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Dörner R, Hägele FA, Müller MJ, Seidel U, Rimbach G, Bosy-Westphal A. Effect of exogenous and endogenous ketones on respiratory exchange ratio and glucose metabolism in healthy subjects. Am J Physiol Cell Physiol 2024; 326:C1027-C1033. [PMID: 38314726 DOI: 10.1152/ajpcell.00429.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
This study examined the effect of exogenous ketone bodies (KB) on oxygen consumption (V̇o2), carbon dioxide production (V̇co2), and glucose metabolism. The data were compared with the effects of endogenous ketonemia during both, a ketogenic diet or fasting. Eight healthy individuals [24.1 ± 2.5 yr, body mass index (BMI) 24.3 ± 3.1 kg/m2] participated in a crossover intervention study and were studied in a whole-room indirect calorimeter (WRIC) to assess macronutrient oxidation following four 24-h interventions: isocaloric controlled mixed diet (ISO), ISO supplemented with ketone salts (38.7 g of β-hydroxybutyrate/day, EXO), isocaloric ketogenic diet (KETO), and total fasting (FAST). A physical activity level of 1.65 was obtained. In addition to plasma KB, 24-h C-peptide and KB excretion rates in the urine and postprandial glucose and insulin levels were measured. Although 24-h KB excretion increased in response to KETO and FAST, there was a modest increase in response to EXO only (P < 0.05). When compared with ISO, V̇o2 significantly increased in KETO (P < 0.01) and EXO (P < 0.001), whereas there was no difference in FAST. V̇co2 increased in EXO but decreased in KETO (both P < 0.01) and FAST (P < 0.001), resulting in 24-h respiratory exchange ratios (RER) of 0.828 ± 0.024 (ISO) and 0.811 ± 0.024 (EXO) (P < 0.05). In response to EXO there were no differences in basal and postprandial glucose and insulin levels, as well as in insulin sensitivity. When compared with ISO, EXO, and KETO, FAST increased homeostatic model assessment β-cell function (HOMA-B) (all P < 0.05). In conclusion, at energy balance exogenous ketone salts decreased respiratory exchange ratio without affecting glucose tolerance.NEW & NOTEWORTHY Our findings revealed that during isocaloric nutrition, additional exogenous ketone salts increased V̇o2 and V̇co2 while lowering the respiratory exchange ratio (RER). Ketone salts had no effect on postprandial glucose metabolism.
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Affiliation(s)
- Rebecca Dörner
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Kiel, Germany
| | - Franziska A Hägele
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Kiel, Germany
| | - Ulrike Seidel
- Department of Food Sciences, Institute of Human Nutrition and Food Sciences, Kiel University, Kiel, Germany
| | - Gerald Rimbach
- Department of Food Sciences, Institute of Human Nutrition and Food Sciences, Kiel University, Kiel, Germany
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Kiel, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Silva AM, Campa F, Stagi S, Gobbo LA, Buffa R, Toselli S, Silva DAS, Gonçalves EM, Langer RD, Guerra-Júnior G, Machado DRL, Kondo E, Sagayama H, Omi N, Yamada Y, Yoshida T, Fukuda W, Gonzalez MC, Orlandi SP, Koury JC, Moro T, Paoli A, Kruger S, Schutte AE, Andreolli A, Earthman CP, Fuchs-Tarlovsky V, Irurtia A, Castizo-Olier J, Mascherini G, Petri C, Busert LK, Cortina-Borja M, Bailey J, Tausanovitch Z, Lelijveld N, Ghazzawi HA, Amawi AT, Tinsley G, Kangas ST, Salpéteur C, Vázquez-Vázquez A, Fewtrell M, Ceolin C, Sergi G, Ward LC, Heitmann BL, da Costa RF, Vicente-Rodriguez G, Cremasco MM, Moroni A, Shepherd J, Moon J, Knaan T, Müller MJ, Braun W, García-Almeida JM, Palmeira AL, Santos I, Larsen SC, Zhang X, Speakman JR, Plank LD, Swinburn BA, Ssensamba JT, Shiose K, Cyrino ES, Bosy-Westphal A, Heymsfield SB, Lukaski H, Sardinha LB, Wells JC, Marini E. The bioelectrical impedance analysis (BIA) international database: aims, scope, and call for data. Eur J Clin Nutr 2023; 77:1143-1150. [PMID: 37532867 DOI: 10.1038/s41430-023-01310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) is a technique widely used for estimating body composition and health-related parameters. The technology is relatively simple, quick, and non-invasive, and is currently used globally in diverse settings, including private clinicians' offices, sports and health clubs, and hospitals, and across a spectrum of age, body weight, and disease states. BIA parameters can be used to estimate body composition (fat, fat-free mass, total-body water and its compartments). Moreover, raw measurements including resistance, reactance, phase angle, and impedance vector length can also be used to track health-related markers, including hydration and malnutrition, and disease-prognostic, athletic and general health status. Body composition shows profound variability in association with age, sex, race and ethnicity, geographic ancestry, lifestyle, and health status. To advance understanding of this variability, we propose to develop a large and diverse multi-country dataset of BIA raw measures and derived body components. The aim of this paper is to describe the 'BIA International Database' project and encourage researchers to join the consortium. METHODS The Exercise and Health Laboratory of the Faculty of Human Kinetics, University of Lisbon has agreed to host the database using an online portal. At present, the database contains 277,922 measures from individuals ranging from 11 months to 102 years, along with additional data on these participants. CONCLUSION The BIA International Database represents a key resource for research on body composition.
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Affiliation(s)
- Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal.
| | - Francesco Campa
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Silvia Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Luís A Gobbo
- Skeletal Muscle Assessment Laboratory, Physical Education Department, School of Technology and Science, São Paulo State University, Presidente Prudente, 19060-900, Brazil
| | - Roberto Buffa
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Stefania Toselli
- Department for Life Quality Studies, University of Bologna, 47921, Rimini, Italy
| | - Diego Augusto Santos Silva
- Research Center of Kinanthropometry and Human Performance, Sports Center, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Ezequiel M Gonçalves
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Raquel D Langer
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Gil Guerra-Júnior
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Dalmo R L Machado
- Laboratory of Kinanthropometry and Human Performance, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, 05508-030, São Paulo, Brazil
| | - Emi Kondo
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Naomi Omi
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Wataru Fukuda
- Yokohama Sports Medical Center, Yokohama Sport Association, Kanagawa, 222-0036, Japan
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, 96010-610 Pelotas, Brazil
| | - Silvana P Orlandi
- Nutrition Department, Federal University of Pelotas, 96010-610, Pelotas, Brazil
| | - Josely C Koury
- Nutrition Institute, State University of Rio de Janeiro, 20550-013, Rio de Janeiro, Brazil
| | - Tatiana Moro
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Antonio Paoli
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Salome Kruger
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, 2520, South Africa
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, NSW, Australia
| | | | | | | | - Alfredo Irurtia
- National Institute of Physical Education of Catalonia (INEFC), University of Barcelona (UB), Barcelona, Spain
| | - Jorge Castizo-Olier
- School of Health Sciences, TecnoCampus, Pompeu Fabra University, Barcelona, Spain
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Cristian Petri
- Department of Sports and Computer Science, Section of Physical Education and Sports, Universidad Pablo de Olavide, Seville, Spain
| | - Laura K Busert
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | | | | | - Hadeel Ali Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Adam Tawfiq Amawi
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, Al-Salt, Jordan
| | - Grant Tinsley
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Suvi T Kangas
- International Rescue Committee, New York, NY, 10168, USA
| | - Cécile Salpéteur
- Department of Expertise and Advocacy, Action contre la Faim, 93358, Montreuil, France
| | - Adriana Vázquez-Vázquez
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mary Fewtrell
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Chiara Ceolin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Berit L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
- Section for general Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Roberto Fernandes da Costa
- Department of Physical Education, Research Group in Physical Activity and Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - German Vicente-Rodriguez
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009, Zaragoza, Spain
| | - Margherita Micheletti Cremasco
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - Alessia Moroni
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jordan Moon
- United States Sports Academy, Daphne, AL, 36526, USA
| | - Tzachi Knaan
- Weight Management, Metabolism & Sports Nutrition Clinic, Metabolic Lab, Tel-Aviv, Tel Aviv-Yafo, Israel
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - Wiebke Braun
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - José M García-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010, Malaga, Spain
| | | | - Inês Santos
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
| | - Sofus C Larsen
- Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Lindsay D Plank
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jude Thaddeus Ssensamba
- Center for Innovations in Health Africa (CIHA Uganda), Kampala, Uganda
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Keisuke Shiose
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
| | - Edilson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory. Physical Education and Sport Center, State University of Londrina, Rod. Celso Garcia Cid, Km 380, 86057-970, Londrina-PR, Brazil
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | | | - Henry Lukaski
- Department of Kinesiology and Public Health Education, Hyslop Sports Center, University of North Dakota Grand Forks, Grand Forks, ND, 58202, USA
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal
| | - Jonathan C Wells
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
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Müller MJ, Matthews DE. The interrelationships of diet, body composition and metabolism. Curr Opin Clin Nutr Metab Care 2023; 26:399-400. [PMID: 37534959 DOI: 10.1097/mco.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
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McCarthy C, Tinsley GM, Bosy-Westphal A, Müller MJ, Shepherd J, Gallagher D, Heymsfield SB. Publisher Correction: Total and regional appendicular skeletal muscle mass prediction from dual-energy X-ray absorptiometry body composition models. Sci Rep 2023; 13:12922. [PMID: 37558734 PMCID: PMC10412529 DOI: 10.1038/s41598-023-39896-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Affiliation(s)
- Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, USA
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Dympna Gallagher
- Department of Medicine, College of Physicians and Surgeons, New York Obesity Research Center, Columbia University, New York, NY, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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Hägele FA, Dörner R, Koop J, Lübken M, Seidel U, Rimbach G, Müller MJ, Bosy-Westphal A. Impact of one-day fasting, ketogenic diet or exogenous ketones on control of energy balance in healthy participants. Clin Nutr ESPEN 2023; 55:292-299. [PMID: 37202059 DOI: 10.1016/j.clnesp.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/02/2023] [Accepted: 03/23/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND & AIMS Oral ketone supplements may mimic the beneficial effects of endogenous ketones on energy metabolism as β-hydroxybutyrate has been proposed to increase energy expenditure and improve body weight regulation. Therefore, our objective was to compare the effects of a one-day isocaloric ketogenic diet, fasting and supplementation with ketone salts on energy expenditure and appetite perception. METHODS Eight healthy young adults (4 women, 4 men, age 24 ± 3 years, BMI 24.3 ± 3.1 kg/m2) participated in a randomized cross-over trial with four 24 h-interventions in a whole room indirect calorimeter at a physical activity level of 1.65: (i) total fasting (FAST), (ii) isocaloric ketogenic diet (3.1% energy from carbohydrates (CHO), KETO), (iii) isocaloric control diet (47.4% energy from CHO, ISO), and (iv) ISO supplemented with 38.7 g/d ketone salts (exogenous ketones, EXO). Effects on serum ketone levels (15 h-iAUC), energy metabolism (total energy expenditure, TEE; sleeping energy expenditure, SEE; macronutrient oxidation) and subjective appetite were measured. RESULTS Compared to ISO, ketone levels were considerably higher with FAST and KETO and little higher with EXO (all p > 0.05). Total and sleeping energy expenditure did not differ between ISO, FAST and EXO whereas KETO increased TEE (+110 ± 54 kcal/d vs. ISO, p < 0.05) and SEE (+201 ± 90 kcal/d vs. ISO, p < 0.05). CHO oxidation was slightly decreased with EXO compared to ISO (-48 ± 27 g/d, p < 0.05) resulting in a positive CHO balance (p < 0.05). No differences between the interventions were found for subjective appetite ratings (all p > 0.05). CONCLUSION A 24 h-ketogenic diet may contribute to maintain a neutral energy balance by increasing energy expenditure. Exogenous ketones in addition to an isocaloric diet did not improve regulation of energy balance. CLINICAL TRIAL REGISTRATION NCT04490226 https://clinicaltrials.gov/.
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Affiliation(s)
- Franziska A Hägele
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Rebecca Dörner
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Jana Koop
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Marie Lübken
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Ulrike Seidel
- Department of Food Sciences, Institute of Human Nutrition and Food Sciences, Kiel University, Hermann-Rodewald-Strasse 6, 24098 Kiel, Germany
| | - Gerald Rimbach
- Department of Food Sciences, Institute of Human Nutrition and Food Sciences, Kiel University, Hermann-Rodewald-Strasse 6, 24098 Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Kiel University, Düsternbrooker Weg 17, 24105 Kiel, Germany.
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Müller MJ, Bosy-Westphal A. Metabolic profiling of liver fat-Limited insights by big data research so far. Obesity (Silver Spring) 2023; 31:898-899. [PMID: 36878668 DOI: 10.1002/oby.23713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 03/08/2023]
Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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Müller MJ, Heymsfield SB, Bosy-Westphal A. Changes in body composition and homeostatic control of resting energy expenditure during dietary weight loss. Obesity (Silver Spring) 2023; 31:892-895. [PMID: 36863769 DOI: 10.1002/oby.23703] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/31/2022] [Accepted: 01/04/2023] [Indexed: 03/04/2023]
Abstract
Adaptive thermogenesis (AT) is the mass-independent decrease in energy expenditure (EE) in response to caloric restriction and weight loss. AT becomes manifest throughout all periods of weight loss and persists during subsequent weight maintenance. AT occurs in resting and nonresting energy expenditure as ATREE and ATNREE , respectively. ATREE appears in different phases of weight loss, each with likely different mechanisms. By contrast, during weight maintenance after weight loss, ATNREE exceeds ATREE . Some of the mechanisms of AT are known now and others are not. Future studies on AT will need an appropriate conceptual framework within which to design experiments and interpret results.
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Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, LSU System, Baton Rouge, Louisiana, USA
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Walowski CO, Herpich C, Enderle J, Braun W, Both M, Hasler M, Müller MJ, Norman K, Bosy-Westphal A. Determinants of bone mass in older adults with normal- and overweight derived from the crosstalk with muscle and adipose tissue. Sci Rep 2023; 13:5030. [PMID: 36977715 PMCID: PMC10050471 DOI: 10.1038/s41598-023-31642-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
Lower bone mass in older adults may be mediated by the endocrine crosstalk between muscle, adipose tissue and bone. In 150 community-dwelling adults (59-86 years, BMI 17-37 kg/m2; 58.7% female), skeletal muscle mass index, adipose tissue and fat mass index (FMI) were determined. Levels of myokines, adipokines, osteokines, inflammation markers and insulin were measured as potential determinants of bone mineral content (BMC) and density (BMD). FMI was negatively associated with BMC and BMD after adjustment for mechanical loading effects of body weight (r-values between -0.37 and -0.71, all p < 0.05). Higher FMI was associated with higher leptin levels in both sexes, with higher hsCRP in women and with lower adiponectin levels in men. In addition to weight and FMI, sclerostin, osteocalcin, leptin × sex and adiponectin were independent predictors of BMC in a stepwise multiple regression analysis. Muscle mass, but not myokines, showed positive correlations with bone parameters that were weakened after adjusting for body weight (r-values between 0.27 and 0.58, all p < 0.01). Whereas the anabolic effect of muscle mass on bone in older adults may be partly explained by mechanical loading, the adverse effect of obesity on bone is possibly mediated by low-grade inflammation, higher leptin and lower adiponectin levels.
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Affiliation(s)
- Carina O Walowski
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Catrin Herpich
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Geriatrics and Medical Gerontology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
| | - Janna Enderle
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Wiebke Braun
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
| | - Mario Hasler
- Applied Statistics, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts-University, Kiel, Germany
| | - Manfred J Müller
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany
| | - Kristina Norman
- Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
- Department of Geriatrics and Medical Gerontology, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Düsternbrooker Weg 17, 24105, Kiel, Germany.
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McCarthy C, Tinsley GM, Bosy-Westphal A, Müller MJ, Shepherd J, Gallagher D, Heymsfield SB. Total and regional appendicular skeletal muscle mass prediction from dual-energy X-ray absorptiometry body composition models. Sci Rep 2023; 13:2590. [PMID: 36788294 PMCID: PMC9929067 DOI: 10.1038/s41598-023-29827-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
Sarcopenia, sarcopenic obesity, frailty, and cachexia have in common skeletal muscle (SM) as a main component of their pathophysiology. The reference method for SM mass measurement is whole-body magnetic resonance imaging (MRI), although dual-energy X-ray absorptiometry (DXA) appendicular lean mass (ALM) serves as an affordable and practical SM surrogate. Empirical equations, developed on relatively small and diverse samples, are now used to predict total body SM from ALM and other covariates; prediction models for extremity SM mass are lacking. The aim of the current study was to develop and validate total body, arm, and leg SM mass prediction equations based on a large sample (N = 475) of adults evaluated with whole-body MRI and DXA for SM and ALM, respectively. Initial models were fit using ordinary least squares stepwise selection procedures; covariates beyond extremity lean mass made only small contributions to the final models that were developed using Deming regression. All three developed final models (total, arm, and leg) had high R2s (0.88-0.93; all p < 0.001) and small root-mean square errors (1.74, 0.41, and 0.95 kg) with no bias in the validation sample (N = 95). The new total body SM prediction model (SM = 1.12 × ALM - 0.63) showed good performance, with some bias, against previously reported DXA-ALM prediction models. These new total body and extremity SM prediction models, developed and validated in a large sample, afford an important and practical opportunity to evaluate SM mass in research and clinical settings.
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Affiliation(s)
- Cassidy McCarthy
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, USA
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Dympna Gallagher
- Department of Medicine, College of Physicians and Surgeons, New York Obesity Research Center, Columbia University, New York, NY, USA
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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11
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Walowski CO, Herpich C, Enderle J, Braun W, Both M, Hasler M, Müller MJ, Norman K, Bosy-Westphal A. Analysis of the adiponectin paradox in healthy older people. J Cachexia Sarcopenia Muscle 2023; 14:270-278. [PMID: 36401062 PMCID: PMC9891976 DOI: 10.1002/jcsm.13127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/04/2022] [Accepted: 10/25/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND It remains unknown why adiponectin levels are associated with poor physical functioning, skeletal muscle mass and increased mortality in older populations. METHODS In 190 healthy adults (59-86 years, BMI 17-37 kg/m2 , 56.8% female), whole body skeletal muscle mass (normalized by height, SMI, kg/m2 ), muscle and liver fat were determined by magnetic resonance imaging. Bone mineral content (BMC) and density (BMD) were assessed by dual X-ray absorptiometry (n = 135). Levels of insulin-like growth factor 1 (IGF-1), insulin, inflammation markers, leptin and fibroblast growth factor 21 were measured as potential determinants of the relationship between adiponectin and body composition. RESULTS Higher adiponectin levels were associated with a lower SMI (r = -0.23, P < 0.01), BMC (r = -0.17, P < 0.05) and liver fat (r = -0.20, P < 0.05) in the total population and with higher muscle fat in women (r = 0.27, P < 0.01). By contrast, IGF-1 showed positive correlations with SMI (r = 0.33), BMD (r = 0.37) and BMC (r = 0.33) (all P < 0.01) and a negative correlation with muscle fat (r = -0.17, P < 0.05). IGF-1 was negatively associated with age (r = -0.21, P < 0.01) and with adiponectin (r = -0.15, P < 0.05). Stepwise regression analyses revealed that IGF-1, insulin and leptin explained 18% of the variance in SMI, and IGF-1, leptin and age explained 16% of the variance in BMC, whereas adiponectin did not contribute to these models. CONCLUSIONS Associations between higher adiponectin levels and lower muscle or bone mass in healthy older adults may be explained by a decrease in IGF-1 with increasing adiponectin levels.
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Affiliation(s)
- Carina O Walowski
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Catrin Herpich
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.,Department of Geriatrics and Medical Gerontology, Charité Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany
| | - Janna Enderle
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Wiebke Braun
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Mario Hasler
- Applied Statistics, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts-University, Kiel, Germany
| | - Manfred J Müller
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Kristina Norman
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany.,Department of Geriatrics and Medical Gerontology, Charité Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Nuthetal, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Anja Bosy-Westphal
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
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12
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Lindner M, Geisler C, Rembarz K, Hummitzsch L, Radke DI, Schulte DM, Müller MJ, Bosy-Westphal A, Elke G. Resting Energy Expenditure in the Critically Ill and Healthy Elderly-A Retrospective Matched Cohort Study. Nutrients 2023; 15:nu15020303. [PMID: 36678174 PMCID: PMC9861149 DOI: 10.3390/nu15020303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
The use of indirect calorimetry to measure resting energy expenditure (mREE) is widely recommended as opposed to calculating REE (cREE) by predictive equations (PE). The aim of this study was to compare mREE with cREE in critically ill, mechanically ventilated patients aged ≥ 75 years and a healthy control group matched by age, gender and body mass index. The primary outcome was the PE accuracy rate of mREE/cREE, derived using Bland Altman plots. Secondary analyses included linear regression analyses for determinants of intraindividual mREE/cREE differences in the critically ill and interindividual mREE differences in the matched healthy cohort. In this retrospective study, 90 critically ill patients (median age 80 years) and 58 matched healthy persons were included. Median mREE was significantly higher in the critically ill (1457 kcal/d) versus the healthy cohort (1351 kcal/d), with low PE accuracy rates (21% to 49%). Independent predictors of mREE/cREE differences in the critically ill were body temperature, heart rate, FiO2, hematocrit, serum sodium and urea. Body temperature, respiratory rate, and FiO2 were independent predictors of interindividual mREE differences (critically ill versus healthy control). In conclusion, the commonly used PE in the elderly critically ill are inaccurate. Respiratory, metabolic and energy homeostasis variables may explain intraindividual mREE/cREE as well as interindividual mREE differences.
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Affiliation(s)
- Matthias Lindner
- Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus 12, 24105 Kiel, Germany
- Correspondence:
| | - Corinna Geisler
- Institute of Diabetes and Clinical Metabolic Research, University Medical Center Schleswig-Holstein, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Kristina Rembarz
- Department of Human Nutrition and Food Science, Christian-Albrechts-University of Kiel, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Lars Hummitzsch
- Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus 12, 24105 Kiel, Germany
| | - David I. Radke
- Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus 12, 24105 Kiel, Germany
| | - Dominik M. Schulte
- Institute of Diabetes and Clinical Metabolic Research, University Medical Center Schleswig-Holstein, Düsternbrooker Weg 17, 24105 Kiel, Germany
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine I, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus 12, 24105 Kiel, Germany
| | - Manfred J. Müller
- Department of Human Nutrition and Food Science, Christian-Albrechts-University of Kiel, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrechts-University of Kiel, Düsternbrooker Weg 17, 24105 Kiel, Germany
| | - Gunnar Elke
- Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 Haus 12, 24105 Kiel, Germany
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13
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Kundermann B, Müller MJ, Speier C, Cabanel N. [Sleep in patients of a memory clinic : Clinical characteristics of the discrepancy between subjective and objective assessment]. Z Gerontol Geriatr 2022; 55:680-688. [PMID: 34609633 DOI: 10.1007/s00391-021-01977-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 09/09/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Dementia is often accompanied by sleep disturbances, whereby the diagnostics with subjective procedures and objective methods can produce discrepant results. The frequency and clinical characteristics of patients, whose subjective sleep efficiency was unimpaired and was in contrast to an objectively conspicuous sleep efficiency in the sense of an overestimation, were investigated in a memory consultation. METHODS On 2 consecutive days, patients underwent guideline-oriented diagnostics for dementia (including mini-mental status examination, MMSE and clinical dementia rating, CDR), supplemented by a subjective (Pittsburgh sleep quality index, PSQI) and objective (overnight actigraphy) sleep assessment. Overestimation of sleep efficiency was defined as a subjective sleep efficiency (SSE) of ≥85% with an actigraphic sleep efficiency (ASE) of <85%. RESULTS Of 45 patients (74.4 ± 7.8 years; 26 f/19 m; CDR < 1: n = 16, CDR = 1: n = 28; diagnostic groups according to ICD-10: F0: n = 39, F3: n = 5, Z03.x: n = 1) 10 showed an overestimation of sleep efficiency, who showed a lower MMSE score and a higher proportion of patients with a dementia syndrome (CDR = 1) when compared with the other three groups of SSE and ASE ≥85% (n = 17), SSE and ASE <85% (n = 9) and SSE <85% with ASE ≥85% (n = 9). Binary regression showed that MMSE remained an important predictor for overestimation of sleep efficiency. CONCLUSION Cognitive deficits in memory clinic patients appear to contribute to a poorer perception and/or an underreporting of objectively disturbed sleep. This could promote false negative subjective screening results in a diagnostic process in which a comprehensive sleep assessment is not routinely considered.
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Affiliation(s)
- B Kundermann
- Vitos Klinik für Psychiatrie und Psychotherapie Gießen, Akademisches Lehrkrankenhaus, Justus-Liebig-Universität Gießen, Licher Str. 106, 35394, Gießen, Deutschland.
- Klinik für Psychiatrie und Psychotherapie, Philipps-Universität Marburg, Marburg, Deutschland.
| | - M J Müller
- Oberberg Gruppe, Berlin, Deutschland
- Fachbereich Medizin, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - C Speier
- Vitos Klinik für Psychiatrie und Psychotherapie Gießen, Akademisches Lehrkrankenhaus, Justus-Liebig-Universität Gießen, Licher Str. 106, 35394, Gießen, Deutschland
| | - N Cabanel
- Klinik für Psychiatrie und Psychotherapie, Philipps-Universität Marburg, Marburg, Deutschland
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14
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Dörner R, Hägele FA, Koop J, Rising R, Foerster T, Olsen T, Hasler M, Müller MJ, Bosy-Westphal A. Validation of energy expenditure and macronutrient oxidation measured by two new whole-room indirect calorimeters. Obesity (Silver Spring) 2022; 30:1796-1805. [PMID: 35927795 DOI: 10.1002/oby.23527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study was to validate two new whole-room indirfect calorimeters according to Room Indirect Calorimetry Operating and Reporting Standards (RICORS 1.0). METHODS For technical validation, 16 propane combustion tests were performed to determine accuracy and precision of energy expenditure (EE) and ventilation rates of oxygen (VO2 ), carbon dioxide (VCO2 ), and respiratory exchange ratio (VCO2 /VO2 ). For biological validation, eight participants (mean [SD], age 24.1 [2.5] years; BMI 24.3 [3.1] kg/m2 ) underwent four 24-hour protocols under highly standardized conditions: (1) isocaloric sedentary, (2) fasting sedentary, (3) isocaloric active, and (4) fasting active. Reliability (coefficients of variation [CV]) and minimal detectable changes (MDC) were calculated for 24-hour EE, sleeping metabolic rate (SMR), physical activity energy expenditure (PAEE), thermic effect of food (TEF), and macronutrient oxidation rates. RESULTS Technical validation showed high reliability and recovery rates for VO2 (0.75% and 100.8%, respectively), VCO2 (0.49% and 100.6%), and EE (0.54% and 98.2%). Biological validation revealed CV and MDC for active conditions of 1.4% and 4.3% for 24-hour EE, 1.7% and 5.9% for SMR, and 30.2% and 38.4% for TEF, as well as 5.8% and 10.5% for PAEE, respectively. Mean CV and MDC for macronutrient oxidation rates were 9.9% and 22.9%, respectively. CONCLUSIONS The precision of 24-hour EE and SMR was high, whereas it was lower for PAEE and poor for TEF.
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Affiliation(s)
- Rebecca Dörner
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Franziska A Hägele
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Jana Koop
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | | | | | - Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mario Hasler
- Applied Statistic, Agricultural and Food Economics Faculty, Christian-Albrechts University, Kiel, Germany
| | - Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
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15
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Müller MJ, Bosy-Westphal A. On Appropriate Phenotypes of Patients With Obesity. J Clin Endocrinol Metab 2022; 107:e3526-e3527. [PMID: 35435966 DOI: 10.1210/clinem/dgac226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts University Kiel, Kiel, Germany
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Casanova N, Bosy-Westphal A, Beaulieu K, Finlayson G, Stubbs RJ, Blundell J, Hopkins M, Müller MJ. Associations between high-metabolic rate organ masses and fasting hunger: A study using whole-body magnetic resonance imaging in healthy males. Physiol Behav 2022; 250:113796. [PMID: 35358549 DOI: 10.1016/j.physbeh.2022.113796] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 03/11/2022] [Accepted: 03/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Fat-free mass (FFM) has been shown to be positively associated with hunger and energy intake, an association mediated by resting metabolic rate (RMR). However, FFM comprises a heterogeneous group of tissues with distinct metabolic rates, and it remains unknown how specific high-metabolic rate organs contribute to the degree of perceived hunger. OBJECTIVE To examine whether FFM and its anatomical components were associated with fasting hunger when assessed at the tissue-organ level. DESIGN Body composition (quantitative magnetic resonance and magnetic resonance imaging), RMR and whole-body glucose oxidation (indirect calorimetry), HOMA-index as a marker of insulin sensitivity, nitrogen balance and fasting hunger (visual analogue scales) were assessed in 21 healthy males (age = 25 ± 3y; BMI = 23.4 ± 2.1 kg/m2) after 3 days of controlled energy balance. RESULTS FFM (rs = 0.39; p = 0.09), RMR (rs = 0.52; p = 0.02) and skeletal muscle mass (rs = 0.57; p = 0.04), but not fat mass (rs = -0.01; p = 0.99), were positively associated with fasting hunger. The association between the combined mass of high-metabolic rate organs (i.e., brain, liver, kidneys and heart; rs = 0.58; p = 0.006) and fasting hunger was stronger than with FFM as a uniform body component. The strongest individual association was between liver mass and fasting hunger (rs = 0.51; p = 0.02). No associations were observed between glucose parameters, markers of insulin sensitivity and fasting hunger. The encephalic measure, an index of brain-to-body energy allocation, was negatively associated with fasting hunger (rs = -0.51; p = 0.02). CONCLUSIONS Fasting hunger was more strongly associated with the combined mass of high-metabolic rate organs than with FFM as a uniform body component, highlighting the importance of integrating individual tissue-organ masses and their functional correlates into homeostatic models of human appetite. The association between liver mass and fasting hunger may reflect its role in ensuring the brain's basal energy needs are met.
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Affiliation(s)
- Nuno Casanova
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, United Kingdom; KinesioLab, Research Unit in Human Movement Analysis, Piaget Institute, Av. Jorge Peixinho 30 Quinta da Arreinela, 2805-059 Almada, Portugal.
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Graham Finlayson
- Appetite Control and Energy Balance Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - R James Stubbs
- Appetite Control and Energy Balance Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - John Blundell
- Appetite Control and Energy Balance Group, School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Mark Hopkins
- School of Food Science and Nutrition, Faculty of Environment, University of Leeds, Leeds, LS2 9JT, United Kingdom.
| | - Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
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Müller MJ, Bosy-Westphal A, Braun W, Wong MC, Shepherd JA, Heymsfield SB. What Is a 2021 Reference Body? Nutrients 2022; 14:nu14071526. [PMID: 35406138 PMCID: PMC9003358 DOI: 10.3390/nu14071526] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/25/2022] [Accepted: 04/01/2022] [Indexed: 01/25/2023] Open
Abstract
The historical 1975 Reference Man is a ‘model’ that had been used as a basis for the calculation of radiation doses, metabolism, pharmacokinetics, sizes for organ transplantation and ergonomic optimizations in the industry, e.g., to plan dimensions of seats and other formats. The 1975 Reference Man was not an average individual of a population; it was based on the multiple characteristics of body compositions that at that time were available, i.e., mainly from autopsy data. Faced with recent technological advances, new mathematical models and socio-demographic changes within populations characterized by an increase in elderly and overweight subjects a timely ‘state-of-the-art’ 2021 Reference Body are needed. To perform this, in vivo human body composition data bases in Kiel, Baton Rouge, San Francisco and Honolulu were analyzed and detailed 2021 Reference Bodies, and they were built for both sexes and two age groups (≤40 yrs and >40 yrs) at BMIs of 20, 25, 30 and 40 kg/m2. We have taken an integrative approach to address ‘structure−structure’ and ‘structure−function’ relationships at the whole-body level using in depth body composition analyses as assessed by gold standard methods, i.e., whole body Magnetic Resonance Imaging (MRI) and the 4-compartment (4C-) model (based on deuterium dilution, dual-energy X-ray absorptiometry and body densitometry). In addition, data obtained by a three-dimensional optical scanner were used to assess body shape. The future applications of the 2021 Reference Body relate to mathematical modeling to address complex metabolic processes and pharmacokinetics using a multi-level/multi-scale approach defining health within the contexts of neurohumoral and metabolic control.
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Affiliation(s)
- Manfred J. Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, D 24105 Kiel, Germany; (A.B.-W.); (W.B.)
- Correspondence: ; Tel.: +49-43188-05671; Fax: +49-43188-05679
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, D 24105 Kiel, Germany; (A.B.-W.); (W.B.)
| | - Wiebke Braun
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, D 24105 Kiel, Germany; (A.B.-W.); (W.B.)
| | - Michael C. Wong
- University of Hawaii Cancer Center, Shepherd Res. Lab, Honolulu, HI 96816, USA; (M.C.W.); (J.A.S.)
- Graduate Program in Nutritional Sciences, University of Hawaii at Manoa, Honolulu, HI 96822, USA
| | - John A. Shepherd
- University of Hawaii Cancer Center, Shepherd Res. Lab, Honolulu, HI 96816, USA; (M.C.W.); (J.A.S.)
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Heymsfield SB, Smith B, Chung EA, Watts KL, Gonzalez MC, Yang S, Heo M, Thomas DM, Turner D, Bosy-Westphal A, Müller MJ. Phenotypic differences between people varying in muscularity. J Cachexia Sarcopenia Muscle 2022; 13:1100-1112. [PMID: 35170220 PMCID: PMC8978029 DOI: 10.1002/jcsm.12959] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/20/2022] [Accepted: 02/01/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Body mass is the primary metabolic compartment related to a vast number of clinical indices and predictions. The extent to which skeletal muscle (SM), a major body mass component, varies between people of the same sex, weight, height, and age is largely unknown. The current study aimed to explore the magnitude of muscularity variation present in adults and to examine if variation in muscularity associates with other body composition and metabolic measures. METHODS Muscularity was defined as the difference (residual) between a person's actual and model-predicted SM mass after controlling for their weight, height, and age. SM prediction models were developed using data from a convenience sample of 492 healthy non-Hispanic (NH) White adults (ages 18-80 years) who had total body SM and SM surrogate, appendicular lean soft tissue (ALST), measured with magnetic resonance imaging and dual-energy X-ray absorptiometry, respectively; residual SM (SMR ) and ALST were expressed in kilograms and kilograms per square meter. ALST mass was also evaluated in a population sample of 8623 NH-White adults in the 1999-2006 National Health and Nutrition Examination Survey. Associations between muscularity and variation in the residual mass of other major organs and tissues and resting energy expenditure were evaluated in the convenience sample. RESULTS The SM, on average, constituted the largest fraction of body weight in men and women up to respective BMIs of 35 and 25 kg/m2 . SM in the convenience sample varied widely with a median of 31.2 kg and an SMR inter-quartile range/min/max of 3.35 kg/-10.1 kg/9.0 kg in men and 21.1 kg and 2.59 kg/-7.2 kg/7.5 kg in women; per cent of body weight as SM at 25th and 75th percentiles for men were 33.1% and 39.6%; corresponding values in women were 24.2% and 30.8%; results were similar for SMR indices and for ALST measures in the convenience and population samples. Greater muscularity in the convenience sample was accompanied by a smaller waist circumference (men/women: P < 0.001/=0.085) and visceral adipose tissue (P = 0.014/0.599), larger liver (P = 0.065/<0.001), kidneys (P = 0.051/<0.009), and bone mineral (P < 0.001/<0.001), and larger magnitude resting energy expenditure (P < 0.001/<0.001) than predicted for the same sex, age, weight, and height. CONCLUSIONS Muscle mass is the largest body compartment in most adults without obesity and is widely variable in mass across people of similar body size and age; and high muscularity is accompanied by distinct body composition and metabolic characteristics. This previously unrecognized heterogeneity in muscularity in the general population has important clinical and research implications.
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Affiliation(s)
| | - Brooke Smith
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - Elizabeth A Chung
- Department of Mathematical Sciences, United States Military Academy West Point, West Point, NY, USA
| | - Krista L Watts
- Department of Mathematical Sciences, United States Military Academy West Point, West Point, NY, USA
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Shengping Yang
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, West Point, NY, USA
| | | | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
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Klehs S, Schneider HE, Backhoff D, Müller MJ, Paul T, Krause U. Repeat Radiofrequency Catheter Ablation of Atrial Tachycardias in Patients with Congenital Heart Disease. J Cardiovasc Electrophysiol 2022; 33:943-952. [PMID: 35199408 DOI: 10.1111/jce.15422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/07/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Atrial tachycardias (AT) in patients with congenital heart disease (CHD) are significantly contributing to morbidity and mortality. Aim of this study was to evaluate the long-term course of CHD patients requiring repeat ablation procedures (RAP) of AT. PATIENTS AND METHODS All 144 patients with CHD who had undergone ablation of AT at our center between January 2003 and October 2018 were enrolled. Patients were classified according to complexity of CHD: complex CHD (cCHD), moderate CHD (mCHD) and simple CHD (sCHD). RESULTS A total of 101 RAP were performed in 64 patients. One RAP was performed in n=40, two in n=13, three in n=10 and 5 in n=1. Acute success rate was 82% (83/101) and was not associated with complexity of CHD (p=1.0). Number of procedures was lower in patients with sCHD than in patients with mCHD and cCHD (sCHD 1.3±0.6, mCHD 1.8±1.0 and cCHD 1.8±1.1, p=0.04). RAP were most frequent in patients after Fontan palliation or Atrial switch procedure (2.0±1.1 (n=41) vs. 1.6±0.9 all others, p=0.016) and in patients with multiple unstable AT´s (2.5±1.1 (n=11) vs. 1.7±1.0, p=0.008). Major complications occurred in 4/101 procedures. Complete follow-up was available in 125 patients. Since last RAP 73% of the patients were in sinus/atrial rhythm and 34/125 patients (27%) with AT recurrence did not require re-ablation with mean follow-up of 52±40 months. CONCLUSIONS Recurrences after ablation of AT in CHD patients were frequent. After RAP promising long-term results could be achieved. Data encourage repetitive ablation procedures in this patient population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- S Klehs
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - H E Schneider
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - D Backhoff
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - M J Müller
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - T Paul
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - U Krause
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
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Casanova N, Bosy-Westphal A, Müller MJ, Beaulieu K, Blundell J, Finlayson G, Hopkins M. The Between-Subject Variance in Fasting Hunger in Healthy Men is Better Explained When Fat-free Mass is Assessed at the Tissue-Organ Level. Appetite 2022. [DOI: 10.1016/j.appet.2021.105561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Müller MJ, Heymsfield SB, Bosy-Westphal A. Are metabolic adaptations to weight changes an artefact? Am J Clin Nutr 2021; 114:1386-1395. [PMID: 34134143 DOI: 10.1093/ajcn/nqab184] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 05/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adaptive thermogenesis (AT) is currently defined as the fat-free mass (FFM)-independent change in resting energy expenditure (REE) in response to caloric restriction (CR) or overfeeding (OF). So far, the impact of changes in the anatomical and molecular composition of FFM on AT has not been addressed. OBJECTIVES To assess the impact of changes in FFM composition on AT. METHODS FFM was assessed in 32 healthy young men during controlled 21-d CR and 14 d of subsequent OF. Anatomical (i.e., the organ/tissue level) and molecular (i.e., water, mineral, and protein content and thus body density) composition of FFM were characterized. REE was measured by indirect calorimetry. RESULTS With CR, body weight and REE decreased by 4.2 ± 0.9 kg and 173 ± 107 kcal/d, respectively, with corresponding increases of 3.5 ± 1.2 kg and 194 ± 110 kcal/d during OF (P < 0.001 for all changes). Changes in FFM explained 56.7% and 66.7% of weight loss and weight gain, respectively. Weight changes were associated with changes in various anatomical (i.e., masses of skeletal muscle, liver, kidneys, and brain) and molecular components (total body water, protein, and bone minerals) of FFM. After adjustments for changes in FFM only, AT was 116 ± 127 (P < 0.001) and 27 ± 115 kcal/d (NS) with CR and OF, respectively. Adjustments for FFM and its anatomical and molecular composition reduced AT in response to CR to 83 ± 116 and 122 ± 123 kcal/d (P < 0.05 and P < 0.001) whereas during OF, AT became significant at 87 ± 146 kcal/d (anatomical; P < 0.05) and 86 ± 118 kcal/d (molecular; P < 0.001). CONCLUSIONS Adjusting changes in REE with under- and overfeeding for the corresponding changes in the anatomical and molecular composition of FFM decreased AT after CR and increased AT after OF, but overall adjusted AT was likely not large enough in magnitude to be able to prevent weight loss or resist weight gain.
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Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | | | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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22
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Bosy-Westphal A, Hägele FA, Müller MJ. Impact of Energy Turnover on the Regulation of Energy and Macronutrient Balance. Obesity (Silver Spring) 2021; 29:1114-1119. [PMID: 34002543 DOI: 10.1002/oby.23133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/06/2021] [Accepted: 01/19/2021] [Indexed: 11/07/2022]
Abstract
Energy turnover, defined as the average daily total metabolic rate, can be normalized for basal metabolic rate in order to compare physical activity level between individuals, whereas normalization of energy turnover for energy intake (energy flux) allows investigation of its impact on regulation of energy partitioning independent of energy balance. Appetite sensations better correspond to energy requirements at a high compared with a low energy turnover. Adaptation of energy intake to habitual energy turnover may, however, contribute to the risk of weight gain associated with accelerated growth, pregnancy, detraining in athletes, or after weight loss in people with obesity. The dose-response relationship between energy turnover and energy intake as well as the metabolic effects of energy turnover varies with the habitual level of physical activity and the etiology of energy turnover (e.g., cold-induced thermogenesis, growth, or lactation; aerobic vs. anaerobic exercise). Whether a high energy turnover due to physical activity or exercise may compensate for adverse effects of overfeeding or an unhealthy diet needs to be further investigated using the concept of energy flux. In summary, the beneficial effects of a high energy turnover on regulation of energy and macronutrient balance facilitate the prevention and treatment of obesity and associated metabolic risk.
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Affiliation(s)
- Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
| | - Franziska A Hägele
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
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23
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Müller MJ. Reports of the EASO physical activity working group: Diverse insights, evidence-based recommendations, and future perspectives. Obes Rev 2021; 22 Suppl 4:e13254. [PMID: 33855797 PMCID: PMC8365737 DOI: 10.1111/obr.13254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Manfred J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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24
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Abstract
Today, more than 50 % of adults in Germany are overweight, 20 million people are obese and 10 to 30 % suffer from non-communicable diseases (NCD). Unhealthy dietary patterns contribute to NCD, thus, NCD are at least partly avoidable. During the last decades nutrition research has changed from nutrients to foods identifying healthy food patterns characterizing healthy diets, e. g., Mediterranean diet, DASH diet and/or the New Nordic Diet. Scientifically, these diets have been shown to be effective strategies of primary and secondary prevention of NCD. Based on this evidence prevention of NCD is now urgently needed at the population level. However, effective public health strategies of prevention and health promotion go beyond daily medical practice and require re-thinking of our food system within a greater context of our environment and climate. To become sustainable, strategies and measures of behavior prevention addressing individuals have to be extended to measures against the obesogenic environment and its systemic drivers within our food system. Thus, social and political changes are needed for a better future health of the nation. Physicians may take the leadership to be prepared to add to a whole of society approach of prevention and health promotion.
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25
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Bosy-Westphal A, Müller MJ. Diagnosis of obesity based on body composition-associated health risks-Time for a change in paradigm. Obes Rev 2021; 22 Suppl 2:e13190. [PMID: 33480098 DOI: 10.1111/obr.13190] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/14/2022]
Abstract
Traditional diagnosis and understanding of the pathophysiology of obesity are based on excessive fat storage due to a chronically positive energy balance characterized by body mass index (BMI). Quantitative and qualitative analysis of lean and adipose tissue compartments by body composition analysis reveals that characterization of obesity as "overfat" does not facilitate a comprehensive understanding of obesity-associated health risk. Instead of being related to fat mass, body composition characteristics underlying BMI-associated prognosis may depend (i) on accelerated growth by a gain in lean mass or fat-free mass (FFM) in children with early BMI rebound or adolescents with early puberty; (ii) on a low muscle mass in aging, associated chronic disease, or severe illness; and (iii) on impaired adipose tissue expandability with respect to cardiometabolic risk. It is therefore time to call the adipocentric paradigm of obesity into question and to avoid the use of BMI and body fat percentage. By contrast, obesity should be seen in face of a limited FFM/muscle mass together with a limited capacity of fat storage.
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Affiliation(s)
- Anja Bosy-Westphal
- 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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26
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Heymsfield SB, Smith B, Dahle J, Kennedy S, Fearnbach N, Thomas DM, Bosy-Westphal A, Müller MJ. Resting Energy Expenditure: From Cellular to Whole-Body Level, a Mechanistic Historical Perspective. Obesity (Silver Spring) 2021; 29:500-511. [PMID: 33624441 DOI: 10.1002/oby.23090] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/12/2022]
Abstract
The basis of heat generated by the human body has been a source of speculation and research for more than 2,000 years. Basal heat production, now usually referred to as resting energy expenditure (REE), is currently recognized as deriving from biochemical reactions at subcellular and cellular levels that are expressed in the energy expended by the body's 78 organs and tissues. These organs and tissues, and the 11 systems to which they belong, influence body size and shape. Connecting these subcellular-/cellular-level reactions to organs and tissues, and then on to body size and shape, provides a comprehensive understanding of individual differences in REE, a contemporary topic of interest in obesity research and clinical practice. This review critically examines these linkages, their association with widely used statistical and physiological REE prediction formulas, and often-unappreciated aspects of measuring basal heat production in humans.
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Affiliation(s)
| | - Brooke Smith
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Jared Dahle
- Integrated Physiology Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Samantha Kennedy
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Nicole Fearnbach
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, New York, USA
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht University of Kiel, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht University of Kiel, Kiel, Germany
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27
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Müller MJ, Bosy-Westphal A. Postpartum Weight Retention in Women With Obesity. J Clin Endocrinol Metab 2020; 105:5803243. [PMID: 32161962 DOI: 10.1210/clinem/dgaa119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/10/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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28
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Walowski CO, Braun W, Maisch MJ, Jensen B, Peine S, Norman K, Müller MJ, Bosy-Westphal A. Reference Values for Skeletal Muscle Mass - Current Concepts and Methodological Considerations. Nutrients 2020; 12:nu12030755. [PMID: 32178373 PMCID: PMC7146130 DOI: 10.3390/nu12030755] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022] Open
Abstract
Assessment of a low skeletal muscle mass (SM) is important for diagnosis of ageing and disease-associated sarcopenia and is hindered by heterogeneous methods and terminologies that lead to differences in diagnostic criteria among studies and even among consensus definitions. The aim of this review was to analyze and summarize previously published cut-offs for SM applied in clinical and research settings and to facilitate comparison of results between studies. Multiple published reference values for discrepant parameters of SM were identified from 64 studies and the underlying methodological assumptions and limitations are compared including different concepts for normalization of SM for body size and fat mass (FM). Single computed tomography or magnetic resonance imaging images and appendicular lean soft tissue by dual X-ray absorptiometry (DXA) or bioelectrical impedance analysis (BIA) are taken as a valid substitute of total SM because they show a high correlation with results from whole body imaging in cross-sectional and longitudinal analyses. However, the random error of these methods limits the applicability of these substitutes in the assessment of individual cases and together with the systematic error limits the accurate detection of changes in SM. Adverse effects of obesity on muscle quality and function may lead to an underestimation of sarcopenia in obesity and may justify normalization of SM for FM. In conclusion, results for SM can only be compared with reference values using the same method, BIA- or DXA-device and an appropriate reference population. Limitations of proxies for total SM as well as normalization of SM for FM are important content-related issues that need to be considered in longitudinal studies, populations with obesity or older subjects.
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Affiliation(s)
- Carina O. Walowski
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, 24105 Kiel, Germany; (C.O.W.); (W.B.); (M.J.M.)
| | - Wiebke Braun
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, 24105 Kiel, Germany; (C.O.W.); (W.B.); (M.J.M.)
| | - Michael J. Maisch
- seca gmbh & co. kg., Hammer Steindamm 3-25, 22089 Hamburg, Germany; (M.J.M.); (B.J.)
| | - Björn Jensen
- seca gmbh & co. kg., Hammer Steindamm 3-25, 22089 Hamburg, Germany; (M.J.M.); (B.J.)
| | - Sven Peine
- Institute for Transfusion Medicine, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Kristina Norman
- Department of Nutrition and Gerontology, German Institute of Human Nutrition, Potsdam-Rehbruecke, 14558 Berlin, Germany;
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, 13347 Berlin, Germany
| | - Manfred J. Müller
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, 24105 Kiel, Germany; (C.O.W.); (W.B.); (M.J.M.)
| | - Anja Bosy-Westphal
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, 24105 Kiel, Germany; (C.O.W.); (W.B.); (M.J.M.)
- Correspondence: ; Tel.: +49-(0)431-880-5674
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29
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Soares MJ, Müller MJ, Wolever TMS. Response to Letter from Bero et al. Eur J Clin Nutr 2019; 74:353-354. [PMID: 31822821 DOI: 10.1038/s41430-019-0546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 11/09/2022]
Affiliation(s)
- M J Soares
- School of Public Health, Curtin University, Kent Street, Perth, Western Australia, Australia.
| | - M J Müller
- Institute of Human Nutrition & Food Science, Christian Albrechts Universität, Kiel, Germany
| | - T M S Wolever
- Department of Nutritional Science and Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
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30
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Hägele FA, Büsing F, Nas A, Hasler M, Müller MJ, Blundell JE, Bosy-Westphal A. Appetite Control Is Improved by Acute Increases in Energy Turnover at Different Levels of Energy Balance. J Clin Endocrinol Metab 2019; 104:4481-4491. [PMID: 31305927 DOI: 10.1210/jc.2019-01164] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 07/09/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Weight control is hypothesized to be improved when physical activity and energy intake are both high [high energy turnover (ET)]. OBJECTIVE The impact of three levels of ET on short-term appetite control is therefore investigated at fixed levels of energy balance. DESIGN In a randomized crossover trial, 16 healthy adults (25.1 ± 3.9 y of age; body mass index, 24.0 ± 3.2 kg/m2) spent three daylong protocols for four times in a metabolic chamber. Four conditions of energy balance (ad libitum energy intake, zero energy balance, -25% caloric restriction, and +25% overfeeding) were each performed at three levels of ET (PAL 1.3 low, 1.6 medium, and 1.8 high ET; by walking on a treadmill). Levels of appetite hormones ghrelin, GLP-1, and insulin (total area under the curve) were measured during 14 hours. Subjective appetite ratings were assessed by visual analog scales. RESULTS Compared with high ET, low ET led to decreased GLP-1 (at all energy balance conditions: P < 0.001) and increased ghrelin concentrations (caloric restriction and overfeeding: P < 0.001), which was consistent with higher feelings of hunger (zero energy balance: P < 0.001) and desire to eat (all energy balance conditions: P < 0.05) and a positive energy balance during ad libitum intake (+17.5%; P < 0.001). CONCLUSION Appetite is regulated more effectively at a high level of ET, whereas overeating and consequently weight gain are likely to occur at low levels of ET. In contrast to the prevailing concept of body weight control, the positive impact of physical activity is independent from burning up more calories and is explained by improved appetite sensations.
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Affiliation(s)
- Franziska A Hägele
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
- Department of Applied Nutritional Science and Dietetics, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Franziska Büsing
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
- Department of Applied Nutritional Science and Dietetics, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Alessa Nas
- Department of Applied Nutritional Science and Dietetics, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Mario Hasler
- Applied Statistics, Faculty of Agricultural and Nutritional Sciences, Christian-Albrechts University, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
| | - John E Blundell
- Institute of Psychological Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, Kiel, Germany
- Department of Applied Nutritional Science and Dietetics, Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
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31
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Müller MJ. About "spendthrift" and "thrifty" phenotypes: resistance and susceptibility to overeating revisited. Am J Clin Nutr 2019; 110:542-543. [PMID: 31172166 DOI: 10.1093/ajcn/nqz090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 03/26/2019] [Indexed: 12/23/2022] Open
Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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32
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Jensen B, Braun W, Geisler C, Both M, Klückmann K, Müller MJ, Bosy-Westphal A. Limitations of Fat-Free Mass for the Assessment of Muscle Mass in Obesity. Obes Facts 2019; 12:307-315. [PMID: 31132777 PMCID: PMC6696776 DOI: 10.1159/000499607] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 02/12/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A high amount of adipose tissue limits the accuracy of methods for body composition analysis in obesity. OBJECTIVES The aim was to quantify and explain differences in fat-free mass (FFM) (as an index of skeletal muscle mass, SMM) measured with bioelectrical impedance analysis (BIA), dual energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), and deuterium dilution in comparison to multicompartment models, and to improve the results of BIA for obese subjects. METHODS In 175 healthy subjects (87 men and 88 women, BMI 20-43.3 kg/m2, 18-65 years), FFM measured by these methods was compared with results from a 3- (3C) and a 4-compartment (4C) model. FFM4C was compared with SMM measured by magnetic resonance imaging. RESULTS BIA and DXA overestimated and ADP underestimated FFM in comparison to 3C and 4C models with increasing BMI (all p < 0.001). -Differences were largest for DXA. In obesity, BIA results were improved: valuecorrected = -valueuncorrected - a(BMI - 30 kg/m2), a = 0.256 for FFM and a = 0.298 for SMM. SMM accounts for 45% of FFM in women and 49% in men. CONCLUSIONS In obesity, the use of FFM is limited by a systematic error of reference methods. In addition, SMM accounts for about 50% of FFM only. Corrected measurement of SMM by BIA can overcome these drawbacks.
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Affiliation(s)
| | - Wiebke Braun
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität Kiel, Kiel, Germany
| | - Corinna Geisler
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität Kiel, Kiel, Germany
| | - Markus Both
- Klinik für Diagnostische Radiologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | - Manfred J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität Kiel, Kiel, Germany,
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Müller MJ, Krawczak M, Heymsfield S, Schutz Y, Dulloo A, Blundell J, Geisler C, Bosy-Westphal A. Thanks for opening an overdue discussion on GWAS of BMI: a reply to Prof. Speakman et al. Int J Obes (Lond) 2018; 43:217-218. [PMID: 30482932 DOI: 10.1038/s41366-018-0264-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/08/2018] [Accepted: 10/15/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Manfred J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.
| | - Michael Krawczak
- Institut für Medizinische Informatik und Statistik, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | | | - Yves Schutz
- Institute de Physiology, University of Lausanne, Lausanne, Switzerland
| | - Abdul Dulloo
- Department of Medicine, Division of Physiology, University of Fribourg, Fribourg, Switzerland
| | - John Blundell
- Institute of Psychological Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Corinna Geisler
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Anja Bosy-Westphal
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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Abstract
Depression is common in old age but is often underdiagnosed and inadequately treated. Although psychotherapy is considered effective for treating elderly patients with depression, it is rarely applied in inpatient settings. Furthermore, treatment on inpatient units specialized for elderly patients and implementation of a psychotherapeutic treatment approach are currently more the exception. From this background, a multiprofessional inpatient behavioral treatment program (MVT) for elderly depressed patients was developed at a specialized unit of a university-affiliated regional psychiatric hospital. The MVT is based on specific and modularized group therapies accompanied by individual therapeutic interventions. While the provision of group therapies (such as psychotherapy, social skills training, relaxation training, euthymic and mindfulness-based methods, exercise and occupational therapy as well as psychoeducational sessions for relatives) is assigned to specific professional groups, a joint multiprofessional treatment planning is of central relevance. First evaluations of different treatment components support the high acceptability of the MVT and highlight that psychotherapeutic inpatient treatment programs for the elderly are feasible. Further research is required to investigate the clinical efficacy of psychotherapy in elderly depressive inpatients.
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Affiliation(s)
- N Cabanel
- Vitos Klinik für Psychiatrie und Psychotherapie Gießen, Vitos Klinikum Gießen-Marburg, Licher Straße 106, 35394, Gießen, Deutschland.
| | - B Kundermann
- Vitos Klinik für Psychiatrie und Psychotherapie Gießen, Vitos Klinikum Gießen-Marburg, Licher Straße 106, 35394, Gießen, Deutschland.,Klinik für Psychiatrie und Psychotherapie, Philipps-Universität Marburg, Marburg, Deutschland
| | - M Franz
- Vitos Klinik für Psychiatrie und Psychotherapie Gießen, Vitos Klinikum Gießen-Marburg, Licher Straße 106, 35394, Gießen, Deutschland.,Fachbereich Medizin, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - M J Müller
- Fachbereich Medizin, Justus-Liebig-Universität Gießen, Gießen, Deutschland.,Oberberggruppe, Berlin, Deutschland
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Bosy-Westphal A, Braun W, Albrecht V, Müller MJ. Determinants of ectopic liver fat in metabolic disease. Eur J Clin Nutr 2018; 73:209-214. [PMID: 30323174 DOI: 10.1038/s41430-018-0323-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 09/09/2018] [Indexed: 12/17/2022]
Abstract
Common obesity-associated hepatic steatosis (nonalcoholic fatty liver disease (NAFLD)) and insulin resistance are mainly caused by dysfunctional adipose tissue. This adipose tissue dysfunction leads to increased delivery of NEFA and glycerol to the liver that (i) drives hepatic gluconeogenesis and (ii) facilitates the accumulation of lipids and insulin signaling inhibiting lipid intermediates. Dysfunctional adipose tissue can be caused by impaired lipid storage (overflow hypothesis, characterized by large visceral adipocytes) or increased lipolysis (due to impaired postprandial suppression of lipolysis in inflamed, insulin-resistant adipocytes). In line with the adipose tissue expandability hypothesis the amount and distribution of adipose tissue correlate with its dysfunction and thus with liver fat. This relationship is however modified by endocrine effects on lipid storage and lipolysis as well as dietary effects on hepatic lipogenesis and lipid oxidation. The association between body composition characteristics like visceral obesity or fat cell size and ectopic liver fat is modified by these influences. Phenotyping obesity according to metabolic risk should integrate body composition characteristics, endocrine parameters and information on diet.
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Affiliation(s)
- Anja Bosy-Westphal
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany.
| | - Wiebke Braun
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Viktoria Albrecht
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany
| | - Manfred J Müller
- Institute for Human Nutrition and Food Science, Christian-Albrechts-University Kiel, Kiel, Germany
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Müller MJ, Geisler C, Hübers M, Pourhassan M, Bosy-Westphal A. Body composition-related functions: a problem-oriented approach to phenotyping. Eur J Clin Nutr 2018; 73:179-186. [PMID: 30323173 DOI: 10.1038/s41430-018-0340-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 09/21/2018] [Indexed: 02/08/2023]
Abstract
AIM The objective of this study is to generate metabolic phenotypes based on structure-function relationships. METHODS In 459 healthy adults (54% females, 18 and 40 years old), we analyzed body composition by air-displacement densitometry (to assess fat mass, (FM) and fat-free mass (FFM)) and whole-body magnetic resonance imaging (to assess skeletal muscle mass (SMM) and masses of brain, heart, liver, kidneys, and subcutaneous (SAT) and visceral adipose tissue (VAT)), resting energy expenditure (REE) by indirect calorimetry, and plasma concentrations of insulin (Ins) and leptin (Lep). RESULTS Three "functional body composition-derived phenotypes" (FBCPs) were derived: (1) REE on FFM-FBCP, (2) Lep on FM-FBCP, and (3) Ins on VAT-FBCP. Assuming that being within the ± 5% range of the respective regression lines reflects a "normal" structure-function relationship, three "normal" FBCPs were generated with prevalences of 9.0%, 5.1%, and 6.8%, respectively, of the study population. The three "FBCPs" did not overlap and were independent from each other. When compared with the two other FBCPs, the "Lep on FM-FBCP" was leanest, whereas the "REE on FFM-FBCP" had the highest BMI and SAT. Taking into account FFM composition, a hierarchical multi-level model is proposed with brain at level 1, the liver at level 2, and SMM and FM at level 3 with insulin coordinating the interplay between level 1 and 2, whereas variance in plasma insulin levels impacts energy and substrate metabolism in SMM and AT. CONCLUSION Structure-function relationships can be used to generate FBCPs. Different FBCPs reflect different dimensions of normality (or health). This is evidence for the idea that there is no across the board "normal" state.
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Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität, Kiel, Germany.
| | - Corinna Geisler
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität, Kiel, Germany
| | - Mark Hübers
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität, Kiel, Germany
| | - Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität, Kiel, Germany
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Wolters M, Joslowski G, Plachta-Danielzik S, Standl M, Müller MJ, Ahrens W, Buyken AE. Dietary Patterns in Primary School are of Prospective Relevance for the Development of Body Composition in Two German Pediatric Populations. Nutrients 2018; 10:nu10101442. [PMID: 30301151 PMCID: PMC6213904 DOI: 10.3390/nu10101442] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/26/2018] [Accepted: 09/27/2018] [Indexed: 12/25/2022] Open
Abstract
This study performed comparative analyses in two pediatric cohorts to identify dietary patterns during primary school years and examined their relevance to body composition development. Nutritional and anthropometric data at the beginning of primary school and two or four years later were available from 298 and 372 participants of IDEFICS-Germany (Identification and prevention of Dietary-induced and lifestyle-induced health Effects In Children and infants Study) and the KOPS (Kiel Obesity Prevention Study) cohort, respectively. Principal component analyses (PCA) and reduced rank regression (RRR) were used to identify dietary patterns at baseline and patterns of change in food group intake during primary school years. RRR extracted patterns explaining variations in changes in body mass index (BMI), fat mass index (FMI), and waist-to-height-ratio (WtHR). Associations between pattern adherence and excess gain in BMI, FMI, or WtHR (>75th percentile) during primary school years were examined using logistic regression. Among PCA patterns, only a change towards a more Mediterranean food choice during primary school years were associated with a favorable body composition development in IDEFICS-Germany (p < 0.05). In KOPS, RRR patterns characterized by a frequent consumption of fast foods or starchy carbohydrate foods were consistently associated with an excess gain in BMI and WtHR (all p < 0.005). In IDEFICS-Germany, excess gain in BMI, FMI, and WtHR were predicted by a frequent consumption of nuts, meat, and pizza at baseline and a decrease in the consumption frequency of protein sources and snack carbohydrates during primary school years (all p < 0.01). The study confirms an adverse impact of fast food consumption on body composition during primary school years. Combinations of protein and carbohydrate sources deserve further investigation.
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Affiliation(s)
- Maike Wolters
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Department: Epidemiological Methods and Etiologic Research, Achterstr. 30, 28359 Bremen, Germany.
| | - Gesa Joslowski
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany.
| | - Sandra Plachta-Danielzik
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, 24118 Kiel, Germany.
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, D-85764 Neuherberg, Germany.
| | - Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, 24118 Kiel, Germany.
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Department: Epidemiological Methods and Etiologic Research, Achterstr. 30, 28359 Bremen, Germany.
| | - Anette E Buyken
- IEL-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany.
- Institute of Nutrition, Consumption and Health, Faculty of Natural Science, University Paderborn, 33098 Paderborn, Germany.
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Heymsfield SB, Thomas DM, Bosy-Westphal A, Müller MJ. The anatomy of resting energy expenditure: body composition mechanisms. Eur J Clin Nutr 2018; 73:166-171. [PMID: 30254244 DOI: 10.1038/s41430-018-0319-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 09/06/2018] [Indexed: 02/02/2023]
Abstract
Body mass in humans and animals is strongly associated with the rate of heat production as defined by resting energy expenditure (REE). Beginning with the ancient Greeks up to the present time, philosophers and scientists have endeavored to understand the nature and sources of bodily heat. Today we recognize that body mass consists of organs and tissues, each of which produces a specified amount of heat at rest. An individual organ's REE can now be estimated in vivo as the product of its assumed mass-specific metabolic rate and its imaging-derived mass; whole-body REE reflects the sum of organ and tissue metabolic rates. The sizes of organs and total body mass in adults are governed by two main factors, a person's stature or height, and their level of adiposity. With greater body size, as represented by adult height independent of adiposity, organs remain stable or increase in mass according to distinct "scaling" patterns. Similarly, with greater relative adiposity organs adaptively accommodate to the increase in imposed mechanical and metabolic loading conditions. Through a detailed analysis of these stature and adiposity effects, we show how classical statistical REE prediction models can be mechanistically understood at the anatomic body composition level.
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Affiliation(s)
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, New York, NY, USA
| | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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)
- S B Heymsfield
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - C M Peterson
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - B Bourgeois
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - D M Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, West Point, NY, USA
| | - D Gallagher
- College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - B 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, Manchester, UK
| | - M J Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - A Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
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Geisler C, Hübers M, Granert O, Müller MJ. Contribution of structural brain phenotypes to the variance in resting energy expenditure in healthy Caucasian subjects. J Appl Physiol (1985) 2018; 125:320-327. [DOI: 10.1152/japplphysiol.00690.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Brain gray (GM) and white matter (WM) volumes are related to weight changes. The impact of structural variations in GM and WM on the variance in resting energy expenditure (REE) and the REE-on-fat-free mass (FFM) association is unknown. The aim of this study was to address this in healthy Caucasian subjects. Cross-sectional data analysis of 493 healthy Caucasian subjects (age range 6–80 years; 3 age groups) was conducted with comprehensive information on FFM, organ and tissue masses, and detailed brain composition as assessed by whole body magnetic resonance imaging and REE (assessed by indirect calorimetry). REE was calculated (REEc) using organ and tissue masses times their specific metabolic rates. FFM was the major determinant of REE (70.6%); individual masses of liver, total brain, and heart explained a further 2.1% of the variance in REE. Replacing total brain with GM and WM did not change the total R2. Nevertheless, GM added more to the variance in REE (5.6%) and corresponding residuals (12.5%) than did total brain. Additionally, up to 12% was explained by age and sex (<2%). There was a systematic bias between REE and REEc with positive values in younger subjects but negative values in older ones. This bias remained after substituting the specific metabolic rate of brain with the specific metabolic rates of GM and WM. In healthy Caucasian subjects, GM and WM contributed to the variance in REE. Detailed brain structures do not explain the bias between REE and REEc.NEW & NOTEWORTHY Detailed brain composition (gray and white matter) contributed to the variances of resting energy expenditure (REE) and REE-on-fat-free mass residuals. Gray matter explained most of the variances, and for future studies on energy expenditure, brain compartments should be analyzed separately with regard to their different energy needs.
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Affiliation(s)
- Corinna Geisler
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Mark Hübers
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Oliver Granert
- Department of Neurology, 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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Abstract
Presently, control of body weight is assumed to exist, but there is no consensus framework of body weight homeostasis. Three different models have been proposed, with a "set point" suggesting (i) a more or less tight and (ii) symmetric or asymmetric biological control of body weight resulting from feedback loops from peripheral organs and tissues (e.g. leptin secreted from adipose tissue) to a central control system within the hypothalamus. Alternatively, a "settling point" rather than a set point reflects metabolic adaptations to energy imbalance without any need for feedback control. Finally, the "dual intervention point" model combines both paradigms with two set points and a settling point between them. In humans, observational studies on large populations do not provide consistent evidence for a biological control of body weight, which, if it exists, may be overridden by the influences of the obesogenic environment and culture on personal behavior and experiences. To re-address the issue of body weight homeostasis, there is a need for targeted protocols based on sound concepts, e.g. lean rather than overweight subjects should be investigated before, during, and after weight loss and weight regain. In addition, improved methods and a multi-level-multi-systemic approach are needed to address the associations (i) between masses of individual body components and (ii) between masses and metabolic functions in the contexts of neurohumoral control and systemic effects. In the future, simplifications and the use of crude and non-biological phenotypes (i.e. body mass index and waist circumference) should be avoided. Since changes in body weight follow the mismatch between tightly controlled energy expenditure at loosely controlled energy intake, control (or even a set point) is more likely to be about energy expenditure rather than about body weight itself.
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Affiliation(s)
- Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Corinna Geisler
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | | | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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Pourhassan M, Norman K, Müller MJ, Dziewas R, Wirth R. Impact of Sarcopenia on One-Year Mortality among Older Hospitalized Patients with Impaired Mobility. J Frailty Aging 2018; 7:40-46. [PMID: 29412441 DOI: 10.14283/jfa.2017.35] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES However, the information regarding the impact of sarcopenia on mortality in older individuals is rising, there is a lack of knowledge concerning this issue among geriatric hospitalized patients. Therefore, aim of the present study was to investigate the associations between sarcopenia and 1-year mortality in a prospectively recruited sample of geriatric inpatients with different mobility and dependency status. DESIGN AND SETTING Sarcopenia was diagnosed using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP). Hand grip strength and skeletal muscle mass were measured using Jamar dynamometer and bioelectrical impedance analysis, respectively. Physical function was assessed with the Short Physical Performance Battery. Dependency status was defined by Barthel-Index (BI). Mobility limitation was defined according to walking ability as described in BI. The survival status was ascertained by telephone interview. RESULTS The recruited population comprised 198 patients from a geriatric acute ward with a mean age of 82.8 ± 5.9 (70.2% females). 50 (25.3%) patients had sarcopenia, while 148 (74.7%) had no sarcopenia. 14 (28%) patients died among sarcopenic subjects compared with 28 (19%) non-sarcopenic subjects (P=0.229). After adjustment for potential confounders, sarcopenia was associated with increased mortality among patients with limited mobility prior to admission (n=138, hazard ratio, HR: 2.52, 95% CI: 1.17-5.44) and at time of discharge (n=162, HR: 1.93, 95% CI: 0.67-3.22). In a sub-group of patients with pre-admission BI<60 (n=45), <70 (n=73) and <80 (n=108), the risk of death was 3.63, 2.80 and 2.55 times higher in sarcopenic patients, respectively. In contrast, no significant relationships were observed between sarcopenia and mortality across the different scores of BI during admission and at time of discharge. CONCLUSION Sarcopenia is significantly associated with higher risk of mortality among sub-groups of older patients with limited mobility and impaired functional status, independently of age and other clinical variables.
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Affiliation(s)
- M Pourhassan
- Dr. oec. troph. Maryam Pourhassan, Marien Hospital Herne, Department of Geriatric Medicine, University Hospital Ruhr-University Bochum, Germany, Hölkeskampring 40, D- 44625 Herne, Germany, Tel: +4923234992416,
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Hübers M, Geisler C, Bosy-Westphal A, Braun W, Pourhassan M, Sørensen TIA, Müller MJ. Association between fat mass, adipose tissue, fat fraction per adipose tissue, and metabolic risks: a cross-sectional study in normal, overweight, and obese adults. Eur J Clin Nutr 2018; 73:62-71. [PMID: 29670259 DOI: 10.1038/s41430-018-0150-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/19/2018] [Accepted: 02/15/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND/OBJECTIVES We investigated whether fat mass (FM) and total adipose tissue (TAT) can be used interchangeably and FM per TAT adds to metabolic risk assessment. SUBJECTS/METHODS Cross-sectional data were assessed in 377 adults (aged 18-60 years; 51.2% women). FM was measured by either 4-compartment (4C) model or quantitative magnetic resonance (QMR); total-, subcutaneous- and visceral adipose tissue (TAT, SAT, VAT), and liver fat by whole-body MRI; leptin, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), C-reactive protein (CRP), and triglycerides; resting energy expenditure and respiratory quotient by indirect calorimetry were determined. Correlations and stepwise multivariate regression analyses were performed. RESULTS FM4C and FMQMR were associated with TAT (r4C = 0.96, rQMR = 0.99) with a mean FM per TAT of 0.85 and 1.01, respectively. Regardless of adiposity, there was a considerable inter-individual variance of FM/TAT-ratio (FM4C/TAT-ratio: 0.77-0.94; FMQMR/TAT-ratio: 0.89-1.10). Both, FM4C and TAT were associated with metabolic risks. Further, FM4C/TAT-ratio was positively related to leptin but inversely with CRP. There was no association between FM4C/TAT-ratio and VAT/SAT or liver fat. FM4C/TAT-ratio added to the variance of leptin and CRP. CONCLUSIONS Independent of FM or TAT, FM4C/TAT-ratio adds to metabolic risk assessment. Therefore, the interchangeable use of FM and TAT to assess metabolic risks is questionable as both parameters may complement each other.
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Affiliation(s)
- Mark Hübers
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Corinna Geisler
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Anja Bosy-Westphal
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Wiebke Braun
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany
| | - Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-University Bochum, Bochum, Germany
| | - Thorkild I A Sørensen
- The Novo Nordisk Foundation Center for Basic Metabolic Research (Section on Metabolic Genetics), and the Department of Public Health, The Faculty of Health and Medical Science, University Copenhagen, Copenhagen, Denmark
| | - Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts-University, Kiel, Germany.
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Haas V, Kent D, Kohn MR, Madden S, Clarke S, Briody J, Fischer F, Müller MJ, Gaskin K. Incomplete total body protein recovery in adolescent patients with anorexia nervosa. Am J Clin Nutr 2018; 107:303-312. [PMID: 29566191 DOI: 10.1093/ajcn/nqx061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 12/04/2017] [Indexed: 12/27/2022] Open
Abstract
Background Bone health and growth during adolescence require adequate total body protein (TBPr). Renutrition for patients with anorexia nervosa (AN) should aim to normalize body composition and to recover both fat mass and TBPr. Objective We intended to analyze predictors of protein status, including exercise status, in adolescents with AN and to investigate whether weight gain would replenish body protein deficits. Methods We assessed TBPr in a longitudinal, observational study as height-adjusted nitrogen index (NI) using in vivo neutron activation analysis in 103 adolescents with AN [mean ± SD age, 15.6 ± 1.4 y; body mass index (BMI, in kg/m2), 16.5 ± 1.6] at the commencement of inpatient refeeding (T0), in 56 of these patients 7 mo thereafter as outpatients (T1), and in age-matched controls (C; n = 51, 15.5 ± 2.1 y, BMI 20.7 ± 1.9). Lean tissue and fat mass were assessed by dual-energy X-ray absorptiometry. BMI, BMI standard deviation score, and lean tissue mass were tested as predictors of protein status using receiver operating characteristic analysis. Results At T0, NI was decreased in AN (AN, 0.88 ± 0.10 compared with C, 1.00 ± 0.08, P < 0.001). In 34%, the patients showed protein depletion. Patients classified as ``exercisers'' had a higher NI than did ``nonexercisers'' (0.89 ± 0.11 compared with 0.85 ± 0.08, P = 0.045). BMI, BMI standard deviation score, and lean tissue mass did not show potential as predictors of protein status. Despite increases in weight (+6.9 ± 4.5 kg), and BMI (+2.5 ± 1.7), protein status did not improve (TBPr T0, 8.0 ± 1.1 kg; T1, 8.1 ± 1.0 kg, P = 0.495). In an AN subgroup at 7 mo matched with controls in age (AN, 16.5 ± 1.1 y; C, 16.2 ± 1.8 y) and BMI (AN, 20.5 ± 1.4; C, 20.7 ± 1.3), protein status was still not normalized in AN (NI: AN, 0.89 ± 0.09 compared with C, 1.00 ± 0.07, P < 0.001). Conclusions Adolescents recovering from AN remained protein depleted at 7 mo after baseline assessment, even though they were weight restored.
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Affiliation(s)
- Verena Haas
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dorothea Kent
- James Fairfax Institute of Pediatric Nutrition, Department of Adolescent and Young Adult Medicine, Westmead Hospital and Centre for Research into Adolescents' Health, and Departments of Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Michael R Kohn
- Department of Adolescent and Young Adult Medicine, Westmead Hospital and Centre for Research into Adolescents' Health, and Departments of Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Sloane Madden
- Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Simon Clarke
- Department of Adolescent and Young Adult Medicine, Westmead Hospital and Centre for Research into Adolescents' Health, and Departments of Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Julie Briody
- Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Felix Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Germany
| | - Manfred J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Germany
| | - Kevin Gaskin
- James Fairfax Institute of Pediatric Nutrition, Department of Adolescent and Young Adult Medicine, Westmead Hospital and Centre for Research into Adolescents' Health, and Departments of Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
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Silva AM, Matias CN, Santos DA, Thomas D, Bosy-Westphal A, Müller MJ, Heymsfield SB, Sardinha LB. Energy Balance over One Athletic Season. Med Sci Sports Exerc 2018; 49:1724-1733. [PMID: 28514233 DOI: 10.1249/mss.0000000000001280] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Magnitude and variation in energy balance (EB) components over an athletic season are largely unknown. PURPOSE We investigated the longitudinal changes in EB over one season and explored the association between EB variation and change in the main fat-free mass (FFM) components in highly trained athletes. METHODS Eighty athletes (54 males; handball, volleyball, basketball, triathlete, and swimming) were evaluated from the beginning of the season to the main competition stage. Resting and total energy expenditure (REE and TEE, respectively) were assessed by indirect calorimetry and doubly labeled water, respectively. Physical activity energy expenditure was calculated as TEE - 0.1 TEE - REE. Fat mass (FM), FFM, and bone mineral were evaluated with dual-energy x-ray absorptiometry; changed body energy stores were calculated as 1.0(ΔFFM/Δtime) + 9.5(ΔFM/Δtime). Total-body water (TBW) and its compartments were assessed through dilution techniques, and total-body protein was calculated from a four-compartment model, with body volume assessed by air displacement plethysmography. RESULTS Although a negative EB of -17.4 ± 72.7 kcal·d was observed (P < 0.05), EB varied widely among sports and across sex groups resulting in a net weight increase (0.7 ± 2.3 kg) that is attributable to significant changes in FFM (1.2 ± 1.6 kg) and FM (-0.7 ± 1.5 kg) (P < 0.05). EB was related with TBW and intracellular water (r = 0.354, r = 0.257, P < 0.05, respectively), regardless of sex, sports, and age. CONCLUSIONS The mean negative EB observed over the season resulted from the rate of FM use and FFM accretion, but with a large variation by sex and sports. TBW, but not total-body protein or mineral balance, explained the magnitude of EB, which means that athletes under a positive or a negative EB showed a TBW expansion or shrinkage, respectively, specifically within the cells, over one athletic season.
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Affiliation(s)
- Analiza M Silva
- 1Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, PORTUGAL; 2Department of Mathematical Sciences, United States Military Academy West Point, NY; 3Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, GERMANY; 4Department of Human Nutrition and Food Science, Christian-Albrechts-University of Kiel, Kiel, GERMANY; and 5Pennington Biomedical Research Center, Baton Rouge, LA
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Hiemke C, Bergemann N, Clement HW, Conca A, Deckert J, Domschke K, Eckermann G, Egberts K, Gerlach M, Greiner C, Gründer G, Haen E, Havemann-Reinecke U, Hefner G, Helmer R, Janssen G, Jaquenoud E, Laux G, Messer T, Mössner R, Müller MJ, Paulzen M, Pfuhlmann B, Riederer P, Saria A, Schoppek B, Schoretsanitis G, Schwarz M, Gracia MS, Stegmann B, Steimer W, Stingl JC, Uhr M, Ulrich S, Unterecker S, Waschgler R, Zernig G, Zurek G, Baumann P. Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017. Pharmacopsychiatry 2018; 51:e1. [PMID: 29390205 DOI: 10.1055/s-0037-1600991] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- C Hiemke
- Department of Psychiatry and Psychotherapy, University Medical Center of Mainz, Mainz, Germany.,Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of Mainz, Mainz, Germany
| | - N Bergemann
- Kitzberg Hospitals, Center for Psychosomatic Medicine and Psychotherapy, Bad Mergentheim, Germany
| | - H W Clement
- Department of Child and Adolescent Psychiatry, University of Freiburg, Freiburg, Germany
| | - A Conca
- Servizio Psichiatrico del Comprensorio Sanitario di Bolzano, Bolzano, Italy
| | - J Deckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | - K Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | - K Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
| | - M Gerlach
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Germany
| | - C Greiner
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - G Gründer
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA - Translational Brain Medicine, Aachen, Germany
| | - E Haen
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - U Havemann-Reinecke
- Department of Psychiatry and Psychosomatics, University of Göttingen, Göttingen, Germany
| | - G Hefner
- Psychiatric Hospital, Vitos Klinik, Eichberg, Eltville, Germany
| | - R Helmer
- Center of Epilepsy, Bielefeld, Germany
| | - G Janssen
- Medical Laboratory Stein, Limbach Group, Mönchengladbach, Germany
| | - E Jaquenoud
- Psychiatric Hospital, Königsfelden, Brugg, Aargau, Switzerland
| | - G Laux
- Institute of Psychological Medicine, Haag in Oberbayern, Germany
| | - T Messer
- Danuviuskliniken, Psychiatric Hospital, Pfaffenhofen, Germany
| | - R Mössner
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - M J Müller
- Psychiatric Hospitals Oberberggruppe, Berlin, Germany
| | - M Paulzen
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, and JARA - Translational Brain Medicine, Aachen, Germany
| | - B Pfuhlmann
- Psychiatric Hospital Weisser Hirsch, Dresden, Germany
| | - P Riederer
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | - A Saria
- Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria
| | - B Schoppek
- kbo-Isar-Amper Klinikum München-Ost, Psychiatric Hospital, Munich-Haar, Germany
| | | | - M Schwarz
- Department of Laboratory Medicine, Ludwig Maximilian University, Munich, Germany
| | - M Silva Gracia
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - B Stegmann
- Clinical Pharmacology, Department of Psychiatry and Psychotherapy and Department of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany
| | - W Steimer
- Institute of Clinical Chemistry and Pathobiochemistry, Technical University Munich, Munich, Germany
| | - J C Stingl
- Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - M Uhr
- Max Planck Institute of Psychiatry, Munich, Germany
| | - S Ulrich
- Aristo Pharma GmbH, Berlin, Germany
| | - S Unterecker
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Würzburg, Germany
| | | | - G Zernig
- Experimental Psychiatry Unit, Department of Psychiatry 1, Medical University of Innsbruck, Innsbruck, Austria.,Private Practice for Psychotherapy and Court-Certified Witness, Hall in Tirol, Austria
| | - G Zurek
- Medical Laboratory Bremen, Bremen, Germany
| | - P Baumann
- Department of Psychiatry, University of Lausanne, Prilly-Lausanne, Switzerland
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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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Dasgupta I, Keane D, Lindley E, Shaheen I, Tyerman K, Schaefer F, Wühl E, Müller MJ, Bosy-Westphal A, Fors H, Dahlgren J, Chamney P, Wabel P, Moissl U. Validating the use of bioimpedance spectroscopy for assessment of fluid status in children. Pediatr Nephrol 2018; 33:1601-1607. [PMID: 29869117 PMCID: PMC6061658 DOI: 10.1007/s00467-018-3971-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 03/31/2018] [Accepted: 04/27/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bioimpedance spectroscopy (BIS) with a whole-body model to distinguish excess fluid from major body tissue hydration can provide objective assessment of fluid status. BIS is integrated into the Body Composition Monitor (BCM) and is validated in adults, but not children. This study aimed to (1) assess agreement between BCM-measured total body water (TBW) and a gold standard technique in healthy children, (2) compare TBW_BCM with TBW from Urea Kinetic Modelling (UKM) in haemodialysis children and (3) investigate systematic deviation from zero in measured excess fluid in healthy children across paediatric age range. METHODS TBW_BCM and excess fluid was determined from standard wrist-to-ankle BCM measurement. TBW_D2O was determined from deuterium concentration decline in serial urine samples over 5 days in healthy children. UKM was used to measure body water in children receiving haemodialysis. Agreement between methods was analysed using paired t test and Bland-Altman method comparison. RESULTS In 61 healthy children (6-14 years, 32 male), mean TBW_BCM and TBW_D2O were 21.1 ± 5.6 and 20.5 ± 5.8 L respectively. There was good agreement between TBW_BCM and TBW_D2O (R2 = 0.97). In six haemodialysis children (4-13 years, 4 male), 45 concomitant measurements over 8 months showed good TBW_BCM and TBW_UKM agreement (mean difference - 0.4 L, 2SD = ± 3.0 L). In 634 healthy children (2-17 years, 300 male), BCM-measured overhydration was - 0.1 ± 0.7 L (10-90th percentile - 0.8 to + 0.6 L). There was no correlation between age and OH (p = 0.28). CONCLUSIONS These results suggest BCM can be used in children as young as 2 years to measure normally hydrated weight and assess fluid status.
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Affiliation(s)
| | - David Keane
- Departments of Renal Medicine and Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Elizabeth Lindley
- Departments of Renal Medicine and Medical Physics, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ihab Shaheen
- Department of Children's Nephrology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Kay Tyerman
- Department of Children's Nephrology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Franz Schaefer
- Pediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Elke Wühl
- Pediatric Nephrology Division, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Manfred J Müller
- Institute for Human Nutrition and Food Science, Christian-Albrecht University, Kiel, Germany
| | | | - Hans Fors
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Paul Chamney
- Global R&D, Fresenius Medical Care, Bad Homburg, Germany
| | - Peter Wabel
- Global R&D, Fresenius Medical Care, Bad Homburg, Germany
| | - Ulrich Moissl
- Global R&D, Fresenius Medical Care, Bad Homburg, Germany
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Affiliation(s)
- M J Müller
- Institut für Humanernährung und Lebensmittelkunde, Kiel, Germany
| | - C Geisler
- Institut für Humanernährung und Lebensmittelkunde, Kiel, Germany
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