Christophe Montaurier

The 24-h Energy Intake of Obese Adolescents Is Spontaneously Reduced after Intensive Exercise: A Randomized Controlled Trial in Calorimetric Chambers

Background Physical exercise can modify subsequent energy intake and appetite and may thus be of particular interest in terms of obesity treatment. However, it is still unclear whether an intensive bout of exercise can affect the energy consumption of obese children and adolescents. Objective To compare the impact of high vs. moderate intensity exercises on subsequent 24-h energy intake, macronutrient preferences, appetite sensations, energy expenditure and balance in obese adolescent. Design This randomized cross-over trial involves 15 obese adolescent boys who were asked to randomly complete three 24-h sessions in a metabolic chamber, each separated by at least 7 days: (1) sedentary (SED); (2) Low-Intensity Exercise (LIE) (40% maximal oxygen uptake, VO2max); (3) High-Intensity Exercise (HIE) (75%VO2max). Results Despite unchanged appetite sensations, 24-h total energy intake following HIE was 6–11% lower compared to LIE and SED (p<0.05), whereas no differences appeared between SED and LIE. Energy intake at lunch was 9.4% and 8.4% lower after HIE compared to SED and LIE, respectively (p<0.05). At dinner time, it was 20.5% and 19.7% lower after HIE compared to SED and LIE, respectively (p<0.01). 24-h energy expenditure was not significantly altered. Thus, the 24-h energy balance was significantly reduced during HIE compared to SED and LIE (p<0.01), whereas those of SED and LIE did not differ. Conclusions In obese adolescent boys, HIE has a beneficial impact on 24-h energy balance, mainly due to the spontaneous decrease in energy intake during lunch and dinner following the exercise bout. Prescribing high-intensity exercises to promote weight loss may therefore provide effective results without affecting appetite sensations and, as a result, food frustrations. Trial Registration ClinicalTrial.gov NCT01036360

Effects of 14 weeks of progressive endurance training on energy expenditure in elderly people

Effects of progressive endurance training on energy expenditure (EE) were studied in thirteen elderly sedentary subjects (62.8 (SD 2.3) years) after 7 and 14 weeks of training. Daily EE (DEE) and energy cost of the various usual activities were measured over 48 h by whole-body indirect calorimetry. Free-living DEE (DEEFLC) was calculated from 7 d activity recordings and the energy costs of activities were measured in the calorimeters using the factorial method. DEEFLC did not vary significantly throughout the training period despite the additional energy cost of training sessions (0.60 (SD 0.15) MJ/d), because energy expended during free-living activities (EEACT) decreased by 4.8 (SD 7.1)% (P < 0.05) and 7.7 (SD 8.6)% (P < 0.01) after 7 and 14 weeks of training respectively. Measurements in the calorimeters showed that sleeping metabolic rate transiently increased by 4.6 (SD 3.2)% after 7 weeks of training (P < 0.001) and returned to its initial level after 14 weeks of training. BMR was 7.6 (SD 7.0)% (P < 0.01) and 4.1 (SD 6.1)% (P = NS) higher after 7 and 14 weeks of training respectively, than before training. Likewise, diet-induced thermogenesis increased from 3.7 (SD 2.5) to 7.2 (SD 2.8)% energy intake after 7 weeks of training (P < 0.05), and returned to its initial level after 14 weeks of training (4.2 (SD 2.6)% energy intake). Despite these changes, energy expended during activities and the corresponding DEE did not vary throughout the training period. It was concluded that: (1) DEEFLC remained constant throughout the training period due to a compensatory decrease in free-living EEACT; (2) progressive endurance training induced a transient increase in sleeping metabolic rate, BMR and diet-induced thermogenesis after 7 weeks which was not reflected in the energy expended during activities and DEE.

Daily energy expenditure and its main components as measured by whole-body indirect calorimetry in athletic and non-athletic adolescents

The objectives of the present study were to determine whether differences in usual physical activity affect BMR, sleeping energy expenditure (EE), and EE during seated activities between athletic and non-athletic adolescents, and to establish individual relationships between heart rate and EE. Adolescents (n 49, four groups of eleven to fifteen boys or girls aged 16-19 years) participated in the study. Body composition was measured by the skinfold-thickness method and maximum O2 consumption (VO2max) by a direct method (respiratory gas exchange) on a cycloergometer. The subjects each spent 36 h in one of two large whole-body calorimeters. They followed a standardized activity programme including two periods of exercise simulating their mean weekly physical activities. Fat-free mass (FFM), VO2max, daily EE and EE during sleep and seated activities were significantly higher in athletic than in non-athletic subjects of both sexes. VO2max, daily EE and EE during exercise adjusted for FFM were higher in athletic than in non-athletic adolescents (P < 0.001), whereas sleeping EE, BMR and EE during seated activities and adjusted for FFM were not significantly different between athletic and non-athletic adolescents. However, sex differences in EE remained significant. Thus, differences in EE between athletic and non-athletic adolescents resulted mainly from differences in FFM and physical exercise. Usual activity did not significantly affect energy utilization of substrates. Finally, individual relationships were computed between heart rate and EE with activity programmes simulating the usual activities of athletic and non-athletic adolescents with the goal of predicting EE of the same subjects in free-living conditions.

Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up

Objective: To assess the occurrence of weight gain in patients with Parkinson’s disease, with an average 16 months of follow-up after subthalamic nucleus deep brain stimulation. Methods: We used dual x ray absorptiometry to evaluate changes in body weight and body composition in 22 patients with Parkinson’s disease (15 men and seven women) before surgery, 3 months after surgery and on average 16 months after surgery. Results: No patient was underweight before surgery and 50% were overweight. By contrast, 68% were overweight or obese 3 months after surgery and 82% after 16 months (p<0.001). For men, the mean increase in body mass index (BMI) was 1.14 (0.23) kg/m2 3 months after surgery and 2.02 (0.36) kg/m2 16 months after surgery. For women, the mean increases in BMI at the same evaluation times were 1.04 (0.30) kg/m2 and 2.11 (0.49) kg/m2. This weight gain was mainly secondary to an increase in fat mass in both men and women. Three months after surgery, acute subthalamic deep brain stimulation induced an improvement in parkinsonian symptoms (evaluated by the Unified Parkinson Disease Rating Scale (UPDRS) part III) by 60.7 (2.9)% in the “off” dopa condition and a dramatic improvement of motor complications (dyskinesia duration: 82.8 (12.8)%, p<0.0001; off period duration: 92.7 (18.8)%, p<0.0001). Conclusion: Although subthalamic nucleus deep brain stimulation significantly improved parkinsonian symptoms and motor complications, many patients became overweight or obese. This finding highlights the necessity to understand the underlying mechanisms and to provide a diet management with a physical training schedule appropriate for patients with Parkinson’s disease.

Critical evaluation of the factorial and heart-rate recording methods for the determination of energy expenditure of free-living elderly people

The aim of the present study was to validate against the doubly-labelled water (DLW) technique the factorial method and the heart rate (HR) recording method for determining daily energy expenditure (DEE) of elderly people in free-living conditions. The two methods were first calibrated and validated in twelve healthy subjects (six males and six females; 70.1 (SD 2.7) years) from open-circuit whole-body indirect calorimetry measurements during three consecutive days and during 1 d respectively. Mean energy costs of the various usual activities were determined for each subject using the factorial method, and individual relationships were set up between HR and energy expenditure for the HR recording method. In free-living conditions, DEE was determined over the same period of time by the DLW, the factorial and the HR recording methods during 17, 14 and 4 d respectively. Mean free-living DEE values for men estimated using the DLW, the factorial and the HR recording methods were 12.8 (SD 3.1), 12.7 (SD 2.2) and 13.5 (SD 2.7) MJ/d respectively. Mean free-living DEE values for women were 9.6 (SD 0.8), 8.8 (SD 1.2) and 10.2 (SD 1.5) MJ/d respectively. No significant differences were found between the three methods for either sex, using the Bland & Altman (1986) test. Mean differences in DEE of men were -0.9 (SD 11.8) % between the factorial and DLW methods, and + 4.7 (SD 16.1) % between the HR recording and DLW methods. Similarly, in women, mean differences were -7.7 (SD 12.7) % between the factorial and DLW methods, and + 5.9 (SD 8.8) % between the HR recording and DLW methods. It was concluded that the factorial and the HR recording methods are satisfactory alternatives to the DLW method when considering the mean DEE of a group of subjects. Furthermore, mean energy costs of activities calculated in the present study using the factorial method were shown to be suitable for determining free-living DEE of elderly people when the reference value (i.e. sleeping metabolic rate) is accurately measured.

Net energy value of two low-digestible carbohydrates, Lycasin HBC and the hydrogenated polysaccharide fraction of Lycasin HBC in healthy human subjects and their impact on nutrient digestive utilization.

The metabolizable energy content of low-digestible carbohydrates does not correspond with their true energy value. The aim of the present study was to determine the tolerance and effects of two polyols on digestion and energy expenditure in healthy men, as well as their digestible, metabolizable and net energy values. Nine healthy men were fed for 32 d periods a maintenance diet supplemented either with dextrose, Lycasin HBC (Roquette Frères, Lestrem, France), or the hydrogenated polysaccharide fraction of Lycasin HBC, at a level of 100 g DM/d in six equal doses per d according to a 3 x 3 Latin square design with three repetitions. After a 20 d progressive adaptation period, food intake was determined for 12d using the duplicate meal method and faeces and urine were collected for 10 d for further analyses. Subjects spent 36 h in one of two open-circuit whole-body calorimeters with measurements during the last 24h. Ingestion of the polyols did not cause severe digestive disorders, except excessive gas emission, and flatulence and gurgling in some subjects. The polyols induced significant increases in wet (+45 and +66% respectively, P<0.01) and dry (+53 and +75 % respectively, P<0.002) stool weight, resulting in a 2% decrease in dietary energy digestibility (P<0.001). They resulted also in significant increases in sleeping (+4.1%, P<0.03) and daily energy expenditure (+2.7 and +2.9% respectively, P<0.02) compared with dextrose ingestion. The apparent energy digestibility of the two polyols was 0.82 and 0.79 respectively, their metabolizable energy value averaged 14.1 kJ/g DM, and their net energy value averaged 10.8 kJ/g DM, that is, 35 % less than those of sucrose and starch.

Perinatal Protein Malnutrition Affects Mitochondrial Function in Adult and Results in a Resistance to High Fat Diet-Induced Obesity

Epidemiological findings indicate that transient environmental influences during perinatal life, especially nutrition, may have deleterious heritable health effects lasting for the entire life. Indeed, the fetal organism develops specific adaptations that permanently change its physiology/metabolism and that persist even in the absence of the stimulus that initiated them. This process is termed “nutritional programming”. We previously demonstrated that mothers fed a Low-Protein-Diet (LPD) during gestation and lactation give birth to F1-LPD animals presenting metabolic consequences that are different from those observed when the nutritional stress is applied during gestation only. Compared to control mice, adult F1-LPD animals have a lower body weight and exhibit a higher food intake suggesting that maternal protein under-nutrition during gestation and lactation affects the energy metabolism of F1-LPD offspring. In this study, we investigated the origin of this apparent energy wasting process in F1-LPD and demonstrated that minimal energy expenditure is increased, due to both an increased mitochondrial function in skeletal muscle and an increased mitochondrial density in White Adipose Tissue. Importantly, F1-LPD mice are protected against high-fat-diet-induced obesity. Clearly, different paradigms of exposure to malnutrition may be associated with differences in energy expenditure, food intake, weight and different susceptibilities to various symptoms associated with metabolic syndrome. Taken together these results demonstrate that intra-uterine environment is a major contributor to the future of individuals and disturbance at a critical period of development may compromise their health. Consequently, understanding the molecular mechanisms may give access to useful knowledge regarding the onset of metabolic diseases.

EPA prevents fat mass expansion and metabolic disturbances in mice fed with a Western diet

The impact of alpha linolenic acid (ALA), EPA, and DHA on obesity and metabolic complications was studied in mice fed a high-fat, high-sucrose (HF) diet. HF diets were supplemented with ALA, EPA, or DHA (1% w/w) and given to C57BL/6J mice for 16 weeks and to Ob/Ob mice for 6 weeks. In C57BL/6J mice, EPA reduced plasma cholesterol (−20%), limited fat mass accumulation (−23%) and adipose cell hypertrophy (−50%), and reduced plasma leptin concentration (−60%) compared with HF-fed mice. Furthermore, mice supplemented with EPA exhibited a higher insulin sensitivity (+24%) and glucose tolerance (+20%) compared with HF-fed mice. Similar effects were observed in EPA-supplemented Ob/Ob mice, although fat mass accumulation was not prevented. By contrast, in comparison with HF-fed mice, DHA did not prevent fat mass accumulation, increased plasma leptin concentration (+128%) in C57BL/6J mice, and did not improve glucose homeostasis in C57BL/6J and Ob/Ob mice. In 3T3-L1 adipocytes, DHA stimulated leptin expression whereas EPA induced adiponectin expression, suggesting that improved leptin/adiponectin balance may contribute to the protective effect of EPA. In conclusion, supplementation with EPA, but not ALA and DHA, could preserve glucose homeostasis in an obesogenic environment and limit fat mass accumulation in the early stage of weight gain.

Comparison of total energy expenditure assessed by two devices in controlled and free-living conditions.

Abstract The objective of this study was to evaluate the validity of total energy expenditure (TEE) provided by Actiheart® and Armband®. Normal-weight adult volunteers wore both devices either for 17 hours in a calorimetric chamber (CC, n = 49) or for 10 days in free-living conditions (FLC) outside the laboratory (n = 41). The two devices and indirect calorimetry or doubly labelled water, respectively, were used to estimate TEE in the CC group and FLC group. In the CC, the relative value of TEE error was not significant (p > 0.05) for Actiheart® but significantly different from zero for Armband®, showing TEE underestimation (−4.9%, p < 0.0001). However, the mean absolute values of errors were significantly different between Actiheart® and Armband®: 8.6% and 6.7%, respectively (p = 0.05). Armband® was more accurate for estimating TEE during sleeping, rest, recovery periods and sitting–standing. Actiheart® provided better estimation during step and walking. In FLC, no significant error in relative value was detected. Nevertheless, Armband® produced smaller errors in absolute value than Actiheart® (8.6% vs. 12.8%). The distributions of differences were more scattered around the means, suggesting a higher inter-individual variability in TEE estimated by Actiheart® than by Armband®. Our results show that both monitors are appropriate for estimating TEE. Armband® is more effective than Actiheart® at the individual level for daily light-intensity activities.

Effects of high-intensity interval training and moderate-intensity continuous training on glycaemic control and skeletal muscle mitochondrial function in db/db mice

Physical activity is known as an effective strategy for prevention and treatment of Type 2 Diabetes. The aim of this work was to compare the effects of a traditional Moderate Intensity Continuous Training (MICT) with a High Intensity Interval Training (HIIT) on glucose metabolism and mitochondrial function in diabetic mice. Diabetic db/db male mice (N = 25) aged 6 weeks were subdivided into MICT, HIIT or control (CON) group. Animals in the training groups ran on a treadmill 5 days/week during 10 weeks. MICT group ran for 80 min (0° slope) at 50–60% of maximal speed (Vmax) reached during an incremental test. HIIT group ran thirteen times 4 minutes (20° slope) at 85–90% of Vmax separated by 2-min-rest periods. HIIT lowered fasting glycaemia and HbA1c compared with CON group (p < 0.05). In all mitochondrial function markers assessed, no differences were noted between the three groups except for total amount of electron transport chain proteins, slightly increased in the HIIT group vs CON. Western blot analysis revealed a significant increase of muscle Glut4 content (about 2 fold) and higher insulin-stimulated Akt phosphorylation ratios in HIIT group. HIIT seems to improve glucose metabolism more efficiently than MICT in diabetic mice by mechanisms independent of mitochondrial adaptations.