Oxygen Uptakes Adjusted for Body Composition in Normal‐Weight and Obese Adolescents

Objective: To test whether resting oxygen uptake (Vo₂), submaximal Vo₂, and maximal Vo₂ (Vo_2max) differs between obese adolescents (n = 18; BMI > 30) and a matched normal‐weight control group after adjustment for differences in fat‐free mass (FFM) and fat mass (FM). Research Methods and Procedures: FFM and FM were assessed by DXA. Resting Vo₂, submaximal Vo₂, and Vo_2max were measured by indirect calorimetry. Results: There was no difference in resting Vo₂ between groups after adjusting for FFM and FM. Submaximal Vo₂ did not differ between groups after adjusting for body weight. Percentage Vo_2max and NET Vo₂ (Vo_2max ? resting Vo₂) were significantly higher in the obese group during submaximal exercise, however not after adjusting for body weight. Vo_2max was not significantly different between groups after adjusting for FFM. Discussion: When body compositions are appropriately controlled for, resting Vo₂, submaximal Vo₂, and Vo_2max do not differ between obese and normal‐weight adolescents. These data suggested that the higher relative Vo₂ observed in obese adolescent subjects is due to their higher FM and not to an impaired Vo_2max even though they may be less physically active.     

Body Fat and Fat‐Free Mass and All‐Cause Mortality

Objective: To investigate whether the association between BMI and all‐cause mortality could be disentangled into opposite effects of body fat and fat‐free mass (FFM). Research Methods and Procedures: All‐cause mortality was studied in the Danish follow‐up study “Diet, Cancer and Health” with 27, 178 men and 29, 875 women 50 to 64 years old recruited from 1993 to 1997. By the end of year 2001, the median follow‐up was 5.8 years, and 1851 had died. Body composition was assessed by bioelectrical impedance. Cox regression models were used to estimate the relationships among body fat mass index (body fat mass divided by height squared), FFM index (FFM divided by height squared), and mortality. All analyses were adjusted for smoking habits. Results: Men and women showed similar associations. J‐shaped associations were found between body fat mass index and mortality adjusted for FFM and smoking. The mortality rate ratios in the upper part of body fat mass were 1.12 per kg/m² (95% confidence interval: 1.07, 1.18) in men and 1.06 per kg/m² (95% confidence interval: 1.02, 1.10) in women. Reversed J‐shaped associations were found between FFM index and mortality with a tendency to level off for high values of FFM. Discussion: Our findings suggest that BMI represents joint but opposite associations of body fat and FFM with mortality. Both high body fat and low FFM are independent predictors of all‐cause mortality.     

Differences in Resting Metabolic Rate between White and African‐American Young Adults

Objective: A reported lower resting metabolic rate (RMR) in African‐American women than in white women could explain the higher prevalence of obesity in the former group. Little information is available on RMR in African‐American men. Research Methods and Procedures: We assessed RMR by indirect calorimetry and body composition by DXA in 395 adults ages 28 to 40 years (100 African‐American men, 95 white men, 94 African‐American women, and 106 white women), recruited from participants in the Coronary Artery Risk Development in Young Adults (CARDIA), Birmingham, Alabama, and Oakland, California, field centers. Results: Using linear models, fat‐free mass, fat mass, visceral fat, and age were significantly related to RMR, but the usual level of physical activity was not. After adjustment for these variables, mean RMR was significantly higher in whites (1665.07 ± 10.78 kcal/d) than in African Americans (1585.05 ± 11.02 kcal/d) by 80 ± 16 kcal/d (p < 0.0001). The ethnic × gender interaction was not significant (p = 0.9512), indicating that the difference in RMR between African‐American and white subjects was similar for men and women. Discussion: RMR is ～5% higher in white than in African‐American participants in CARDIA. The difference was the same for men and women and for lean and obese individuals. The prevalence of obesity is not higher in African‐American men than in white men. Because of these reasons, we believe that RMR differences are unlikely to be a primary explanation for why African‐American women are more prone to obesity than white women.     

Fat Intake Affects Adiposity,Comorbidity Factors,and Energy Metabolism of Sprague‐Dawley Rats

Objective: Childhood obesity is an emerging health problem. This study assesses the effects of three levels of dietary fat (10%, 32%, and 45% measured by kilocalories) on weight gain, body composition, energy metabolism, and comorbidity factors in rats from weaning through maturation. Research Methods and Procedures: The role of dietary fat on the susceptibility to obesity was assessed by feeding diets containing three levels of dietary fat to rats from weaning through 7 months of age. Body composition was analyzed by DXA after 6 and 12 weeks of dietary treatment. Energy metabolism was measured by indirect calorimetry. Results: Energy intake, weight gain, fat mass, and plasma glucose, cholesterol, triglyceride, free fatty acid, leptin, and insulin levels increased dose‐dependently with increased dietary fat. No difference in absolute lean mass among the three groups was observed. Therefore, the differences in weight gain are accounted for primarily by increased fat accretion. Compared with rats that were relatively resistant to obesity when on a 45% fat diet, diet‐induced obesity‐prone rats were in positive energy balance and had an elevated respiratory quotient, indicating a switch in energy substrate use from fat to carbohydrate, which promotes body‐fat accretion. Discussion: Our data support the hypothesis that administration of increasing amount of dietary fat to very young rats enhances susceptibility to diet‐induced obesity and its comorbidities.     

Self‐Selected Macronutrient Diet Affects Energy and Glucose Metabolism in Brown Fat‐Ablated Mice

Objective: Obese transgenic UCP‐DTA mice have largely ablated brown adipose tissue and develop obesity and diabetes, which are highly susceptible to a high‐fat diet. We investigated macronutrient self‐selection and its effect on development of obesity, diabetes, and energy homeostasis in UCP‐DTA mice. Research Methods and Procedures: UCP‐DTA and wild‐type littermates were fed a semisynthetic macronutrient choice diet (CD) ad libitum from weaning until 17 weeks. Energy homeostasis was assessed by measurement of food intake, food digestibility, body composition, and energy expenditure. Diabetes was assessed by blood glucose measurements and insulin tolerance test. Results: Wild‐type and UCP‐DTA mice showed a high fat preference and increased energy digestion on CD compared with a low‐fat standard diet. On CD, wild‐type mice accumulated less body fat (16.9%) than UCP‐DTA (32.6%) mice, although they had a higher overall energy intake. Compared with wild‐type mice, resting metabolic rate was reduced in UCP‐DTA mice irrespective of diet. UCP‐DTA mice progressively decreased their carbohydrate intake, resulting in an almost complete avoidance of carbohydrate. UCP‐DTA mice developed severe insulin resistance but showed decreased fed and fasted blood glucose on CD. Discussion: In contrast to wild‐type mice, UCP‐DTA mice were not able to reduce their weight gain efficiency on CD. This suggests that, because of the high fat preference of the background strain and the increased metabolic efficiency, brown adipose tissue‐deficient mice still develop obesity and insulin resistance on a macronutrient CD even when decreasing overall energy intake. Through the avoidance of carbohydrates, however, they are able to maintain normoglycemia.     

Triaxial accelerometry for assessment of physical activity in young children

Objective: The purpose of the present study was to derive linear and non‐linear regression equations that estimate energy expenditure (EE) from triaxial accelerometer counts that can be used to quantitate activity in young children. We are unaware of any data regarding the validity of triaxial accelerometry for assessment of physical activity intensity in this age group. Research Methods and Procedures: EE for 27 girls and boys (6.0 ± 0.3 years) was assessed for nine activities (lying down, watching a video while sitting and standing, line drawing for coloring‐in, playing blocks, walking, stair climbing, ball toss, and running) using indirect calorimetry and was then estimated using a triaxial accelerometer (ActivTracer, GMS). Results: Significant correlations were observed between synthetic (synthesized tri‐axes as the vector), vertical, and horizontal accelerometer counts and EE for all activities (0.878 to 0.932 for EE). However, linear and non‐linear regression equations underestimated EE by >30% for stair climbing (up and down) and performing a ball toss. Therefore, linear and non‐linear regression equations were calculated for all activities except these two activities, and then evaluated for all activities. Linear and non‐linear regression equations using combined vertical and horizontal acceleration counts, synthetic counts, and horizontal counts demonstrated a better relationship between accelerometer counts and EE than did regression equations using vertical acceleration counts. Adjustment of the predicted value by the regression equations using the vertical/horizontal counts ratio improved the overestimation of EE for performing a ball toss. Discussion: The results suggest that triaxial accelerometry is a good tool for assessing daily EE in young children.     

Evaluation of a multisensor armband in estimating energy expenditure in obese individuals

Objective: To examine the reliability and validity of the SenseWear Pro 2 Armband (SWA; Body Media, Pittsburgh, PA) during rest and exercise compared with indirect calorimetry (IC) in obese individuals. Research Methods and Procedures: Energy expenditure was assessed during rest with the SWA and IC in 142 obese adults (37 men and 105 women, BMI = 42.3 ± 7.0) and in 25 lean and overweight adults (BMI = 25.3 ± 3.2) who were used as a comparison group. Twenty‐nine of the obese adults also participated in three separate short exercise sessions including cycle ergometry, stair stepping, and treadmill walking. Results: The repeatability of SWA estimates in obese subjects was high (r = 0.88, p < 0.001). The SWA generally underestimated the resting energy expenditure (REE) (1811 ± 346 vs. 1880 ± 382 kcal/d) and highly overestimated the energy expenditure during the exercise sessions in obese individuals. REE estimations by SWA were significantly correlated with fat‐free mass (r = 0.88, p < 0.001). Bland‐Altman plots based statistical analysis for the estimated REE, and measured IC showed a low agreement (Total Error > 20% but Systematic Error < 5%) between the two methods in obese subjects, although they showed a high correlation and a very good agreement in lean and overweight patients. Discussion: The SWA is an easy to handle, practical, new portable device for measuring energy expenditure. The accuracy of the SWA appeared to be poor in the obese subjects we examined, especially those with high REE both in rest and exercise. We believe that it is necessary to incorporate new, obesity‐specific algorithms in the relative software.     

Effects of Energy Expenditure and Ucp1 on Photoperiod‐Induced Weight Gain in Collared Lemmings

Objective: To determine the role of total energy expenditure (TEE) and its components in the ability of collared lemmings to increase weight in response to a decrease in photoperiod. Research Methods and Procedures: Energy expenditure was measured by 24‐hour indirect calorimetry concurrent with food‐intake studies. TEE and resting and nonresting energy expenditure (REE and NREE, respectively) were adjusted for body weight by analysis of covariance (ANCOVA). Uncoupling protein 1 (Ucp1) mRNA levels from interscapular brown adipose tissue were determined by Northern blot. Results: TEE and REE of lemmings exposed to a short photoperiod for 10 days were significantly lower than that of lemmings exposed to a long photoperiod (p < 0.05), whereas NREE was not significantly different (p = 0.44). Ucp1 mRNA levels in interscapular brown adipose tissue were 50% lower in short‐ vs. long‐photoperiod lemmings (p < 0.01). Ucp1 mRNA levels were positively related to REE (r² = 0.79, p < 0.01). After adjustment of REE for differences in Ucp1 mRNA levels, there was no longer a significant difference attributable to photoperiod treatment (p = 0.54). Discussion: The results of this study indicate that the increase in body mass that occurs when collared lemmings are exposed to a short photoperiod may be primarily fueled by a decrease in REE and is correlated with a decrease in Ucp1 mRNA levels.     

Leptin Levels Are Associated with Fat Oxidation and Dietary‐Induced Weight Loss in Obesity

Objective: To examine the relationship between fasting plasma leptin and 24‐hour energy expenditure (EE), substrate oxidation, and spontaneous physical activity (SPA) in obese subjects before and after a major weight reduction compared with normal weight controls. To test fasting plasma leptin, substrate oxidations, and SPA as predictive markers of success during a standardized weight loss intervention. Research Methods and Procedures: Twenty‐one nondiabetic obese (body mass index: 33.9 to 43.8 kg/m²) and 13 lean (body mass index: 20.4 to 24.7 kg/m²) men matched for age and height were included in the study. All obese subjects were reexamined after a mean weight loss of 19.2 kg (95% confidence interval: 15.1–23.4 kg) achieved by 16 weeks of dietary intervention followed by 8 weeks of weight stability. Twenty‐four‐hour EE and substrate oxidations were measured by whole‐body indirect calorimetry. SPA was assessed by microwave radar. Results: In lean subjects, leptin adjusted for fat mass (FM) was correlated to 24‐hour EE before (r = ?0.56, p < 0.05) but not after adjustment for fat free mass. In obese subjects, leptin correlated inversely with 24‐hour and resting nonprotein respiratory quotient (r = ?0.47, p < 0.05 and r = ?0.50, p < 0.05) both before and after adjustments for energy balance. Baseline plasma leptin concentration, adjusted for differences in FM, was inversely related to the size of weight loss after 8 weeks (r = ?0.41, p = 0.07), 16 weeks (r = ?0.51, p < 0.05), and 24 weeks (r = ?0.50, p < 0.05). Discussion: The present study suggests that leptin may have a stimulating effect on fat oxidation in obese subjects. A low leptin level for a given FM was associated with a greater weight loss, suggesting that obese subjects with greater leptin sensitivities are more successful in reducing weight.     

Work‐Related Physical Activity Is Not Associated with Body Mass Index and Obesity

Objective: To analyze the association of work‐related physical activity (WRPA) and leisure‐time physical activity (LTPA) with body mass index (BMI) and obesity in the Spanish adult population aged 20 to 60 years. Research Methods and Procedures: The data were taken from the 1993 Spanish National Health Survey. We analyzed a sample of 12,044 men and women representative of the Spanish population aged 20 to 60 years. BMI and frequency of obesity (BMI ≥ 30 kg/m²) were obtained from self‐reported weight and height. Multiple linear regression and logistic regression models were constructed, adjusting for the main confounding factors. WRPA and LTPA were measured by two questions to classify subjects into four categories of physical activity. Results: Neither mean BMI nor percentage of obesity varied significantly (p > 0.05) by WRPA. Mean BMI was significantly higher (p < 0.01) in those who were inactive in their leisure time (25.90 kg/m² in men and 24.43 kg/m² in women) than in those who reported vigorous activity (24.42 kg/m² and 22.97 kg/m² in men and women, respectively). The odds ration (OR) for obesity decreased with increasing level of LTPA in both men (OR of 0.64 for vigorous activity) and women (OR = 0.68), showing a statistically significant dose‐response relation in both men (for linear trend, p = 0.0021) and women (p = 0.0245). Discussion: These results raise questions about the association between WRPA and obesity and suggest the need to reexamine models of the obesity epidemic that point to automation of the workplace as one of the major explanatory factors.     

Gene or Size: Metabolic Rate and Body Temperature in Obese Growth Hormone‐Deficient Dwarf Mice

Objective: SMA1 mice carry a missense mutation in the growth hormone gene that leads to semidominant dwarfism and obesity. In this study, the basic thermal and metabolic properties of SMA1 mice were examined to detect metabolic alterations that can support the accretion of excess fat. Research Methods and Procedures: Basal and resting metabolic rates (RMRs) in wild‐type and SMA1 (sma1/+ and sma1/sma1) mice were determined by indirect calorimetry. Body temperature (T_b) was recorded using intraperitoneally implanted temperature‐sensitive transmitters, and body composition was determined by DXA. Results: SMA1 mice have proportionally lower basal and resting metabolic rates, higher body mass (BM)‐specific RMRs, and a higher lower critical temperature, and display a decrease in T_b by 0.4 °C in sma1/+ and 0.9 °C in sma1/sma1. Discussion: The analysis of gene effects on BM and energy expenditure in mouse mutants must consider the appropriate allometric relationship between BM and metabolic rate. With the exception of T_b, all metabolic alterations observed in SMA1 reflect reduced size.     

Objectively Measured Intensity of Physical Activity and Adiposity in Middle‐Aged Women

Objective: The aim of this study was to evaluate the relationship between objectively measured physical activity (ACT), particularly intensity of physical activity (iACT), and body fat percentage (BF%) in 278 middle‐aged women. Secondary purposes were to ascertain the association between physical activity duration (dACT) and BF% and the extent to which potentially confounding factors, including total ACT, energy intake, body weight, and season of assessment, influenced the relationship between iACT and BF%. Research Methods and Procedures: A cross‐sectional design was used. Subjects were apparently healthy, 35 to 45 years old, premenopausal, nonsmokers, with BMIs < 30 kg/m². Approximately 90 percent were white, 81% were married, and 37% were college graduates. ACT was assessed using Computer Science and Application accelerometers worn for 7 consecutive days. The accelerometers recorded movement continuously, and activity counts were collapsed into 10‐minute epochs. Intensity was indexed using seven activity count cut‐off points, and duration was based on the number of 10‐minute epochs at each intensity level. BF% was assessed using multiple measurements in the Bod Pod. Energy intake was measured using 7‐day weighed diet records during the same week subjects wore the accelerometers. Results: BF% was strongly and inversely associated with iACT and dACT. Controlling for energy intake and body weight strengthened the relationships among iACT, dACT, and BF%. Control of total ACT weakened the association. Discussion: Engaging in higher intensity and/or longer duration ACT is associated with lower BF% compared with lower intensity and/or shorter durations of activity.     

Obesity‐related Comorbidities in Obese African Americans in an Outpatient Weight Loss Program

Objective: To identify, among obese African‐American enrollees in an outpatient weight loss program, differences between those with and without obesity‐related comorbidities (ORCMs). Research Methods and Procedures: Data were from 237 obese African Americans (BMI, 30 to 50 kg/m²; 90% women) who enrolled in a 10‐week lifestyle weight loss program. Analyses compared subgroups defined by ORCM status (from medical history) on baseline characteristics, program attendance, and postprogram weight change. Results: Most participants (76%) had one or more ORCMs. Those with versus without ORCMs, respectively, were older (mean age, 45.6 vs. 37.1 years; p < 0.001), were less educated (59.2% vs. 76.6% with >12 years; p = 0.031), were more likely to perceive a physical limitation affecting activity (22.2% vs. 1.8%; p < 0.001), and had higher waist circumference (mean, 113.7 vs. 106.9 cm; p < 0.001) but not BMI (38.3 vs. 37.0 kg/m²; p = 0.095). Logistic regression analyses confirmed the independence of these associations. Having ORCMs was not associated with class attendance or return for data collection after the 10‐week program. Postprogram weight change (n = 134) was unrelated to ORCMs, but better weight loss was seen among those without perceived physical limitations (1.9 vs. 0.4 kg in those without versus with limitations; p = 0.069). Conclusion: Data from this clinical sample of obese African Americans suggest that waist circumference is relevant to ORCM status at BMI levels up to 50 kg/m². Clear indications for tailoring of treatment based on ORCM status were not identified, although the possible influence of ORCM‐related activity limitations warrants further study.     

Obesity‐Related Knowledge,Attitudes, and Behaviors in Obese and Non‐obese Urban Philadelphia Female Adolescents

Objectives: To examine relationships between knowledge, attitudinal and behavioral factors, and obesity and to determine how these factors influence obesity status in west Philadelphia female adolescents. Research Methods and Procedures: A matched‐pairs study was conducted with 32 stature‐ and age‐matched pairs of obese (body mass index and triceps skinfold ≥95th percentile of National Health and Nutrition Examination Survey I) and non‐obese (body mass index and triceps skinfold between the 15th and 85th percentiles of National Health and Nutrition Examination Survey I) female African American adolescents (aged 11 to 15 years), selected from a school‐based study sample, based on obesity status and matching criteria. Adolescents were compared on the following measures: physical activity, inactivity, dietary intake, eating attitudes, health behavior knowledge, body image, self‐esteem, and maturation status. Differences between obese and non‐obese females were tested using paired t tests and Wilcoxon matched‐pairs signed‐rank tests. Results: Physical activity, inactivity, and perception of ideal body size emerged as the most important contributory factors to obesity status. There were no statistically significant matched‐pair differences in macronutrient and micronutrient intakes, self‐esteem, eating attitudes, health behavior knowledge, or maturation status of these adolescents. Obese adolescents had significantly lower levels of physical activity, higher inactivity, and a larger perception of ideal body size than non‐obese adolescents. Discussion: Knowledge and attitudinal factors (with the exception of perception of ideal body size) had far less association with obesity than activity‐related behavioral factors. These findings suggest that future intervention strategies should pay particular attention to physical activity, inactivity, and body image attitudes.     

Decreased Glucagon‐like Peptide 1 Release after Weight Loss in Overweight/Obese Subjects

Objective: Postprandial glucagon‐like peptide 1 (GLP‐1) release seems to be attenuated in obese subjects. Results on whether weight loss improves GLP‐1 release are contradictory. The aim of this study was to further investigate the effect of weight loss on basal and postprandial GLP‐1 release in overweight/obese subjects. Research Methods and Procedures: Thirty‐two overweight/obese subjects participated in a repeated measurement design before (BMI, 30.3 ± 2.8 kg/m²; waist circumference, 92.6 ± 7.8 cm; hip circumference, 111.1 ± 7.4 cm) and after a weight loss period of 6 weeks (BMI, 28.2 ± 2.7 kg/m²; waist circumference, 85.5 ± 8.5 cm; hip circumference, 102.1 ± 9.2 cm). During weight loss, subjects received a very‐low‐calorie diet (Optifast) to replace three meals per day. Subjects came to the laboratory fasted, and after a baseline blood sample, received a standard breakfast (1.9 MJ). Postprandially, blood samples were taken every one‐half hour relative to intake for 120 minutes to determine GLP‐1, insulin, glucose, and free fatty acids from plasma. Appetite ratings were obtained with visual analog scales. Results: After weight loss, postprandial GLP‐1 concentrations at 30 and 60 minutes were significantly lower than before weight loss (p < 0.05). Glucose concentrations were also lower, and free fatty acids were higher compared with before weight loss. Ratings of satiety were increased, and hunger scores were decreased after weight loss (p < 0.05). Discussion: In overweight/obese subjects, GLP‐1 concentrations after weight loss were decreased compared with before weight loss, and nutrient‐related stimulation was abolished. This might be a response to a proceeding negative energy balance. Satiety and GLP‐1 seem to be unrelated in the long term.     

Accelerometry‐Measured Activity or Sedentary Time and Overweight in Rural Boys and Girls

Objective: The aim of this study was to examine the association between overweight and physical activity or sedentary time measured by accelerometry in rural boys and girls 7 to 19 years old. Research Methods and Procedures: A cross‐sectional study was conducted involving 130 girls and 99 boys in elementary, middle, and high school in rural Maryland. After weight, height, and body composition were measured, children wore an Actiwatch accelerometer for 6 days. Comparisons for activity counts were made between normal and overweight or at risk for overweight (at‐risk/overweight) participants (≥85th percentile of BMI). The associations between body composition and accelerometry‐defined activity levels (sedentary, light, moderate, and vigorous) were analyzed by age group for boys and girls. Results: Differences in total activity in counts per day or counts per minute were not observed between normal and at‐risk/overweight boys or girls in all age groups. No associations between measures of body composition and time spent in an activity level were seen in boys. Fat mass and percentage fat were positively correlated to time spent in sedentary activity (range r = 0.42 to 0.54, all p < 0.01) for girls. In contrast, fat mass and percentage fat were negatively related to time spent in light activity (range, r = ?0.40 to ?0.51, p < 0.05) for girls. Discussion: In girls, but not boys, greater body fat is associated with greater time spent being inactive, and lower levels of body fat are associated with more time spent in light activity. Physical activity interventions targeting inactive children in rural communities are warranted.     

Dietary effects on body composition, glucose metabolism, and longevity are modulated by skeletal muscle mitochondrial uncoupling in mice

Little is known about how diet and energy metabolism interact in determination of lifespan under ad libitum feeding. From 12 weeks of age until death, male and female wild-type (WT) and transgenic (TG) mice with increased skeletal muscle mitochondrial uncoupling (HSA-mUCP1 mice) were fed one of three different semisynthetic diets differing in macronutrient ratio: control (high-carbohydrate/low-fat-HCLF) and two high-fat diets: high-carbohydrate/high-fat (HCHF), and low-carbohydrate/high-fat (LCHF). Compared to control and LCHF, HCHF feeding rapidly and significantly increased body fat content in WT. Median lifespan of WT was decreased by 33% (HCHF) and 7% (LCHF) compared to HCLF. HCHF significantly increased insulin resistance (HOMA) of WT from 24 weeks on compared to control. TG mice had lower lean body mass and increased energy expenditure, insulin sensitivity, and maximum lifespan (+10%) compared to WT. They showed a delayed development of obesity on HCHF but reached similar maximum adiposity as WT. TG median lifespan was only slightly reduced by HCHF (-7%) and unaffected by LCHF compared to control. Correlation analyses showed that decreased longevity was more strongly linked to a high rate of fat gain than to adiposity itself. Furthermore, insulin resistance was negatively and weight-specific energy expenditure was positively correlated with longevity. We conclude that (i) dietary macronutrient ratios strongly affected obesity development, glucose homeostasis, and longevity, (ii) that skeletal muscle mitochondrial uncoupling alleviated the detrimental effects of high-fat diets, and (iii) that early imbalances in energy homeostasis leading to increased insulin resistance are predictive for a decreased lifespan.     

Physical Activity Levels Are Low in Free‐Living Adults with Chronic Paraplegia

Objectives: To compare physical activity levels (PALs) of free‐living adults with chronic paraplegia with World Health Organization recommendations and to compare energy expenditure between persons with complete vs. incomplete paraplegia. Research Methods and Procedures: Twenty‐seven euthyroid adults (17 men and 10 women) with paraplegia (12.5 ± 9.5 years since onset; 17 with complete lesions and 10 with incomplete lesions) participated in this cross‐sectional study. Resting metabolic rate was measured by indirect calorimetry and total daily energy expenditure (TDEE) by heart rate monitoring. PAL was calculated as TDEE/resting metabolic rate. Total body water was measured by deuterium dilution and fat‐free mass (FFM) and fat mass (FM) by calculation (FFM = total body water/0.732; FM = weight ? FFM). Obesity was defined using the following percentage FM cutoffs: men 18 to 40 years >22% and 41 to 60 years >25%; and women 18 to 40 years >35% and 41 to 60 years >38%. Results: Nineteen subjects (70.4%; 13 men and six women) were obese. Fifteen subjects (56%) engaged in structured physical activity 1.46 ± 0.85 times during the observation period for a mean of 49.4 ± 31.0 minutes per session. Despite this, mean PAL of the group was 1.56 ± 0.34, indicative of limited physical activity. TDEE was 24.6% lower in subjects with complete paraplegia (2072 ± 505 vs. 2582 ± 852 kcal/d, p = 0.0372). Discussion: PAL of the group was low, indicating that persons with paraplegia need to engage in increased frequency, intensity, and/or duration of structured physical activity to achieve a PAL ≥1.75 and, thereby, to offset sedentary activities of daily living.     

Medium‐Chain Triglycerides Increase Energy Expenditure and Decrease Adiposity in Overweight Men

Objective: The objectives of this study were to compare the effects of diets rich in medium‐chain triglycerides (MCTs) or long‐chain triglycerides (LCTs) on body composition, energy expenditure, substrate oxidation, subjective appetite, and ad libitum energy intake in overweight men. Research Methods and Procedures: Twenty‐four healthy, overweight men with body mass indexes between 25 and 31 kg/m² consumed diets rich in MCT or LCT for 28 days each in a crossover randomized controlled trial. At baseline and after 4 weeks of each dietary intervention, energy expenditure was measured using indirect calorimetry, and body composition was analyzed using magnetic resonance imaging. Results: Upper body adipose tissue (AT) decreased to a greater extent (p < 0.05) with functional oil (FctO) compared with olive oil (OL) consumption (?0.67 ± 0.26 kg and ?0.02 ± 0.19 kg, respectively). There was a trend toward greater loss of whole‐body subcutaneous AT volume (p = 0.087) with FctO compared with OL consumption. Average energy expenditure was 0.04 ± 0.02 kcal/min greater (p < 0.05) on day 2 and 0.03 ± 0.02 kcal/min (not significant) on day 28 with FctO compared with OL consumption. Similarly, average fat oxidation was greater (p = 0.052) with FctO compared with OL intake on day 2 but not day 28. Discussion: Consumption of a diet rich in MCTs results in greater loss of AT compared with LCTs, perhaps due to increased energy expenditure and fat oxidation observed with MCT intake. Thus, MCTs may be considered as agents that aid in the prevention of obesity or potentially stimulate weight loss.