Total and resting energy expenditure in obese women reduced to ideal body weight.

Obesity could be due to excess energy intake or decreased energy expenditure (EE). To evaluate this, we studied 18 obese females (148 +/- 8% of ideal body weight [IBW], mean +/- SD) before and after achieving and stabilizing at IBW for at least 2 mo and a control group of 14 never obese females (< 110% of IBW or < 30% fat). In the obese, reduced obese, and never obese groups, the percent of body fat was 41 +/- 4%, 27 +/- 4%, and 25 +/- 3%; total energy expenditure (TEE) was 2704 +/- 449, 2473 +/- 495, and 2259 +/- 192 kcal/24 h; while resting metabolic rate was 1496 +/- 169, 1317 +/- 159, and 1341 +/- 103 kcal/24 h, respectively. 15 obese subjects who withdrew from the study had a mean initial body composition and EE similar to the subjects who were successful in achieving IBW. In 10 subjects followed for at least one year after stabilizing at IBW there was no significant relationship between the deviation from predicted TEE at IBW and weight regain. These studies indicate that, in a genetically heterogeneous female population, neither the propensity to become obese nor to maintain the obese state are due to an inherent metabolic abnormality characterized by a low EE.

Mechanism of glomerular hyperfiltration after a protein meal in humans. Role of hormones and amino acids.

OBJECTIVES: Previous studies demonstrated that protein meals and amino acid (AA) infusions increase glomerular filtration rate (GFR) and renal plasma flow (RPF) and that somatostatin (SRIH) infusion inhibits these increments. We tested whether a single AA such as alanine could increase GFR and RPF and whether the changes in GFR and RPF could be explained on the basis of changes in glucagon, growth hormone (GH), and insulin. RESEARCH DESIGN AND METHODS: In the first experiment, alanine was infused with or without SRIH in five normal subjects. In the second experiment, five other subjects were infused with SRIH on three separate occasions. In a control study, insulin, glucagon, and GH were given at replacement doses; in a hyperglucagonemia study, glucagon was given at a rate of 0.2 microgram.kg-1.h-1 (hypoglucagonemia); and in a high GH study, GH was given at a rate of 2 micrograms.kg-1.h-1. GFR and RPF were measured using insulin and para-aminohippurate, respectively. RESULTS: Alanine increased GFR and RPF, whereas SRIH inhibited these changes (P < 0.05). Hyperglucagonemia or high GH with or without insulin failed to increase RPF or GFR. CONCLUSIONS: A single AA such as alanine increases GFR and RPF, and this increase is dependent on a factor inhibited by SRIH. Although GH, glucagon, and insulin are factors inhibited by SRIH, none of these factors explains the changes in RPF and GFR in our acute studies.

Failure of dehydroepiandrosterone to influence energy and protein metabolism in humans.

It was reported recently that 4 weeks of dehydroepiandrosterone (DHEA) treatment [5.55 mmol/day (1600 mg/day), orally] reduced body fat and increased lean body mass in healthy men. The present study was performed to examine whether these effects could be explained by increased energy expenditure and muscle protein synthesis. Eight healthy men were given placebo and DHEA (1600 mg/day) for 4 weeks each in a double blind cross-over study. DHEA treatment caused a 9-fold increase in mean plasma DHEA sulfate concentrations, but had no significant effect on body weight or on two indices of lean body mass (total body water and total body potassium). DHEA had no effect on any of the parameters of energy and protein metabolism, including resting metabolic rate, total energy expenditure (estimated by the 2H2(18)O method during the final 2 weeks of each treatment period), leucine flux (an index of whole body proteolysis), the nonoxidized portion of leucine flux (an index of whole body protein synthesis), and the rate of incorporation of leucine into muscle protein. Circulating levels of cholesterol, T3, and T4 also were unaffected by DHEA. These data suggest that DHEA is not an important regulator of energy or protein metabolism in humans.

Growth hormone increases muscle mass and strength but does not rejuvenate myofibrillar protein synthesis in healthy subjects over 60 years old.

The rate of synthesis of myofibrillar proteins is slower in muscle of healthy subjects over 60 yr old than it is in young adults. Previous research suggests that reduced activity of the GH/insulin-like growth factor-I system could be a determinant of this slowing of protein synthesis. To test the hypothesis that GH could rejuvenate the rate of myofibrillar protein synthesis, we studied healthy subjects over 60 yr old, after a single injection (0.03 mg/kg.sc) of recombinant human GH (n = 6 males/2 females) or placebo (n = 6 males/2 females), or after 3 months of either GH (0.03 mg/kg, sc, 3 x /week, n = 5 males) or placebo (n = 5 males) treatment. Myofibrillar protein synthesis and whole-body protein metabolism were evaluated with the tracer L-[1-13C]leucine. GH reduced whole-body leucine oxidation by 36% (P < 0.01) in the single injection study. There was no effect of GH on whole-body protein breakdown or synthesis, or on myofibrillar protein synthesis in the quadriceps, either acutely or after 3 months of treatment. GH treatment for 3 months increased lean body mass (3.3 +/- 0.7 kg, P < 0.01, as evaluated by 40K counting), muscle mass (3.3 +/- 1.1 kg, P < 0.02, as evaluated by urinary creatinine excretion), and thigh strength (14 +/- 5%, P < 0.05, as evaluated by isokinetic dynamometry). We conclude that GH can increase muscle mass and strength in healthy men over 60 yr old, but does not restore a youthful rate of myofibrillar protein synthesis.

Energy expenditure under free-living conditions in normal-weight and overweight women.

Total energy expenditure under free-living conditions of 12 normal-weight and 26 overweight women was determined with the 2H2(18)O method. Overweight women tended to expend more energy (mean +/- SD, 11.20 +/- 1.79 MJ/d) than normal-weight women (9.46 +/- 0.87 MJ/d, P less than 0.005). Approximately half of this effect was explained by an increase in basal metabolic rate (BMR) in the overweight group compared with the normal-weight group (6.47 +/- 0.74 vs 5.68 +/- 0.39 MJ/d, respectively, P less than 0.005) and the other half by an increase in above-basal energy expenditure (4.73 +/- 1.49 vs 3.78 +/- 0.94 MJ/d, P less than 0.05). Total energy expenditure was approximately 1.7 times the BMR in both groups. After adjusting energy expenditure for weight or lean body mass by analysis of covariance, there was no significant difference between normal-weight and overweight groups. We conclude that most overweight subjects must consume more energy than lean subjects to maintain their excess weight, although some could maintain their obesity without eating more than lean subjects.

Reduced metabolic rate during beta-adrenergic blockade in humans.

We previously reported that 1 week of propranolol treatment (160 to 240 mg/d, orally) reduced resting metabolic rate (RMR) an average of 9% in healthy men. To determine whether this response was caused by the 25% reduction in serum triidothyronine (T3), rather than beta-adrenergic blockade, we examined the effect of nadolol on RMR in five healthy men. Nadolol is a nonselective beta-adrenergic antagonist that does not affect T3 production. After 6 to 10 days of nadolol treatment (240 mg/d), mean postabsorptive RMR declined 7% (P less than .01), with no significant change in serum T3 or thyroxine (T4) concentrations. This effect is significantly different from that of a hospitalized control group that received no drug and had no change in mean RMR, and was not different from the response to propranolol (previously published data). Nadolol slightly reduced the mean thermic response to a meal (12%), but this effect was not statistically significant. Mean postprandial RMR was 8% lower after nadolol treatment (P less than .01), mainly because of the reduced postabsorptive RMR, rather than a change in the response to the meal. These data suggest that beta-adrenergic activity makes a small but significant contribution to resting energy expenditure in man.

Differential effect of insulin on whole-body proteolysis and glucose metabolism in normal-weight, obese, and reduced-obese women.

The whole-body rate of proteolysis, as indicated by the postabsorptive appearance rate (Ra) of leucine, is increased in obese women. The present study was conducted to examine the hypothesis that the increased proteolysis is explained by insulin resistance, and to determine if proteolysis returns to normal when obese women reduce to normal weight. The mean basal leucine Ra was 21% higher in 31 obese women (> 135% ideal weight) than in 17 normal-weight women, and 9% higher per kilogram lean body mass ([LBM] P > .05). When 17 of the obese women reduced and stabilized at 100% to 116% of ideal weight, their mean basal leucine Ra decreased 17% (7%/kg LBM) and was not significantly different from that of the normal-weight control group. Insulin (40 mU/m2/min) was infused for 2 hours while maintaining euglycemia in eight normal-weight, 14 obese, and eight reduced-obese subjects. Glucose disposal per kilogram LBM was 29% lower in obese than in normal-weight subjects (P < .05) and was normal in the reduced-obese subjects. Insulin suppressed the leucine Ra an average of 18.4% in the control group, 20.4% in the obese group, and 24.1% in the reduced-obese group. Suppression of the leucine Ra by insulin did not correlate with the waist to hip ratio (WHR), glucose disposal rate, or basal leucine Ra. We conclude that the increased basal proteolysis of obese women is reversed by weight loss, and is not caused by insulin resistance.

Increased protein turnover in obese women.

Some previous studies have indicated that rates of proteolysis and protein synthesis are greater in obese than in lean subjects, whereas others have not supported this finding. In the present study, we have measured postabsorptive protein turnover in a large group (n = 24) of obese women to establish more conclusively whether obese women have higher rates of protein turnover than lean women (n = 12), and to determine whether obese subjects with the greatest abdominal fat accumulation or those with the most severe insulin resistance (as determined by oral glucose tolerance testing) have the highest rates of protein turnover. Leucine appearance rate (Ra) was used as an index of whole-body proteolysis, and the fraction of Ra not oxidized was used as an index of whole-body protein synthesis. Leu Ra, oxidation, and incorporation into protein after an overnight fast were approximately 25% greater in obese than in lean women, and were approximately 10% to 15% greater after dividing by lean body mass (LBM) or adjusting for LBM by analysis of covariance. Among obese women, the degree of obesity (over the range of 30% to 47% fat) was not a significant determinant of protein turnover, nor were degree of insulin resistance, visceral fat accumulation (determined by magnetic resonance imaging [MRI]), or subcutaneous abdominal fat accumulation (also determined by MRI). However, the women with the highest rates of protein turnover also had higher waist to hip circumference ratios (WHR). We conclude that even moderate obesity is associated with increased protein turnover, and that this effect is not completely explained by the higher LBM in obese subjects.

The effects of weight reduction to ideal body weight on body fat distribution.

Obesity is a well-known health risk factor. Several studies have demonstrated that upper-body fat distribution plays a major role in the association between increased adiposity and metabolic disorders. The present study was undertaken to evaluate changes in intraabdominal and subcutaneous fat areas in obese subjects undergoing a weight reduction to their ideal body weight (IBW), as defined by a body mass index (BMI) no greater than 21 or body fat less than 30%, and compare the fat distribution at IBW with that of never-obese control subjects. We studied 33 obese women (151% +/- 1% of IBW; BMI, 31.6 +/- 2.5 [mean +/- SE]) before and after weight loss and a control group of 16 never-obese women (101.0% +/- 1.0% of IBW; BMI, 21.2 +/- 1.1). Eighteen obese women successfully achieved and stabilized at IBW for at least 2 months. Nonsuccessful obese subjects were significantly younger than reduced-weight subjects, but other physical characteristics were similar. In obese, reduced-obese, and never-obese groups, weight was 85 +/- 2.0, 62 +/- 1, and 58 +/- 1 kg; percent body fat was 41% +/- 1%, 24% +/- 2%, and 23% +/- 1%; intraabdominal fat area was 82 +/- 5, 28 +/- 3, and 25 +/- 4 cm2; waist subcutaneous fat area was 275 +/- 15, 120 +/- 9, and 81 +/- 7 cm2; hip subcutaneous fat area was 416 +/- 17, 204 +/- 10, and 195 +/- 7 cm2; and waist to hip ratio (WHR) was 0.84 +/- 0.02, 0.77 +/- 0.01, and 0.73 +/- 0.01, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Myofibrillar protein synthesis in young and old human subjects after three months of resistance training.

Muscle protein synthesis is slower in healthy older men and women than in young adults, but whether this results from relative disuse rather than aging is unclear. The present study was done to examine rates of myofibrillar protein synthesis before and after a 3-mo progressive resistance exercise program in young and old men and women. Protein synthesis was determined by incorporation of the tracer L-[1-13C]leucine into myofibrillar proteins obtained from the vastus lateralis muscle by needle biopsy. Before exercise, mean fractional myofibrillar synthesis was 33% slower (P < 0.01) in nine older subjects (62-72 yr old, 5 men and 4 women) than in 9 young subjects (22-31 yr old, 5 men and 4 women). Initial strength, as determined by three-repetition-maximum tests, was significantly less in the older group. Strength and training weights increased similarly in young and old groups, when expressed in relation to baseline values. Posttraining myofibrillar synthesis was determined on the day after the final training session. There was not a significant change in fractional myofibrillar synthesis in either the young or the old group after training, and the rate in the older group remained 27% slower (P < 0.05). Whole body protein turnover increased approximately 10% only in the younger group, and 24-h urinary 3-methylhistidine excretion (an index of myofibrillar proteolysis) was not significantly affected by training. These data suggest that the slower myofibrillar synthesis rate in older subjects cannot be explained by disuse.

Postprandial myofibrillar and whole body protein synthesis in young and old human subjects.

Rates of incorporation of leucine (using L-[1-13C]leucine as a tracer) into myofibrillar and whole body proteins were determined in healthy old (> 60 yr old, n = 7) and young (< 30 yr old, n = 9) men and women who were fed small meals (4% of daily energy) every 30 min. There was no difference in whole body incorporation of leucine into proteins in the young (148 +/- 5 mumol.h-1.kg lean body mass-1, means +/- SE) and old groups (150 +/- 3 mumol.h-1.kg lean body mass-1). However, the fractional myofibrillar protein synthesis in the vastus lateralis muscle was 28% slower in the older group (0.063 +/- 0.004 vs. 0.088 +/- 0.003 %/h, P < 0.001). Extrapolation of these results to whole body myofibrillar synthesis (fractional rate x myofibrillar mass estimated by creatinine excretion) indicated that, in the older group, total myofibrillar synthesis was 43% slower (1.8 +/- 0.2 vs. 3.1 +/- 0.2 g/h, P < 0.01) and that their myofibrillar synthesis was a smaller portion of whole body protein synthesis (15 +/- 1 vs. 23 +/- 1%, P < 0.001). Compared with age-matched postabsorptive subjects, whole body protein synthesis was approximately 25% faster, and fractional myofibrillar synthesis was approximately 50% faster in these fed subjects, both young and old. We conclude that myofibrillar synthesis is slower in older subjects during both postabsorptive and postprandial conditions but that aging does not impair the stimulatory effect of feeding on protein synthesis.

Myofibrillar protein synthesis in young and old men.

We tested the hypothesis that healthy older men (> 60 yr old) have a slower rate of myofibrillar protein synthesis than young men (< 35 yr old). Myofibrillar protein synthesis was determined by the in vivo incorporation of L-[1-13C]leucine into myofibrillar proteins obtained by muscle biopsy. Subjects were eight young (21-31 yr) and eight older (62-81 yr) men, all healthy and moderately active. There was no significant difference in the mean height and weight of the two age groups, but the older group had 12% less lean body mass (determined by 40K counting) and 21% less muscle mass (estimated by urinary creatinine excretion). Upper leg strength was approximately one-third lower in the older subjects according to isokinetic dynamometry. The fractional rate of myofibrillar protein synthesis was 28% slower in the older group (0.039 +/- 0.009 vs. 0.054 +/- 0.010 %/h, mean +/- SD, P < 0.01). Total myofibrillar protein synthesis, estimated as total myofibrillar mass (from creatinine excretion) times the fractional synthesis rate, was 44% slower in the older group (1.4 vs. 2.5 g/h, P < 0.001). Whole body protein synthesis, assessed as the difference between leucine disappearance rate and leucine oxidation, was marginally slower (8%, P = 0.10) in the older group, but not when the data were adjusted for lean body mass. Myofibrillar protein synthesis was a smaller fraction of whole body protein synthesis in the older group (12 vs. 19%). Reduced myofibrillar protein synthesis may be an important mechanism of the muscle atrophy associated with aging.