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.     

Effect of sarcopenia on cardiovascular disease risk factors in obese postmenopausal women

Objective: To compare sarcopenic‐obese and obese postmenopausal women for risk factors predisposing to cardiovascular disease (CVD) and determine whether there may be a relationship between muscle mass and metabolic risk in obese postmenopausal women. Research Methods and Procedures: In this cross‐sectional study, 22 healthy obese postmenopausal women (mean age, 66 ± 5 years; mean BMI, 27 ± 3 kg/m²) were divided into two groups matched for age (±2 years) and fat mass (FM) (±2%). Sarcopenia was defined as a muscle mass index of <14.30 kg fat‐free mass (FFM)/m² (which corresponds to 1 standard deviation below the values of a young reference population), and obesity was defined as an FM of >35% (which corresponds to the World Health Organization guidelines). FM, FFM (measured by DXA), daily energy expenditure (accelerometry), dietary intake (3‐day dietary record), and blood biochemical analyses (lipid profile, insulin, glucose, and C‐reactive protein) were obtained. Visceral fat mass (VFM) was calculated by the equation of Bertin, which estimates VFM from DXA measurements. Results: Obese women had more FFM (p = 0.006), abdominal FM (p = 0.047), and VFM (p = 0.041) and a worse lipid profile [p = 0.040 for triglycerides; p = 0.004 for high‐density lipoprotein (HDL); p = 0.026 for total cholesterol/HDL] than sarcopenic‐obese postmenopausal women. Obese women also ingested significantly more animal (p = 0.001) and less vegetal proteins (p = 0.013), although both groups had a similar total protein intake (p = 0.967). Discussion: Sarcopenia seems to be associated with lower risk factors predisposing to CVD in obese postmenopausal women. With the increase in the number of aging people, the health implications of being sarcopenic‐obese merit more attention.     

Similarity in Percent Body Fat Between White and Vietnamese Women: Implication for a Universal Definition of Obesity

It has been widely assumed that for a given BMI, Asians have higher percent body fat (PBF) than whites, and that the BMI threshold for defining obesity in Asians should be lower than the threshold for whites. This study sought to test this assumption by comparing the PBF between US white and Vietnamese women. The study was designed as a comparative cross‐sectional investigation. In the first study, 210 Vietnamese women ages between 50 and 85 were randomly selected from various districts in Ho Chi Minh City (Vietnam). In the second study, 419 women of the same age range were randomly selected from the Rancho Bernardo Study (San Diego, CA). In both studies, lean mass (LM) and fat mass (FM) were measured by dual‐energy X‐ray absorptiometry (DXA) (QDR 4500; Hologic). PBF was derived as FM over body weight. Compared with Vietnamese women, white women had much more FM (24.8 ± 8.1 kg vs. 18.8 ± 4.9 kg; P < 0.0001) and greater PBF (36.4 ± 6.5% vs. 35.0 ± 6.2%; P = 0.012). However, there was no significant difference in PBF between the two groups after matching for BMI (35.1 ± 6.2% vs. 35.0 ± 5.7%; P = 0.87) or for age and BMI (35.6 ± 5.1% vs. 35.8 ± 5.9%; P = 0.79). Using the criteria of BMI ≥30, 19% of US white women and 5% of Vietnamese women were classified as obese. Approximately 54% of US white women and 53% of Vietnamese women had their PBF >35% (P = 0.80). Although white women had greater BMI, body weight, and FM than Vietnamese women, their PBF was virtually identical. Further research is required to derive a more appropriate BMI threshold for defining obesity for Asian women.     

Calcium and dairy product modulation of lipid utilization and energy expenditure

Objective: The purpose of this study was to investigate the impact of dietary calcium or dairy product intake on total energy expenditure (TEE), fat oxidation, and thermic effect of a meal (TEM) during a weight loss trial. Methods and Procedures: The intervention included a prescribed 500‐kcal deficit diet in a randomized placebo‐controlled calcium or dairy product intervention employing twenty‐four 18 to 31‐year‐old (22.2 ± 3.1 years, mean ± s.d.) overweight women (75.5 ± 9.6 kg). TEM and fat oxidation were measured using respiratory gas exchange after a meal challenge, and TEE was measured by doubly labeled water. Fat mass (FM) and lean mass (fat‐free mass (FFM)) were measured by dual‐energy X‐ray absorptiometry. Subjects were randomized into one of these three intervention groups: (i) placebo (<800 mg/day calcium intake); (ii) 900 mg/day calcium supplement; (iii) three servings of dairy products/day to achieve an additional 900 mg/day. Results: There were no group effects observed in change in TEE; however, a group effect was observed for fat oxidation after adjusting for FFM (P = 0.02). The treatment effect was due to an increase in fat oxidation in the calcium‐supplemented group of 1.5 ± 0.6 g/h, P = 0.02. Baseline 25‐hydroxyvitamin D (25OHD) was positively correlated with TEM (R = 0.31, P = 0.004), and trended toward a correlation with fat oxidation (P = 0.06), independent of group assignment. Finally, the change in log parathyroid hormone (PTH) was positively correlated with the change in trunk FM (R = 0.27, P = 0.03). Discussion: These results support that calcium intake increases fat oxidation, but does not change TEE and that adequate vitamin D status may enhance TEM and fat oxidation.     

Effects of Obesity on Substrate Utilization during Exercise

Objective: The capacity for lipid and carbohydrate (CHO) oxidation during exercise is important for energy partitioning and storage. This study examined the effects of obesity on lipid and CHO oxidation during exercise. Research Methods and Procedures: Seven obese and seven lean [body mass index (BMI), 33 ± 0.8 and 23.7 ± 1.2 kg/m², respectively] sedentary, middle‐aged men matched for aerobic capacity performed 60 minutes of cycle exercise at similar relative (50% Vo _2max) and absolute exercise intensities. Results: Obese men derived a greater proportion of their energy from fatty‐acid oxidation than lean men (43 ± 5% 31 ± 2%; p = 0.02). Plasma fatty‐acid oxidation determined from recovery of infused [0.15 μmol/kg fat‐free mass (FFM) per minute] [1‐¹³C]‐palmitate in breath CO₂ was similar for obese and lean men (8.4 ± 1.1 and 29 ± 15 μmol/kg FFM per minute). Nonplasma fatty‐acid oxidation, presumably, from intramuscular sources, was 50% higher in obese men than in lean men (10.0 ± 0.6 versus 6.6 ± 0.8 μmol/kg FFM per minute; p < 0.05). Systemic glucose disposal was similar in lean and obese groups (33 ± 8 and 29 ± 15 μmol/kg FFM per minute). However, the estimated rate of glycogen‐oxidation was 50% lower in obese than in lean men (61 ± 12 versus 90 ± 6 μmol/kg FFM per minute; p < 0.05). Discussion: During moderate exercise, obese sedentary men have increased rates of fatty‐acid oxidation from nonplasma sources and reduced rates of CHO oxidation, particularly muscle glycogen, compared with lean sedentary men.     

Validation of BIA in Obese Children and Adolescents and Re‐evaluation in a Longitudinal Study

Decrease in fat mass (FM) is a one of the aims of pediatric obesity treatment; however, measurement techniques suitable for routine clinical assessment are lacking. The objective of this study was to validate whole‐body bioelectrical impedance analysis (BIA; TANITA BC‐418MA) against the three‐component (3C) model of body composition in obese children and adolescents, and to test the accuracy of our new equations in an independent sample studied longitudinally. A total of 77 white obese subjects (30 males) aged 5–22 years, BMI‐standard deviation score (SDS) 1.6–3.9, had measurements of weight, height (HT), body volume, total body water (TBW), and impedance (Z). FM and fat‐free mass (FFM) were calculated using the 3C model or predicted from TANITA. FFM was predicted from HT²/Z. This equation was then evaluated in 17 other obese children (5 males) aged 9–13 years. Compared to the 3C model, TANITA manufacturer's equations overestimated FFM by 2.7 kg (P < 0.001). We derived a new equation: FFM = ?2.211 + 1.115 (HT²/Z), with r² of 0.96, standard error of the estimate 2.3 kg. Use of this equation in the independent sample showed no significant bias in FM or FFM (mean bias 0.5 ± 2.4 kg; P = 0.4), and no significant bias in change in FM or FFM (mean bias 0.2 ± 1.8 kg; P = 0.7), accounting for 58% (P < 0.001) and 55% (P = 0.001) of the change in FM and FFM, respectively. Our derived BIA equation, shown to be reliable for longitudinal assessment in white obese children, will aid routine clinical monitoring of body composition in this population.     

Lower than predicted resting metabolic rate is associated with severely impaired cardiorespiratory fitness in obese individuals

Obese individuals have reduced cardiorespiratory fitness as compared with leaner counterparts. Regular exercise maintains or increases fitness and lean body mass. Lean body mass, in turn, has a direct impact on resting metabolic rate (RMR). Given these relationships, we sought to evaluate the association between RMR and cardiorespiratory fitness in obese individuals. We evaluated 64 obese individuals (78% female) with direct assessment of RMR and cardiorespiratory fitness via breath‐by‐breath measurement of oxygen consumption and carbon dioxide production at rest and during exercise. The mean age and BMI were 47.4 ± 12.2 years and 47.2 ± 9.2 kg/m², respectively. The majority of subjects, 69%, had a measured RMR above that predicted by the Harris‐Benedict equation. Compared with the higher RMR group, those with a lower than predicted RMR had increased BMI, with values of 52.9 vs. 44.7 kg/m², P = 0.001, respectively. Analysis of those demonstrating significant effort during cardiopulmonary exercise testing (peak respiratory exchange ratio ≥1.10) revealed a significantly higher peak oxygen uptake (VO₂ peak) in the higher RMR group (17.3 ± 3.5 ml/min/kg) compared with the lower RMR group (13.6 ± 1.9 ml/min/kg), P = 0.003. In summary, a lower than predicted RMR was associated with a severely reduced VO₂ peak and a higher BMI in this cohort. These data suggest that morbid obesity may be a vicious cycle of increasing BMI, reduced cardiorespiratory fitness, muscle deconditioning, and lower RMR. Collectively, these responses may, over time, exacerbate the imbalance between energy intake and expenditure, resulting in progressive increases in body weight and fat stores.     

Influence of Short‐Term Consumption of the Caffeine‐Free,Epigallocatechin‐3‐Gallate Supplement,Teavigo, on Resting Metabolism and the Thermic Effect of Feeding

Green tea is purported to promote weight loss. Resting metabolic rate (RMR) and the thermic effect of feeding (TEF) are significant components of total daily energy expenditure and are partially determined by the sympathetic nervous system via catecholamine‐mediated stimulation of β‐adrenergic receptors. Epigallocatechin‐3‐gallate (EGCG: the most bioactive catechin in green tea) inhibits catechol‐O‐methyltransferase, an enzyme contributing to the degradation of catecholamines. Accordingly, we hypothesized that short‐term consumption of a commercially available EGCG supplement (Teavigo) augments RMR and TEF. On two separate occasions, seven placebo or seven EGCG capsules (135 mg/capsule) were administered to 16 adults (9 males, 7 females, age 25 ± 2 years, BMI 24.6 ± 1.2 kg/m² (mean ± s.e.)). Capsules (three/day) were consumed over 48 h; the final capsule was consumed 2 h prior to visiting the laboratory. Energy expenditure (ventilated hood technique) was determined at rest and for 5 h following ingestion of a liquid meal (caloric content: 40% RMR). Contrary to our hypothesis, RMR was not greater (P = 0.10) following consumption of EGCG (6,740 ± 373 kJ/day) compared with placebo (6,971 ± 352). Similarly, the area under the TEF response curve (Δ energy expenditure) was also unaffected by EGCG (246,808 ± 23,748 vs. 243,270 ± 22,177 kJ; P = 0.88). EGCG had no effect on respiratory exchange ratio at rest (P = 0.29) or throughout the TEF measurement (P = 0.56). In summary, together RMR and TEF may account for up to 85% of total daily energy expenditure; we report that short‐term consumption of a commercially available EGCG supplement did not increase RMR or TEF.     

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.     

A Weight Reduction Program Preserves Fat‐Free Mass but Not Metabolic Rate in Obese Adolescents

Objective: To determine the effects of a multidisciplinary weight reduction program on body composition and energy expenditure (EE) in severely obese adolescents. Research Methods and Procedures: Twenty‐six severely obese adolescents, 12 to 16 years old [mean BMI: 33.9 kg/m²; 41.5% fat mass (FM)] followed a 9‐month weight reduction program including moderate energy restriction and progressive endurance and resistance training. Body composition was assessed by DXA, basal metabolic rate by indirect calorimetry, and EE by whole‐body indirect calorimetry with the same activity program over 36‐hour periods before starting and 9 months after the weight reduction period. Results: Adolescents gained (least‐square mean ± SE) 2.9 ± 0.2 cm in height, lost 16.9 ± 1.3 kg body weight (BW), 15.2 ± 0.9 kg FM, and 1.8 ± 0.5 kg fat‐free mass (FFM) (p < 0.001). Basal metabolic rate, sleeping, sedentary, and daily EE were 8% to 14% lower 9 months after starting (p < 0.001) and still 6% to 12% lower after adjustment for FFM (p < 0.05). Energy cost of walking decreased by 22% (p < 0.001). The reduction in heart rate during sleep and sedentary activities (?10 to ?13 beats/min), and walking (?20 to ?25 beats/min) (p < 0.001) resulted from both the decrease in BW and physical training. Discussion: A weight reduction program combining moderate energy restriction and physical training in severely obese adolescents resulted in great BW and FM losses and improvement of cardiovascular fitness but did not prevent the decline in EE even after adjustment for FFM.     

Low Plasma Leptin Concentration and Low Rates of Fat Oxidation in Weight‐Stable Post‐Obese Subjects

Objective: A low resting metabolic rate for a given body size and composition, a low rate of fat oxidation, low levels of physical activity, and low plasma leptin concentrations are all risk factors for body weight gain. The aim of the present investigation was to compare resting metabolic rate (RMR), respiratory quotient (RQ), levels of physical activity, and plasma leptin concentrations in eight post‐obese adults (2 males and 6 females; 48.9 ± 12.2 years; body mass index [BMI]: 24.5 ± 1.0 kg/m²; body fat 33 ± 5%; mean ± SD) who lost 27.1 ± 21.3 kg (16 to 79 kg) and had maintained this weight loss for ≥2 months (2 to 9 months) to eight age‐ and BMI‐matched control never‐obese subjects (1 male and 7 females; 49.1 ± 5.2 years; BMI 24.4 ± 1.0 kg/m²; body fat 33 ± 7%). Research Methods and Procedures: Following 3 days of weight maintenance diet (50% carbohydrate and 30% fat), RMR and RQ were measured after a 10‐hour fast using indirect calorimetry and plasma leptin concentrations were measured using radioimmunoassay. Levels of physical activity were estimated using an accelerometer over a 48‐hour period in free living conditions. Results: After adjustment for fat mass and fat‐free mass, post‐obese subjects had, compared with controls, similar levels of physical activity (4185 ± 205 vs. 4295 ± 204 counts) and similar RMR (1383 ± 268 vs. 1430 ± 104 kcal/day) but higher RQ (0.86 ± 0.04 vs. 0.81 ± 0.03, p < 0.05). Leptin concentration correlated positively with percent body fat (r = 0.57, p < 0.05) and, after adjusting for fat mass and fat‐free mass, was lower in post‐obese than in control subjects (4.5 ± 2.1 vs. 11.6 ± 7.9 ng/mL, p < 0.05). Discussion: The low fat oxidation and low plasma leptin concentrations observed in post‐obese individuals may, in part, explain their propensity to relapse.     

Energy Expenditure in Lean and Obese Prepubertal Children

The relationship between energy expenditure and obesity was examined in prepubertal children. Consenting fifth graders underwent Tanner Staging, weight, height and skinfold measurements. Subjects were selected for further study to obtain equal numbers of girls and boys with a wide range of body composition. Weight, total daily energy expenditure (TDEE) by doubly labeled water (DLW), resting metabolic rate (RMR), and body composition were measured. Children were grouped into level of obesity based on tertiles of subscapular plus triceps skinfolds. The skinfold tertiles did quite well in grouping subjects by degree of obesity, as differences in percent fat in each tertile were significantly different. There were no differences in fat-free mass between the groups, while the highest tertile group weighed 14 kg more than the lowest. For DLW, energy expenditure was calculated using day 8 and day 9 urine samples as the final time point to examine precision. Mean energy expenditure using either day was nearly identical (2220 ± 400 vs. 2300 ± 370 kcal/d), with a CV of the difference of 5.5%. No differences in RMR, energy expended in activity, or TDEE between the three groups were observed. A reduction in RMR or TDEE could not explain differences in obesity in these prepubertal children. However, the fact that the heaviest children expended the same amount of energy in activity and had the same TDEE as the leanest, while weighing 14 kg more, indicates that the obese children had a reduced activity level.     

Estimating Activity‐related Energy Expenditure Under Sedentary Conditions Using a Tri‐axial Seismic Accelerometer

Activity‐related energy expenditure (AEE) is difficult to quantify, especially under sedentary conditions. Here, a model was developed using the detected type of physical activity (PA) and movement intensity (MI), based on a tri‐axial seismic accelerometer (DynaPort MiniMod; McRoberts B.V., The Hague, the Netherlands), with energy expenditure for PA as a reference. The relation between AEE (J/min/kg), MI, and the type of PA was determined for standardized PAs as performed in a laboratory including: lying, sitting, standing, and walking. AEE (J/min/kg) was calculated from total energy expenditure (TEE) and sleeping metabolic rate (SMR) as assessed with indirect calorimetry ((TEE × 0.9) ‐ SMR). Subsequently, the model was validated over 23‐h intervals in a respiration chamber. Subjects were 15 healthy women (age: 22 ± 2 years; BMI: 24.0 ± 4.0 kg/m²). Predicted AEE in the chamber was significantly related to measured AEE both within (r² = 0.81 ± 0.06, P < 0.00001) and between (r² = 0.70, P < 0.001) subjects. The explained variation in AEE by the model was higher than the explained variation by MI alone. This shows that a tri‐axial seismic accelerometer is a valid tool for estimating AEE under sedentary conditions.     

Postprandial Cytokine Concentrations and Meal Composition in Obese and Lean Women

The aim of this study was to compare the acute effect of (i) meals rich in saturated fat, oleic acid, and α‐linolenic acid and (ii) meals rich in starch and fiber on markers of inflammation and oxidative stress in obese and lean women. In a crossover study, 15 abdominally obese women (age, 54 ± 9 years; BMI, 37.3 ± 5.5 kg/m2) and 14 lean women (age, 53 ± 10 years; BMI, 22.9 ± 1.9 kg/m2) consumed meals rich in cream (CR), olive oil (OL), canola oil (CAN), potato (POT), and All‐Bran (BRAN) in random order. Blood samples were collected before and up to 6 h after the meals and plasma interleukin‐6 (IL‐6), IL‐8, tumor necrosis factor‐α (TNF‐α), lipid peroxides (LPOs), free‐fatty acids (FFAs), insulin, glucose, and cortisol were measured. Plasma IL‐6 decreased significantly 1 h after the meals then increased significantly above baseline at 4 h and 6 h in obese women and at 6 h in lean women. The incremental area under the curve (iAUC) for IL‐6 was significantly (P = 0.02) higher in obese compared with lean women and was significantly lower following the high fiber BRAN meal compared with a POT meal (P = 0.003). Waist circumference (R = 0.491, P = 0.007) and cortisol AUC (R = ?0.415, P = 0.03) were significant determinants of the magnitude of 6 h changes in plasma IL‐6 after the meals. These findings suggest that the postprandial response of plasma IL‐6 concentrations may be influenced by the type of carbohydrate in the meal, central adiposity, and circulating cortisol concentrations in women.     

Altered Intramuscular Lipid Metabolism Relates to Diminished Insulin Action in Men,but Not Women,in Progression to Diabetes

Whether sex differences in intramuscular triglyceride (IMTG) metabolism underlie sex differences in the progression to diabetes are unknown. Therefore, the current study examined IMTG concentration and fractional synthesis rate (FSR) in obese men and women with normal glucose tolerance (NGT) vs. those with prediabetes (PD). PD (n = 13 men and 7 women) and NGT (n = 7 men and 12 women) groups were matched for age and anthropometry. Insulin action was quantified using a hyperinsulinemic‐euglycemic clamp with infusion of [6,6^?2H₂]‐glucose. IMTG concentration was measured by gas chromatography/mass spectrometry (GC/MS) and FSR by GC/combustion isotope ratio MS (C‐IRMS), from muscle biopsies taken after infusion of [U^?13C]palmitate during 4 h of rest. In PD men, the metabolic clearance rate (MCR) of glucose was lower during the clamp (4.71 ± 0.77 vs. 8.62 ± 1.26 ml/kg fat‐free mass (FFM)/min, P = 0.04; with a trend for lower glucose rate of disappearance (Rd), P = 0.07), in addition to higher IMTG concentration (41.2 ± 5.0 vs. 21.2 ± 3.4 µg/mg dry weight, P ≤ 0.01), lower FSR (0.21 ± 0.03 vs. 0.42 ± 0.06 %/h, P ≤ 0.01), and lower oxidative capacity (P = 0.03) compared to NGT men. In contrast, no difference in Rd, IMTG concentration, or FSR was seen in PD vs. NGT women. Surprisingly, glucose Rd during the clamp was not different between NGT men and women (P = 0.25) despite IMTG concentration being higher (42.6 ± 6.1 vs. 21.2 ± 3.4 µg/mg dry weight, P = 0.03) and FSR being lower (0.23 ± 0.04 vs. 0.42 ± 0.06 %/h, P = 0.02) in women. Alterations in IMTG metabolism relate to diminished insulin action in men, but not women, in the progression toward diabetes.     

Relationship Between Body Fat Mass and Free Fatty Acid Kinetics in Men and Women

An increased release of free fatty acids (FFAs) into plasma likely contributes to the metabolic complications associated with obesity. However, the relationship between body fat and FFA metabolism is unclear because of conflicting results from different studies. The goal of our study was to determine the inter‐relationships between body fat, sex, and plasma FFA kinetics. We determined FFA rate of appearance (R_a) in plasma, by using stable isotopically labeled tracer techniques, during basal conditions in 106 lean, overweight, and obese, nondiabetic subjects (43 men and 63 women who had 7.0–56.0% body fat). Correlation analyses demonstrated: (i) no differences between men and women in the relationship between fat mass (FM) and total FFA R_a (µmol/min); (ii) total FFA R_a increased linearly with increasing FM (r = 0.652, P < 0.001); (iii) FFA R_a per kg FM decreased in a curvilinear fashion with increasing FM (r = ?0.806; P < 0.001); (iv) FFA R_a in relationship to fat‐free mass (FFM) was greater in obese than lean subjects and greater in women than in men; and (v) abdominal fat itself was not an important determinant of total FFA R_a. We conclude that total body fat, not regional fat distribution or sex, is an important modulator of the rate of FFA release into plasma. Although increased adiposity is associated with a decrease in fatty acid release in relationship to FM, this downregulation is unable to completely compensate for the increase in FM, so total FFA R_a and FFA R_a with respect to FFM are greater in women than in men and in obese than in lean subjects.     

The Effects of Consuming Frequent,Higher Protein Meals on Appetite and Satiety During Weight Loss in Overweight/Obese Men

The purpose of this study was to determine the effects of dietary protein and eating frequency on perceived appetite and satiety during weight loss. A total of 27 overweight/obese men (age 47 ± 3 years; BMI 31.5 ± 0.7 kg/m²) were randomized to groups that consumed an energy‐restriction diet (i.e., 750 kcal/day below daily energy need) as either higher protein (HP, 25% of energy as protein, n = 14) or normal protein (NP, 14% of energy as protein, n = 13) for 12 weeks. Beginning on week 7, the participants consumed their respective diets as either 3 eating occasions/day (3‐EO; every 5 h) or 6 eating occasions/day (6‐EO; every 2 h), in randomized order, for 3 consecutive days. Indexes of appetite and satiety were assessed every waking hour on the third day of each pattern. Daily hunger, desire to eat, and preoccupation with thoughts of food were not different between groups. The HP group experienced greater fullness throughout the day vs. NP (511 ± 56 vs. 243 ± 54 mm · 15 h; P < 0.005). When compared to NP, the HP group experienced lower late‐night desire to eat (13 ± 4 vs. 27 ± 4 mm, P < 0.01) and preoccupation with thoughts of food (8 ± 4 vs. 21 ± 4 mm; P < 0.01). Within groups, the 3 vs. 6‐EO patterns did not influence daily hunger, fullness, desire to eat, or preoccupation with thoughts of food. The 3‐EO pattern led to greater evening and late‐night fullness vs. 6‐EO but only within the HP group (P < 0.005). Collectively, these data support the consumption of HP intake, but not greater eating frequency, for improved appetite control and satiety in overweight/obese men during energy restriction‐induced weight loss.     

Serum Leptin Levels in Obese Males During Over‐ and Underfeeding

Leptin levels in lean adults vary in response to short‐term alterations in energy balance. We tested whether leptin responded to short‐term changes in energy balance in obese males in a similar manner to lean individuals. We enrolled eight obese, healthy males in a 12‐day study composed of four consecutive dietary treatment periods of 3 days each: baseline eucaloric feeding followed by randomized crossover periods of overfeeding (130% of total energy expenditure (TEE)) or underfeeding (70% of TEE), separated by a eucaloric (100% of TEE) washout period. We measured TEE with doubly labeled water prior to baseline. Leptin levels were measured throughout the third day of each treatment and 24‐h weighted averaged were calculated. Subjects' ad libitum intake during a breakfast buffet following each treatment period was recorded. During underfeeding, leptin levels decreased by 21 ± 6% (P < 0.01) from the previous eucaloric period. During overfeeding, leptin levels increased by 25 ± 11% (P < 0.01) when subjects were underfed first, but did not increase (5 ± 8%, nonsignificant (n.s.)) when subjects were overfed first. Changes in ad libitum intake from baseline were calculated for each subject after over‐, under‐, and eucaloric feeding and did not to correlate with the changes in mesor leptin levels from baseline (R² = 0.006, n.s). Leptin levels in obese males were acutely responsive to negative energy balance, but not to positive energy balance unless subjects were previously underfed. Consequently, leptin levels in obese males do not respond to changes in energy intake in a manner that would protect against weight gain.