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1.
J Intern Med ; 282(2): 187-201, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28548281

RESUMO

BACKGROUND: Overconsumption of dietary sugars, fructose in particular, is linked to cardiovascular risk factors such as type 2 diabetes, obesity, dyslipidemia and nonalcoholic fatty liver disease. However, clinical studies have to date not clarified whether these adverse cardiometabolic effects are induced directly by dietary sugars, or whether they are secondary to weight gain. OBJECTIVES: To assess the effects of fructose (75 g day-1 ), served with their habitual diet over 12 weeks, on liver fat content and other cardiometabolic risk factors in a large cohort (n = 71) of abdominally obese men. METHODS: We analysed changes in body composition, dietary intake, an extensive panel of cardiometabolic risk markers, hepatic de novo lipogenesis (DNL), liver fat content and postprandial lipid responses after a standardized oral fat tolerance test (OFTT). RESULTS: Fructose consumption had modest adverse effects on cardiometabolic risk factors. However, fructose consumption significantly increased liver fat content and hepatic DNL and decreased ß-hydroxybutyrate (a measure of ß-oxidation). The individual changes in liver fat were highly variable in subjects matched for the same level of weight change. The increase in liver fat content was significantly more pronounced than the weight gain. The increase in DNL correlated positively with triglyceride area under the curve responses after an OFTT. CONCLUSION: Our data demonstrated adverse effects of moderate fructose consumption for 12 weeks on multiple cardiometabolic risk factors in particular on liver fat content despite only relative low increases in weight and waist circumference. Our study also indicates that there are remarkable individual differences in susceptibility to visceral adiposity/liver fat after real-world daily consumption of fructose-sweetened beverages over 12 weeks.


Assuntos
Bebidas/efeitos adversos , Frutose/efeitos adversos , Metabolismo dos Lipídeos , Fígado/metabolismo , Obesidade Abdominal/complicações , Obesidade Abdominal/metabolismo , Edulcorantes/efeitos adversos , Adulto , Idoso , Composição Corporal , Doenças Cardiovasculares/etiologia , Dieta , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
2.
Nutr Metab Cardiovasc Dis ; 27(6): 534-542, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28428027

RESUMO

BACKGROUND AND AIMS: Incretin hormones glucagon-like peptide (GLP)-1 and glucose-dependent insulinotropic polypeptide (GIP) are affected early on in the pathogenesis of metabolic syndrome and type 2 diabetes. Epidemiologic studies consistently link high fructose consumption to insulin resistance but whether fructose consumption impairs the incretin response remains unknown. METHODS AND RESULTS: As many as 66 obese (BMI 26-40 kg/m2) male subjects consumed fructose-sweetened beverages containing 75 g fructose/day for 12 weeks while continuing their usual lifestyle. Glucose, insulin, GLP-1 and GIP were measured during oral glucose tolerance test (OGTT) and triglycerides (TG), GLP-1, GIP and PYY during a mixed meal test before and after fructose intervention. Fructose intervention did not worsen glucose and insulin responses during OGTT, and GLP-1 and GIP responses during OGTT and fat-rich meal were unchanged. Postprandial TG response increased significantly, p = 0.004, and we observed small but significant increases in weight and liver fat content, but not in visceral or subcutaneous fat depots. However, even the subgroups who gained weight or liver fat during fructose intervention did not worsen their glucose, insulin, GLP-1 or PYY responses. A minor increase in GIP response during OGTT occurred in subjects who gained liver fat (p = 0.049). CONCLUSION: In obese males with features of metabolic syndrome, 12 weeks fructose intervention 75 g/day did not change glucose, insulin, GLP-1 or GIP responses during OGTT or GLP-1, GIP or PYY responses during a mixed meal. Therefore, fructose intake, even accompanied with mild weight gain, increases in liver fat and worsening of postprandial TG profile, does not impair glucose tolerance or gut incretin response to oral glucose or mixed meal challenge.


Assuntos
Bebidas/efeitos adversos , Glicemia/metabolismo , Carboidratos da Dieta/efeitos adversos , Frutose/efeitos adversos , Hormônios Gastrointestinais/sangue , Teste de Tolerância a Glucose , Insulina/sangue , Síndrome Metabólica/sangue , Obesidade/sangue , Adulto , Idoso , Biomarcadores/sangue , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/sangue , Ingestão de Líquidos , Europa (Continente) , Frutose/administração & dosagem , Frutose/sangue , Humanos , Resistência à Insulina , Fígado/metabolismo , Fígado/patologia , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/fisiopatologia , Período Pós-Prandial , Valor Preditivo dos Testes , Quebeque , Fatores de Tempo , Triglicerídeos/sangue , Aumento de Peso , Adulto Jovem
3.
Int J Obes (Lond) ; 39(11): 1638-43, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26095245

RESUMO

BACKGROUND/OBJECTIVES: Although weight loss has been associated with changes in circulating 25-hydroxyvitamin D (25(OH)D) levels, the quantification of the increase in 25(OH)D levels as a function of adipose tissue volume loss precisely assessed by imaging has not been reported before. The objective of this substudy was to describe the effects of a 1-year lifestyle intervention on plasma 25(OH)D levels. The relationships between changes in 25(OH)D levels and changes in adiposity volume (total and by adipose tissue compartment) were studied. SUBJECTS/METHODS: This intervention study was performed between 2004 and 2006 and participants were recruited from the general community. Sedentary, abdominally obese and dyslipidemic men (n=103) were involved in a 1-year lifestyle modification program. Subjects were individually counseled by a kinesiologist and a nutritionist once every 2 weeks during the first 4 months with subsequent monthly visits in order to elicit a 500-kcal daily energy deficit and to increase physical activity/exercise habits. Body weight, body composition and fat distribution were assessed by dual-energy X-ray absorptiometry and computed tomography, whereas the 25(OH)D levels were measured with an automated assay. RESULTS: The 1-year intervention resulted in a 26% increase in circulating 25(OH)D (from 48±2 nmol l(-1) or 19±0.8 ng ml(-1) (±s.e.m.) to 58±2 nmol l(-1) or 23±0.8 ng ml(-1), P<0.0001) along with a 26% decrease in visceral adiposity volume (from 1947±458 to 1459±532 cm3). One-year increases in 25(OH)D levels correlated inversely with changes in all adiposity indices, especially Δvisceral (r=-0.36, P<0.0005) and Δtotal abdominal (r=-0.37, P<0.0005) adipose tissue volumes. CONCLUSIONS: These results indicate that there is a linear increase in circulating 25(OH)D levels as a function of adiposity volume loss, and therefore suggest a role of adiposity reduction in the management of obesity-associated vitamin D insufficiency.


Assuntos
Restrição Calórica , Dislipidemias/sangue , Exercício Físico , Obesidade/sangue , Comportamento de Redução do Risco , Vitamina D/análogos & derivados , Redução de Peso , Tecido Adiposo , Adiposidade , Adulto , Biomarcadores/sangue , Dislipidemias/terapia , Comportamento Alimentar , Humanos , Masculino , Saúde do Homem , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/prevenção & controle , Quebeque , Valores de Referência , Resultado do Tratamento , Vitamina D/sangue
4.
Int J Obes (Lond) ; 39(3): 495-501, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25179244

RESUMO

OBJECTIVES: To examine the specific distribution of liver fat content, visceral and subcutaneous adiposity in normal glucose tolerance (NGT/NGT), isolated impaired fasting glucose (iIFG), isolated impaired glucose tolerance (iIGT) and combined conditions (IFG+IGT), as well as with newly diagnosed type 2 diabetes (nT2D). DESIGN: Multicenter, international observational study: cross-sectional analysis. SUBJECTS: Two thousand five hundred and fifteen patients (50.0% women, 54.5% non-Caucasian) without previously known diabetes were recruited from 29 countries. Abdominal fat distribution was measured by computed tomography (CT). Liver fat was estimated using the CT-liver mean attenuation. RESULTS: Compared with NGT/NGT patients, increased visceral adiposity was found in iIFG, iIGT, IFG+IGT and nT2D; estimated liver fat progressively increased across these conditions. A one-s.d. increase in visceral adiposity was associated with an increased risk of having iIFG (men: odds ratio (OR) 1.41 (95% confidence interval (CI) 1.15-1.74), women: OR 1.62 (1.29-2.04)), iIGT (men: OR 1.59 (1.15-2.01), women: OR 1.30 (0.96-1.76)), IFG+IGT (men: OR 1.64 (1.27-2.13), women: OR 1.83 (1.36-2.48)) and nT2D (men: OR 1.80 (1.35-2.42), women: OR 1.73 (1.25-2.41)). A one-s.d. increase in estimated liver fat was associated with iIGT (men: OR 1.46 (1.12-1.90), women: OR 1.81 (1.41-2.35)), IFG+IGT (men: OR 1.42 (1.14-1.77), women: OR 1.74 (1.35-2.26)) and nT2D (men: OR 1.77 (1.40-2.27), women: OR 2.38 (1.81-3.18)). Subcutaneous abdominal adipose tissue showed an inverse relationship with nT2D in women (OR 0.63 (0.45-0.88)). CONCLUSIONS: Liver fat was associated with iIGT but not with iIFG, whereas visceral adiposity was associated with both. Liver fat and visceral adiposity were associated with nT2D, whereas subcutaneous adiposity showed an inverse relationship with nT2D in women.


Assuntos
Glicemia/metabolismo , Intolerância à Glucose/metabolismo , Gordura Intra-Abdominal/metabolismo , Fígado/metabolismo , Estado Pré-Diabético/metabolismo , Índice de Massa Corporal , Estudos Transversais , Jejum , Feminino , Intolerância à Glucose/sangue , Teste de Tolerância a Glucose , Humanos , Resistência à Insulina , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/sangue , Valor Preditivo dos Testes
5.
Diabet Med ; 31(9): 1086-92, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24890138

RESUMO

AIMS: Thiazolidinediones reduce ectopic fat, increase adiponectin and reduce inflammatory adipokines, fatty acids and glucose in people with Type 2 diabetes. We aimed to measure these effects in people with impaired fasting glucose and/or impaired glucose tolerance. METHODS: After approximately 3.5 years of exposure to rosiglitazone 8 mg (n = 88) or placebo (n = 102), 190 DREAM trial participants underwent abdominal computed tomography and dual-energy X-ray absorptiometry scans. Visceral and subcutaneous adipose tissue areas, estimated hepatic fat content, total fat and lean mass were calculated and changes in levels of fasting adipokines, free fatty acids, glucose and post-load glucose were assessed. RESULTS: Compared with the placebo, participants on rosiglitazone had no difference in lean mass, had 4.1 kg more body fat (P < 0.0001) and 31 cm(2) more subcutaneous abdominal adipose tissue area (P = 0.007). Only after adjusting for total fat, participants on rosiglitazone had 23 cm² less visceral adipose tissue area (P = 0.01) and an 0.08-unit higher liver:spleen attenuation ratio (i.e. less hepatic fat; P = 0.02) than those on the placebo. Adiponectin increased by 15.0 µg/ml with rosiglitazone and by 0.4 µg/ml with placebo (P < 0.0001). Rosiglitazone's effect on fat distribution was not independent of changes in adiponectin. Rosiglitazone's effects on fasting (-0.36 mmol/l; P = 0.0004) and 2-h post-load glucose (-1.21 mmol/l; P = 0.0008) were not affected by adjustment for fat distribution or changes in adiponectin or free fatty acids. CONCLUSIONS: In people with impaired fasting glucose/impaired glucose tolerance, rosiglitazone is associated with relatively less hepatic and visceral fat, increased subcutaneous fat and increased adiponectin levels. These effects do not appear to explain the glucose-lowering effect of rosiglitazone.


Assuntos
Composição Corporal/efeitos dos fármacos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Gordura Intra-Abdominal/metabolismo , Fígado/metabolismo , Obesidade/tratamento farmacológico , Tiazolidinedionas/uso terapêutico , Absorciometria de Fóton , Adipocinas/metabolismo , Adulto , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatologia , Ácidos Graxos/metabolismo , Ácidos Graxos não Esterificados/metabolismo , Feminino , Glucose/metabolismo , Humanos , Gordura Intra-Abdominal/efeitos dos fármacos , Fígado/efeitos dos fármacos , Masculino , Obesidade/fisiopatologia , Obesidade/prevenção & controle , Rosiglitazona , Tomografia Computadorizada por Raios X , Resultado do Tratamento
6.
Diabetes Obes Metab ; 15(7): 629-41, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23356633

RESUMO

AIM: Visceral adipose tissue (VAT) and liver fat (LF) are strongly associated with type 2 diabetes. It is not known, however, how diabetes treatment and/or risk factor management modulates the association between VAT, LF and diabetes. The aim was to determine the level of VAT and LF in patients with type 2 diabetes according to their treatment status and achievement of the American Diabetes Association's (ADA) diabetes management goals. METHODS: We performed a cross-sectional analysis of the baseline data of the International Study of the Prediction of Intra-Abdominal Adiposity and its Relationship with Cardiometabolic risk/Intra-Abdominal Adiposity (INSPIRE ME IAA), a 3-year prospective cardiometabolic imaging study conducted in 29 countries. Patients (n = 3991) were divided into four groups: (i) those without type 2 diabetes (noT2D n = 1003 men, n = 1027 women); (ii) those with type 2 diabetes but not treated with diabetes medications (T2Dnomeds n = 248 men, n = 198 women); (iii) those with type 2 diabetes and treated with diabetes medications but not yet using insulin (T2Dmeds-ins n = 591 men, n = 484 women) and (iv) those with type 2 diabetes and treated with insulin (T2Dmeds+ins n = 233 men, n = 207 women). Abdominal and liver adiposity were measured by computed tomography. RESULTS: Fewer patients with high VAT or LF achieved the ADA's goals for high-density lipoprotein cholesterol (HDL-C) or triglycerides compared to patients with low VAT or LF. Visceral adiposity (p = 0.02 men, p = 0.003 women) and LF (p = 0.0002 men, p = 0.0004 women) increased among patients who met fewer of the ADA treatment criteria, regardless of type 2 diabetes treatment. CONCLUSION: Residual cardiometabolic risk exists among patients with type 2 diabetes characterized by elevated VAT and LF.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Síndrome Metabólica/prevenção & controle , Adiposidade , Adulto , Idoso , Estudos de Coortes , Terapia Combinada , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/patologia , Diabetes Mellitus Tipo 2/terapia , Quimioterapia Combinada , Feminino , Humanos , Hiperlipidemias/etiologia , Hiperlipidemias/prevenção & controle , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/patologia , Metabolismo dos Lipídeos , Fígado/diagnóstico por imagem , Fígado/patologia , Masculino , Adesão à Medicação , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Radiografia , Fatores de Risco
7.
Diabetologia ; 52(2): 213-7, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18972095

RESUMO

AIMS/HYPOTHESIS: We previously reported that the plasma levels of the endocannabinoid, 2-arachidonoylglycerol (2-AG), in a cohort of viscerally obese men are directly correlated with visceral adipose tissue (VAT) accumulation and metabolic risk factors including low HDL-cholesterol and high triacylglycerol. It is not known, however, if such correlations persist after vigorous lifestyle interventions that reduce metabolic risk factors. We analysed the changes in endocannabinoid levels in a subsample from the same cohort following a 1 year lifestyle modification programme, and correlated them with changes in VAT and metabolic risk factors. METHODS: Forty-nine viscerally obese men (average age 49 years, BMI 30.9 kg/m(2), waist 107.3 cm) underwent a 1 year lifestyle modification programme including healthy eating and physical activity. Plasma levels of 2-AG and the other most studied endocannabinoid, anandamide, were measured by liquid chromatography-mass spectrometry. Anthropometric and metabolic risk factors, including VAT, insulin resistance and glucose intolerance, HDL-cholesterol and triacylglycerol, were measured. RESULTS: Most risk factors were improved by the intervention, which led to a significant decrease in body weight (-6.4 kg, p < 0.0001), waist circumference (-8.0 cm, p < 0.0001) and VAT (-30%, p < 0.0001), and in plasma 2-AG (-62.3%, p < 0.0001) and anandamide (-7.1%, p = 0.005) levels. The decrease in levels of 2-AG but not those of anandamide correlated with decreases in VAT and triacylglycerol levels, and with the increase in HDL(3)-cholesterol levels. Multivariate analyses suggested that decreases in 2-AG and VAT were both independently associated with decreases in triacylglycerol. CONCLUSIONS/INTERPRETATION: This study shows that a strong correlation exists between 2-AG levels and high plasma triacylglycerol and low HDL(3)-cholesterol in viscerally obese men.


Assuntos
Ácidos Araquidônicos/sangue , Glicerídeos/sangue , Estilo de Vida , Obesidade/sangue , Obesidade/reabilitação , Adiponectina/sangue , Tecido Adiposo/anatomia & histologia , Apolipoproteínas/sangue , Índice de Massa Corporal , Peso Corporal , Proteína C-Reativa/metabolismo , Endocanabinoides , Humanos , Interleucina-6/sangue , Leptina/sangue , Lipídeos/sangue , Masculino , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura , Redução de Peso
8.
Circulation ; 102(2): 179-84, 2000 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-10889128

RESUMO

BACKGROUND: The present study tested the hypothesis that simple variables, such as waist circumference and fasting plasma triglyceride (TG) concentrations, could be used as screening tools for the identification of men characterized by a metabolic triad of nontraditional risk factors (elevated insulin and apolipoprotein [apo] B and small, dense LDL particles). METHODS AND RESULTS: Results of the metabolic study (study 1) conducted on 185 healthy men indicate that a large proportion (>80%) of men with waist circumference values >/=90 cm and with elevated TG levels (>/=2.0 mmol/L) were characterized by the atherogenic metabolic triad. Validation of the model in an angiographic study (study 2) on a sample of 287 men with and without coronary artery disease (CAD) revealed that only men with both elevated waist and TG levels were at increased risk of CAD (odds ratio of 3.6, P<0.03) compared with men with low waist and TG levels. CONCLUSIONS: It is suggested that the simultaneous measurement and interpretation of waist circumference and fasting TG could be used as inexpensive screening tools to identify men characterized by the atherogenic metabolic triad (hyperinsulinemia, elevated apo B, small, dense LDL) and at high risk for CAD.


Assuntos
Apolipoproteínas B/sangue , Composição Corporal , Hiperinsulinismo/diagnóstico , Hipertrigliceridemia/diagnóstico , Lipoproteínas LDL/sangue , Abdome , Adulto , Biomarcadores , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/patologia , Doença das Coronárias/sangue , Doença das Coronárias/diagnóstico , Doença das Coronárias/epidemiologia , Humanos , Hiperinsulinismo/sangue , Hiperinsulinismo/epidemiologia , Hipertrigliceridemia/sangue , Hipertrigliceridemia/epidemiologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco , Triglicerídeos/sangue
9.
Arterioscler Thromb Vasc Biol ; 21(6): 961-7, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11397704

RESUMO

Recent studies have suggested that elevated plasma C-reactive protein (CRP) levels are associated with the features of insulin resistance syndrome. In the present study, we have examined the contribution of body composition measured by hydrostatic weighing and of abdominal adipose tissue (AT) accumulation assessed by computed tomography to the variation in plasma CRP levels associated with atherogenic dyslipidemia of the insulin resistance syndrome in a sample of 159 men, aged 22 to 63 years, covering a wide range of adiposity (body mass index values from 21 to 41 kg/m(2)). Plasma CRP levels showed positive and significant correlations with body fat mass (r=0.41, P<0.0001), waist girth (r=0.37, P<0.0001), and visceral AT accumulation measured by computed tomography at L4 to L5 (r=0.28, P<0.0003). Although CRP levels were associated with plasma insulin levels measured in the fasting state and after a 75-g oral glucose load, no significant correlations were found with plasma lipoprotein levels. Finally, comparison of body fatness, of abdominal fat accumulation, and of the features of the insulin resistance syndrome across quintiles of CRP revealed major differences in body fatness and in indices of abdominal AT accumulation between the lowest and the highest CRP quintiles, whereas no significant differences were found for variables of the plasma lipoprotein-lipid profile. These results suggest that obesity and abdominal AT accumulation are the critical correlates of elevated plasma CRP levels found in men with atherogenic dyslipidemia of the insulin resistance syndrome.


Assuntos
Arteriosclerose/etiologia , Proteína C-Reativa/metabolismo , Hiperlipidemias/etiologia , Resistência à Insulina , Obesidade/sangue , Abdome/crescimento & desenvolvimento , Tecido Adiposo/crescimento & desenvolvimento , Adulto , Arteriosclerose/sangue , Composição Corporal , Índice de Massa Corporal , Teste de Tolerância a Glucose , Humanos , Hiperlipidemias/sangue , Insulina/sangue , Lipoproteínas/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Síndrome , Trombose/sangue , Vísceras/crescimento & desenvolvimento
10.
Diabetes Care ; 24(5): 902-8, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11347752

RESUMO

OBJECTIVE: To determine whether the impaired glucose tolerance (IGT) state contributes to the deterioration of the metabolic profile in women after taking into account the contribution of visceral adipose tissue (AT) accumulation, as measured by computed tomography. RESEARCH DESIGN AND METHODS: We studied 203 women with normal glucose tolerance (NGT) and 46 women with IGT, defined as a glycemia between 7.8 and 11.1 mmol/l measured 2 h after a 75-g oral glucose load. RESULTS: Women with IGT were characterized by a higher visceral AT accumulation and by higher concentrations of fasting plasma glucose, insulin, and C-peptide as well as by higher plasma concentrations of cholesterol, triglycerides, and apolipoprotein B (apoB) and by greater cholesterol-to-HDL-cholesterol ratio, reduced LDL peak particle size, lower HDL-cholesterol and HDL2-cholesterol concentrations, and higher blood pressure (P < 0.01) than women with NGT. When we matched 27 pairs of women for visceral AT and fat mass as well as for menopausal status, differences previously found in LDL-cholesterol, LDL peak particle size, HDL-cholesterol, and HDL2-cholesterol concentrations as well as in the cholesterol-to-HDL-cholesterol ratio and blood pressure were eliminated, whereas triglyceride concentrations remained significantly higher in women with IGT. CONCLUSIONS: A high visceral AT accumulation is a major factor involved in the deterioration of many metabolic variables in women with IGT, with the notable exception of triglyceride concentrations, which remained significantly different between women with NGT and women with IGT after adjustment for visceral fat.


Assuntos
Tecido Adiposo/anatomia & histologia , Doenças Cardiovasculares/epidemiologia , Intolerância à Glucose/epidemiologia , Intolerância à Glucose/fisiopatologia , Tecido Adiposo/diagnóstico por imagem , Adulto , Idoso , Apolipoproteínas/sangue , Glicemia/metabolismo , Pressão Sanguínea , Peptídeo C/sangue , Colesterol/sangue , Feminino , Teste de Tolerância a Glucose , Humanos , Insulina/sangue , Lipoproteínas/sangue , Pessoa de Meia-Idade , Quebeque , Medição de Risco , Fatores de Risco , Tomografia Computadorizada por Raios X , Triglicerídeos/sangue , Vísceras
11.
J Clin Endocrinol Metab ; 85(4): 1550-6, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10770196

RESUMO

The aim of the present study was to determine the impact of weight loss and its related metabolic and hormonal changes on resting energy expenditure (REE) and substrate oxidation. Forty subjects (16 men and 24 women) took part in a 15-week weight loss program that consisted of drug therapy (fenfluramine, 60 mg/day) or placebo coupled to an energy restriction (-700 Cal/day). Subjects were asked to come to the laboratory after an overnight fast for an indirect calorimetry measurement before and after weight loss. Fasting blood samples were also drawn and were analyzed for plasma glucose, insulin, leptin, and free fatty acid determinations. This program reduced body weight by 11% and 9% (P < 0.01) in men and women, respectively. Fat mass (FM) and fat-free mass (FFM) were also significantly reduced in both sexes. A significant decrease in REE (13%; P < 0.01) and fat oxidation (11%; P = 0.08) was observed in men in response to this program, whereas no significant differences were noted for these variables in women. In men, positive correlations were found between changes in FFM and energy-related variables, whereas the best predictor of changes in REE and substrate oxidation was the change in FM in women. The most important finding of this study is that in men, the association between changes in fasting plasma leptin and changes in REE (r = 0.50; P < 0.01) and fat oxidation (r = 0.63; P < 0.01) persist after correction for changes in body composition. These results suggest that a comparable weight loss is accompanied by a greater decrease in REE and substrate oxidation in men than in women, and that these changes are better explained by changes in leptinemia in men and by changes in FM in women.


Assuntos
Metabolismo Energético , Leptina/fisiologia , Obesidade/terapia , Redução de Peso , Adulto , Metabolismo Basal , Glicemia/metabolismo , Índice de Massa Corporal , Dieta Redutora , Ingestão de Energia , Ácidos Graxos não Esterificados/sangue , Feminino , Fenfluramina/uso terapêutico , Humanos , Insulina/sangue , Masculino , Obesidade/metabolismo , Análise de Regressão
12.
J Clin Endocrinol Metab ; 85(11): 4231-7, 2000 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11095459

RESUMO

The aim of the present investigation was to determine whether leptinemia is only a reflection of the status of fat stores or if insulinemia has a significant influence over leptin levels. Study 1 focused on the association between fasting plasma insulin and leptin in subjects of the Quebec Family Study who were first classified as either high- or low-insulin individuals and were then individually matched on the basis of fat mass (FM). In Study 2, 19 men and 23 women took part in a 15-week weight loss program that consisted of drug therapy (fenfluramine, 60 mg/day) or placebo coupled to an energy-restricted diet (-2930 kJ/day). Body weight, FM, and fat-free mass (assessed by underwater weighing) as well as visceral and sc abdominal and mid-thigh adipose tissue measured by computed tomography were assessed before and after weight loss. Blood samples were drawn and analyzed for fasting plasma insulin and leptin before and after weight loss. In Study 1, significant positive associations were noted between log10 transformed fasting insulin and leptin in both men (r = 0.55, P < 0.0001) and women (r = 0.48, P < 0.0001). Moreover, after having carefully matched high-insulin to low-insulin individuals on the basis of FM, significantly lower leptin levels were observed in the low-insulin groups, in men (5.5 vs. 8.1 ng/mL, P < 0.05) as well as in women (18.7 vs. 24 ng/mL, P < 0.05). Results from Study 2 showed significant reductions of body weight, FM, fat-free mass, visceral abdominal tissue, sc abdominal tissue, and mid-thigh adipose tissue levels in men and women in response to the weight loss protocol. Moreover, the decrease in fasting plasma insulin was the only significant correlate of changes in fasting plasma leptin levels during weight loss, even after corrections for changes in FM in both men (r = 0.50, P < 0.05) and women (r = 0.46, P < 0.05). These results suggest that in a population characterized by a wide range of adiposity hyperinsulinemia has the potential to modulate leptin levels beyond what can be explained by total adiposity. Moreover, this relation also seems to exist in a dynamic setting (i.e. during weight loss) because changes in insulin were independent predictors of the changes in leptinemia in both men and women after correction for changes in FM.


Assuntos
Dieta Redutora , Fenfluramina/uso terapêutico , Insulina/sangue , Leptina/sangue , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Redução de Peso , Tecido Adiposo/anatomia & histologia , Tecido Adiposo/diagnóstico por imagem , Adulto , Composição Corporal , Peso Corporal , Estudos Transversais , Ingestão de Energia , Jejum , Feminino , Humanos , Masculino , Análise Multivariada , Placebos , Quebeque , Análise de Regressão , Caracteres Sexuais , Tomografia Computadorizada por Raios X , População Branca
13.
Am J Clin Nutr ; 54(3): 506-8, 1991 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-1877506

RESUMO

Three experiments were performed to test the validity of the low reported energy intake of weight maintenance in a postobese man. In the first experiment the subject reported a mean energy intake of 8008 kJ/d during 16 d and he maintained a stable body weight. This finding was not reproduced in the second experiment, which consisted of a 6-d inpatient study during which the subject was confined to a whole-body calorimeter for 5 d. Indeed, he lost weight when fed a controlled energy intake of 7950 kJ/d. Moreover, this experiment showed that direct and indirect calorimetry provided comparable energy-expenditure measurements during this period. Finally, when the subject was refed a controlled energy intake of 7950 kJ/d for 21 d, body weight and fat losses were observed. Therefore, these observations do not support the validity of the low energy intake that may be reported by people predisposed to obesity.


Assuntos
Peso Corporal , Ingestão de Energia , Necessidades Nutricionais , Obesidade/fisiopatologia , Calorimetria Indireta , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/patologia , Obesidade/terapia
14.
Am J Clin Nutr ; 53(5): 1134-7, 1991 May.
Artigo em Inglês | MEDLINE | ID: mdl-2021125

RESUMO

Two studies were performed to evaluate the short-term effect of a high-fat diet on spontaneous energy intake and the respective contribution of diet composition and energy density of food. Ingestion of high-fat foods was associated with a significant increase in energy intake in the two studies (P less than 0.05). In study 1 this increase was accompanied by a reduction in total weight of food consumed when compared with values obtained under low-fat-diet conditions. Moreover, the occurrence of satiety coincided with a level of carbohydrate intake corresponding to the expected daily carbohydrate oxidation when high-fat foods contained a moderate amount of carbohydrates. In study 2, where the carbohydrate content of high-fat foods was unusually low (less than or equal to 25% of their energy content), carbohydrate intake was lower than usual carbohydrate oxidation. Under the conditions of this study, energy density of foods seemed to play a significant role on the occurrence of satiety.


Assuntos
Gorduras na Dieta/administração & dosagem , Ingestão de Energia , Adulto , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/metabolismo , Ingestão de Alimentos , Humanos , Masculino , Oxirredução
15.
Am J Clin Nutr ; 59(5): 975-9, 1994 May.
Artigo em Inglês | MEDLINE | ID: mdl-8172103

RESUMO

This study was aimed at investigating the effect of exercise on energy balance under dietary conditions differing by the relative lipid content of foods. Nine healthy men performed a 60-min treadmill exercise followed by a 48-h observation period during which they maintained their habitual daily activities and had free access to either a low-fat, a mixed, or a high-fat diet. Energy balance, summing up the excess of energy expended during exercise and the 48-h postexercise energy balance, was -6.4, -4.5, and 0.9 MJ under low-fat, mixed, and high-fat diet conditions, respectively. These observations suggest that exercise can induce a substantial energy deficit when a low-fat diet conforming to nutritional recommendations is consumed after exercise. They also suggest that the increase in energy intake associated with a high-fat diet is sufficient to fully compensate for the energy deficit resulting from the energy cost of exercise and the increase in postexercise energy expenditure.


Assuntos
Dieta , Gorduras na Dieta/administração & dosagem , Metabolismo Energético , Exercício Físico/fisiologia , Adulto , Ingestão de Energia , Humanos , Masculino
16.
J Appl Physiol (1985) ; 80(1): 133-9, 1996 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-8847293

RESUMO

The maintenance of weight and adipose tissue mass in humans appears to be related to a balance between the rates of oxidation and consumption of macronutrients; yet, little evidence is available on the reproducibility of 24-h macronutrient oxidation rates and how this relates to diet in the days preceding a chamber session. This study examined the reproducibility of 24-h macronutrient oxidation rates, 24-h energy expenditure (EE), and respiratory quotient (RQ) in 30 adults who ate their habitual diets before two 24-h whole body indirect calorimeter sessions. Results showed that the within-subject coefficients of variation (CVws) for 24-h EE and RQ were 2.8 and 2.6%, respectively. CVws for macronutrient oxidations ranged from approximately 15 to 25%. Means comparisons of 24-h EE, RQ, and macronutrient oxidation rates between sessions showed no significant differences, and all variables had significant positive intraclass correlation coefficients (P < 0.05). In conclusion, macronutrient oxidations all showed significant reproducibility for the group and a significant but lower reproducibility for individuals when habitual diet and activity preceded the experimental sessions.


Assuntos
Carboidratos da Dieta/metabolismo , Gorduras na Dieta/metabolismo , Proteínas Alimentares/metabolismo , Metabolismo Energético/fisiologia , Tecido Adiposo/metabolismo , Adulto , Idoso , Índice de Massa Corporal , Peso Corporal/fisiologia , Calorimetria Indireta , Dióxido de Carbono/farmacologia , Dieta , Ingestão de Alimentos , Feminino , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Oxirredução , Reprodutibilidade dos Testes , Mecânica Respiratória/fisiologia
17.
Physiol Behav ; 61(6): 811-7, 1997 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9177551

RESUMO

The association between diet and body composition was investigated in 6 elite female swimmers subjected to a 13-month nutritional supervision and in 11 female untrained subjects matched for fat-free mass. The impact of a 2-month interruption of training on diet and body composition was also studied in the swimmers. A positive correlation was observed between the percentage of dietary energy as fat and percent body fat in the untrained subjects (r = 0.68, p < 0.05). When values of the swimmers were incorporated in the regression analysis, the correlation coefficient remained the same. Following detraining for 2 months, a 4.8-kg body weight gain, including 4.3 kg fat mass, was observed. The energy equivalent of these morphological changes was 170 MJ and corresponded to about the amount of energy that would have been normally expended during this detraining period. In conclusion, these results suggest that the association between diet and body composition is not altered by exercise training, and that body fat gain occurs in response to detraining, perhaps to promote the restoration of energy and fat balance.


Assuntos
Exercício Físico/fisiologia , Gorduras/metabolismo , Esportes/fisiologia , Natação/fisiologia , Aumento de Peso/fisiologia , Adolescente , Adulto , Metabolismo Energético/fisiologia , Feminino , Humanos
18.
Physiol Behav ; 57(5): 995-1000, 1995 May.
Artigo em Inglês | MEDLINE | ID: mdl-7610155

RESUMO

The main objective of this study was to evaluate the short-term effect of exercise-induced alteration in fat oxidation on postexercise spontaneous energy and macronutrient intakes. Eleven young males were submitted to two randomly assigned sessions of 48 h each, during which they were requested to eat in the laboratory. One of these sessions was preceded by a 90-min exercise bout at an intensity of 60% VO2max. During both sessions, subjects ate ad lib food with a fat content conforming to the recommendations of nutrition agencies with a food quotient (FQ) > or = 0.85. Results showed that there was no significant change in postexercise energy and macronutrient intakes in comparison with the sedentary session. However, when subjects were subdivided into two groups on the basis of the respiratory quotient (RQ) measured during exercise, men with a low RQ (high fat oxidation) were characterized by a reduced postexercise increase in energy intake relative to the energy cost of exercise (ECE), i.e., they were more predisposed to be in negative postexercise energy balance compared to those exhibiting a high RQ. Accordingly, exercise RQ was positively associated with postexercise energy and lipid balance. These results show that postexercise energy balance partly depends on the composition of the substrate mix oxidized during exercise.


Assuntos
Gorduras na Dieta/metabolismo , Metabolismo Energético/fisiologia , Exercício Físico/fisiologia , Adulto , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/metabolismo , Gorduras na Dieta/administração & dosagem , Humanos , Masculino , Oxirredução
19.
Med Sci Sports Exerc ; 32(2): 392-5, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10694122

RESUMO

PURPOSE: The aim of this study was to investigate the association between participation in vigorous physical activities (VPA) and indicators of adiposity and fat distribution in male adolescents. METHODS: Subjects were classified on the basis of the number of reported 15-min periods over 3 d during which VPA were performed. RESULTS: Body weight, fat mass, body mass index, sum of six subcutaneous skinfolds, trunk and extremity skinfolds, and trunk to extremity skinfolds ratio (T/E ratio) were all significantly and inversely related to a higher VPA participation. Moreover, T/E ratio was significantly lower in the subgroup reporting a mean of 7.8 15-min periods of activity for 3 d (equivalent to a mean of 39 min x d(-1)) compared with subjects reporting no participation. This decrease in T/E ratio was more pronounced in subjects reporting a mean of 13.6 15-min periods of VPA for 3 d. CONCLUSION: These observations reinforce the idea that excess abdominal fat accumulation can be prevented by regular participation in vigorous physical activities.


Assuntos
Composição Corporal , Exercício Físico/fisiologia , Obesidade/prevenção & controle , Abdome , Tecido Adiposo/fisiologia , Adolescente , Peso Corporal , Humanos , Estilo de Vida , Masculino , Aptidão Física/fisiologia
20.
Med Sci Sports Exerc ; 26(2): 248-53, 1994 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-8164544

RESUMO

The purpose of this study was to compare estimations of daily energy expenditure (DEE) made with a physical activity journal (PAJ) and a heart rate monitoring method (HR-VO2) in endurance athletes. Seven male cross-country skiers (21 +/- 5 yr of age, mean +/- SD) with high aerobic power (70.4 +/- 7.2 mlO2.kg-1.min-1) and eight lean and moderately active males serving as controls (22 +/- 1 yr; 50.9 +/- 9.9 mlO2.kg-1.min-1) were tested. VO2max, resting metabolic rate (RMR), energy cost of standardized activities, PAJ, HR monitoring, and food diaries for measurement of daily energy intake (DEI) were measured in October, before the specific training period. Results indicated that the skiers had a higher RMR (P < 0.05) than the controls (8.2 +/- 1.6 vs 6.9 +/- 0.6 MJ.d-1), as measured by indirect calorimetry. DEE estimates made with the PAJ and the HR-VO2 methods were similar in the controls subjects but the HR-VO2 method yielded significantly higher results in the skiers (17.0 +/- 4.0 vs 13.1 +/- 2.1 MJ.d-1). DEI measurements were similar to HR-VO2 DEE in both groups. Thus, it appears that the PAJ, which was established with a sedentary population, underestimated DEE in trained cross-country skiers. Thus, the physical activity status of subjects has to be investigated before using a physical activity diary.


Assuntos
Metabolismo Energético/fisiologia , Esqui , Adulto , Dieta , Frequência Cardíaca , Humanos , Masculino , Métodos , Monitorização Fisiológica , Esforço Físico , Registros
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