One-month of a low-energy diet, with no additional effect of high-protein, reduces Obstructive Sleep Apnea severity and improve metabolic parameters in obese males.

PURPOSE: Obstructive Sleep Apnea (OSA) is closely associated with obesity. Weight loss ameliorates OSA and its associated metabolic disorders. A high protein intake may improve weight loss through increased energy expenditure, and fat-free mass maintenance during weight loss. OBJECTIVES: To evaluate the effects of a low-energy, high-protein diet on OSA severity and metabolic parameters in obese men. METHODS: Forty-five OSA obese (BMI ≥ 30 kg/m2) males were included in this randomized study and submitted to nocturnal polysomnography, body composition measured by plethysmography, biochemical analyses of blood glucose, insulin and lipids, and food intake evaluations before and after one month of a low-energy diet. Diets were designed to create a 30% deficit in total energy expenditure with 1.6 g of protein/kg/day (High Protein group - HP) or 0.8 g of protein/kg/day (Low Protein group - LP). RESULTS: Only a time effect of the intervention was observed in body mass (-3.7 ± 2.0% for the LP group and -4.0 ± 1.5% for the HP group; p < 0.001), Body Mass Index (p < 0.001), fat mass in kg (p < 0.01) and fat-free mass in kg (p < 0.01). Significant improvements in Apnea Hypopnea Index were observed in both groups (54.0 ± 25.0 to 33.7 ± 31.7 in LP group; 39.7 ± 24.3 to 21.4 ± 25.9 in HP group; p = 0.06). Improvements of 38% and 46% in the Apnea-Hypopnea Index were observed in the LP and HP groups, respectively. Both interventions provided equivalent metabolic benefits as reductions in glucose (p < 0.001), insulin (p < 0.001), HOMA-IR (p = 0.005), triglycerides (p = 0.002), and in total cholesterol (p = 0.004). CONCLUSION: One month of a low-energy diet resulted in significant improvements in OSA severity in obese men. Increased protein intake during a short period of low-energy diet had no further beneficial effects on OSA severity or biochemical parameters than a standard protein diet. Registered under ClinicalTrials.gov Identifier no. NCT01985035.

Relationship of evening meal with sleep quality in obese individuals with obstructive sleep apnea.

PURPOSE: To determine the relationship between habitual food intake, resting energy expenditure and sleep pattern in obstructive sleep apnea (OSA) patients. METHODS: Forty-five OSA obese males were included in the study. All participants were submitted to nocturnal polysomnography, body composition measurements by plethysmography, resting energy expenditure (REE) analysis by indirect calorimetry and they filled in a 3-day food record. RESULTS: No differences in body composition, REE and food intake were found between the moderate and severe OSA groups. A trend towards higher energy intake in the severe OSA group was observed, compared to the moderate group (p = 0.08). Significant associations between apnea-hypopnea index (AHI) with body weight, body mass index (BMI) and resting energy expenditure (REE) were found. Higher food intake in the evening period was positively correlated with sleep stage NREM1, arousal index, and AHI and negatively correlated with sleep stage NREM3 and sleep efficiency. A multivariate linear regression showed energy intake at breakfast to be a significant negative predictor of AHI; protein intake (g/kg) showed a positive association, while energy intake at breakfast and at dinner were negative predictors of sleep efficiency; and energy intake at dinner was a negative predictor of stage NREM1 sleep. CONCLUSIONS: We conclude that higher amounts of food intake during the evening period may diminish sleep quality in moderate and severe sleep apnea patients. In addition, despite observing no differences between OSA severity groups, a moderate correlation between REE and sleep quality and OSA exists.

Applicability of predictive equations for resting energy expenditure in obese patients with obstructive sleep apnea

ABSTRACT Objective To investigate the applicability of predictive equations for resting energy expenditure (REE) in obese individuals with obstructive sleep apnea (OSA) and the effects of OSA severity on REE. Materials and methods Twenty-nine obese men, 41.5 ± 7 years old, with moderate and severe OSA were recruited. All subjects were submitted to a clinical polysomnography, body composition, and indirect calorimetry measurements. REE was also predicted by three different equations: Harris and Benedict (1919), Cunningham (1990), and DRI (2002). Results No effects of OSA severity on REE were found. The measured REE (2416.0 ± 447.1 kcal/day) and the REE predicted by equations were different from each other (F = 2713.88; p < 0.05): Harris and Benedict (2128.0 ± 245.8 kcal/day), Cunningham (1789.1 ± 167.8 kcal/day) and DRI (2011.1 ± 181.4 kcal/day). Pearson correlations showed a moderate positive correlation between the REE measured and predicted by all equations. Conclusion Our findings suggest that predictive equations for REE underestimate the energy expenditure in obese patients with sleep apnea. Also, no effects of OSA severity on REE were found.

Applicability of predictive equations for resting energy expenditure in obese patients with obstructive sleep apnea.

OBJECTIVE: To investigate the applicability of predictive equations for resting energy expenditure (REE) in obese individuals with obstructive sleep apnea (OSA) and the effects of OSA severity on REE. MATERIALS AND METHODS: Twenty-nine obese men, 41.5 ± 7 years old, with moderate and severe OSA were recruited. All subjects were submitted to a clinical polysomnography, body composition, and indirect calorimetry measurements. REE was also predicted by three different equations: Harris and Benedict (1919), Cunningham (1990), and DRI (2002). RESULTS: No effects of OSA severity on REE were found. The measured REE (2416.0 ± 447.1 kcal/day) and the REE predicted by equations were different from each other (F = 2713.88; p < 0.05): Harris and Benedict (2128.0 ± 245.8 kcal/day), Cunningham (1789.1 ± 167.8 kcal/day) and DRI (2011.1 ± 181.4 kcal/day). Pearson correlations showed a moderate positive correlation between the REE measured and predicted by all equations. CONCLUSION: Our findings suggest that predictive equations for REE underestimate the energy expenditure in obese patients with sleep apnea. Also, no effects of OSA severity on REE were found.

Emotional eating is related to carbohydrate intake in active women

Abstract BACKGROUND: Physical exercise may contribute to changes in eating behavior. AIMS: to investigate eating behavior and reported energy intake in physically active individuals. METHODS: Thirty-nine healthy adults of both sexes, who were involved in physical fitness training, were enrolled to participate in the study. A food diary and the TFEQ-21 was used for energy intake measurementandeating behaviors identification. RESULTS: All participants showed acceptable levels of all evaluated behaviors: Cognitive restraint (46.58±16.4 and 49.5±20.0), Emotional eating (8.12±12.5 and 40.8±26.7),and Uncontrolled eating (21.6±15.1 and 35.6±20.9) in men and women, respectively. Uncontrolled eating was associated with increased carbohydate intake for women, andfat-free masscontent was associated with less Emotional eating only in men. There were no differences in energy and macronutrient consumption between training and non-training days. CONCLUSION: Regular physical exercise is associateto bettereating behaviors, but women mayfind it harder to maintain or lose weight due to higher levels of emotional eating.