Teresa F. Barbieri

Effects of nandrolone decanoate therapy in borderline hypogonadal men with HIV-associated weight loss.

Serum testosterone concentrations are frequently in the low-normal range (lowest quartile, <500 ng/dl) in men with AIDS-wasting syndrome (AWS) and in other chronic wasting disorders. The response of patients in this group to androgen treatment has not been determined, however. Eighteen men with AWS (mean +/- standard error [SE]: 87% +/- 1% usual body weight; CD4 count 90 +/- 24) and borderline low serum testosterone concentrations (382 +/- 33 ng/dl) completed a 21-day placebo-controlled inpatient metabolic ward study comparing intramuscular (i.m.) placebo (n = 7) with low-dose (65 mg/week; n = 4) and high-dose (200 mg/week; n = 7) nandrolone decanoate, a testosterone analogue. Nitrogen balance, stable isotope-mass spectrometric measurement of de novo lipogenesis (DNL), resting energy expenditure, and gonadal hormone levels were measured. Both low-dose and high-dose nandrolone resulted in significant nitrogen retention (33-52 g nitrogen/14 days, representing gains of 0.5 to 0.9 kg lean tissue/week) compared with placebo (loss of 11 g nitrogen/week). This was reflected biochemically in a borderline significant reduction of high DNL (p < .06). Serum testosterone and gonadotropins were suppressed whereas resting energy expenditure was unchanged by nandrolone treatment. In 10 study subjects completing a 12-week open-label follow-up phase, body weight increased by 4.9 +/- 1.2 kg, including 3.1 +/- 0.5 kg lean body mass, and treadmill exercise performance also improved. In summary, nandrolone decanoate therapy in the absence of an exercise program in borderline hypogonadal men with AWS caused substantial nitrogen retention compared with placebo, similar in extent to the nitrogen retention previously achieved with recombinant growth hormone. It is reasonable to expand the criteria for androgen treatment in AWS to include at least patients in the lowest quartile of serum testosterone.

Effects of a carotene-deficient diet on measures of oxidative susceptibility and superoxide dismutase activity in adult women

The effect of consuming a low carotene diet (approximately 60 micrograms carotene/day) on oxidative susceptibility and superoxide dismutase (SOD) activity in women living in a metabolic research unit was evaluated. The diet had sufficient vitamins A, E, and C. The women ate the diet supplemented with 1500 micrograms/day beta-carotene for 4 days (baseline), then the unsupplemented diet for 68 days (depletion), followed by the diet supplemented with > 15,000 micrograms/day carotene for 28 days (repletion). Production of hexanal, pentanal, and pentane by copper-oxidized plasma low density lipoproteins from carotene-depleted women was greater than their production of these compounds when repleted with carotene. Erythrocyte SOD activity was depressed in carotene-depleted women; it recovered with repletion. Thiobarbituric acid reactive substances in plasma of carotene-depleted women were elevated and diminished with repletion. Dietary carotene seems to be needed, not only as a precursor of vitamin A, but also to inhibit oxidative damage and decrease oxidation susceptibility.

Energy expenditure and physical performance in overweight women: Response to training with and without caloric restriction

The metabolic effects of exercise training and the influence of a moderate calorie restriction on the training response were examined in overweight women. Ten healthy women, 119% to 141% of desirable weight, completed the 14-week study. After a 2-week stabilization period, in which diets were designed to maintain body weight (BW), five women were assigned to a 12-week experimental program of diet and exercise (D + EX) that included a 50% reduction in energy intake and a program of moderate intensity aerobic exercise 6 days per week. The other five women were assigned to the same daily exercise (EX) and continued to consume the stabilization diet. Periodic measurements of resting metabolic rate (RMR), thermic effect of food (TEF), energy cost of exercise, and predicted maximal aerobic capacity (VO2 max) were obtained, and the respiratory quotient (RQ) was determined during rest and exercise. Body composition was monitored weekly. Tests of strength and anaerobic capacity were conducted. D + EX lost an average of approximately 1.1 kg/wk, which was 67% fat, 33% lean. EX lost approximately 0.5 kg/wk, which was 86% fat, 14% lean. In both groups, the exercise program resulted in an 11% to 13% improvement in VO2 max and an 8% to 16% decrease in energy expenditure at submaximal workloads. The caloric restriction significantly increased fat utilization during exercise. The RMR declined 9% in D + EX, from 1,550 to 1,411 kcal/d, whereas it was maintained in EX, 1,608 to 1,626 kcal/d. The decrease in RMR observed in D + EX was consistent with the loss of fat-free mass (FFM).(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of meal size and frequency on the thermic effect of food

Abstract Results from previous studies suggest that energy content and frequency of meals may affect total daily thermic effect of food (TEF). TEF response to 2 large meals, each representing 50% of daily energy needs, was compared to the TEF response to 4 small meals, each representing 25% of daily energy needs. Total 10-hour TEF, measured as increase in oxygen consumption from rest, did not differ between the large and small meal patterns (43.43 ±5.01 vs. 43.42±4.72 liters, respectively). Measured TEF was significantly greater than predicted response due to a more complete measurement period. An optimum pattern for energy intake to either maximize or minimize TEF was not observed.

Predicting total body water and extracellular fluid volumes from bioelectrical measurements of the human body.

Two biological impedance analyzers, a 50 kHz (RJL) and 20-100 kHz (BMA) instrument, and a total body electrical conductivity (TOBEC) instrument were used to estimate total body water (TBW), extracellular (ECF) and intracellular (ICF) fluid volumes by repeated measurements of 16 normal men (19-38 years old) to assess which, if any, would provide the best estimates. At 3-week intervals, TBW was determined by deuterium dilution, ECF by bromide dilution, ICF by difference (TBW-ECF) and lean body mass by density. Prediction equations were obtained by regression; predicted values for the body fluid volumes were calculated and the results were statistically evaluated. Both the TOBEC and the BMA provided rapid and reliable estimates for body fluid volumes with standard errors of the estimates of about 0.5-1.1 L for ECF, 1.0-1.8 L for TBW, and 1.0-1.3 L for ICF. Part of the error was attributable to standard tracer-dilution methods.

Changes in human body composition during calorie restriction with two levels of protein

Abstract Four women (140–160% of ideal weight, 32–42 yr old) were monitored for 6 weeks of weight maintenance, 12 weeks of calorie restriction (1000–1200 kcal/day) and 6 weeks of maintaining reduced body weights. To observe the effects of dietary protein levels in the weight reducing diet upon changes in body composition and energy stores, the restriction diet of two women was reduced 50% for all macronutrients while that of the remaining two women was reduced about 60% in fat and carbohydrate while maintaining the protein intake at the prerestriction level. Body composition changes were monitored with bioelectrical analyzers as well as the traditional density and deuterium dilution techniques. Maintaining daily protein intakes at the prerestriction quantities did not affect lean body tissue losses nor body weight losses, 9.6 to 19.0kg/person for the study. Minimal changes in resting metabolic rates were consistent with minimal changes in lean body mass. The total body electrical conductivity instrument (TOBEC) 3 and the underwater weighing-density method yielded similar body composition changes during weight loss.

Moderate diet restriction alters the substrate and hormone response to exercise

Substrate and hormone responses to submaximal exercise were studied in 10 overweight women (119-141% ideal body weight) to learn if a moderately restricted diet would influence the responses. Subjects consumed diets with adequate energy (ADEX), N = 5, or low energy (LDEX)--50% reduction in energy, N = 5. Three times during the 12-wk study, blood was drawn before and immediately following exercise; results were combined since there were no differences between replicates. Postexercise free fatty acids and glycerol increased to 465 +/- 27 mg.l-1 in LDEX but only to 245 +/- 19 mg.l-1 in ADEX. Postexercise insulin increased to 129 +/- 13 pmol.l-1 in LDEX, but did not increase in ADEX. Postexercise growth hormone increased to 10.5 +/- 1.0 microgram.l-1 in ADEX but only to 6.6 +/- 1.0 microgram.l-1 in LDEX. All postexercise increases within diet groups were highly significant (P < 0.0001), and the postexercise responses between diet groups were also different (P < 0.01). Respiratory gas exchange indicated that both groups increased fat utilization during exercise, but diet restriction altered postexercise hormones so that fat mobilization and utilization might be inhibited. The postexercise recovery period should be studied further to determine whether diet restriction results in a sustained altered hormone pattern that would curtail lipolysis and possibly limit body fat loss.

Comparison of conductivity, impedance and density methods for body composition assessment of obese women.

Body composition assessment should be used routinely to monitor progress of obese individuals participating in weight control programs. The advent of newer techniques based on bioelectrical properties has simplified body composition assessment, but accuracy of these techniques is still uncertain when applied to the obese. We report here our experience with 3 methods: 1) total body conductivity (TBC), 2) bioelectrical impedance (BIA) and 3) body density (DEN) used for body composition assessment of obese women.

Brief communication: changes in thermogenesis and caloric efficiency with high and normal protein-reducing diets in women.

A pilot study with four women (40-60% above ideal weight, 32-42 years old) was conducted for 6 weeks of weight maintenance, 12 weeks at 50% calories (1000 and 1200 kcal/day) and 6 weeks of weight maintenance after weight loss. Two women consumed 17% and two 32% of their calories from protein during restriction; their energy metabolism and body composition changes were examined. The use of doubly labeled water for measuring energy expenditure during weight loss was evaluated. Although the 32% protein diet did not reduce lean body tissue loss, the apparent increased efficiency of calorie utilization compared to the 17% protein diet is worthy of further investigation. Thermic effect of a meal was greatly reduced in these women compared to previously reported responses. Further refinements of the doubly labeled water method are needed prior to application in weight loss studies.