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Heymsfield SB, Yang S, McCarthy C, Brown JB, Martin CK, Redman LM, Ravussin E, Shen W, Müller MJ, Bosy-Westphal A. Proportion of caloric restriction-induced weight loss as skeletal muscle. Obesity (Silver Spring) 2024; 32:32-40. [PMID: 37807154 PMCID: PMC10872987 DOI: 10.1002/oby.23910] [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: 07/06/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE This study's objective was to develop models predicting the relative reduction in skeletal muscle (SM) mass during periods of voluntary calorie restriction (CR) and to validate model predictions in longitudinally monitored samples. METHODS The model development group included healthy nonexercising adults (n = 897) who had whole-body SM mass measured with magnetic resonance imaging. Model predictions of relative SM changes with CR were evaluated in two longitudinal studies, one 12 to 14 weeks in duration (n = 74) and the other 12 months in duration (n = 26). RESULTS A series of SM prediction models were developed in a sample of 415 males and 482 females. Model-predicted changes in SM mass relative to changes in body weight (i.e., ΔSM/Δbody weight) with a representative model were (mean ± SE) 0.26 ± 0.013 in males and 0.14 ± 0.007 in females (sex difference, p < 0.001). The actual mean proportions of weight loss as SM in the longitudinal studies were 0.23 ± 0.02/0.20 ± 0.06 in males and 0.10 ± 0.02/0.17 ± 0.03 in females, similar to model-predicted values. CONCLUSIONS Nonelderly males and females with overweight and obesity experience respective reductions in SM mass with voluntary CR in the absence of a structured exercise program of about 2 to 2.5 kg and 1 to 1.5 kg per 10-kg weight loss, respectively. These estimates are predicted to be influenced by interactions between age and body mass index in males, a hypothesis that needs future testing.
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Affiliation(s)
- Steven B. Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Shengping Yang
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Jasmin B. Brown
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Corby K. Martin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Leanne M. Redman
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Wei Shen
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, and Institute of Human Nutrition, Columbia University Irving Medical Center; Columbia Magnetic Resonance Research Center, Columbia University, New York, NY, USA
| | - Manfred J. Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht’s-University of Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht’s-University of Kiel, Kiel, Germany
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Cortez FM, Nunes CL, Sardinha LB, Silva AM, Teixeira VH. The BREAK study protocol: Effects of intermittent energy restriction on adaptive thermogenesis during weight loss and its maintenance. PLoS One 2023; 18:e0294131. [PMID: 37956119 PMCID: PMC10642783 DOI: 10.1371/journal.pone.0294131] [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: 05/16/2023] [Accepted: 10/18/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Adaptive thermogenesis, defined as the decrease in the energy expenditure components beyond what can be predicted by changes in body mass stores, has been studied as a possible barrier to weight loss and weight maintenance. Intermittent energy restriction (IER), using energy balance refeeds, has been pointed out as a viable strategy to reduce adaptive thermogenesis and improve weight loss efficiency (greater weight loss per unit of energy deficit), as an alternative to a continuous energy restriction (CER). Following a randomized clinical trial design, the BREAK Study aims to compare the effects of IER versus CER on body composition and in adaptive thermogenesis, and understand whether participants will successfully maintain their weight loss after 12 months. METHODS Seventy-four women with obesity and inactive (20-45 y) will be randomized to 16 weeks of CER or IER (8x2 weeks of energy restriction interspersed with 7x1 week in energy balance). Both groups will start with 2 weeks in energy balance before energy restriction, followed by 16 weeks in energy restriction, then 8 weeks in energy balance and finally a 12-month weight maintenance phase. Primary outcomes are changes in fat-mass and adaptive thermogenesis after weight loss and weight maintenance. Secondary outcomes include weight loss, fat-free mass preservation, alterations in energy expenditure components, and changes in hormones (thyroid function, insulin, leptin, and cortisol). DISCUSSION We anticipate that The BREAK Study will allow us to better understand adaptive thermogenesis during weight loss and weight maintenance, in women with obesity. These findings will enable evidence-based decisions for obesity treatment. TRIAL REGISTRATION ClinicalTrials.gov: NCT05184361.
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Affiliation(s)
- Filipa M Cortez
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - Catarina L Nunes
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Cruz-Quebrada, Portugal
| | - Vítor H Teixeira
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Research Centre of Physical Activity, Health and Leisure, CIAFEL, Faculty of Sport Sciences, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health, ITR, Porto, Portugal
- Futebol Clube do Porto, Porto, Portugal
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Flores LE, Beavers KM, Beavers DP, Greene KA, Madrid DA, Miller RM, Ard JD, Bilek LD, Weaver AA. Risedronate use may blunt appendicular lean mass loss secondary to sleeve gastrectomy: Results from a pilot randomized controlled trial. JCSM RAPID COMMUNICATIONS 2023; 6:18-25. [PMID: 37273449 PMCID: PMC10236921 DOI: 10.1002/rco2.72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/22/2022] [Indexed: 06/06/2023]
Abstract
Background Despite robust weight loss and cardiometabolic benefit, lean mass loss following sleeve gastrectomy (SG) confers health risk. Bisphosphonates are a potential therapeutic agent for lean mass maintenance. Thus, our objective was to explore the effect of six months of risedronate (vs placebo) on change in dual energy x-ray absorptiometry (DXA) and computed tomography (CT) derived lean mass metrics in the year following SG. Methods 24 SG patients were randomized to six months of 150 mg oral risedronate or placebo capsules (NCT03411902). Body composition was assessed at baseline and six months with optional 12-month follow-up using whole-body DXA and CT at the lumbar spine and mid-thigh. Group treatment effects and 95% CIs were generated from a mixed model using contrast statements at six and 12 months, adjusted for baseline values. Results Of 24 participants enrolled [55.7±6.7 years (mean±SD), 79% Caucasian, 83% women, body mass index (BMI) 44.7±6.3kg/m2], 21 returned for six-month testing, and 14 returned for 12-month testing. Six-month weight loss was -16.3 kg (-20.0, -12.5) and -20.9 kg (-23.7, -18.1) in the risedronate and placebo groups, respectively (p=.057). Primary analysis at six-months revealed a non-significant sparing of appendicular lean mass in the risedronate group compared to placebo [-1.2 kg (-2.3, -0.1) vs -2.1 kg (-3.0, -1.2)]; p=.20. By 12-months, the risedronate group displayed no change in appendicular lean mass from baseline [-0.5 kg (-1.5, 0.6)]; however, the placebo group experienced significantly augmented loss [-2.9 kg (-3.6, -2.1)]. Conclusion Pilot data indicate risedronate treatment may mitigate appendicular lean mass loss following SG. Further study is warranted.
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Affiliation(s)
- Laura E. Flores
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kristen M. Beavers
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Daniel P. Beavers
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Katelyn A. Greene
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Diana A. Madrid
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Ryan M. Miller
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jamy D. Ard
- Department of Bariatric and Weight Management Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Laura D. Bilek
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ashley A. Weaver
- Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Martin A, Fox D, Murphy CA, Hofmann H, Koehler K. Tissue losses and metabolic adaptations both contribute to the reduction in resting metabolic rate following weight loss. Int J Obes (Lond) 2022; 46:1168-1175. [PMID: 35181758 PMCID: PMC9151388 DOI: 10.1038/s41366-022-01090-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/29/2022] [Accepted: 02/02/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To characterize the contributions of the loss of energy-expending tissues and metabolic adaptations to the reduction in resting metabolic rate (RMR) following weight loss. METHODS A secondary analysis was conducted on data from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy study. Changes in RMR, body composition, and metabolic hormones were examined over 12 months of calorie restriction in 109 individuals. The contribution of tissue losses to the decline in RMR was determined by weighing changes in the size of energy-expending tissues and organs (skeletal muscle, adipose tissue, bone, brain, inner organs, residual mass) assessed by dual-energy X-ray absorptiometry with their tissue-specific metabolic rates. Metabolic adaptations were quantified as the remaining reduction in RMR. RESULTS RMR was reduced by 101 ± 12 kcal/d as participants lost 7.3 ± 0.2 kg (both p < 0.001). On average, 60% of the total reduction in RMR were explained by energy-expending tissues losses, while 40% were attributed to metabolic adaptations. The loss of skeletal muscle mass (1.0 ± 0.7 kg) was not significantly related to RMR changes (r = 0.14, p = 0.16), whereas adipose tissue losses (7.2 ± 3.0 kg) were positively associated with the reduction in RMR (r = 0.42, p < 0.001) and metabolic adaptations (r = 0.31, p < 0.001). Metabolic adaptations were correlated with declines in leptin (r = 0.27, p < 0.01), triiodothyronine (r = 0.19, p < 0.05), and insulin (r = 0.25, p < 0.05). CONCLUSIONS During weight loss, tissue loss and metabolic adaptations both contribute to the reduction in RMR, albeit variably. Contrary to popularly belief, it is not skeletal muscle, but rather adipose tissue losses that seem to drive RMR reductions following weight loss. Future research should target personalized strategies addressing the predominant cause of RMR reduction for weight maintenance.
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Affiliation(s)
- Alexandra Martin
- grid.6936.a0000000123222966Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
| | - Darius Fox
- grid.24434.350000 0004 1937 0060Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE USA
| | - Chaise A. Murphy
- grid.6936.a0000000123222966Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
| | - Hande Hofmann
- grid.6936.a0000000123222966Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
| | - Karsten Koehler
- grid.6936.a0000000123222966Department of Sport and Health Sciences, Technical University Munich, Munich, Germany
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Adaptive thermogenesis after moderate weight loss: magnitude and methodological issues. Eur J Nutr 2021; 61:1405-1416. [PMID: 34839398 DOI: 10.1007/s00394-021-02742-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was (1) to assess AT through 13 different mathematical approaches and to compare their results; and (2) to understand if AT occurs after moderate WL. METHODS Ninety-four participants [mean (SD); BMI, 31.1 (4.3) kg/m2; age, 43.0 (9.4) years; 34% females] underwent a 1-year lifestyle intervention (clinicaltrials.gov ID: NCT03031951) and were randomized to intervention (IG, n = 49) or control groups (CG, n = 45), and all measurements were made at baseline and after 4 months. Fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry and REE by indirect calorimetry. AT was assessed through 13 different approaches, varying in how REE was predicted and/or how AT was assessed. RESULTS IG underwent a mean negative energy balance (EB) of 270 (289) kcal/day, p < 0.001), resulting in a WL of - 4.8 (4.9)% and an FM loss of - 11.3 (10.8)%. Regardless of approach, AT occurred in the IG, ranging from ~ - 65 to ~ - 230 kcal/day and three approaches showed significant AT in the CG. CONCLUSIONS Regardless of approach, AT occurred after moderate WL in the IG. AT assessment should be standardized and comparisons among studies with different methodologies to assess AT must be avoided.
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Shen W, Chen J, Zhou J, Martin CK, Ravussin E, Redman LM. Effect of 2-year caloric restriction on organ and tissue size in nonobese 21- to 50-year-old adults in a randomized clinical trial: the CALERIE study. Am J Clin Nutr 2021; 114:1295-1303. [PMID: 34159359 PMCID: PMC8645192 DOI: 10.1093/ajcn/nqab205] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/28/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sustained calorie restriction (CR) promises to extend the lifespan. The effect of CR on changes in body mass across tissues and organs is unclear. OBJECTIVES We used whole-body MRI to evaluate the effect of 2 y of CR on changes in body composition. METHODS In an ancillary study of the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial, 43 healthy adults [25-50 y; BMI (kg/m2): 22-28] randomly assigned to 25% CR (n = 28) or ad libitum (AL) eating (n = 15) underwent whole-body MRI at baseline and month 24 to measure adipose tissue in subcutaneous, visceral, and intermuscular depots (SAT, VAT, and IMAT, respectively); skeletal muscle; and organs including brain, liver, spleen, and kidneys but not heart. RESULTS The CR group lost more adipose tissue and lean tissue than controls (P < 0.05). In the CR group, at baseline, total tissue volume comprised 32.1%, 1.9%, and 1.0% of SAT, VAT, and IMAT, respectively. The loss of total tissue volume over 24 mo comprised 68.4%, 7.4%, and 2.2% of SAT, VAT, and IMAT, respectively, demonstrating preferential loss of fat vs. lean tissue. Although there is more muscle loss in CR than AL (P < 0.05), the loss of muscle over 24 mo in the CR group comprised only 17.2% of the loss of total tissue volume. Changes in organ volumes were not different between CR and AL. The degree of CR (% decrease in energy intake vs. baseline) significantly (P < 0.05) affected changes in VAT, IMAT, muscle, and liver volume (standardized regression coefficient ± standard error of estimates: 0.43 ± 0.15 L, 0.40 ± 0.19 L, 0.55 ± 0.17 L, and 0.45 ± 0.18 L, respectively). CONCLUSIONS Twenty-four months of CR (intended, 25%; actual, 13.7%) in young individuals without obesity had effects on body composition, including a preferential loss of adipose tissue, especially VAT, over the loss of muscle and organ tissue. This trial was registered at www.clinicaltrials.gov as NCT02695511.
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Affiliation(s)
- Wei Shen
- Address correspondence to WS (e-mail: )
| | - Jun Chen
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Irving Medical Center, New York, NY, USA
| | - Jane Zhou
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Columbia University Irving Medical Center, New York, NY, USA
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Pedrianes-Martin PB, Perez-Valera M, Morales-Alamo D, Martin-Rincon M, Perez-Suarez I, Serrano-Sanchez JA, Gonzalez-Henriquez JJ, Galvan-Alvarez V, Acosta C, Curtelin D, de Pablos-Velasco P, Calbet JAL. Resting metabolic rate is increased in hypertensive patients with overweight or obesity: Potential mechanisms. Scand J Med Sci Sports 2021; 31:1461-1470. [PMID: 33749940 DOI: 10.1111/sms.13955] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/15/2021] [Indexed: 12/17/2022]
Abstract
The purpose of this investigation was to determine whether differences in body composition, pharmacological treatment, and physical activity explain the increased resting metabolic rate (RMR) and impaired insulin sensitivity in hypertension. Resting blood pressure, RMR (indirect calorimetry), body composition (dual-energy X-ray absorptiometry), physical activity (accelerometry), maximal oxygen uptake (VO2 max) (ergospirometry), and insulin sensitivity (Matsuda index) were measured in 174 patients (88 men and 86 women; 20-68 years) with overweight or obesity. Hypertension (HTA) was present in 51 men (58%) and 42 women (49%) (p = .29). RMR was 6.9% higher in hypertensives than normotensives (1777 ± 386 and 1663 ± 383 kcal d-1 , p = .044). The double product (systolic blood pressure × heart rate) was 18% higher in hypertensive than normotensive patients (p < .001). The observed differences in absolute RMR were non-significant after adjusting for total lean mass and total fat mass (estimated means: 1702 kcal d-1 , CI: 1656-1750; and 1660 kcal d-1 , CI: 1611-1710 kcal d-1 , for the hypertensive and normotensive groups, respectively, p = .19, HTA × sex interaction p = .37). Lean mass, the double product, and age were the variables with the higher predictive value of RMR in hypertensive patients. Insulin sensitivity was lower in hypertensive than in normotensive patients, but these differences disappeared after accounting for physical activity and VO2max . In summary, hypertension is associated with increased RMR and reduced insulin sensitivity. The increased RMR is explained by an elevated myocardial oxygen consumption due to an increased resting double product, combined with differences in body composition between hypertensive and normotensive subjects.
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Affiliation(s)
- Pablo B Pedrianes-Martin
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Mario Perez-Valera
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - David Morales-Alamo
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Marcos Martin-Rincon
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Ismael Perez-Suarez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jose A Serrano-Sanchez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Juan Jose Gonzalez-Henriquez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Mathematics, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Victor Galvan-Alvarez
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Carmen Acosta
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - David Curtelin
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain
| | - Pedro de Pablos-Velasco
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Jose A L Calbet
- Research Institute of Biomedical and Health Sciences (IUIBS), Las Palmas de Gran Canaria, Spain.,Department of Physical Education, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.,Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
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Abstract
Adaptive thermogenesis (AT) has been proposed to be a compensatory response that may resist weight loss (WL) and promote weight regain. This systematic review examined the existence of AT in adults after a period of negative energy balance (EB) with or without a weight stabilisation phase. Studies published until 15 May 2020 were identified from PubMed, Cochrane Library, EMBASE, MEDLINE, SCOPUS and Web of Science. Inclusion criteria included statistically significant WL, observational with follow-up or experimental studies, age > 18y, sample size ≥10 participants, intervention period ≥ 1week, published in English, objective measures of total daily energy expenditure (EE) (TDEE), resting EE (REE) and sleeping EE(SEE). The systematic review was registered at PROSPERO (2020 CRD42020165348). A total of thirty-three studies comprising 2528 participants were included. AT was observed in twenty-seven studies. Twenty-three studies showed significant values for AT for REE (82·8 %), four for TDEE (80·0 %) and two for SEE (100 %). A large heterogeneity in the methods used to quantify AT and between subjects and among studies regarding the magnitude of WL and/or of AT was reported. Well-designed studies reported lower or non-significant values for AT. These findings suggest that although WL may lead to AT in some of the EE components, these values may be small or non-statistically significant when higher-quality methodological designs are used. Furthermore, AT seems to be attenuated, or non-existent, after periods of weight stabilisation/neutral EB. More high-quality studies are warranted not only to disclose the existence of AT but also to understand its clinical implications on weight management outcomes.
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Rommersbach N, Wirth R, Lueg G, Klimek C, Schnatmann M, Liermann D, Janssen G, Müller MJ, Pourhassan M. The impact of disease-related immobilization on thigh muscle mass and strength in older hospitalized patients. BMC Geriatr 2020; 20:500. [PMID: 33238889 PMCID: PMC7687989 DOI: 10.1186/s12877-020-01873-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 11/05/2020] [Indexed: 01/10/2023] Open
Abstract
Background We assessed the quantitative changes in muscle mass and strength during 2 weeks of hospitalization in immobile and mobile acutely ill hospitalized older adults. Methods Forty-one patients (82.4 ± 6.6 years, 73.0% females) participated in this prospective longitudinal observational study. Mobility status was defined according to walking ability as described in the Barthel-Index. Functional status, including handgrip strength and isometric knee-extension strength, and mid-thigh magnetic resonance imaging (MRI) measurements of cross-sectional area (CSA) were conducted on admission and at discharge. Results Twenty-two participants (54%) were immobile and 19 (46%) mobile. In all, 54.0 and 12.0% were at risk of malnutrition and malnourished, respectively. The median time between baseline and follow-up for MRI scans were 13 days in mobile and immobile participants (P = 0.072). Mid-thigh muscle and subcutaneous fat CSA significantly decreased by 3.9cm2 (5.0%, P = 0.002) and 5.3cm2 (5.7%, P = 0.036) during hospitalization whereas intermuscular fat remained unchanged in immobile subjects. No significant changes were observed in mobile patients. In a regression analysis, mobility was the major independent risk factor for changes in mid-thigh muscle CSA as a percentage of initial muscle area (P = 0.022) whereas other variables such as age (P = 0.584), BMI (P = 0.879), nutritional status (P = 0.835) and inflammation (P = 0.291) were not associated with muscle mass changes. There was a significant decrease in isometric knee extension strength (P = 0.002) and no change in handgrip strength (P = 0.167) in immobile patients whereas both parameters increased significantly over time in mobile patients (P = 0.048 and P = 0.012, respectively). Conclusions Two weeks of disease-related immobilization result in a significant loss of thigh muscle mass and muscle strength in older patients with impaired mobility. Concomitantly, there was a significant reduction of subcutaneous adipose tissue in immobile older hospitalized patients whereas no changes were observed in intermuscular fat among these patients. These data highlight the importance of mobility support in maintaining muscle mass and function in older hospitalized patients.
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Affiliation(s)
- Nikola Rommersbach
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Gero Lueg
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Christiane Klimek
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Mirja Schnatmann
- Department of Radiology, Marien Hospital Herne, Ruhr-Universität Bochum, Herne, Germany
| | - Dieter Liermann
- Department of Radiology, Marien Hospital Herne, Ruhr-Universität Bochum, Herne, Germany
| | - Gregor Janssen
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Germany
| | - Manfred James Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Germany.
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10
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The Relationship between Changes in Organ-Tissue Mass and Sleeping Energy Expenditure Following Weight Change in College Sumo Wrestlers. ACTA ACUST UNITED AC 2020; 56:medicina56100536. [PMID: 33066288 PMCID: PMC7602072 DOI: 10.3390/medicina56100536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 11/17/2022]
Abstract
Background and objectives: It has been well established that the resting energy expenditure (REE) for the whole body is the sum of the REE for each organ-tissue in young and middle-aged healthy adults. Based on these previous studies, although it is speculated that sleeping energy expenditure (SEE, which has small inter-individual variability) changes with a commensurate gain or reduction in the resting metabolic rate of each organ-tissue, it is unclear whether a change in organ-tissue masses is directly attributed to the fluctuation of SEE at present. This study aimed to assess the relationship between changes in organ-tissue mass and sleeping energy expenditure (SEE) following weight change in college Sumo wrestlers. This included blood analysis, which is related to energy expenditure. Materials and Methods: A total of 16 healthy male college Sumo wrestlers were recruited in this study. All measurements were obtained before and after weight change. Magnetic resonance imaging measurements were used to determine the volume of the skeletal muscle (SM), liver, and kidneys, and an indirect human calorimeter was used to determine SEE before and after weight change. Results: The change in body mass and SEE ranged between -8.7~9.5 kg, and -602~388 kcal/day. Moreover, changes in SM, liver, and kidneys ranged between -3.3~3.6 kg, -0.90~0.77 kg, and -0.12~0.07 kg. The change in SEE was not significantly correlated with the change in SM or liver mass, nor with blood analyses; however, a significant relationship between the change in kidney mass and SEE was observed. Conclusions: Based on our results, there is a possibility that the mass of the kidneys has an effect on the change in SEE following weight change in college Sumo wrestlers.
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11
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Most J, Redman LM. Impact of calorie restriction on energy metabolism in humans. Exp Gerontol 2020; 133:110875. [DOI: 10.1016/j.exger.2020.110875] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 02/06/2020] [Accepted: 02/09/2020] [Indexed: 11/28/2022]
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12
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Is There a Contribution of Structural Brain Phenotypes to the Variance in Resting Energy Expenditure before and after Weight Loss in Overweight Females? Nutrients 2019; 11:nu11112759. [PMID: 31739433 PMCID: PMC6893761 DOI: 10.3390/nu11112759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 11/17/2022] Open
Abstract
Brain gray (GM) and white matter (WM) are associated with resting energy expenditure (REE). The impact of weight loss on GM and WM masses, as well as on their associations with REE and the ratio between body and brain metabolism, i.e., encephalic measure (EM)), are unknown. Longitudinal data of 69 female Caucasian subjects (age range 19–69 years) with detailed information on fat mass (FM), fat free mas (FFM), GM, WM and REE. Mean weight loss was 14.5 ± 11.9 kg with changes in FM (−12.9 ± 9.8 kg), FFM (−1.7 ± 4.8 kg) and REE (−159 ± 191 kcal/24 h) (all p < 0.05). With weight loss, there were no changes in GM and WM. Before and after weight loss, FFM was the main determinant of REE (r2 = 0.483 and 0.413; p < 0.05). After weight loss, GM added to the variances in REE (3.6%), REEadjFFM (6.1%) and the REE on FFM residuals (6.6%). In addition, before and after weight loss GM explained 25.0% and 10.0% of the variances in EM (p < 0.05). Weight loss had no effect on volumes of GM and WM. After weight loss, both, GM added to the variances of REE, REE on FFM residuals and EM.
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13
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Metabolic adaptations during negative energy balance and their potential impact on appetite and food intake. Proc Nutr Soc 2019; 78:279-289. [DOI: 10.1017/s0029665118002811] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This review examines the metabolic adaptations that occur in response to negative energy balance and their potential putative or functional impact on appetite and food intake. Sustained negative energy balance will result in weight loss, with body composition changes similar for different dietary interventions if total energy and protein intake are equated. During periods of underfeeding, compensatory metabolic and behavioural responses occur that attenuate the prescribed energy deficit. While losses of metabolically active tissue during energy deficit result in reduced energy expenditure, an additional down-regulation in expenditure has been noted that cannot be explained by changes in body tissue (e.g. adaptive thermogenesis). Sustained negative energy balance is also associated with an increase in orexigenic drive and changes in appetite-related peptides during weight loss that may act as cues for increased hunger and food intake. It has also been suggested that losses of fat-free mass (FFM) could also act as an orexigenic signal during weight loss, but more data are needed to support these findings and the signalling pathways linking FFM and energy intake remain unclear. Taken together, these metabolic and behavioural responses to weight loss point to a highly complex and dynamic energy balance system in which perturbations to individual components can cause co-ordinated and inter-related compensatory responses elsewhere. The strength of these compensatory responses is individually subtle, and early identification of this variability may help identify individuals that respond well or poorly to an intervention.
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14
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Heymsfield SB, Peterson CM, Bourgeois B, Thomas DM, Gallagher D, Strauss B, Müller MJ, Bosy-Westphal A. Human energy expenditure: advances in organ-tissue prediction models. Obes Rev 2018; 19:1177-1188. [PMID: 30035381 PMCID: PMC6107421 DOI: 10.1111/obr.12718] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/23/2018] [Accepted: 05/09/2018] [Indexed: 01/02/2023]
Abstract
Humans expend energy at rest (REE), and this major energy exchange component is now usually estimated using statistical equations that include weight and other predictor variables. While these formulas are useful in evaluating an individual's or group's REE, an important gap remains: available statistical models are inadequate for explaining underlying organ-specific and tissue-specific mechanisms accounting for resting heat production. The lack of such systems level REE prediction models leaves many research questions unanswered. A potential approach that can fill this gap began with investigators who first showed in animals and later in humans that REE reflects the summated heat production rates of individual organs and tissues. Today, using advanced imaging technologies, REE can be accurately estimated from the measured in vivo mass of 10 organ-tissue mass components combined with their respective mass-specific metabolic rates. This review examines the next frontier of energy expenditure models and discusses how organ-tissue models have the potential not only to better predict REE but also to provide insights into how perturbations in organ mass lead to structure-function changes across other interacting organ systems. The introductory ideas advanced in this review provide a framework for future human energy expenditure modelling research.
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Affiliation(s)
| | | | | | - Diana M. Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, NY, USA
| | - Dympna Gallagher
- Columbia University, College of Physicians and Surgeons, New York, NY, USA
| | - Boyd Strauss
- Dept. of Medicine, School of Clinical Sciences, Monash University, Australia and Institute of Inflammation and Repair, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | - Manfred J. Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht’s-University of Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht’s-University of Kiel, Kiel, Germany
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15
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André A, Leriche I, Chaix G, Thorin C, Burger M, Nguyen P. Recovery of insulin sensitivity and optimal body composition after rapid weight loss in obese dogs fed a high-protein medium-carbohydrate diet. J Anim Physiol Anim Nutr (Berl) 2018. [PMID: 28627053 DOI: 10.1111/jpn.12744] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study investigated the effects of an experimental high-protein medium-carbohydrate diet (protein level, 46% metabolizable energy, ME). First, postprandial plasma glucose and insulin kinetics were determined in steady-state overweight/obese Beagle dogs (28%-41% excess body weight) for an experimental high-protein medium-carbohydrate diet (protein level, 46% ME) and a commercial high-carbohydrate medium-protein diet (protein level, 24%ME) in obese dogs. Secondly, all the dogs were included in a weight loss programme. They were fed the high-protein medium-carbohydrate diet, and the energy allocation was gradually reduced until they reached their optimal body weight. Insulin sensitivity and body composition were evaluated before and after weight loss using a euglycaemic-hyperinsulinaemic clamp and the deuterium oxide dilution technique respectively. For statistical analysis, linear mixed effect models were used with a significance level of 5%. Postprandial plasma glucose and insulin concentrations were substantially lower with the high-protein medium-carbohydrate diet than the high-carbohydrate medium-protein diet. These differences can be explained mainly by the difference in carbohydrate content between the two diets. Energy restriction (35% lower energy intake than in the obese state) resulted in a 2.23 ± 0.05% loss in body weight/week, and the dogs reached their optimal body weight in 12-16 weeks. Weight loss was associated with a significant increase in insulin sensitivity. The high-protein medium-carbohydrate diet allowed fat-free mass preservation despite a relatively high rate of weekly weight loss. The increase in insulin sensitivity indicated improved control of carbohydrate metabolism, possible due to weight loss and to the nature of the diet. Thus, a high-protein medium-carbohydrate diet is a good nutritional solution for managing the weight of overweight dogs. This diet may improve glycaemic control, which could be beneficial for preventing or managing impaired glucose tolerance in obese dogs and for safe and successful weight loss while preserving lean body mass.
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Affiliation(s)
- A André
- UBL, Oniris, National College of Veterinary Medicine, Food Science and Engineering Nantes-Atlantic, Nutrition, Physiopathology and Pharmacology Unit (NP3), Nantes, France
| | | | - G Chaix
- Virbac Medical Department, Carros, France
| | - C Thorin
- UBL, Oniris, National College of Veterinary Medicine, Food Science and Engineering Nantes-Atlantic, Nutrition, Physiopathology and Pharmacology Unit (NP3), Nantes, France
| | - M Burger
- UBL, Oniris, National College of Veterinary Medicine, Food Science and Engineering Nantes-Atlantic, Nutrition, Physiopathology and Pharmacology Unit (NP3), Nantes, France
| | - P Nguyen
- UBL, Oniris, National College of Veterinary Medicine, Food Science and Engineering Nantes-Atlantic, Nutrition, Physiopathology and Pharmacology Unit (NP3), Nantes, France
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16
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Drabsch T, Holzapfel C, Stecher L, Petzold J, Skurk T, Hauner H. Associations Between C-Reactive Protein, Insulin Sensitivity, and Resting Metabolic Rate in Adults: A Mediator Analysis. Front Endocrinol (Lausanne) 2018; 9:556. [PMID: 30294302 PMCID: PMC6158372 DOI: 10.3389/fendo.2018.00556] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 08/31/2018] [Indexed: 12/26/2022] Open
Abstract
Objective: Long-term positive energy balance promotes the development of obesity, a main risk factor for type 2 diabetes mellitus (T2DM). While an association between increased resting metabolic rate (RMR) and insulin sensitivity (IS) was shown previously, the underlying mechanisms remain unclear. Aim of the mediator analysis was to investigate the role of inflammation within the association between RMR and IS. Methods: Anthropometric, clinical, and lifestyle data were collected according to standard operating procedures. RMR was measured using indirect calorimetry. Homeostasis model assessment for insulin resistance (HOMA-IR) was used as an IS parameter and C-reactive protein (CRP) was measured to represent the inflammatory status. Statistical analyses were performed using SPSS. Results: The analysis included 782 adults (517 females) with a mean age of 32.4 ± 12.0 years and a mean body mass index (BMI) of 24.6 ± 5.2 kg/m2. Regression analysis indicated a significant evidence for associations between RMR and HOMA-IR (ß = 39.3 ± 7.3 kcal/d; p ≤ 0.001) and CRP and HOMA-IR (ß = 0.5 ± 0.1; p ≤ 0.001) after adjustment for fat-free mass, sex, age, and study site. Results of the mediator analysis did not support the hypothesis that CRP is a mediator for the association between RMR and HOMA-IR. These results did not change after participant stratification according to sex or BMI. Conclusion: A significant evidence for an association between RMR and IS was shown in a large cohort. However, the inflammatory status, determined via CRP levels, was not a mediator within this association.
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Affiliation(s)
- Theresa Drabsch
- Institute for Nutritional Medicine, University Hospital Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christina Holzapfel
- Institute for Nutritional Medicine, University Hospital Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- *Correspondence: Christina Holzapfel
| | - Lynne Stecher
- Institute for Nutritional Medicine, University Hospital Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Julia Petzold
- Institute for Nutritional Medicine, University Hospital Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Skurk
- ZIEL Institute for Food and Health, Technical University of Munich, Munich, Germany
| | - Hans Hauner
- Institute for Nutritional Medicine, University Hospital Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- ZIEL Institute for Food and Health, Technical University of Munich, Munich, Germany
- Else Kroener-Fresenius-Center for Nutritional Medicine, Chair for Nutritional Medicine, Technical University of Munich, Munich, Germany
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17
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Geisler C, Schweitzer L, Müller MJ. Functional correlates of detailed body composition in healthy elderly subjects. J Appl Physiol (1985) 2018; 124:182-189. [DOI: 10.1152/japplphysiol.00162.2017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Methods of body composition analysis are now widely used to characterize health status, i.e., nutritional status, metabolic rates, and cardiometabolic risk factors. However, the functional correlates of individual body components have not been systematically analyzed. In this study, we have used a two-compartment model, which was assessed by air displacement plethysmography. Detailed body composition was measured by whole body magnetic resonance imaging in a healthy population of 40 Caucasians, aged 65–81 yr (20 men; body mass index range: 18.6–37.2 kg/m2). Physical, metabolic, as well as endocrine functions included pulmonary function, handgrip strength, gait speed, sit-to-stand test, physical activity, blood pressure, body temperature, resting energy expenditure (REE), liver and kidney functions (glomerular filtration rate), insulin sensitivity [homeostasis model assessment (HOMA)], plasma lipids, plasma leptin, testosterone, dehydroepiandrosterone, insulin-like growth factor I levels, thyroid status, vitamins, and inflammation. Individual body compartments were intercorrelated, e.g., skeletal muscle mass (SM) correlated with visceral adipose tissue ( r = 0.53) and kidneys ( r = 0.62). For the functional correlates, SM ( r = 0.58) and liver volume ( r = 0.63) were associated with REE, SM correlated with handgrip strength ( r = 0.57), and kidneys with glomerular filtration rate ( r = 0.57). While visceral adipose tissue correlated with HOMA ( r = 0.59), subcutaneous adipose tissue was related to plasma leptin levels ( r = 0.84). The subcutaneous adipose tissue-to-leptin relationship was moderated by inflammation increasing the explained variance of leptin levels by 4.0%. In linear regression analysis, detailed body composition explained variances in REE (75.0%), HOMA (41.0%), and leptin (78.0%) compared with a body mass index-based model (REE 16.0%, HOMA 31.0%, leptin 45.0%). In addition, detailed body composition explained 39.0% of the variance in kidney function. NEW & NOTEWORTHY BCA should be used to address specific body functions only. In clinical practice, there is need of a clear focus on the specific research question related to physical, metabolic, or endocrine functions.
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Affiliation(s)
- Corinna Geisler
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Lisa Schweitzer
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Manfred J. Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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18
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Kusters YH, Schalkwijk CG, Houben AJ, Kooi ME, Lindeboom L, Op 't Roodt J, Joris PJ, Plat J, Mensink RP, Barrett EJ, Stehouwer CDA. Independent tissue contributors to obesity-associated insulin resistance. JCI Insight 2017; 2:89695. [PMID: 28679946 DOI: 10.1172/jci.insight.89695] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 05/19/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Induction of insulin resistance is a key pathway through which obesity increases risk of type 2 diabetes, hypertension, dyslipidemia, and cardiovascular events. Although the detrimental effects of obesity on insulin sensitivity are incompletely understood, accumulation of visceral, subcutaneous, and liver fat and impairment of insulin-induced muscle microvascular recruitment (MVR) may be involved. As these phenotypic changes often coincide in obesity, we aimed to unravel whether they independently contribute to insulin resistance and thus constitute separate targets for intervention. METHODS We measured visceral (VAT) and subcutaneous adipose tissue (SAT) volumes and intrahepatic lipid (IHL) content by MRI, and whole body glucose disposal (WBGD) and MVR (using contrast-enhanced ultrasound) responses to a euglycemic insulin clamp in lean (n = 25) and abdominally obese men (n = 52). Abdominally obese men were randomized to dietary weight loss intervention or habitual diet. RESULTS Obesity-associated increases in VAT, SAT, and IHL, along with the decrease in MVR, contributed independently to insulin resistance. Moreover, a dietary weight loss intervention reduced insulin resistance, and mediation analyses showed that decreased IHL and insulin-induced MVR, but not decreased VAT or SAT volumes, independently contributed to improved insulin resistance seen with weight loss. CONCLUSION Quantifying the mutually independent contributions of visceral and subcutaneous adipose tissue, intrahepatic lipid, and insulin-induced muscle microvascular recruitment reveals distinct targets for treating obesity-associated insulin resistance. TRIAL REGISTRATION Clinicaltrials.gov NCT01675401. FUNDING Funding was from the Top Institute Food and Nutrition.
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Affiliation(s)
- Yvo Ham Kusters
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands.,Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands
| | - Casper G Schalkwijk
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands.,Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands
| | - Alfons Jhm Houben
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
| | - M Eline Kooi
- CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, The Netherlands
| | - Lucas Lindeboom
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, The Netherlands.,Department of Human Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jos Op 't Roodt
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands.,Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands
| | - Peter J Joris
- Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, The Netherlands.,Department of Human Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jogchum Plat
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, The Netherlands.,Department of Human Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ronald P Mensink
- Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands.,School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht, The Netherlands.,Department of Human Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Eugene J Barrett
- Departments of Medicine, Pediatrics, and Pharmacology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Coen DA Stehouwer
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.,CARIM School for Cardiovascular Diseases, Maastricht, The Netherlands
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19
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Geisler C, Müller MJ. Impact of Fat-Free Mass Quality and Detailed Body Composition on Changes of Resting Energy Expenditure with Age. Curr Nutr Rep 2017. [DOI: 10.1007/s13668-017-0197-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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20
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Carroll AM, Cheng R, Collie-Duguid ESR, Meharg C, Scholz ME, Fiering S, Fields JL, Palmer AA, Lionikas A. Fine-mapping of genes determining extrafusal fiber properties in murine soleus muscle. Physiol Genomics 2017; 49:141-150. [PMID: 28087756 PMCID: PMC5374456 DOI: 10.1152/physiolgenomics.00092.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/07/2016] [Accepted: 12/12/2016] [Indexed: 02/08/2023] Open
Abstract
Muscle fiber cross-sectional area (CSA) and proportion of different fiber types are important determinants of muscle function and overall metabolism. Genetic variation plays a substantial role in phenotypic variation of these traits; however, the underlying genes remain poorly understood. This study aimed to map quantitative trait loci (QTL) affecting differences in soleus muscle fiber traits between the LG/J and SM/J mouse strains. Fiber number, CSA, and proportion of oxidative type I fibers were assessed in the soleus of 334 genotyped female and male mice of the F34 generation of advanced intercross lines (AIL) derived from the LG/J and SM/J strains. To increase the QTL detection power, these data were combined with 94 soleus samples from the F2 intercross of the same strains. Transcriptome of the soleus muscle of LG/J and SM/J females was analyzed by microarray. Genome-wide association analysis mapped four QTL (genome-wide P < 0.05) affecting the properties of muscle fibers to chromosome 2, 3, 4, and 11. A 1.5-LOD QTL support interval ranged between 2.36 and 4.67 Mb. On the basis of the genomic sequence information and functional and transcriptome data, we identified candidate genes for each of these QTL. The combination of analyses in F2 and F34 AIL populations with transcriptome and genomic sequence data in the parental strains is an effective strategy for refining QTL and nomination of the candidate genes.
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Affiliation(s)
- A M Carroll
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill Aberdeen, United Kingdom.,The New Zealand Institute for Plant & Food Research Limited, Palmerston North, New Zealand
| | - R Cheng
- Research School of Biology, Australian National University, Acton, Australia
| | - E S R Collie-Duguid
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill Aberdeen, United Kingdom.,Centre for Genome Enabled Biology and Medicine, University of Aberdeen, Old Aberdeen, Aberdeen, United Kingdom
| | - C Meharg
- Institute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom
| | - M E Scholz
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill Aberdeen, United Kingdom
| | - S Fiering
- Department of Microbiology/Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; and
| | - J L Fields
- Department of Microbiology/Immunology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; and
| | - A A Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - A Lionikas
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill Aberdeen, United Kingdom;
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21
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Gallagher D, Kelley DE, Thornton J, Boxt L, Pi-Sunyer X, Lipkin E, Nyenwe E, Janumala I, Heshka S. Changes in skeletal muscle and organ size after a weight-loss intervention in overweight and obese type 2 diabetic patients. Am J Clin Nutr 2017; 105:78-84. [PMID: 27881389 PMCID: PMC5183727 DOI: 10.3945/ajcn.116.139188] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/18/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The effect of a weight-loss intervention on the masses of lean tissues and organs in humans is not well known. OBJECTIVE We studied the effects of a diet and exercise weight-loss intervention on skeletal muscle (SM) mass and selected organs over 2 y using MRI in overweight adults with type 2 diabetes. DESIGN Participants were 53 women and 39 men [mean ± SD: age 58 ± 7 y; body mass index (BMI; in kg/m2) 32 ± 3] enrolled in the Look AHEAD (Action for Health in Diabetes) trial and randomly assigned to an intensive lifestyle intervention (ILI) or diabetes support and education (DSE) on whom 2 y of data were collected. MRI-derived measurements of SM, heart, liver, kidney, spleen, and pancreas were acquired. RESULTS Adjusted for baseline weight, height, age, sex, and ethnicity, the ILI group weighed (mean ± SE) 6.6 ± 0.7 kg less after 1 y and 5.2 ± 0.7 kg less after 2 y, whereas the DSE group did not change significantly (-0.4 ± 0.6 and -1.0 ± 0.7 kg after 1 and 2 y, respectively; P-interaction < 0.001). Total SM decreased in both groups during year 1 (-1.4 ± 0.2 kg; P < 0.001) with appendicular SM regained during year 2. Liver and spleen masses decreased in the ILI group (-0.12 ± 0.02 and -0.006 ± 0.003 kg, respectively) but were unchanged in the DSE group (0.00 ± 0.02 and 0.004 ± 0.003 kg, respectively). Kidney mass decreased by 0.013 ± 0.003 kg (P < 0.001) over 2 y in both groups. CONCLUSIONS Decreases in liver (in Caucasians but not African Americans) and spleen were detected after a 6.2-kg weight reduction compared with a control group. SM and kidney mass decreased in both groups. Appendicular SM was regained during the second year whereas trunk SM was not. No evidence of a disproportionate loss of high-metabolic rate organs (heart, liver, kidney, spleen) compared with SM was found.
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Affiliation(s)
- Dympna Gallagher
- New York Obesity Nutrition Research Center and .,Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
| | - David E Kelley
- Obesity and Nutrition Research Center, University of Pittsburgh, Pittsburgh, PA
| | | | - Lawrence Boxt
- Department of Radiology, St. Luke’s Hospital, New York, NY
| | - Xavier Pi-Sunyer
- New York Obesity Nutrition Research Center and,Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
| | - Edward Lipkin
- Division of Metabolism, University of Washington, Seattle, WA; and
| | - Ebenezer Nyenwe
- Division of Endocrinology Diabetes and Metabolism, University of Tennessee, Martin, TN
| | | | - Stanley Heshka
- New York Obesity Nutrition Research Center and,Institute of Human Nutrition and Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, NY
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22
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Geisler C, Prado CM, Müller MJ. Inadequacy of Body Weight-Based Recommendations for Individual Protein Intake-Lessons from Body Composition Analysis. Nutrients 2016; 9:E23. [PMID: 28042853 PMCID: PMC5295067 DOI: 10.3390/nu9010023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 12/06/2016] [Accepted: 12/23/2016] [Indexed: 12/25/2022] Open
Abstract
Current body weight-based protein recommendations are ignoring the large variability in body composition, particularly lean mass (LM), which drives protein requirements. We explored and highlighted the inter-individual variability of weight versus body composition-adjusted protein intakes by secondary analysis in three cohorts of (1) 574 healthy adults (mean ± SD age: 41.4 ± 15.2 years); (2) 403 cirrhotic patients (age: 44.7 ± 12.3 years) and (3) 547 patients with lung cancer (age: 61.3 ± 8.2 years). LM was assessed using different devices (magnetic resonance imaging, dual-energy X-ray absorptiometry, computer tomography, total body potassium and bioelectrical impedance), body weight-based protein intake, its ratio (per kg LM) and mean protein requirement were calculated. Variability in protein intake in all cohorts ranged from 0.83 to 1.77 g protein per kg LM per day using (theoretical protein intake of 60 g protein per day). Calculated mean protein requirement was 1.63 g protein per kg LM per day; consequently, 95.3% of healthy subjects, 100% of cirrhotic and 97.4% of cancer patients would present with a low protein intake per kg LM. Weight-adjusted recommendations are inadequate to address the LM specific differences in protein needs of healthy subjects or clinical populations. Absolute protein intake seems to be more relevant compared to the relative proportion of protein, which in turn changes with different energy needs.
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Affiliation(s)
- Corinna Geisler
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, D-24105 Kiel, Germany.
| | - Carla M Prado
- Alberta Institute for Human Nutrition, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre, Edmonton, AB T6G 2P5, Canada.
| | - Manfred J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, D-24105 Kiel, Germany.
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Impact of weight loss-associated changes in detailed body composition as assessed by whole-body MRI on plasma insulin levels and homeostatis model assessment index. Eur J Clin Nutr 2016; 71:212-218. [PMID: 27759067 DOI: 10.1038/ejcn.2016.189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 08/11/2016] [Accepted: 08/18/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND/OBJECTIVES We assessed the effect of weight loss-associated changes in detailed body composition on plasma insulin levels and homeostatic model assessment (HOMA) index to calculate the magnitude of reduction in different adipose tissue depots required to improve insulin sensitivity. SUBJECTS/METHODS A total of 50 subjects aged 20-69 years were studied. The participants were compiled from low-calorie diet interventions and bariatric surgery and differed in their baseline body mass index (BMI; range 21.6-54.4 kg/m2) and degree of weight losses (range -3.3 to -56.9 kg). Detailed body composition and liver fat were measured using whole-body magnetic resonance imaging (MRI). Insulin resistance was assessed by HOMA. RESULTS Mean body weight decreased by -16.0±13.6 kg. Significant changes were observed in total adipose tissue (TATMRI, range -0.5 to -36.0 kg), total subcutaneous adipose tissue (SATMRI), visceral adipose tissue (VATMRI), skeletal muscle, liver fat, plasma insulin levels and HOMA. Decreases in insulin and HOMA were correlated with reductions in TATMRI, SATMRI, VATMRI (just with HOMA) and liver fat. Losses of 2.9 and 6.5 kg body weight, 2.0 and 5.0 kg TATMRI as well as 1.6 and 6% liver fat were required to decrease plasma insulin levels by 1 μU/ml and HOMAadjusted for baseline HOMA by 1 point. Multiple regression analysis showed that baseline liver fat and changes in liver fat explained 49.7% and 55.1% of the variance in weight loss-associated changes in plasma insulin and HOMA, respectively. CONCLUSIONS Decreases of adipose tissues and liver fat are the major determinants of reduction in plasma insulin levels and improvement in HOMA index.
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Gale R, Namestnic J, Singer P, Kagan I. Caloric Requirements of Patients With Brain Impairment and Cerebral Palsy Who Are Dependent on Chronic Ventilation. JPEN J Parenter Enteral Nutr 2016; 41:1366-1370. [DOI: 10.1177/0148607116662970] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Rena Gale
- Children’s Respiratory Unit, Herzog Hospital, Jerusalem, Israel
| | - Julia Namestnic
- Children’s Respiratory Unit, Herzog Hospital, Jerusalem, Israel
| | - Pierre Singer
- General Intensive Care Department and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Ilya Kagan
- General Intensive Care Department and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
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Drenowatz C, Hand GA, Sagner M, Shook RP, Burgess S, Blair SN. The Prospective Association between Different Types of Exercise and Body Composition. Med Sci Sports Exerc 2016; 47:2535-41. [PMID: 25970664 DOI: 10.1249/mss.0000000000000701] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE Despite the widely accepted benefits of exercise on chronic disease risk, controversy remains on the role of exercise in weight loss. This study examined the effect of different exercise types on measures of adiposity across different fat categories. METHODS A total of 348 young adults (49% male; 28 ± 4 yr), participating in an ongoing observational study provided valid data over a period of 12 months. Fat mass (FM) and lean mass (LM) were measured via dual x-ray absorptiometry every 3 months. Percent body fat was calculated and used to differentiate between normal-fat, "overfat," and obese participants. At each measurement time point, participants reported engagement (min·wk) in aerobic exercise, resistance exercise, and other forms of exercise. RESULTS Most participants (93%) reported some exercise participation during the observation period. Total exercise or specific exercise types did not significantly affect subsequent body mass index after adjusting for sex, ethnicity, age, and baseline values of adiposity and exercise. Resistance exercise affected LM (P < 0.01) and FM (P < 0.01), whereas aerobic exercise only affected FM (P < 0.01). Any exercise type positively affected LM in normal-fat participants (P < 0.04). In overfat and obese participants, FM was reduced with increasing resistance exercise (P ≤ 0.02) but not with aerobic exercise (P ≥ 0.09). Additionally adjusting for objectively assessed total physical activity level did not change these results. CONCLUSIONS Despite the limited effects on body mass index, exercise was associated with beneficial changes in body composition. Exercise increased LM in normal-fat participants and reduced FM in overfat and obese adults. Adults with excess body fat may benefit particularly from resistance exercise.
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Affiliation(s)
- Clemens Drenowatz
- 1Department of Exercise Science, University of South Carolina, Columbia, SC; 2Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV; 3European Society of Lifestyle Medicine, Paris, FRANCE; 4Department of Kinesiology, Iowa State University, Ames, IA; 5College of Nursing, University of South Carolina, Columbia, SC; and 6Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
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Hames KC, Coen PM, King WC, Anthony SJ, Stefanovic-Racic M, Toledo FG, Brown J, Helbling N, Dubé JJ, DeLany JP, Jakicic JJ, Goodpaster BH. Resting and exercise energy metabolism in weight-reduced adults with severe obesity. Obesity (Silver Spring) 2016; 24:1290-8. [PMID: 27129892 PMCID: PMC6455966 DOI: 10.1002/oby.21501] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 02/14/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine effects of physical activity (PA) with diet-induced weight loss on energy metabolism in adults with severe obesity. METHODS Adults with severe obesity (n = 11) were studied across 6 months of intervention, then compared with controls with less severe obesity (n = 7) or normal weight (n = 9). Indirect calorimetry measured energy metabolism during exercise and rest. Markers of muscle oxidation were determined by immunohistochemistry. Data were presented as medians. RESULTS The intervention induced 7% weight loss (P = 0.001) and increased vigorous PA by 24 min/wk (P = 0.02). During exercise, energy expenditure decreased, efficiency increased (P ≤ 0.03), and fatty acid oxidation (FAO) did not change. Succinate dehydrogenase increased (P = 0.001), but fiber type remained the same. Post-intervention subjects' resting metabolism remained similar to controls. Efficiency was lower in post-intervention subjects compared with normal-weight controls exercising at 25 W (P ≤ 0.002) and compared with all controls exercising at 60% VO2peak (P ≤ 0.019). Resting and exercise FAO of post-intervention subjects remained similar to adults with less severe obesity. Succinate dehydrogenase and fiber type were similar across all body weight statuses. CONCLUSIONS While metabolic adaptations to PA during weight loss occur in adults with severe obesity, FAO does not change. Resulting FAO during rest and exercise remains similar to adults with less severe obesity.
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Affiliation(s)
- Kazanna C. Hames
- Department of Health and Physical Activity, School of Education, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Endocrine Research Unit, Mayo Clinic, Rochester, MN 55905 USA
| | - Paul M. Coen
- Department of Health and Physical Activity, School of Education, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL 32804, USA
| | - Wendy C. King
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Steven J. Anthony
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Maja Stefanovic-Racic
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Frederico G.S. Toledo
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jolene Brown
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Nicole Helbling
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - John J. Dubé
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - James P. DeLany
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - John J. Jakicic
- Department of Health and Physical Activity, School of Education, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Bret H. Goodpaster
- Division of Endocrinology and Metabolism, Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL 32804, USA
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Chang AR, Chen Y, Still C, Wood GC, Kirchner HL, Lewis M, Kramer H, Hartle JE, Carey D, Appel LJ, Grams ME. Bariatric surgery is associated with improvement in kidney outcomes. Kidney Int 2016; 90:164-71. [PMID: 27181999 DOI: 10.1016/j.kint.2016.02.039] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 02/11/2016] [Accepted: 02/18/2016] [Indexed: 02/06/2023]
Abstract
Severe obesity is associated with increased risk of kidney disease. Whether bariatric surgery reduces the risk of adverse kidney outcomes is uncertain. To resolve this we compared the risk of estimated glomerular filtration rate (eGFR) decline of ≥30% and doubling of serum creatinine or end-stage renal disease (ESRD) in 985 patients who underwent bariatric surgery with 985 patients who did not undergo such surgery. Patients were matched on demographics, baseline body mass index, eGFR, comorbidities, and previous nutrition clinic use. Mean age was 45 years, 97% were white, 80% were female, and 33% had baseline eGFR <90 ml/min per 1.73 m(2). Mean 1-year weight loss was 40.4 kg in the surgery group compared with 1.4 kg in the matched cohort. Over a median follow-up of 4.4 years, 85 surgery patients had an eGFR decline of ≥30% (22 had doubling of serum creatinine/ESRD). Over a median follow-up of 3.8 years, 177 patients in the matched cohort had an eGFR decline of ≥30% (50 had doubling of serum creatinine/ESRD). In adjusted analysis, bariatric surgery patients had a significant 58% lower risk for an eGFR decline of ≥30% (hazard ratio 0.42, 95% confidence interval 0.32-0.55) and 57% lower risk of doubling of serum creatinine or ESRD (hazard ratio 0.43, 95% confidence interval: 0.26-0.71) compared with the matched cohort. Results were generally consistent among subgroups of patients with and without eGFR <90 ml/min per 1.73 m(2), hypertension, and diabetes. Thus, bariatric surgery may be an option to prevent kidney function decline in severely obese individuals.
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Affiliation(s)
- Alex R Chang
- Division of Nephrology, Geisinger Health System, Danville, Pennsylvania, USA.
| | - Yuan Chen
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Christopher Still
- Obesity Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | - G Craig Wood
- Obesity Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | - H Lester Kirchner
- Biomedical & Translational Informatics, Geisinger Health System, Danville, Pennsylvania, USA
| | - Meredith Lewis
- Biomedical & Translational Informatics, Geisinger Health System, Danville, Pennsylvania, USA
| | - Holly Kramer
- Division of Nephrology, Loyola University Medical Center, Chicago, Illinois, USA
| | - James E Hartle
- Division of Nephrology, Geisinger Health System, Danville, Pennsylvania, USA
| | - David Carey
- Biomedical & Translational Informatics, Geisinger Health System, Danville, Pennsylvania, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA; Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Morgan E Grams
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA; Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Müller MJ, Braun W, Enderle J, Bosy-Westphal A. Beyond BMI: Conceptual Issues Related to Overweight and Obese Patients. Obes Facts 2016; 9:193-205. [PMID: 27286962 PMCID: PMC5644873 DOI: 10.1159/000445380] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 03/08/2016] [Indexed: 12/21/2022] Open
Abstract
BMI is widely used as a measure of weight status and disease risks; it defines overweight and obesity based on statistical criteria. BMI is a score; neither is it biologically sound nor does it reflect a suitable phenotype worthwhile to study. Because of its limited value, BMI cannot provide profound insight into obesity biology and its co-morbidity. Alternative assessments of weight status include detailed phenotyping by body composition analysis (BCA). However, predicting disease risks, fat mass, and fat-free mass as assessed by validated techniques (i.e., densitometry, dual energy X ray absorptiometry, and bioelectrical impedance analysis) does not exceed the value of BMI. Going beyond BMI and descriptive BCA, the concept of functional body composition (FBC) integrates body components into regulatory systems. FBC refers to the masses of body components, organs, and tissues as well as to their inter-relationships within the context of endocrine, metabolic and immune functions. FBC can be used to define specific phenotypes of obesity, e.g. the sarcopenic-obese patient. Well-characterized obesity phenotypes are a precondition for targeted research (e.g., on the genomics of obesity) and patient-centered care (e.g., adequate treatment of individual obese phenotypes such as the sarcopenic-obese patient). FBC contributes to a future definition of overweight and obesity based on physiological criteria rather than on body weight alone.
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Affiliation(s)
- Manfred James Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
- *Prof. Dr. med. Manfred James Müller, Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Düsternbrooker Weg 17, 24105 Kiel, Germany,
| | - Wiebke Braun
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Janna Enderle
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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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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Abstract
The aim of this review is to extend present concepts of body composition and to integrate it into physiology. In vivo body composition analysis (BCA) has a sound theoretical and methodological basis. Present methods used for BCA are reliable and valid. Individual data on body components, organs and tissues are included into different models, e.g. a 2-, 3-, 4- or multi-component model. Today the so-called 4-compartment model as well as whole body MRI (or computed tomography) scans are considered as gold standards of BCA. In practice the use of the appropriate method depends on the question of interest and the accuracy needed to address it. Body composition data are descriptive and used for normative analyses (e.g. generating normal values, centiles and cut offs). Advanced models of BCA go beyond description and normative approaches. The concept of functional body composition (FBC) takes into account the relationships between individual body components, organs and tissues and related metabolic and physical functions. FBC can be further extended to the model of healthy body composition (HBC) based on horizontal (i.e. structural) and vertical (e.g. metabolism and its neuroendocrine control) relationships between individual components as well as between component and body functions using mathematical modelling with a hierarchical multi-level multi-scale approach at the software level. HBC integrates into whole body systems of cardiovascular, respiratory, hepatic and renal functions. To conclude BCA is a prerequisite for detailed phenotyping of individuals providing a sound basis for in depth biomedical research and clinical decision making.
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Anton SD, Woods AJ, Ashizawa T, Barb D, Buford TW, Carter CS, Clark DJ, Cohen RA, Corbett DB, Cruz-Almeida Y, Dotson V, Ebner N, Efron PA, Fillingim RB, Foster TC, Gundermann DM, Joseph AM, Karabetian C, Leeuwenburgh C, Manini TM, Marsiske M, Mankowski RT, Mutchie HL, Perri MG, Ranka S, Rashidi P, Sandesara B, Scarpace PJ, Sibille KT, Solberg LM, Someya S, Uphold C, Wohlgemuth S, Wu SS, Pahor M. Successful aging: Advancing the science of physical independence in older adults. Ageing Res Rev 2015; 24:304-27. [PMID: 26462882 DOI: 10.1016/j.arr.2015.09.005] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 09/08/2015] [Accepted: 09/30/2015] [Indexed: 02/08/2023]
Abstract
The concept of 'successful aging' has long intrigued the scientific community. Despite this long-standing interest, a consensus definition has proven to be a difficult task, due to the inherent challenge involved in defining such a complex, multi-dimensional phenomenon. The lack of a clear set of defining characteristics for the construct of successful aging has made comparison of findings across studies difficult and has limited advances in aging research. A consensus on markers of successful aging is furthest developed is the domain of physical functioning. For example, walking speed appears to be an excellent surrogate marker of overall health and predicts the maintenance of physical independence, a cornerstone of successful aging. The purpose of the present article is to provide an overview and discussion of specific health conditions, behavioral factors, and biological mechanisms that mark declining mobility and physical function and promising interventions to counter these effects. With life expectancy continuing to increase in the United States and developed countries throughout the world, there is an increasing public health focus on the maintenance of physical independence among all older adults.
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Müller MJ, Enderle J, Pourhassan M, Braun W, Eggeling B, Lagerpusch M, Glüer CC, Kehayias JJ, Kiosz D, Bosy-Westphal A. Metabolic adaptation to caloric restriction and subsequent refeeding: the Minnesota Starvation Experiment revisited. Am J Clin Nutr 2015; 102:807-19. [PMID: 26399868 DOI: 10.3945/ajcn.115.109173] [Citation(s) in RCA: 155] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 07/28/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Adaptive thermogenesis (AT) is the fat-free mass (FFM)-independent reduction of resting energy expenditure (REE) to caloric restriction (CR). AT attenuates weight loss and favors weight regain. Its variance, dynamics, and control remain obscure. OBJECTIVES Our aims were to address the variance and kinetics of AT, its associations with body composition in the context of endocrine determinants, and its effect on weight regain. DESIGN Thirty-two nonobese men underwent sequential overfeeding (1 wk at +50% of energy needs), CR (3 wk at -50% of energy needs), and refeeding (2 wk at +50% of energy needs). AT and its determinants were measured together with body composition as assessed with the use of quantitative magnetic resonance, whole-body MRI, isotope dilution, and nitrogen and fluid balances. RESULTS Changes in body weight were +1.8 kg (overfeeding), -6.0 kg (CR), and +3.5 kg (refeeding). CR reduced fat mass and FFM by 114 and 159 g/d, respectively. Within FFM, skeletal muscle (-5%), liver (-13%), and kidneys (-8%) decreased. CR also led to reductions in REE (-266 kcal/d), respiratory quotient (-15%), heart rate (-14%), blood pressure (-7%), creatinine clearance (-12%), energy cost of walking (-22%), activity of the sympathetic nervous system (SNS) (-38%), and plasma leptin (-44%), insulin (-54%), adiponectin (-49%), 3,5,3'-tri-iodo-thyronine (T3) (-39%), and testosterone (-11%). AT was 108 kcal/d or 48% of the decrease in REE. Changes in FFM composition explained 36 kcal, which left 72 kcal/d for true AT. The decrease in AT became significant at ≤3 d of CR and was related to decreases in insulin secretion (r = 0.92, P < 0.001), heart rate (r = 0.60, P < 0.05), creatinine clearance (r = 0.79, P < 0.05), negative fluid balance (r = 0.51, P < 0.01), and the free water clearance rate (r = -0.90, P < 0.002). SNS activity and plasma leptin, ghrelin, and T3 and their changes with CR were not related to AT. CONCLUSION During early weight loss, AT is associated with a fall in insulin secretion and body fluid balance. This trial was registered at clinicaltrials.gov as NCT01737034.
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Affiliation(s)
| | | | | | - Wiebke Braun
- Institute of Human Nutrition and Food Science and
| | | | | | - Claus-Christian Glüer
- Clinic of Radiology and Neuroradiology, Biomedical Imaging, Molecular Imaging North Competence Centre, University Medical Center Schleswig Holstein, Christian-Albrechts University, Kiel, Germany
| | - Joseph J Kehayias
- the Body Composition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA; and
| | - Dieter Kiosz
- Institute of Human Nutrition and Food Science and
| | - Anja Bosy-Westphal
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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Lean and obese dietary phenotypes: differences in energy and substrate metabolism and appetite. Br J Nutr 2015; 114:1724-33. [DOI: 10.1017/s0007114515003402] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AbstractThis study aimed to characterise lean and obese phenotypes according to diet and body composition, and to compare fasting and postprandial appetite and metabolic profiles following a high-fat test meal. A total of ten lean (BMI<25 kg/m2) high-fat (LHF), ten lean low-fat (LLF; >40 and <30 % energy from fat) and ten obese (BMI>30 kg/m2) high-fat consumers (OHF; >40 % energy from fat) were recruited. Before and following the test meal (4727 kJ (1130 kcal), 77 % fat, 20 % carbohydrate (CHO) and 3 % protein), fasting plasma glucose, insulin, leptin, ghrelin, peptide YY (PYY), RER, RMR and subjective appetite ratings (AR) were measured for 6 h. Thereafter, subjects consumed a self-selected portion of a standardised post-test meal (40 % fat, 45 % CHO and 15 % protein) and reported AR. Fasting (P=0·01) and postprandial (P<0·001) fat oxidation was significantly higher in LHF than in LLF but was not different between LHF and OHF. Although similar between the lean groups, fasting and postprandial energy expenditures were significantly higher in OHF compared with LHF (P<0·01). Despite similar AR across groups, LLF consumed a relatively greater quantity of the post-test meal than did LHF (7·87 (sd 2·96) v. 7·23 (sd 2·67) g/kg, P=0·013). The lean groups showed appropriate changes in plasma ghrelin and PYY following the test meal, whereas the OHF group showed a blunted response. In conclusion, the LHF phenotype had a greater capacity for fat oxidation, which may be protective against weight gain. OHF individuals had a blunted appetite hormone response to the high-fat test meal, which may subsequently increase energy intake, driving further weight gain.
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Geisler C, Pourhassan M, Braun W, Schweitzer L, Müller MJ. The prediction of total skeletal muscle mass in a Caucasian population - comparison of Magnetic resonance imaging (MRI) and Dual-energy X-ray absorptiometry (DXA). Clin Physiol Funct Imaging 2015. [DOI: 10.1111/cpf.12282] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Corinna Geisler
- Institut für Humanernährung und Lebensmittelkunde; Christian-Albrechts-Universität zu Kiel; Kiel Germany
| | - Maryam Pourhassan
- Institut für Humanernährung und Lebensmittelkunde; Christian-Albrechts-Universität zu Kiel; Kiel Germany
| | - Wiebke Braun
- Institut für Humanernährung und Lebensmittelkunde; Christian-Albrechts-Universität zu Kiel; Kiel Germany
| | - Lisa Schweitzer
- Institut für Humanernährung und Lebensmittelkunde; Christian-Albrechts-Universität zu Kiel; Kiel Germany
| | - Manfred J. Müller
- Institut für Humanernährung und Lebensmittelkunde; Christian-Albrechts-Universität zu Kiel; Kiel Germany
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Abstract
Testosterone is a key hormone in the pathology of metabolic diseases such as obesity. Low testosterone levels are associated with increased fat mass (particularly central adiposity) and reduced lean mass in males. These morphological features are linked to metabolic dysfunction, and testosterone deficiency is associated with energy imbalance, impaired glucose control, reduced insulin sensitivity and dyslipidaemia. A bidirectional relationship between testosterone and obesity underpins this association indicated by the hypogonadal-obesity cycle and evidence weight loss can lead to increased testosterone levels. Androgenic effects on enzymatic pathways of fatty acid metabolism, glucose control and energy utilization are apparent and often tissue specific with differential effects noted in different regional fat depots, muscle and liver to potentially explain the mechanisms of testosterone action. Testosterone replacement therapy demonstrates beneficial effects on measures of obesity that are partially explained by both direct metabolic actions on adipose and muscle and also potentially by increasing motivation, vigour and energy allowing obese individuals to engage in more active lifestyles. The degree of these beneficial effects may be dependent on the treatment modality with longer term administration often achieving greater improvements. Testosterone replacement may therefore potentially be an effective adjunctive treatment for weight management in obese men with concomitant hypogonadism.
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Affiliation(s)
- D M Kelly
- Department of Human Metabolism, Medical School, The University of Sheffield, Sheffield, UK
| | - T H Jones
- Department of Human Metabolism, Medical School, The University of Sheffield, Sheffield, UK.,Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
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Hezel MP, Liu M, Schiffer TA, Larsen FJ, Checa A, Wheelock CE, Carlström M, Lundberg JO, Weitzberg E. Effects of long-term dietary nitrate supplementation in mice. Redox Biol 2015; 5:234-242. [PMID: 26068891 PMCID: PMC4475696 DOI: 10.1016/j.redox.2015.05.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 05/26/2015] [Accepted: 05/26/2015] [Indexed: 01/23/2023] Open
Abstract
Background Inorganic nitrate (NO3-) is a precursor of nitric oxide (NO) in the body and a large number of short-term studies with dietary nitrate supplementation in animals and humans show beneficial effects on cardiovascular health, exercise efficiency, host defense and ischemia reperfusion injury. In contrast, there is a long withstanding concern regarding the putative adverse effects of chronic nitrate exposure related to cancer and adverse hormonal effects. To address these concerns we performed in mice, a physiological and biochemical multi-analysis on the effects of long-term dietary nitrate supplementation. Design 7 week-old C57BL/6 mice were put on a low-nitrate chow and at 20 weeks-old were treated with NaNO3 (1 mmol/L) or NaCl (1 mmol/L, control) in the drinking water. The groups were monitored for weight gain, food and water consumption, blood pressure, glucose metabolism, body composition and oxygen consumption until one group was reduced to eight animals due to death or illness. At that point remaining animals were sacrificed and blood and tissues were analyzed with respect to metabolism, cardiovascular function, inflammation, and oxidative stress. Results Animals were supplemented for 17 months before final sacrifice. Body composition, oxygen consumption, blood pressure, glucose tolerance were measured during the experiment, and vascular reactivity and muscle mitochondrial efficiency measured at the end of the experiment with no differences identified between groups. Nitrate supplementation was associated with improved insulin response, decreased plasma IL-10 and a trend towards improved survival. Conclusions Long term dietary nitrate in mice, at levels similar to the upper intake range in the western society, is not detrimental. Long term dietary nitrate supplementation for 17 months in mice. Nitrate treatment in the upper range in the western society diet, has no adverse health effects. Chronic nitrate intake in mice improves fasting insulin and insulin response. Cardiovascular and inflammatory parameters were unchanged after long-term dietary nitrate treatment.
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Affiliation(s)
- Michael P Hezel
- Department of Physiology and Pharmacology, Karolinska Institutet, Nanna Svartz väg 2, Stockholm 171 77, Sweden.
| | - Ming Liu
- Department of Physiology and Pharmacology, Karolinska Institutet, Nanna Svartz väg 2, Stockholm 171 77, Sweden
| | - Tomas A Schiffer
- Department of Physiology and Pharmacology, Karolinska Institutet, Nanna Svartz väg 2, Stockholm 171 77, Sweden
| | - Filip J Larsen
- Department of Physiology and Pharmacology, Karolinska Institutet, Nanna Svartz väg 2, Stockholm 171 77, Sweden
| | - Antonio Checa
- Division of Physiological Chemistry 2, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Craig E Wheelock
- Division of Physiological Chemistry 2, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Mattias Carlström
- Department of Physiology and Pharmacology, Karolinska Institutet, Nanna Svartz väg 2, Stockholm 171 77, Sweden
| | - Jon O Lundberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Nanna Svartz väg 2, Stockholm 171 77, Sweden
| | - Eddie Weitzberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Nanna Svartz väg 2, Stockholm 171 77, Sweden.
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Abstract
PURPOSE OF REVIEW The purpose of this article is to examine the contemporary data linking testosterone therapy in overweight and obese men with testosterone deficiency to increased lean body mass, decreased fat mass, improvement in overall body composition and sustained weight loss. This is of paramount importance because testosterone therapy in obese men with testosterone deficiency represents a novel and a timely therapeutic strategy for managing obesity in men with testosterone deficiency. RECENT FINDINGS Long-term testosterone therapy in men with testosterone deficiency produces significant and sustained weight loss, marked reduction in waist circumference and BMI and improvement in body composition. Further, testosterone therapy ameliorates components of the metabolic syndrome. The aforementioned improvements are attributed to improved mitochondrial function, increased energy utilization, increased motivation and vigor resulting in improved cardio-metabolic function and enhanced physical activity. SUMMARY The implication of testosterone therapy in management of obesity in men with testosterone deficiency is of paramount clinical significance, as it produces sustained weight loss without recidivism. On the contrary, alternative therapeutic approaches other than bariatric surgery failed to produce significant and sustained outcome and exhibit a high rate of recidivism. These findings represent strong foundations for testosterone therapy in obese men with testosterone deficiency and should spur clinical research for better understanding of usefulness of testosterone therapy in treatment of underlying pathophysiological conditions of obesity.
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Affiliation(s)
- Abdulmaged M Traish
- Departments of Biochemistry and Urology, Boston University School of Medicine, Boston, Massachusetts, USA
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Genetic and Environmental Relationships Between Change in Weight and Insulin Resistance: The Healthy Twin Study. Twin Res Hum Genet 2014; 17:199-205. [DOI: 10.1017/thg.2014.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We aimed to investigate the association between weight change from 20 years of age and insulin resistance (IR), and genetic and environmental relationships between these traits. In 594 Korean twins and family members (209 men, 385 women, 44.0 ± 10.8 years old), the percentage of weight change was calculated using self-reported body weight at 20 years of age and currently measured bodyweight. IR traits were assessed using fasting plasma glucose and insulin, the homeostasis model assessment of IR index (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI). Linear mixed analysis was applied after adjusting for household, body mass index (BMI) at the age of 20 years, age, sex, alcohol, smoking, physical activity, and caloric intake. Heritabilities and genetic and environmental correlations were estimated after adjusting for covariates. In 55 monozygotic twin pairs discordant for HOMA-IR level by >0.3, a conditional logistic regression analysis was conducted regarding weight change. Increases in glucose, insulin, and HOMA-IR and a decrease in QUICKI were associated with a higher percentage of weight change (p < .05). Estimated heritabilities for IR traits were 0.401–0.606 (p < .001). In cross-trait relationships, environmental correlations were -0.43–0.42 (p < .05 for all IR), while genetic correlations were -0.27–0.27 (p < .05 for QUICKI, insulin, and HOMA-IR). In 55 pairs of monozygotic twins, the odds ratio (95% confidence interval) for having a higher level of HOMA-IR was 1.10 (1.03–1.17) with 1% increase in weight change since 20 years old, after adjusting for lifestyle-related factors. In conclusion, both genetic and environmental influences played significant roles in the positive association between weight change from 20 years of age and IR.
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