Ad libitum food intake on a "cafeteria diet" in Native American women: relations with body composition and 24-h energy expenditure.

Epidemiologic studies consistently report associations between obesity and dietary fat but not total energy intake. We measured ad libitum food intake in a laboratory setting and evaluated its relation to body weight and composition, energy expenditure, and macronutrient utilization in 28 women of Pima-Papago heritage (aged 27 +/- 7 y, 85.3 +/- 19.0 kg, 44 +/- 6% body fat; means +/- SD). All women were studied during the follicular phase of the menstrual cycle. After a 4-d weight-maintenance period, the volunteers selected their food for 5 d from computerized vending machines offering a variety of familiar and preferred foods, ie, a "cafeteria diet". Twenty-four-hour energy expenditure and substrate oxidation were measured in a respiratory chamber on the 4th d o weight maintenance and the 5th d of ad libitum intake. Average ad libitum intake was 13,732 +/- 4238 kJ/d (11 +/- 1% protein, 40 +/- 1% fat, 49 +/- 4% carbohydrate), ie, moderate overeating by 27 +/- 37% above weight maintenance requirements (range: -27% to 124%). Percent body fat correlated with daily energy intake (r = 0.53, P < 0.01), the degree of overeating (r = 0.41, P < 0.05), and the selection of a diet higher in fat and lower in carbohydrate (r = 0.70 and r = -0.63, respectively, P < 0.001). Excess carbohydrate intake caused an increase in carbohydrate oxidation (r = 0.51, P < 0.01), whereas excess fat intake resulted in a decrease in fat oxidation (r = -0.53, P < 0.01) and thus a positive fat balance of 85 +/- 65 g/d. The positive relations among degrees of obesity, dietary fat intake and overeating, and the fact that dietary fat does not induce fat oxidation, support the hypothesis that dietary fat promotes obesity in women.

Energy metabolism in weight-stable postobese individuals.

A low metabolic rate for a given body size and body composition and a low ratio of fat to carbohydrate oxidation predict body weight gain. Such metabolic traits could also explain, in part, the propensity of previously obese (postobese) individuals to regain weight after dieting. We studied 11 postobese volunteers (4 males, 7 females; aged 43 +/- 13 y, weighing 80.6 +/- 10.2 kg, with 30 +/- 7% body fat; x +/- SD) who lost 57 +/- 38 kg (23-139 kg) over 14 +/- 12 mo (6-48 mo) on various diet programs and had maintained this weight loss for > or = 2 mo (2-72 mo; 21 +/- 27 mo). After > or = 2 d of a weight-maintenance diet on a metabolic ward, 24-h energy expenditure and ratio of fat to carbohydrate oxidation were measured in a respiratory chamber. Compared with a control group (n = 110) with similar physical characteristics (aged 43 +/- 14 y, weighing 79.5 +/- 11.4 kg, with 30 +/- 12% body fat), [sequence: see text] postobese individuals had similar energy expenditures adjusted for fat-free mass, fat mass, age, and sex, but significantly higher respiratory quotients over 24 h (0.883 +/- 0.026 compared with 0.863 +/- 0.024, P < 0.01) and during sleep, 10 h after the last meal (0.894 +/- 0.063 compared with 0.845 +/- 0.055). These results suggest that postobese individuals have low rates of fat oxidation that may explain their propensity to regain weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Spontaneous overfeeding with a 'cafeteria diet' in men: effects on 24-hour energy expenditure and substrate oxidation.

OBJECTIVE: To investigate the relationship between obesity and ad libitum food intake (quantity and composition) and to assess the impact of ad libitum food intake on energy expenditure and macronutrient oxidation. DESIGN: Male volunteers were first fed a weight maintaining diet for at least 4 days before selecting their food for the next 5 days from two computerized vending machines offering a variety of familiar, palatable foods. 24-h energy expenditure (24EE) and substrate oxidation were measured in a respiratory chamber on the last day of each weight maintenance and ad libitum intake periods. SETTING: Ten day admission on a metabolic research ward. SUBJECTS: Thirty-four non-diabetic Pima Indian males covering a wide range of body weight and body composition (30 +/- 8 y, 102.1 +/- 30.2 kg, 34 +/- 9% body fat, mean +/- s.d.). RESULTS: Weight maintenance requirements averaged 2913 +/- 342 kcal/d. Energy intake during the ad libitum period increased to 4550 +/- 921 kcal/d (12 +/- 1% protein, 40 +/- 4% fat, 48 +/- 4% carbohydrate) i.e., a spontaneous overeating by 54 +/- 32% above weight maintenance requirement, resulting in a 0.9 +/- 1.0 kg body weight gain. Neither the composition of the selected diet nor the degree of overeating was associated with physical characteristics, such as body weight and body composition. When compared with baseline, spontaneous overeating on day 5 was associated with a 396 +/- 233 kcal/d increase in 24EE, a 607 +/- 503 kcal/d increase in carbohydrate oxidation, a 214 +/- 392 kcal/d decreased in lipid oxidation (P < 0.01), and no change in protein oxidation. Increased carbohydrate oxidation correlated with the excess carbohydrate intake (r = 0.69, P = 0.0001) accounting for 68 +/- 13% (mean +/- s.e.e.) of the excess, whereas excess fat intake was not oxidized. CONCLUSION: In response to spontaneous overfeeding on a mixed 'cafeteria diet', excess carbohydrate intake is oxidized, suggesting a physiological control of carbohydrate stores, whereas excess fat intake is channeled toward fat stores. None of the observed changes were related to indices of obesity.

Determinants of total daily energy expenditure: variability in physical activity.

Excessive energy intake and/or reduced total daily energy expenditure (TEE) causes obesity. To determine the relationship between obesity and TEE in an obesity-prone population, we measured TEE, 24-h sedentary energy expenditure (SEDEE), and basal metabolic rate (BMR) in 30 Pima Indian men (83.6 +/- 20.0 kg and 31 +/- 9% fat) by the doubly labeled water method and a respiratory chamber. The energy expenditure for physical activity (EEACT) was calculated as TEE - (BMR + 0.1 TEE), where 10% of TEE is an estimate of the thermic effect of food. Fat-free mass was the best single determinant (P < 0.01) of TEE, explaining 48% of its variance. TEE, SEDEE, BMR, and EEACT were 12,010 +/- 2292, 9945 +/- 1559, 7677 +/- 1901, and 3297 +/- 1732 kJ/d, respectively. Because EEACT is dependent on body weight, EEACT/kg body wt (41.7 +/- 23.2 kJ.d-1.kg-1) and TEE/(BMR + 0.1 TEE) (1.39 +/- 0.22) were used as indexes of the level of physical activity. Both indexes correlated negatively with percent body fat (r = -0.56, P < 0.01 and r = -0.42, P < 0.03, respectively). These results suggest that obesity is associated with lower levels of physical activity.

Energy cost of arousal: effect of sex, race and obesity.

The basal (BMR) to sleeping metabolic rate (SMR) ratio might represent an estimate of the activation of the nervous system (central/sympathetic) from sleeping to basal state. Since this activation might be influenced by the degree of obesity, and might be different between sexes, we retrospectively analysed energy expenditure data collected for a large number of subjects. Twenty-four hour energy expenditure (24EE), BMR and SMR were measured in a respiratory chamber in 122 Caucasians (63 males/59 females, 32 +/- 10 years, 94 +/- 33 kg, 29 +/- 11% fat) (means +/- s.d.) and in 123 Pima Indians (68 males/55 females, 29 +/- 7 years, 100 +/- 25 kg, 34 +/- 9% fat). The BMR/SMR ratio varied greatly between individuals (1.05 +/- 0.08; range 0.87-1.34). In Pima Indians, BMR/SMR was inversely correlated to both fat mass (r = -0.26; P < 0.01) and BMI (r = -0.22; P < 0.05), whereas, in Caucasians, BMR/SMR was inversely correlated to waist/thigh circumference ratio (r = -0.28; P < 0.01). On average, the BMR/SMR was higher in Pima Indians than in Caucasians (1.06 +/- 0.08 vs. 1.03 +/- 0.07, P < 0.01) and higher in Pima Indian males than in Pima Indian females (1.08 +/- 0.09 vs. 1.04 +/- 0.06, P < 0.05). Studies are needed to investigate whether these differences in the increase in energy expenditure from the sleeping to the basal state are related to differences in the activation of the nervous system and/or to other metabolic factors.

Daily energy expenditure by five-year-old children, measured by doubly labeled water.

Current recommendations for daily energy requirements in 5-year-old children (90 kcal/kg per day) are based on energy intake associated with normal growth. It is not known, however, how these recommendations compare with total free-living energy expenditure (TEE) and how much of TEE is related to physical activity. The TEE and the resting metabolic rate (RMR) were measured in 28 white children, aged 5 years (15 boys, 13 girls; mean (+/- SD) weight 20.1 +/- 3.4 kg; height 113 +/- 6 cm; fat 20% +/- 5%). The TEE was calculated during a 7-day period from urinary elimination rates of deuterium (2H) and heavy oxygen (18O) by using a modification of the two-point slope-intercept method; RMR was measured by a ventilated-hood indirect calorimeter. Physical activity indexes were also collected from questionnaires completed by the parents. Measured TEE was considerably lower than the recommended dietary allowances (1370 +/- 222 kcal/day vs 1807 +/- 310 kcal/day; p < 0.0001), whereas measured RMR was slightly higher than predicted RMR (1001 +/- 119 kcal/day vs 952 +/- 78 kcal/day; p < 0.001). The energy cost of physical activity accounted for only 16% +/- 7% of TEE. An index of activity, assessed as the difference between the measured TEE and the predicted TEE, correlated positively with past-year sport-leisure activity assessed by questionnaire (r = 0.40; p < 0.05). We conclude that measured TEE in 5-year-old children yields lower values (approximately 400 kcal/day) than current estimates. A minute part of this difference (20 to 30 kcal/day) is related to the changes in energy stores during growth, but most seems due to lower-than-expected levels of physical activity. This might be related to increased television viewing, which replaces activities requiring energy.

Relationship between skeletal muscle lipoprotein lipase activity and 24-hour macronutrient oxidation.

A low ratio of whole-body 24-h fat/carbohydrate (CHO) oxidation has been shown to be a predictor of subsequent body weight gain. We tested the hypothesis that the variability of this ratio may be related to differences in skeletal muscle metabolism. Since lipoprotein lipase (LPL) plays a pivotal role in partitioning lipoprotein-borne triglycerides to adipose (storage) and skeletal muscle (mostly oxidation), we postulated that a low ratio of fat/CHO oxidation was associated with a low skeletal muscle LPL (SMLPL) activity. As an index of substrate oxidation, 24-h RQ was measured under sedentary and eucaloric conditions in 16 healthy nondiabetic Pima males. During a 6-h euglycemic, hyperinsulinemic clamp, muscle biopsies were obtained at baseline, 3, and 6 h. Heparin-elutable SMLPL activity was 2.92 +/- 0.56 nmol free fatty acids/g.min (mean +/- SD) at baseline, was unchanged (2.91 +/- 0.51) at the third hour, and increased significantly (P < 0.05) to 3.13 +/- 0.57 at the sixth hour of the clamp. The mean (of baseline and 3-h) SMLPL activity correlated inversely with 24-h RQ (r = 0.57, P < 0.03) but not with body size, body composition, or insulin-mediated glucose uptake. Since SMLPL activity is related to the ratio of whole body fat/CHO oxidation rate, a decreased muscle LPL activity may, therefore, predispose to obesity.

Effect of phenylpropanolamine on energy expenditure and weight loss in overweight women.

The effect of phenylpropanolamine (PPA), a noncatecholamine sympathomimetic weight-loss agent, on energy expenditure (EE) and substrate oxidation was measured in a respiratory chamber in 24 overweight women after 4 d of treatment (PPA or placebo) during weight maintenance and after 7 wk of treatment on a hypoenergetic diet (70% of measured baseline 24-h EE). Twelve women (37 +/- 2 y, 74 +/- 6 kg, 33 +/- 1% body fat) were randomly assigned to the PPA group [75 mg osmotic release oral system (OROS)-PPA/d] and 12 (mean +/- SEM: 38 +/- 2 y, 79 +/- 1 kg, 37 +/- 1% body fat) to the placebo group. Baseline measurements of 24-h EE (7849 +/- 226 vs 7834 +/- 142 kJ/d), basal metabolic rate (BMR) and 24-h respiratory quotient (RQ) were comparable between PPA and placebo groups. After 4 d of treatment, there was no significant effect of PPA on 24-h EE, BMR, and 24-h RQ compared with placebo. Over the 7-wk diet period, however, the PPA group (n = 8) had greater weight loss than the placebo group (n = 10): -5.0 +/- 0.5 vs -3.0 +/- 0.4 kg (P < 0.05). The changes in 24-h EE and 24-h RQ over the 7 wk were not different between the groups. We conclude that weight loss is enhanced by OROS-PPA, but this change was not explained by changes in 24-h EE or 24-h RQ. The small number of subjects may have hindered detection of subtle differences in energy metabolism.

Twenty-four-hour energy expenditure in Pima Indians with type 2 (non-insulin-dependent) diabetes mellitus.

To assess the impact of Type 2 (non-insulin-dependent) diabetes mellitus on energy metabolism, 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were measured in a respiratory chamber in 151 Pima Indians, 102 with normal glucose tolerance (67 male/35 female, (mean +/- SD) 28 +/- 7 years, 99 +/- 24 kg, 32 +/- 9% body fat) and in 49 with Type 2 diabetes (22 male/27 female, 35 +/- 11 years, 107 +/- 33 kg, 39 +/- 7% body fat), after at least 3 days on a weight maintaining diet. After adjustment for differences in fat-free mass, fat mass, age and sex, 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were significantly higher in diabetic patients than in control subjects (72 kcal/day, p less than 0.05; 99 kcal/day, p less than 0.005; 99 kcal/day, p less than 0.001 respectively). Spontaneous physical activity was similar in both groups whereas the thermic effect of food, calculated as the mean energy expenditure corrected for activity throughout the day above sleeping metabolic rate and expressed as a percentage of energy intake, was significantly lower in Type 2 diabetic patients (17.1 +/- 7.1 vs 19.8 +/- 5.6%, p less than 0.05). Adjusted values of 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were correlated with hepatic endogenous glucose production (r = 0.22, p less than 0.05; r = 0.22, p less than 0.05; r = 0.31, p less than 0.01 respectively). Therefore, increased basal and sleeping metabolic rates, resulting in increased 24-h sedentary energy expenditure may play a role in the weight loss so often observed in Type 2 diabetic subjects in addition to the energy loss from glycosuria.

Spontaneous physical activity and obesity: cross-sectional and longitudinal studies in Pima Indians.

Healthy, nondiabetic Pima Indians [103 males, 77 females; 27 +/- 6 (SD) yr, 97 +/- 25 kg, 33 +/- 9% body fat] were studied in a respiratory chamber in which spontaneous physical activity (SPA) was measured by two microwave sensors. SPA, defined as the percentage of time the subjects were active, varied widely from 4.4 to 17.5%. It was higher in males (9.3 +/- 2.0%) than in females (8.6 +/- 2.3%; P less than 0.05) and was not related to body fatness in either sex. However, SPA accounted for a significant portion of the daily energy expenditure (24-h EE) in males (1,389 +/- 423 kJ/day) and females (1,163 +/- 351 kJ/day) and correlated positively with 24-h EE adjusted for differences in fat-free mass, fat mass, age, and sex (r = 0.42, P less than 0.0001). In 88 siblings, family membership accounted for 57% of the variance in SPA (r(i) = 0.57, P less than 0.02). Body composition was reassessed in a subgroup of 123 subjects (65 males, 58 females) 33 +/- 14 mo later. In males only, SPA correlated inversely to the rate of subsequent body weight change (r = -0.25, P less than 0.05) and the rate of fat-mass change (r = -0.35, P less than 0.005). We conclude that spontaneous physical activity is a familial trait that may play a role in the pathogenesis of obesity.