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PubMed1989

Energy metabolism in human obesity.

Obesity results from a chronic imbalance between energy intake and expenditure. Accurate measurements of total energy expenditure of lean and obese individuals with a respiration chamber have clearly shown that obese individuals expand more energy than lean sedentary subjects. Studies on the body composition of obese individuals reveal that not only the fat mass is enlarged, but the fat-free mass is also increased as compared with that of lean subjects. Since basal metabolic rate is proportional to the fat-free mass, obese subjects have a greater basal metabolic rate than lean controls. The energy cost of weight bearing activities such as walking and standing is related to body weight, and is therefore increased in obese individuals. The thermogenic response to food ingestion, the diet-induced thermogenesis, has been found to be reduced in some groups of obese people, but not in all obese individuals. The thermic effect of glucose or to meal ingestion is blunted in obese subjects with insulin resistance. Any alteration in thermogenic responses to a caloric excess can be important to store or to oxidize part of the excessive energy intake. After weight reduction in obese subjects due to a hypocaloric diet, the total 24-hour energy expenditure decreases by 20 to 25 kcal/day for each kilogram of weight loss. Failure to adapt the every day energy intake accordingly will result in body weight gain and relapse of obesity.

Basal Metabolism↗

PubMed1984

Major influences on median energy and nutrient intakes among teenagers: a Tasmanian survey.

This report explores the characteristics that influenced median intakes of energy and ten nutrients in a representative sample of 1055 adolescents (11-16 years) in Tasmania, Australia. Among girls, the characteristic with greatest influence on intakes was different for different nutrients. Thus, median intakes of fat, iron, thiamin and niacin-equivalent were lower in heavier, fatter girls. Girls from larger families consumed more riboflavin, while girls with poorly educated mothers consumed less vitamin A. Girls who regularly took vitamin supplements had higher median intakes of (food-derived) calcium. Among boys the increase of intakes of energy and nutrients with age overshadowed the influence of other characteristics. Among younger boys the characteristic with greatest influence varied. Those with highly educated fathers had lower median intakes of energy and carbohydrate; those who exercised vigorously consumed more fat; those who smoked 'heavily' (greater than 10 cigarettes in the previous week) consumed more thiamin and niacin-equivalent. Among older boys the characteristic with greatest influence varied. Those who drank 'heavily' (greater than five glasses in the previous week) had higher intakes of energy and fat. Those from professional-managerial households consumed more thiamin. For vitamin C, there was no sex difference in intakes. Social status had the greatest influence, with children from professional-managerial households eating more. Food choices underlying these differences in energy and nutrient intakes were explored.

Adolescent↗

PubMed1991

Energy content of stools in normal healthy controls and patients with cystic fibrosis.

Stool energy losses and the sources of energy within the stool were determined in 20 healthy controls and 20 patients with cystic fibrosis while on their habitual pancreatic enzyme replacement treatment. Stool energy losses were equivalent to 3.5% of gross energy intake in healthy children (range 1.3-5.8%). Despite a comparable gross energy intake, stool energy losses were three times greater in patients with cystic fibrosis than controls averaging 10.6% of gross energy intake (range 4.9-19.7%). Stool lipid could account for only 29% and 41% of the energy within the stool in controls and patients with cystic fibrosis respectively and was poorly related to stool energy. Approximately 30% of the energy within the stool could be attributable to colonic bacteria in both the healthy children and patients with cystic fibrosis. These results suggest that stool energy losses in healthy children are relatively modest but that even when patients with cystic fibrosis are symptomatically well controlled on pancreatic enzyme replacement, raised stool energy losses may continue to contribute towards an energy deficit sufficient to limit growth in cystic fibrosis. As the energy content per gram wet weight remains relatively constant (8 kJ/g), stool energy losses may be estimated from simple measurements of stool wet weight.

Adolescent↗

PubMed1996

Influence of imposed feed intake patterns during lactation on reproductive performance and on circulating levels of glucose, insulin, and luteinizing hormone in primiparous sows.

Thirty-six primiparous sows were assigned to one of five treatments designed to mimic the lactation feed intake patterns observed in a previous study of commercial farms: high energy intake (HHH) or low energy intake during each week of a 3-wk lactation (LLL), or reduced intake during wk 1 (LHH), wk 2 (HLH) or wk 3 of lactation (HHL). The metabolizable energy intake of sows was either 16.5 (H) or 6.5 (L) Mcal/d. Diets were equal in lysine, providing 45 g/d. The HHH sows had a shorter (P < .05) weaning-to-estrus interval (9 +/- 3.2 d) than the sows in the LLL (23 +/- 3.5 d), HLH (22 +/- 3.5 d), and HHL (18 +/- 3.2 d) groups. The LH pulse frequencies of HHH (d 14: 1.5 pulses/8 h; d 21: 2.1 pulses/8 h) were greater (P < .05) than those of LLL (.2 pulses/8 h) and HLH (.5 pulses/8 h) on d 14 and those of LLL (0 pulses/8 h) and HHL (.9 pulses/8 h) on d 21 of lactation. No differences (P > .1) in mean serum concentrations of LH were observed among treatment groups either on d 21 of lactation or on d 1 postweaning. When fed a low-energy diet, sows had lower (P < .05) concentrations of serum insulin and plasma glucose than did sows fed a high-energy diet. Our results indicate that energy intake during lactation influences circulating insulin and glucose levels and LH pulse frequency and amplitude during midlactation and during the postweaning period.

Animal Feed↗

PubMed2001

Cost of selective feeding by the blue mussel (Mytilus trossulus) as measured by respiration and ammonia excretion rates.

The metabolic cost as measured by respiration and ammonia excretion rates associated with a selective as compared to a non-selective feeding behaviour was determined for the blue mussel, Mytilus trossulus. Mussels were challenged with four environmentally relevant seston matrices of different quality and quantity, which were known to evoke either a sorting response (i.e., selective feeding) where organic-rich particles were selected over inorganic particles as compared to no sorting (i.e., non-selective) where either inorganic or organic particles were ingested by the bivalve. Seston matrices were prepared by mixing known quantities of silt and algae such that the following extent of feeding responses would occur; no pre-sorting of ingested material, (1) no algae+50 mg silt l(-1), (2) 150x10(6) cells l(-1) of algae+no silt, and, where pre-sorting of ingested material occurred, (3) 20x10(6) cells l(-1) of algae and 20 mg l(-1) of silt, and (4) 150x10(6) cells l(-1) of algae and 50 mg l (1) of silt. A control, which represented basal metabolism consisting of mussels exposed only to filtered seawater (0.45 &mgr;m), was included for a total of five treatments. Mussel respiration and ammonia excretion rates were independent of whether mussels were pre-sorting or not sorting ingested material. Of the four matrices, only rates determined for conditions of maximum seston quality and quantity where pre-sorting of the seston occurred were significantly different from control mussels (p<0.05, ANOVA). Estimates of net energy used for feeding, where net energy is total energy intake (food) minus energy expenditure (energy lost through respiration and excreta as measured by ammonia excretion rates), indicated that feeding, whether selective or non-selective required only 0.92% of net energy intake. Hence, mussels appear to be highly adapted to a dynamic food environment with negligible costs associated with the feeding process, even when significant pre-selection of organic-rich particles occurs.

Journal Article↗

PubMed2002

Effect of postpartum exercise on mothers and their offspring: a review of the literature.

Epidemiological studies suggest that childbearing may contribute to the development of obesity. In the past 12 years, several cross-sectional and randomized trials have addressed the effect of postpartum exercise on weight loss and/or energy balance in mostly lactating women. These studies suggest that moderate exercise without specific calorie restriction does not promote greater weight or fat loss. This may be because exercise may promote greater energy intake and/or reduced energy expenditure from nonexercise physical activity (thus preventing negative energy balance), but further research is needed. Regular exercise, however, is likely to have other important health benefits after childbirth. A few published studies suggest that postpartum exercise improves aerobic fitness, high-density lipoprotein-cholesterol levels, and insulin sensitivity. Exercise may also enhance psychological well-being, but controlled clinical studies are needed. Although two published studies have addressed whether exercise training attenuates lactation-induced bone loss, better controlled studies are needed to determine whether postpartum weight-bearing exercise can improve bone mineral density in lactating and nonlactating women alike. In lactating women, several studies have collectively determined that neither acute nor regular exercise has adverse effects on a mother's ability to successfully breast-feed. It needs to be determined whether a woman's participation in regular exercise after childbirth will improve her ability to mother or instill lifetime habits of regular physical activity in either herself or her offspring. Overall, published studies have established the importance of regular exercise during the postpartum period. More research, however, is needed in this important area.

Body Composition↗

PubMed2003

Dusting off the epidemiological triad: could it work with obesity?

The search for effective ways of dealing with obesity has centred on biological research and clinical management. However, obesity needs to be conceptualized more broadly if the modern pandemic is to be arrested. The epidemiological triad (hosts, agent/vectors and environments) has served us well in dealing with epidemics in the past, and may be worth re-evaluating to this end. Education, behaviour change and clinical practices deal predominantly with the host, although multidisciplinary practices such as shared-care might also be expected to impact on other corners of the triad. Technology deals best with the agent of obesity (energy imbalance) and it's vectors (excessive energy intake and/or inadequate energy expenditure), and policy and social change are needed to cope with the environment. The value of a broad model like this, rather than specific isolated approaches, is that the key players such as legislators, health professionals, governments and industry can see their roles in attenuating and eventually reversing the epidemic. It also highlights the need to intervene at all levels in obesity control and reduces the relevance of arguments about nature vs. nurture.

Dietary Fats↗

PubMed1998

What do pharmacological approaches to obesity management offer? Linking pharmacological mechanisms of obesity management agents to clinical practice.

Obesity is characterised by pathophysiological defects affecting both sides of the energy balance equation. Individuals with a predisposition to obesity have impaired appetite control when diets are fat-rich and energy dense. They also exhibit a lower than expected resting metabolic rate (RMR). A low RMR, in concert with a sedentary lifestyle, contributes to a low total energy output, which may lead to obesity if continued over a period of years. A low metabolic rate seems to be genetically determined, and is partly caused by low sympathetic nervous system activity. Classical treatment programmes for obesity do not provide a satisfactory long-term outcome for the majority of patients. Patients who achieve only a small weight loss during dietary therapy, and have a tendency to weight regain, are characterised by lower energy expenditure, lower sympathetic activity, and a reduced ability to mobilise fat stores, compared with patients who are more successful at losing weight. It is reasonable to improve or normalise these traits by supporting the dietary approach with pharmacological manipulation of central and peripheral pathways. Agents which stimulate adrenergic neurons are particularly suitable because they offer mechanisms for inhibiting hunger and for stimulating energy expenditure, lipolysis and fat oxidation. Sympathomimetic compounds can reduce appetite and increase energy expenditure. Energy expenditure can be increased by 5-10% via stimulation of a combination of beta-adrenoceptors; beta3-adrenoceptors may predominate during chronic therapy. This increased energy expenditure increases the relative proportion of fat oxidation; as this is not fully compensated by increased energy intake, a negative energy balance occurs. This mechanism may be responsible for the long-term weight loss efficiency of agents like ephedrine/caffeine and sibutramine. Pharmacotherapy can be used to support short-term induction of weight loss or long-term weight maintenance. In the latter case, adrenergic agents enable a greater proportion of patients to maintain a satisfactory weight loss, compared with patients treated with conventional programmes alone. Pharmacotherapy which stabilises the size of fat stores at a lower level contributes indirectly to a pronounced improvement of risk factors, leading to a decreased potential for cardiovascular disease, type 2 diabetes and associated morbidity.

Adrenergic beta-Agonists↗

PubMed1998

The relationship between serum oestradiol concentration and energy balance in young women distance runners.

Reproductive dysfunction in women distance runners has been linked to an imbalance between energy intake (EI) and energy expenditure (EE) which leads to an energy deficit. To determine whether ovarian suppression is associated with an energy deficit, the relationships between serum oestradiol (E2) concentration and indices of energy balance (EB) were explored in a group of women runners with a variety of menstrual patterns and a range of activity levels. Subjects comprised 33 women distance runners of mean (SD) age 27.2 (1.8) years. Sixteen of these women were defined as eumenorrhoeic (11-13 menstrual bleeds per year during the past 2 years), 8 as oligomenorrhoeic (< or = 3 menstrual bleeds per year for 2 years) and 9 as amenorrhoeic (absence of menses for > 1 year). Their volume of running training ranged from 36 to 97 km x wk(-1) [mean (SD): 68.6 (21.4) km x wk(-1). The body mass index (BMI) and percent body fat (BF) of each subject was measured. Their mean daily energy balance (EB) was calculated by subtracting their dietary EI from their estimated EE recorded over 7 days. Serum concentrations of E2, total T3 and IGF-1 were measured from a fasting blood sample (taken in early follicular phase for Eu women). Relationships between serum E2, T3 and IGF-1, EB, BMI and BF were explored using bivariate correlation and regression analysis. The results showed that the most powerful predictors of serum E2 concentration were estimated EB (r = 0.88, P<0.001), serum T3 (r=0.94, P<0.001) and IGF-1 (r=0.84; P<0.001). Weaker correlations were observed between serum E2 and BMI (r=0.42; P=0.008) and serum E2 and BF (r=0.48; P=0.004). These relationships add support to the hypothesis that reproductive dysfunction in women distance runners is associated with an energy deficit.

Adipose Tissue↗

PubMed1986

Energy metabolism in healthy black Kenyan children.

1. Twenty-four healthy black Kenyan children, mean age 29 (SD 19) months, were studied over a 24 h period. Energy expenditure (EE) was determined using a ventilated-hood indirect calorimeter; measuring oxygen consumption and carbon dioxide production. Metabolizable energy intake was measured in twenty children. Anthropometric measurements were used to estimate surface area and lean body-weight. 2. The mean daily intake of metabolizable energy was 338.4 (SE 28.4) kJ/kg; 70% of gross dietary energy being provided by carbohydrate. The level of postprandial EE was significantly (P less than 0.05) higher than the resting level (12.6 (SE 0.47) and 11.38 (SE 0.37) kJ/kg per h respectively) while the level of the postprandial respiratory quotient (RQ) was similar to the resting level (0.94 (SE 0.02) and 0.98 (SE 0.03 respectively). In 33% of total observations of the resting RQ the value was more than 1.0. These findings suggest that short-term fat storage may be a normal feature of metabolism in children, and also that the energy cost of (postprandial) fat synthesis is increased by a high-carbohydrate diet. 3. Values for the resting metabolic rate and various estimators of body size were compared using regression analysis. It was evident that, in these young children with considerable variation in body composition, body-weight remained a satisfactory metabolic-size estimator.

Black People↗

PubMed2001

Combined effects of red pepper and caffeine consumption on 24 h energy balance in subjects given free access to foods.

The effects of red pepper and caffeine ingestion on energy and macronutrient balances were examined in eight Caucasian male subjects. All subjects participated in two randomly assigned conditions: control and experimental (red pepper and caffeine). After ingesting a standardized breakfast, subjects ate three meals ad libitum (lunch, dinner and breakfast) and snacks which were served approximately 2 h after the lunch and dinner over a 24 h period. Two appetizers with or without 3 g red pepper) were given before lunch and dinner, and a drink (decaffeinated coffee with or without 200 mg caffeine) was served at all meals and snacks except for the after-dinner snack. It is also important to note that on the experimental day, 8.6 and 7.2 g red pepper were also added to lunch and dinner respectively. Red pepper and caffeine consumption significantly reduced the cumulative ad libitum energy intake and increased energy expenditure. The mean difference in energy balance between both conditions was 4000 kJ/d. Moreover, the power spectral analysis of heart rate suggested that this effect of red pepper was associated with an increase in sympathetic:parasympathetic nervous system activity ratio. These results indicate that the consumption of red pepper and caffeine can induce a considerable change in energy balance when individuals are given free access to foods.

Adult↗

PubMed2002

Energy metabolism of young rats after early postnatal overnutrition.

Early postnatal overnutrition (PNO) induced by restricting litter size in rats leads to increased body-weight (BW) and body-fat gain in later life. PNO rats are used as an animal model of moderate obesity and early hyperinsulinism. We investigated whether the increased adiposity could be due to a decreased energy expenditure. Male newborn Wistar rats were raised in litters of either two (SL) or twelve pups (NL), weaned at 4 weeks of age and subsequently fed ad libitum. BW was recorded continuously until 12 weeks of age. Daily energy intake, total daily energy expenditure (EE, measured by indirect calorimetry) and body composition were measured in weaned pups at 5, 8 and 12 weeks of age. SL rats displayed increased BW compared with NL rats from week 2 to 5 and again from week 10 to 12. Lean body mass, body fat and protein content and total EE were increased in SL rats at week 5. The same linear correlation described the relationship between BW and total EE in NL and SL rats. At week 8 to 12 no differences in energy metabolism could be found, but the total fat content was increased in SL rats at week 12. Energy balance, i.e. assimilated energy minus EE, was no different between SL and NL at any time that it was measured. We conclude that although PNO rats display increased adiposity in early life, there seem to be no long-lasting effects on energy metabolism in later life, even if a tendency to increased adiposity can still be detected.

Adipose Tissue↗

PubMed2005

Effects of subthalamic nucleus deep brain stimulation and levodopa on energy production rate and substrate oxidation in Parkinson's disease.

Patients with Parkinson's disease (PD) often lose weight, but after subthalamic nucleus deep brain stimulation (STN-DBS), they gain weight. We compared daily energy intake (DEI), resting energy expenditure (REE) and substrate oxidation rates (measured by indirect calorimetry) in nineteen STN-DBS-treated patients (Group S), thirteen others on pharmacologic treatment by levodopa (Group L) and eight control subjects. We also determined the acute effects of STN-DBS and levodopa on REE and substrate oxidation rates. STN-DBS treated patients gained 9.7 (SEM 7.1) kg after surgery, whereas patients on pharmacologic treatment lost 3.8 (SEM 10.0) kg since diagnosis. In STN-DBS-treated patients, REE (-16.5 %; P<0.001), lipid oxidation (-27 %; P<0.05) and protein oxidation (-46 %; P<0.05) were decreased, whereas glucose oxidation was elevated (+81 %; P<0.05) as compared to patients on pharmacologic treatment. Levodopa acutely reduced REE (-8.3 %; P<0.05) and glucose oxidation (-37 %; P<0.01) with a slight hyperglycaemic effect (after levodopa challenge: 5.6 (SEM 0.8) v. before levodopa challenge: 5.3 (SEM 0.6) mmol/l; P<0.01). Switching 'on' STN-DBS acutely reduced REE (-17.5 %; P<0.01) and lipid oxidation (-24 %; P<0.001) 30 min after starting stimulation. Fasting glycaemia was slightly but significantly reduced (5.4 (SEM 1.4) v. 5.5 (SEM 1.3) mmol/l; P<0.01). After STN-DBS, the normalization of REE and the reduction in lipid and protein oxidation contribute to the restoration of weight. As levodopa decreases glucose oxidation, the reduction in daily dose of levodopa in STN-DBS-treated patients helps prevent the effect of weight gain on glycaemia.

Antiparkinson Agents↗

PubMed2001

Chronic pulmonary insufficiency in children and its effects on growth and development.

Conditions leading to chronic pulmonary insufficiency can affect infants and children. These can lead to growth failure and delayed development. Among the most common and severe of these are bronchopulmonary dysplasia (BPD) and cystic fibrosis. In addition to the respiratory consequences of these diseases, there is ample evidence that they lead to decreased growth as a result of decreased energy intake and increased energy expenditure. Furthermore, there is evidence that infants with BPD may also have delayed development, independent of the effects of their prematurity. Enhancing the long-term outlook for these conditions may therefore require consideration of both improved pulmonary management and aggressive nutritional management to limit growth failure and potentially enhance developmental outcome. Specific micronutrient supplementation, such as antioxidant therapy, may also enhance pulmonary and nutritional status.

Asthma↗

PubMed2003

Energy availability, not body fatness, regulates reproductive function in women.

The morbid consequences of menstrual disorders in athletes require medical diagnosis and treatment. Reproductive disruption appears to occur when energy availability (dietary energy intake minus exercise energy expenditure) falls below a threshold between 20 and 30 kcal x kgLBM(-1) x d(-1), and some women may be more severely affected than others by subthreshold energy availability.

Body Composition↗

PubMed2000

Energetic factors, ovarian steroids and the risk of breast cancer.

In industrial countries, women often have excess metabolic energy due to high food consumption and low physical activity. High lifetime energy availability results in high lifetime levels of ovarian steroid hormones. Oestrogens and progesterone are hypothesized to play a crucial role in the development and prognosis of breast cancer. Epidemiological studies document the importance of physical activity and caloric limitations in reducing breast cancer risk. The risk of breast cancer is much higher in industrial countries than in developing countries, where women are characterized by lower energy intake and higher energy expenditure. It is likely, that the beneficial effects of physical activity and of negative energy balance are mediated by the reduced levels of ovarian steroids. While both weight loss and physical activity may have similar efficacy in suppressing ovarian function and, therefore, in reducing the risk of breast cancer, we suggest that it may be more advantageous for premenstrual women to achieve lifetime reduction in steroid levels by increasing their physical activity, rather than by weight loss due to caloric restriction alone.

Breast Neoplasms↗

PubMed1992

Correlation between ovarian steroids and lipid fractions in relation to age in premenopausal women.

OBJECTIVE: We evaluated the effect of sex steroids on the lipid fractions (cholesterol, triglycerides, LDL-C, HLD-C and subfractions HDL2-C and HDL3-C) and on the apolipoproteins (A-1 and B) in relation to age in women. DESIGN: Twenty-eight normally cycling women belonging to three age groups (20-29, n = 11; 30-39, n = 10; 40-49, n = 7) had blood samples taken daily during one cycle. MEASUREMENTS: Serum lipid fractions, apolipoproteins (Apo) and ovarian steroids were measured daily during the menstrual cycle. Diet and exercise were also evaluated. RESULTS: Each age group had comparable profiles for daily serum concentrations of oestradiol, progesterone and testosterone. There were no significant variations of the lipid fractions or of the ApoA-I and ApoB during the menstrual cycle in each group. Using regression analysis, modifications of cholesterol, triglycerides, LDL-C and ApoB were partially but significantly correlated with age. These changes occurred in spite of similar serum concentrations of oestradiol, progesterone and testosterone in the three groups. Lipid fractions were also affected by the increase of body mass index with age, especially HDL-C and HDL2C. However, there were no differences in lipid and energy intake or in energy expenditure during physical leisure activities. CONCLUSIONS: These results indicate that physiological fluctuations of ovarian steroids have no effects on lipids and Apo in normally cycling women of increasing age. In this study, the age related changes in the lipid fractions were partially correlated with body mass index but not with energy intake or exercise.

Adult↗

PubMed2005

Evidence for secular trends in children's physical activity behaviour.

It is not clear whether the global increase in weight problems in children is the result of excessive energy intake or decreasing energy expenditure. Methodological limitations have made it difficult to analyse. There is evidence that at least part of the problem may lie with increasing energy consumption, but it is important to examine the other side of the energy equation also. However, it is not possible to conclusively describe physical activity trends because of the absence of suitable baseline data. One solution is to summate all available evidence in as many areas of daily activities as possible and then draw tentative conclusions. This review summarises available trend data on direct representations of physical activity in a range of contexts, together with indirect measures such as sedentariness, fitness, and attitudes. The conclusions drawn are: physical activity in clearly defined contexts such as active transport, school physical education, and organised sports is declining in many countries; young people would like to be active but are often constrained by external factors such as school policy or curricula, parental rules in relation to safety and convenience, and physical environmental factors.

Activities of Daily Living↗