprandial hepatic energy metabolism, whereas elderly T2Ds have impaired fasting muscle energy metabolism. These findings support the concept of a differential and tissue-specific regulation of energy metabolism, which can occur independently of insulin resistance. This trial was registered at clinicaltrials.gov as NCT01229059.
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Affiliation(s)
- Maria Fritsch
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Department of Pediatric and Adolescent Medicine, Medical University of Vienna, Vienna, Austria; and
| | - Chrysi Koliaki
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Department of Endocrinology and Diabetology, Medical Faculty, and German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Roshan Livingstone
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research
| | - Esther Phielix
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research
| | - Alessandra Bierwagen
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Markus Meisinger
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research
| | - Tomas Jelenik
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Klaus Strassburger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, Heinrich-Heine University, Düsseldorf, Germany, German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Stefanie Zimmermann
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Katharina Brockmann
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Christina Wolff
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Jong-Hee Hwang
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Julia Szendroedi
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Department of Endocrinology and Diabetology, Medical Faculty, and German Center of Diabetes Research, Partner Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research, Department of Endocrinology and Diabetology, Medical Faculty, and German Center of Diabetes Research, Partner Düsseldorf, Germany
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De Waele E, van Zwam K, Mattens S, Staessens K, Diltoer M, Honoré PM, Czapla J, Nijs J, La Meir M, Huyghens L, Spapen H. Measuring resting energy expenditure during extracorporeal membrane oxygenation: preliminary clinical experience with a proposed theoretical model. Acta Anaesthesiol Scand 2015; 59:1296-302. [PMID: 26046372 DOI: 10.1111/aas.12564] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/13/2015] [Accepted: 05/06/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients with severe respiratory failure. Indirect calorimetry (IC) is a safe and non-invasive method for measuring resting energy expenditure (REE). No data exist on the use of IC in ECMO-treated patients as oxygen uptake and carbon dioxide elimination are divided between mechanical ventilation and the artificial lung. We report our preliminary clinical experience with a theoretical model that derives REE from IC measurements obtained separately on the ventilator and on the artificial lung. METHODS A patient undergoing veno-venous ECMO for acute respiratory failure due to bilateral pneumonia was studied. The calorimeter was first connected to the ventilator and oxygen consumption (VO2 ) and carbon dioxide transport (VCO2 ) were measured until steady state was reached. Subsequently, the IC was connected to the membrane oxygenator and similar gas analysis was performed. VO2 and VCO2 values at the native and artificial lung were summed and incorporated in the Weir equation to obtain a REEcomposite . RESULTS At the ventilator level, VO2 and VCO2 were 29.5 ml/min and 16 ml/min. VO2 and VCO2 at the artificial lung level were 213 ml/min and 187 ml/min. Based on these values, a REEcomposite of 1703 kcal/day was obtained. The Faisy-Fagon and Harris-Benedict equations calculated a REE of 1373 and 1563 kcal/day. CONCLUSION We present IC-acquired gas analysis in ECMO patients. We propose to insert individually obtained IC measurements at the native and the artificial lung in the Weir equation for retrieving a measured REEcomposite .
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Affiliation(s)
- E. De Waele
- Intensive Care Department; Universitair Ziekenhuis Brussel (UZ Brussel); Vrije Universiteit Brussel (VUB); Brussels Belgium
| | - K. van Zwam
- Department of Cardiac Surgery; Universitair Ziekenhuis Brussel (UZ Brussel); Brussels Belgium
| | - S. Mattens
- Intensive Care Department; Universitair Ziekenhuis Brussel (UZ Brussel); Vrije Universiteit Brussel (VUB); Brussels Belgium
| | - K. Staessens
- Department of Cardiac Surgery; Universitair Ziekenhuis Brussel (UZ Brussel); Brussels Belgium
| | - M. Diltoer
- Intensive Care Department; Universitair Ziekenhuis Brussel (UZ Brussel); Vrije Universiteit Brussel (VUB); Brussels Belgium
| | - P. M. Honoré
- Intensive Care Department; Universitair Ziekenhuis Brussel (UZ Brussel); Vrije Universiteit Brussel (VUB); Brussels Belgium
| | - J. Czapla
- Department of Cardiac Surgery; Universitair Ziekenhuis Brussel (UZ Brussel); Brussels Belgium
| | - J. Nijs
- Department of Cardiac Surgery; Universitair Ziekenhuis Brussel (UZ Brussel); Brussels Belgium
| | - M. La Meir
- Department of Cardiac Surgery; Universitair Ziekenhuis Brussel (UZ Brussel); Brussels Belgium
| | - L. Huyghens
- Intensive Care Department; Universitair Ziekenhuis Brussel (UZ Brussel); Vrije Universiteit Brussel (VUB); Brussels Belgium
| | - H. Spapen
- Intensive Care Department; Universitair Ziekenhuis Brussel (UZ Brussel); Vrije Universiteit Brussel (VUB); Brussels Belgium
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50
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Ziegler D, Strom A, Nowotny B, Zahiragic L, Nowotny PJ, Carstensen-Kirberg M, Herder C, Roden M. Effect of Low-Energy Diets Differing in Fiber, Red Meat, and Coffee Intake on Cardiac Autonomic Function in Obese Individuals With Type 2 Diabetes. Diabetes Care 2015; 38:1750-7. [PMID: 26070589 DOI: 10.2337/dc15-0466] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 05/20/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The autonomic nervous system (ANS) regulates both the cardiovascular system and energy balance and is disturbed in diabetes and obesity. The effect of different approaches of caloric restriction on ANS function has not been assessed in individuals with diabetes. Thus, we sought to determine whether low-energy diets differing in fiber, red meat, and coffee intake exert differential effects on cardiac autonomic function. RESEARCH DESIGN AND METHODS In this randomized parallel-group pilot trial, obese patients with type 2 diabetes were randomly allocated to consume either a diet high in cereal fiber, free of red meat, and high in coffee (n = 13) or a diet low in fiber, high in red meat, and coffee free (n = 15) over 8 weeks. Eight measures of heart rate variability (HRV) indicating vagal and/or sympathetic modulation over 3 h and inflammatory markers were determined during a hyperinsulinemic-euglycemic clamp. RESULTS After 8 weeks, both dietary interventions resulted in a mean weight loss of 5-6 kg, a mean decline in heart rate of 4-6 bpm, and improvement in vagally mediated HRV. However, the changes in HRV parameters from baseline to 8 weeks did not differ between the groups. In the entire study cohort, incremental HRV from baseline to 8 weeks was associated with enhanced oxidative glucose utilization (P < 0.05), but not with insulin sensitivity and inflammatory markers. CONCLUSIONS In obese patients with type 2 diabetes, energy restriction per se over 8 weeks contributed to improved cardiac vagal function in relation to improved oxidative glucose utilization. This preliminary finding should be verified in a confirmatory trial.
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Affiliation(s)
- Dan Ziegler
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Alexander Strom
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Bettina Nowotny
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany
| | - Lejla Zahiragic
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Peter J Nowotny
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany
| | - Maren Carstensen-Kirberg
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Christian Herder
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Michael Roden
- Institute for Clinical Diabetology, German Diabetes Center at Heinrich Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany Department of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
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