Penelope J. Morris

Improvement in insulin resistance and reduction in plasma inflammatory adipokines after weight loss in obese dogs

Obesity is now a major disease of dogs, predisposing to numerous disorders including diabetes mellitus. Adipocytes are active endocrine cells, and human obesity is characterized by derangements in inflammatory adipokine production. However, it is unclear as to whether similar changes occur in dogs. The purpose of the current study was to assess insulin sensitivity and inflammatory adipokine profiles in dogs with naturally occurring obesity and to investigate the effect of subsequent weight loss. Twenty-six overweight dogs were studied, representing a range of breeds and both sexes. All dogs underwent a weight loss program involving diet and exercise. Body fat mass was measured by dual-energy x-ray absorptiometry; plasma concentrations of insulin, glucose, and a panel of inflammatory adipokines (including acute-phase proteins, cytokines, and chemokines) were also analyzed. Body fat mass before weight loss was positively correlated with both plasma insulin concentrations (Kendall tau=0.30, P=0.044) and insulin:glucose ratio (Kendall tau=0.36, P=0.022), and both decreased after weight loss (P=0.0037 and 0.0063, respectively). Weight loss also led to notable decreases in plasma tumor necrosis factor-alpha (TNF-alpha), haptoglobin, and C-reactive protein concentrations (P<0.05 for all), suggesting improvement of a subclinical inflammatory state associated with obesity. This study has demonstrated that in obese dogs, insulin resistance correlates with degree of adiposity, and weight loss improves insulin sensitivity. Concurrent decreases in TNF-alpha and adipose tissue mass suggest that in dogs, as in humans, this adipokine may be implicated in the insulin resistance of obesity.

Obesity-related metabolic dysfunction in dogs: a comparison with human metabolic syndrome

BackgroundRecently, metabolic syndrome (MS) has gained attention in human metabolic medicine given its associations with development of type 2 diabetes mellitus and cardiovascular disease. Canine obesity is associated with the development of insulin resistance, dyslipidaemia, and mild hypertension, but the authors are not aware of any existing studies examining the existence or prevalence of MS in obese dogs.Thirty-five obese dogs were assessed before and after weight loss (median percentage loss 29%, range 10-44%). The diagnostic criteria of the International Diabetes Federation were modified in order to define canine obesity-related metabolic dysfunction (ORMD), which included a measure of adiposity (using a 9-point body condition score [BCS]), systolic blood pressure, fasting plasma cholesterol, plasma triglyceride, and fasting plasma glucose. By way of comparison, total body fat mass was measured by dual-energy X-ray absorptiometry, whilst total adiponectin, fasting insulin, and high-sensitivity C-reactive protein (hsCRP) were measured using validated assays.ResultsSystolic blood pressure (P = 0.008), cholesterol (P = 0.003), triglyceride (P = 0.018), and fasting insulin (P < 0.001) all decreased after weight loss, whilst plasma total adiponectin increased (P = 0.001). However, hsCRP did not change with weight loss. Prior to weight loss, 7 dogs were defined as having ORMD, and there was no difference in total fat mass between these dogs and those who did not meet the criteria for ORMD. However, plasma adiponectin concentration was less (P = 0.031), and plasma insulin concentration was greater (P = 0.030) in ORMD dogs.ConclusionsIn this study, approximately 20% of obese dogs suffer from ORMD, and this is characterized by hypoadiponectinaemia and hyperinsulinaemia. These studies can form the basis of further investigations to determine path genetic mechanisms and the health significance for dogs, in terms of disease associations and outcomes of weight loss.

Quality of life is reduced in obese dogs but improves after successful weight loss

Obesity is thought to affect quality of life, but limited objective data exist to support this supposition. The current study aim was to use a questionnaire to determine health-related quality of life (HRQOL) both before and after weight loss, in obese client-owned dogs. Fifty obese dogs were included, and represented a variety of breeds and genders. Prior to weight loss, owners were asked to complete a validated standardised questionnaire to determine HRQOL. Thirty of the dogs successfully completed their weight loss programme and reached target, and owners then completed a follow-up questionnaire. The completed questionnaire responses were transformed to scores corresponding to each of four factors (vitality, emotional disturbance, anxiety and pain), and scored on a scale of 0-6. Changes in the scores were used to explore the sensitivity of the questionnaire, and scores were correlated with responses to direct questions about quality of life and pain, as well as weight loss. Dogs that failed to complete their weight loss programme had lower vitality and higher emotional disturbance scores than those successfully losing weight (P=0.03 for both). In the 30 dogs that completed, weight loss led to an increased vitality score (P<0.001), and decreased scores for both emotional disturbance (P<0.001) and pain (P<0.001). However, there was no change in anxiety (P=0.09). The change in vitality score was positively associated with percentage weight loss (r(P)=0.43, P=0.02) and percentage body fat loss (r(P)=0.39, P=0.03). These results indicate demonstrable improvement in HRQOL for obese dogs that successfully lose weight.

Dose-response effect of a whey protein preload on within-day energy intake in lean subjects.

The effect of consuming different amounts of whey protein on appetite and energy intake was investigated in two separate studies using randomised, crossover designs. Healthy-weight men and women (range: BMI 19·0-25·0 kg/m², age 19·4-40·4 years) consumed one of four 400 ml liquid preloads, followed by an ad libitum test meal 90 min later. In study 1, preloads were 1675 kJ with 12·5, 25 or 50 % of energy from protein, and in study 2, preloads were 1047 kJ with 10, 20 or 40 % energy from protein. Flavoured water was used as the control in both the studies. Appetite ratings were collected immediately before 30, 60 and 90 min after consuming the preloads; and immediately, 30 and 60 min after consuming the test meal. In study 1, energy intake following the control preload (4136 ((SEM) 337) kJ) was significantly higher than each of the 12·5 % (3520 ((SEM) 296) kJ), 25 % (3384 ((SEM) 265) kJ) and 50 % (2853 ((SEM) 244) kJ) protein preloads (P < 0·05). Intake after the 12·5 % preload was significantly higher than following 25 and 50 % preloads (P < 0·05). In study 2, energy intake following the control preload (4801 ((SEM) 325) kJ) was higher than following the 10 % (4205 ((SEM) 310) kJ), 20 % (3988 ((SEM) 250) kJ) and 40 % (3801 ((SEM) 245) kJ) protein preloads (P < 0·05). There were no differences in subjective appetite ratings between preloads in either study. These findings indicate a dose-response effect of protein content of the preload on energy intake at a subsequent meal.

Effects of weight loss in obese cats on biochemical analytes related to inflammation and glucose homeostasis.

The aim of the current study was to measure circulating metabolic and inflammation-related biochemical analytes in obese cats before and after weight loss. Thirty-seven overweight neutered cats were studied, median body weight 6.85 kg (range, 4.70 to 10.30 kg), representing a range of ages and both sexes. An individualized weight-loss program was devised for each cat and monitored until completion. Body fat mass was determined by dual-energy x-ray absorptiometry, whereas plasma concentrations of acute-phase proteins (APPs; eg, haptoglobin and serum amyloid A), hormones (eg, insulin, IGF-1, and adiponectin), and enzymes (eg, butyrylcholinesterase and paraoxonase type 1 [PON-1]) associated with inflammation and metabolic compounds (eg, glucose) were also measured. No significant changes were found in APPs after weight loss (P > 0.3), but significant increases in plasma adiponectin (P = 0.021) and IGF-1 (P = 0.036) were seen, whereas insulin (P < 0.001) and homeostasis model assessment (P = 0.005) decreased significantly. Plasma concentrations before weight loss of PON-1 (P = 0.004), adiponectin (P = 0.02), and IGF-1 (P = 0.048) were less in cats that failed to complete weight loss than cats that were successful, whereas glucose concentration was greater. Finally, multivariable linear regression analysis showed that lean tissue loss during weight management was associated with percentage weight loss (greater weight loss, greater lean tissue loss; R = 0.71, P < 0.001) and plasma adiponectin concentration before weight loss (lesser adiponectin, more lean tissue loss; R = -0.52, P = 0.023). In conclusion, various metabolic abnormalities occur in feline obesity, and these can be linked to outcomes of weight-loss programs. The changes that occur with weight loss suggest an improved metabolic status.

Imprecision when using measuring cups to weigh out extruded dry kibbled food

Many pet cats and dogs are fed dry extruded kibbled food by measuring cup, yet the precision and accuracy of this feeding strategy is not known. Over 12 studies, we assessed precision and accuracy of weighing out food portions, of various dry kibbled foods, by measuring cup. Poor precision was noted in all studies, with intra- and inter-subject coefficients of variation ranging from 2 to 13% and 2 to 28% respectively. Variable accuracy was also noted, which ranged from an 18% under-estimate to an 80% over-estimate in portion size. No specific factors were associated with imprecision, but the degree of inaccuracy was negatively associated with portion size (R = -0.67, p = 0.022), and positively associated with the number of subjects participating in the study (R = 0.60, p = 0.048). This is the first study to document imprecision and inaccuracy of using measuring cups to estimate portions of extruded dry kibbled food. Over time, such errors could contribute to insidious weight gain in companion animals, potentially contributing to the development of obesity. Imprecision in measuring food portions could also contribute to failure of weight management programmes for obese animals.

Long-term follow-up after weight management in obese dogs: The role of diet in preventing regain

Regain after weight loss is widely reported in humans, but there is little information on this phenomenon in dogs. The current study aim was to determine long-term success of a weight loss regime and those factors linked with regain. Thirty-three obese dogs, that had successfully lost weight, were included, all enrolled between December 2004 and May 2009. After weight loss, dogs were switched to a maintenance regime and follow-up weight checks were performed periodically. A review of cases that had completed their weight programme was held during the summer of 2010 and a follow-up check was subsequently conducted, where dogs were reweighed and information was collected on current feeding practices. Median duration of follow-up was 640 days (119-1828 days). Fourteen dogs (42%) maintained weight, 3 (9%) lost >5% additional weight, and 16 (48%) gained >5% weight. Dogs fed a purpose-formulated weight loss diet regained less weight than those switched onto a standard maintenance diet (P=0.0016). Energy intake at the time of follow-up was significantly higher in those dogs fed a standard maintenance diet, compared with those that had remained on a purpose-formulated weight loss diet (P=0.017). These results suggest that weight regain occurs in about half of dogs after successful weight loss. Long-term use of a purpose-formulated weight management diet can significantly limit regain in the follow-up period, likely by limiting food intake.

Effect of Weight Loss in Obese Dogs on Indicators of Renal Function or Disease

BACKGROUND Obesity is a common medical disorder in dogs, and can predispose to a number of diseases. Human obesity is a risk factor for the development and progression of chronic kidney disease. OBJECTIVES To investigate the possible association of weight loss on plasma and renal biomarkers of kidney health. ANIMALS Thirty-seven obese dogs that lost weight were included in the study. METHODS Prospective observational study. Three novel biomarkers of renal functional impairment, disease, or both (homocysteine, cystatin C, and clusterin), in addition to traditional markers of chronic renal failure (serum urea and creatinine, urine specific gravity [USG], urine protein-creatinine ratio [UPCR], and urine albumin corrected by creatinine [UAC]) before and after weight loss in dogs with naturally occurring obesity were investigated. RESULTS Urea (P = .043) and USG (P = .012) were both greater after weight loss than before loss, whilst UPCR, UAC, and creatinine were less after weight loss (P = .032, P = .006, and P = .026, respectively). Homocysteine (P < .001), cystatin C (P < .001) and clusterin (P < .001) all decreased upon weight loss. Multiple linear regression analysis revealed associations between percentage weight loss (greater weight loss, more lean tissue loss; r = -0.67, r(2) = 0.45, P < .001) and before-loss plasma clusterin concentration (greater clusterin, more lean tissue loss; r = 0.48, r(2) = 0.23, P = .003). CONCLUSION AND CLINICAL IMPORTANCE These results suggest possible subclinical alterations in renal function in canine obesity, which improve with weight loss. Further work is required to determine the nature of these alterations and, most notably, the reason for the association between before loss plasma clusterin and subsequent lean tissue loss during weight management.

Use of starting condition score to estimate changes in body weight and composition during weight loss in obese dogs.

Prior to starting a weight loss programme, target weight (TW) is often estimated, using starting body condition score (BCS). The current study assessed how well such estimates perform in clinical practice. Information on body weight, BCS and body composition was assessed before and after weight loss in 28 obese, client-owned dogs. Median decrease in starting weight per BCS unit was 10% (5-15%), with no significant difference between dogs losing moderate (1-2 BCS points) or marked (3-4 BCS points) amounts of weight (P=0.627). Mean decrease in body fat per BCS unit change was 5% (3-9%). A model based on a change of 10% of starting weight per unit of BCS above ideal (5/9) most closely estimated actual TW, but marked variability was seen. Therefore, although such calculations may provide a guide to final TW in obese dogs, they can either over- or under-estimate the appropriate end point of weight loss.

Changes in body composition during weight loss in obese client-owned cats: loss of lean tissue mass correlates with overall percentage of weight lost

Obesity is one of the most common medical diseases in cats, but there remains little information on success of weight loss regimes in obese client-owned cats. No information currently exists on body composition changes during weight loss in clinical cases. Twelve obese client-owned cats undertook a weight loss programme incorporating a high-protein low fat diet. Body composition was quantified by dual-energy X-ray absorptiometry, before and after weight loss. Mean (±standard deviation) weight loss was 27±6.8% of starting weight, and mean rate of weight loss was 0.8±0.32% per week. Mean energy allocation during weight loss was 32±7.0 kcal/kg target weight. Mean composition of tissue lost was 86:13:1 (fat:lean:bone mineral). The proportion of lean tissue loss was positively associated with overall percentage of weight loss (simple linear regression, r 2=44.2%, P=0.026). Conventional weight loss programmes produce safe weight loss, but lean tissue loss is an inevitable consequence in cats that lose significant proportions of their starting body weight.