Germain Thériault

The response to long-term overfeeding in identical twins.

We undertook this study to determine whether there are differences in the responses of different persons to long-term overfeeding and to assess the possibility that genotypes are involved in such differences. After a two-week base-line period, 12 pairs of young adult male monozygotic twins were overfed by 4.2 MJ (1000 kcal) per day, 6 days a week, for a total of 84 days during a 100-day period. The total excess amount each man consumed was 353 MJ (84,000 kcal). During overfeeding, individual changes in body composition and topography of fat deposition varied considerably. The mean weight gain was 8.1 kg, but the range was 4.3 to 13.3 kg. The similarity within each pair in the response to overfeeding was significant (P less than 0.05) with respect to body weight, percentage of fat, fat mass, and estimated subcutaneous fat, with about three times more variance among pairs than within pairs (r approximately 0.5). After adjustment for the gains in fat mass, the within-pair similarity was particularly evident with respect to the changes in regional fat distribution and amount of abdominal visceral fat (P less than 0.01), with about six times as much variance among pairs as within pairs (r approximately 0.7). We conclude that the most likely explanation for the intrapair similarity in the adaptation to long-term overfeeding and for the variations in weight gain and fat distribution among the pairs of twins is that genetic factors are involved. These may govern the tendency to store energy as either fat or lean tissue and the various determinants of the resting expenditure of energy.

Role of Deep Abdominal Fat in the Association Between Regional Adipose Tissue Distribution and Glucose Tolerance in Obese Women

Computed tomography (CT) was used to study the association between adipose tissue localization and glucose tolerance in a sample of 52 premenopausal obese women aged 35.7 ± 5.5 yr (mean ± SD) and with a body fat of 45.9 ± 5.5%. Body-fat mass and the body mass index (BMI) were significantly correlated with plasma glucose, insulin, and connecting peptide (C-peptide) areas after glucose (75 g) ingestion (.40 ≥ r ≤ .51, P < .01). Trunk-fat accumulation and the size of fat cells in the abdomen displayed highly significant correlations with postglucose insulin levels. The C-peptide area was also positively correlated with abdominal fat cell size (r = .76, P < .01) and was more closely associated with the sum of trunk skin folds (r = .59, P <.001) than with the extremity skin folds (r = .29, P < .05). Subcutaneous and deep-abdominal-fat areas measured by CT displayed comparable associations with the plasma insulin area (r = .44 and .49, respectively; P < .001) but marked differences in the associations with glucose tolerance. Indeed, subcutaneous abdominal fat was not significantly correlated with the glucose area, whereas deep abdominal fat showed a significant correlation (r = .57, P < .001) with the glucose area. Midthigh fat deposition measured by CT was not, however, correlated with plasma glucose, insulin, or C-peptide areas. Partial correlation analyses indicated that the effect of accumulation of deep abdominal fat on glucose tolerance was independent from total adiposity and that no association was observed between total adiposity and glucose tolerance after control for accumulation of deep abdominal fat. These results emphasize the importance of deep abdominal fat as an independent correlate of glucose tolerance in obese women.

Assessment of adipose tissue distribution by computed axial tomography in obese women: association with body density and anthropometric measurements

1. Abdominal obesity is associated with numerous metabolic complications. Deep abdominal adipose tissue is critical in the association between the level of abdominal obesity and cardiovascular risk factors. 2. Adipose tissue localization was assessed by computed axial tomography (CAT), and its association with body density and anthropometric measurements was investigated in a sample of fifty-one obese women (percentage body fat 45.9 (SD 5.6)) aged 35.7 (SD 5.5) years. The CAT scans were performed at three levels: lower chest, abdomen and mid-thigh. 3. The total adipose tissue volume computed from these three scans was highly correlated with body fat mass (r 0.94, P less than 0.001). The proportion of deep abdominal fat as measured by the ratio of deep: total adipose tissue areas at the abdominal level was not significantly correlated with body fat mass, but it was moderately associated with the ratio of waist: hip circumferences (WHR) (r 0.49, P less than 0.001). The absolute amount of deep abdominal fat was, however, significantly correlated with body fat mass (r 0.72, P less than 0.001). 4. The subscapular (r 0.38) and the abdominal (r 0.38) skinfolds were the only two skinfolds that were significantly associated with the proportion of deep abdominal fat (P less than 0.01). These skinfolds were also those which showed the highest correlation with the absolute amount of deep abdominal fat (r 0.65, P less than 0.001, for both skinfolds). 5. A three-site CAT-scan procedure can be used for the estimation of body fat mass in premenopausal obese women. 6. In these obese women, there was no significant association between total adiposity and the proportion of deep adipose tissue at the abdominal level. 7. In premenopausal obese women, the absolute amount of deep abdominal fat can be predicted from anthropometric measurements with more accuracy than the relative amount of deep abdominal fat.

Aerobic performance in brothers, dizygotic and monozygotic twins.

Forty-two brothers, 66 dizygotic twins of both sexes and 106 monozygotic twins of both sexes, 16 to 34 yr of age, took part in this study that was designed to investigate the effect of heredity in aerobic performance. Maximal oxygen uptake (VO2 max), maximal heart rate (HR max), maximal ventilation, and maximal oxygen pulse were obtained from a progressive ergocycle test to exhaustion. Total work output in a 90-min maximal ergocycle test was also determined in the twins. Fat-free weight was estimated from body density measurements obtained through underwater weighing. Aerobic performance scores were adjusted for age (brothers), and age and sex (dizygotic and monozygotic twins) by regression procedures. Dizygotic twins and brothers of same sibship exhibited about the same level of resemblance for all variables or were only slightly different, with the exception of HR max. Monozygotic pairs were generally more alike than the other sibs, as suggested by the intra-class coefficients. Twin data were used to compute the genetic effects. The within-pair estimate of genetic variance revealed that it was significant (P less than or equal to 0.05) for all variables except VO2 max X kg-1 fat-free weight X min-1. In the case of HR max, the among-pairs component estimate had to be used, and it also proved significant (P less than or equal to 0.01). The size of the genetic effect was computed from three different methods, and it reached about 40% for VO2 max X kg-1 X min-1, 50% for HR max, 60% for maximal oxygen pulse and maximal ventilation, and 70% for 90-min work output X kg-1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose tissue distribution and plasma lipoprotein levels in obese women. Importance of intra-abdominal fat.

Prospective studies have shown that excess abdominal fat Is associated with an Increased risk of coronary heart disease and related death. We used computed axial tomography (CAT) to assess the association between deep and subcutaneous abdominal adipose tissue and plasma lipoprotein levels In a sample of 52 premenopausal obese women aged 35.7±5.5 years (mean±SD). Whereas the plasma lipoprotein concentrations were not significantly correlated with fat mass, the data obtained by CAT Indicated that the absolute amount of deep abdominal fat was negatively correlated with high density lipoprotein cholesterol (HDL-CHOL) levels (r=−0.35, /x 0.01), as well as with HDL-CHOL/low density lipoprotein (LDL)-CHOL, HDL- apoprotein-(apo) A-l/LDL-apo B, and HDL2-CHOL/HDL,-CHOL ratios (−0.32srs-0.40, 0.05>p<0.01). Adipose tissue deposition at the mid-thigh region determined by CAT did not show any significant relationship with plasma lipoprotein levels. When subgroups of women with comparable ages and adiposity but with high and low Intra-abdominal fat accumulation were compared, women with a high accumulation of Intra-abdominal fat displayed significantly lower HDL-CHOL (p<0.001), HDLj- CHOL (p<0.001), HDL3-CHOL (p<0.01), and HDL-apo A-l (p<0.05) levels, as well as reduced HDL-CHOL/LDL-CHOL (p<0.01), HDL-apo A-l/LDL-apo B (p<0.05), and HDL2-CHOL/HDL4-CHOL ratios (p<0.05) in comparison with obese women with low accumulations of Intra-abdominal fat These data Indicate that, in a sample of obese women, body fat distribution, especially Intra-abdominal fat accumulation, is a significant correlate of plasma lipoprotein levels Independent of total fatness.

Genetic effect in resting and exercise metabolic rates

Two studies dealing with the contribution of the genotype in individual differences for resting metabolic rate (RMR), thermic effect of a 4.2 MJ carbohydrate meal (TEM), and energy cost of submaximal exercise are reported. The genetic effect for RMR and TEM was studied in 31 pairs of parent-child, 21 pairs of dizygotic (DZ) twins, and 37 pairs of monozygotic (MZ) twins, whereas the heritability of the energy cost of submaximal exercise was determined from data on 22 pairs of DZ twins and 31 pairs of MZ twins. The heritability of RMR reached approximately 40% of the variance remaining after adjustment for age, gender, and fat-free mass, (FFM). The genetic effect for TEM was equivalent to at least 40% to 50% of the variation in the energy expended during four hours after the meal test. A highly significant genetic effect was found for fasting plasma glucose (greater than .72), but the results for fasting plasma insulin are unclear. No significant genetic variance was seen for the glucose and insulin response to the carbohydrate meal. Finally, heritability for the metabolic rate during cycle exercise was high (greater than or equal to .46) at low power output, but it became nonsignificant when the energy cost reached about 6 times the RMR.

Role of hepatic-triglyceride lipase activity in the association between intra-abdominal fat and plasma HDL cholesterol in obese women.

Intra-abdominal fat content is an important variable in the association between regional body fat distribution and plasma high density lipoprotein (HDL) cholesterol levels. In the present study, we report on the role of plasma postheparin lipases as well as abdominal and femoral adipose tissue lipoprotein lipase activities in the association between body fat distribution and plasma lipoprotein levels. Postheparin plasma lipoprotein lipase (LPL), hepatic-triglyceride lipase (H-TGL), abdominal and femoral adipose tissue (AT)-LPL activities and plasma lipoprotein levels were measured after an overnight fast in a sample of 16 obese women (ages 36.0 +/- 6.1 years [mean +/- SD], percent body fat 46% +/- 6%). Computed axial tomography was used to assess body fat distribution. Plasma postheparin LPL activity was neither correlated with total adiposity nor with the level of intra-abdominal fat. Intra-abdominal fat deposition was, however, positively correlated with H-TGL activity (r = 0.66, p less than 0.005). Furthermore, covariance analysis showed that the association between intra-abdominal fat and H-TGL was independent from total adiposity. Plasma postheparin LPL and abdominal AT-LPL activities showed no significant correlation with plasma lipoprotein levels, whereas femoral AT-LPL activity was positively correlated with the HDL2 cholesterol/HDL3 cholesterol ratio (r = 0.51, p less than 0.05). H-TGL activity was, however, negatively correlated with HDL2 cholesterol (r = -0.60, p less than 0.05), but not with HDL3 cholesterol (r = -0.28, NS). These results suggest that the high H-TGL activity in obese women with excess deep abdominal fat could be responsible for the reduction in plasma HDL2 cholesterol levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Are gender differences in cardiovascular disease risk factors explained by the level of visceral adipose tissue

SummaryIt has been suggested that the lower prevalence of cardiovascular disease in women before menopause in comparison with men may be explained by differences in body fat distribution, plasma lipoprotein levels and indices of plasma glucose-insulin homeostasis. Thus, gender differences in visceral adipose tissue accumulation measured by computed tomography and metabolic variables were studied in 80 men and 69 pre-menopausal women, aged 23–50 years. Despite the fact that women had higher levels of total body fat (p<0.0001), they displayed lower areas of abdominal visceral adipose tissue (p<0.06) and a lower ratio of abdominal visceral to mid-thigh adipose tissue areas than men (p<0.0001). After adjustment for body fat mass, women generally displayed a more favourable risk profile than men which included higher plasma HDL2-cholesterol and lower plasma insulin, apolipoprotein B and triglyceride levels (p<0.01). Metabolic variables adjusted for body fat mass were then compared between genders after control for differences in abdominal visceral adipose tissue area. After such controls, variables related to plasma glucose-insulin homeostasis were no longer significantly different between men and women. Gender differences for plasma concentrations of triglyceride, apolipoprotein B and the ratio of HDL2-cholesterol/HDL3-cholesterol also disappeared, whereas plasma concentrations of HDL-cholesterol, HDL2-cholesterol as well as the ratio of HDL-cholesterol/total cholesterol remained significantly higher in women than in men (p<0.01). These results suggest that abdominal visceral adipose tissue is an important correlate of gender differences in cardiovascular disease risk. However, additional factors are likely to be involved in gender differences in plasma HDL-cholesterol levels.

Golf injuries. An overview

Over the years, golf has become an increasingly popular sport, attracting new players of almost all ages and socioeconomic groups. Golf is practised by up to 10 to 20% of the overall adult population in many countries. Beyond the enjoyment of the sport itself, the health-related benefits of the exercise involved in walking up to 10km and of relaxing in a pleasant natural environment are often reported to be the main motives for adhering to this activity by recreational golfers.Golf is considered to be a moderate risk activity for sports injury; however, excessive time spent golfing and technical deficiencies lead to overuse injuries. These are the 2 main causes of injuries among golfers, and each has specific differences in the pattern in which they occur in professional and amateur golfers. Golf injuries originate either from overuse or from a traumatic origin and primarily affect the elbow, wrist, shoulder and the dorsolumbar sites. Professional and weekend golfers, although showing a similar overall anatomical distribution of injuries by body segment, tend to present differences in the ranking of injury occurrence by anatomical site; these differences can be explained by their playing habits and the biomechanical characteristics of their golf swing.Many of these injuries can be prevented by a preseason, and year-round, sportspecific conditioning programme including: (i) muscular strengthening, flexibility and aerobic exercise components; (ii) a short, practical, pre-game warm-up routine; and (iii) the adjustment of an individual’s golf swing to meet their physical capacities and limitations through properly supervised golf lessons. Finally, the correct selection of golf equipment and an awareness of the environmental conditions and etiquette of golf can also contribute to making golf a safe and enjoyable lifetime activity.

The effect of a 20-week endurance training program on adipose-tissue morphology and lipolysis in men and women

In order to assess the effect of endurance training on adipose-tissue morphology and lipolysis, 22 adult subjects (11 men and 11 women) took part in a 20-week ergocycle training program, four to five days a week, 40 minutes a day, at 80% of their maximal heart rate. Before and after training, they were submitted to an adipose-tissue biopsy in the suprailiac region. Fat cell weight (FCW), and lipolytic activity were determined on isolated fat cells. For the whole sample, training significantly reduced FCW (pre: 0.40 +/- 0.13 (mean +/- SD) versus post: 0.36 +/- 0.13 micrograms; P less than 0.05), percentage of fat (pre: 22.0 +/- 8.3 versus post: 19.7 +/- 8.1%; P less than 0.05), and increased adipocyte epinephrine maximal stimulated lipolysis (ESL) (pre: 1.08 +/- 0.49 versus post: 1.69 +/- 0.67 mumol glycerol/30 min/10(6) cells; P less than 0.001). No changes were observed in fat cell number. In women, however, training induced no changes in the fatness indicators (% fat, sum of skinfolds, FCW). The exercise program significantly lowered the adiposity of men (% fat: P less than 0.001; sum of skinfolds: P less than 0.01; FCW: P less than 0.05). In both sexes, a significant increase in ESL was observed after training. ESL of men, however, responded better than that of women to training (ESL of women: 1.36 +/- 0.67 versus ESL of men: 2.02 +/- 0.50 mumol glycerol/30 min/10(6) cells; P less than 0.05), with increases over pre-training values of 46% and 66% in women and men, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)