Increased resting energy expenditure after 40 minutes of aerobic but not resistance exercise

Objective: Resting energy expenditure (REE) is increased 24 hours after high‐intensity aerobic exercise lasting 60 minutes, whereas results have been inconsistent after resistance training and aerobic exercise of shorter duration. The objective of the study was to compare the effects of 40 minutes of high‐intensity aerobic vs. resistance exercise on REE 19 to 67 hours after exercise. Research Methods and Procedures: REE was compared 19, 43, and 67 hours after 40 minutes of aerobic training (AT; 80% maximum heart rate) or resistance training (RT; 10 repetitions at 80% maximum strength, two sets and eight exercises). Twenty‐three black and 22 white women were randomly assigned to AT, RT, or no training (controls). Exercisers trained 25 weeks. REE was measured after a 12‐hour fast. Results: There was a significant time × group interaction for REE when adjusted for fat‐free mass and fat mass, with post hoc tests revealing that the 50‐kcal difference between 19 and 43 hours (1310 ± 196 to 1260 ± 161 kcal) and the 34‐kcal difference between 19 and 67 hours (1310 ± 196 to 1276 ± 168 kcal) were significant for AT. No other differences were found, including RT (19 hours, 1256 ± 160; 43 hours, 1251 ± 160; 67 hours, 1268 ± 188 kcal). Urine norepinephrine increased with training only in AT. After adjusting for fat‐free mass, REE Δ between 19 and both 43 and 67 hours was significantly related to urine norepinephrine (r = 0.76, p < 0.01 and 0.68, p < 0.03, respectively). Discussion: Consistent with findings on longer duration AT, these results show that 40 minutes of AT elevates REE for 19 hours in trained black and white women. This elevation did not occur with 40 minutes of RT. Results suggest that differences are, in part, due to increased sympathetic tone.     

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.     

Resistance training conserves fat-free mass and resting energy expenditure following weight loss

Objective: To determine what effect diet‐induced ～12 kg weight loss in combination with exercise training has on body composition and resting energy expenditure (REE) in premenopausal African‐American (AA) and European‐American (EA) women. Methods and Procedures: This study was a longitudinal, randomized weight loss clinical intervention, with either aerobic (AT), resistance (RT), or no exercise training (NT). Forty‐eight AA and forty‐six EA premenopausal overweight (BMI between 27 and 30) women underwent weight loss to a BMI <25. Body composition (densitometry), REE (indirect calorimetry), maximal oxygen uptake (VO₂max), and muscular strength (isometric elbow flexion) were evaluated when subjects were in energy balance. Results: AA women lost less fat‐free mass (FFM, P ≤ 0.05) (47.0 ± 4.6 to 46.9 ± 5.0 kg) than EA women (46.4 ± 4.9 to 45.2 ± 4.6 kg). Regardless of race, RT maintained FFM (P ≤ 0.05) following weight loss (46.9 ± 5.2 to 47.2 ± 5.0 kg) whereas AT (45.4 ± 4.2 to 44.4 ± 4.1 kg) and NT (47.9 ± 4.7 to 46.4 ± 5.1 kg) decreased FFM (P ≤ 0.05). Both AT and NT decreased in REE with weight loss but RT did not. Significant time by group interactions (all P ≤ 0.05) for strength indicated that RT maintained strength and AT did not. Discussion: AA women lost less FFM than EA women during equivalent weight losses. However, following weight loss in both AA and EA, RT conserved FFM, REE, and strength fitness when compared to women who AT or did not train.     

Methylphenidate hydrochloride increases energy expenditure in healthy adults

Objective: To examine the effects of methylphenidate hydrochloride (MPH) on resting energy expenditure (REE) and postprandial energy expenditure (PEE) and substrate partitioning. Methods and Procedures: Seven healthy men and seven healthy women participated in this double‐blind, randomized, placebo‐controlled, crossover study. MPH (0.5 mg/kg) or placebo was administered orally in the fasting state, 60 min before a REE measurement, and 90 min before a standardized breakfast of ～650 kcal. REE, PEE, and respiratory exchange ratio (RER) were obtained from indirect calorimetry. Body composition was measured using DEXA. Vital signs (blood pressure (BP) and heart rate (HR)) were assessed pre‐ and post‐administration of MPH or placebo in every session. Results: During the, MPH condition, REE increased over values observed during the placebo session (7%, P < 0.001). No changes in fasting RER were noted. Although PEE continually decreased with time as expected, MPH treatment resulted in significantly greater PEE values at 90 min (5%, P < 0.01). No significant effects of MPH were found for vital signs (HR, systolic, and diastolic BP). Discussion: MPH causes a significant increase in both REE and PEE without the significant changes in HR and BP that are commonly associated with psychostimulant use.     

Resting Energy Expenditure Changes With Weight Loss: Racial Differences

It is controversial whether weight loss reduces resting energy expenditure (REE) to a different magnitude in black and white women. This aim of this study was to determine whether changes in REE with weight loss were different between black and white postmenopausal women, and whether changes in body composition (including regional lean and fat mass) were associated with REE changes within each race. Black (n = 26) and white (n = 65) women (age = 58.2 ± 5.4 years, 25 < BMI < 40 kg/m²) completed a 20‐week weight‐loss intervention. Body weight, lean and fat mass (total body, limb, and trunk) via dual‐energy X‐ray absorptiometry, and REE via indirect calorimetry were measured before and after the intervention. We found that baseline REE positively correlated with body weight, lean and fat mass (total, limb, and trunk) in white women only (P < 0.05 for all). The intervention decreased absolute REE in both races similarly (1,279 ± 162 to 1,204 ± 169 kcal/day in blacks; 1,315 ± 200 to 1,209 ± 185 kcal/day in whites). REE remained decreased after adjusting for changes in total or limb lean mass in black (1,302–1,182 kcal/day, P = 0.043; 1,298–1,144 kcal/day, P = 0.006, respectively), but not in white, women. Changes in REE correlated with changes in body weight (partial r = 0.277) and fat mass (partial r = 0.295, 0.275, and 0.254 for total, limb, and trunk, respectively; P < 0.05) independent of baseline REE in white women. Therefore, with weight loss, REE decreased in proportion to the amount of fat and lean mass lost in white, but not black, women.     

Enhanced Weight Loss Following Coadministration of Pramlintide With Sibutramine or Phentermine in a Multicenter Trial

Preclinical evidence suggests that pharmacotherapy for obesity using combinations of agents targeted at distinct regulatory pathways may produce robust additive or synergistic effects on weight loss. This randomized placebo‐controlled trial examined the safety and efficacy of the amylin analogue pramlintide alone or in combination with either phentermine or sibutramine. All patients also received lifestyle intervention. Following a 1‐week placebo lead‐in, 244 obese or overweight, nondiabetic subjects (88% female; 41 ± 11 years; BMI 37.7 ± 5.4 kg/m²; weight 103 ± 19 kg; mean ± s.d.) received placebo subcutaneously (sc) t.i.d., pramlintide sc (120 µg t.i.d.), pramlintide sc (120 µg t.i.d.) + oral sibutramine (10 mg q.a.m.), or pramlintide sc (120 µg t.i.d.) + oral phentermine (37.5 mg q.a.m.) for 24 weeks. Treatment was single‐blind for subjects receiving subcutaneous medication only and open‐label for subjects in the combination arms. Weight loss achieved at week 24 with either combination treatment was greater than with pramlintide alone or placebo (P < 0.001; 11.1 ± 1.1% with pramlintide + sibutramine, 11.3 ± 0.9% with pramlintide + phentermine, ?3.7 ± 0.7% with pramlintide; ?2.2 ± 0.7% with placebo; mean ± s.e.). Elevations from baseline in heart rate and diastolic blood pressure were demonstrated with both pramlintide + sibutramine (3.1 ± 1.2 beats/min, P < 0.05; 2.7 ± 0.9 mm Hg, P < 0.01) and pramlintide + phentermine (4.5 ± 1.3 beats/min, P < 0.01; 3.5 ± 1.2 mm Hg, P < 0.001) using 24‐h ambulatory monitoring. However, the majority of subjects receiving these treatments remained within normal blood pressure ranges. These results support the potential of pramlintide‐containing combination treatments for obesity.     

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.     

Differences in daily energy expenditure in lean and obese women: the role of posture allocation

Objective: A low resting metabolic rate (RMR) is considered a risk factor for weight gain and obesity; however, due to the greater fat‐free mass (FFM) found in obesity, detecting an impairment in RMR is difficult. The purposes of this study were to determine the RMR in lean and obese women controlling for FFM and investigate activity energy expenditure (AEE) and daily activity patterns in the two groups. Methods and Procedures: Twenty healthy, non‐smoking, pre‐menopausal women (10 lean and 10 obese) participated in this 14‐day observational study on free‐living energy balance. RMR was measured by indirect calorimetry; AEE and total energy expenditure (TEE) were calculated using doubly labeled water (DLW), and activity patterns were investigated using monitors. Body composition including FFM and fat mass (FM) was measured by dual energy X‐ray absorptiometry (DXA). Results: RMR was similar in the obese vs. lean women (1601 ± 109 vs. 1505 ± 109 kcal/day, respectively, P = 0.12, adjusting for FFM and FM). Obese women sat 2.5 h more each day (12.7 ± 3.2 h vs. 10.1 ± 2.0 h, P < 0.05), stood 2 h less (2.7 ± 1.0 h vs. 4.7 ± 2.2 h, P = 0.02) and spent half as much time in activity than lean women (2.6 ± 1.5 h vs. 5.4 ± 1.9 h, P = 0.002). Discussion: RMR was not lower in the obese women; however, they were more sedentary and expended less energy in activity than the lean women. If the obese women adopted the activity patterns of the lean women, including a modification of posture allocation, an additional 300 kcal could be expended every day.     

Weight loss strategies for obese adults: personalized weight management program vs. standard care

Objective: The objective of this study was to evaluate the effect of a 32‐week personalized Polar weight management program (PWMP) compared with standard care (SC) on body weight, body composition, waist circumference, and cardiorespiratory fitness in overweight or obese adults. Research Methods and Procedures: Overweight or obese (29 ± 2 kg/m²) men and women (n = 74) 38 ± 5 years of age were randomly assigned into either PWMP (men = 20, women = 21) or SC (men = 15, women = 18). Both groups managed their own diet and exercise program after receiving the same standardized nutrition and physical activity advice. PWMP also received a weight management system with literature to enable the design of a personalized diet and exercise weight loss program. Body weight and body composition, waist circumference, and cardiorespiratory fitness were measured at weeks 0, 16, and 32. Results: Eighty percent of participants completed the 32‐week intervention, with a greater proportion of the dropouts being women (PWMP: 2 men vs. 7 women; SC: 2 men vs. 4 women). At 32 weeks, PWMP completers had significantly (p < 0.001) greater losses in body weight [6.2 ± 3.4 vs. 2.6 ± 3.6 (standard deviation) kg], fat mass (5.9 ± 3.4 vs. 2.2 ± 3.6 kg), and waist circumference (4.4 ± 4.5 vs. 1.0 ± 3.6 cm). Weight loss and fat loss were explained by the exercise energy expenditure completed and not by weekly exercise duration. Discussion: More effective weight loss was achieved after treatment with the PWMP compared with SC. The results suggest that the PWMP enables effective weight loss through tools that support self‐monitoring without the requirement of more costly approaches to program supervision.     

Effects of acute and chronic protein intake on metabolism, appetite, and ghrelin during weight loss

Objective: This study evaluated the effects of acute and chronic consumption of higher dietary protein on energy expenditure, macronutrient use, appetite, and appetite‐regulating hormones during weight loss in women. Research Methods and Procedures: Thirty‐eight women chronically consuming a 750 kcal/d energy‐deficit diet with a protein content of 30% (higher protein‐chronic diet, HP‐CD, n = 21) or 18% (normal protein‐chronic diet, NP‐CD, n = 17) for 9 weeks were tested. On separate days, metabolic, appetite, and hormonal responses were measured over 4 hours when the women consumed a higher protein‐acute meal (HP‐AM) (30% of energy as protein) or a normal protein‐acute meal (NP‐AM) (18% of energy as protein). Results: With chronic diet groups combined, HP‐AM led to lower respiratory exchange ratio (0.829 ± 0.005 vs. 0.843 ± 0.008; p < 0.05), lower carbohydrate oxidation (p < 0.05), and higher fat oxidation (p < 0.05) compared with NP‐AM. HP‐AM also led to reduced self‐reported postprandial hunger (p < 0.001) and desire to eat (p < 0.001) and lower postprandial ghrelin (252 ± 16 vs. 274 ± 18 ng/mL · 240 minutes, p < 0.05) compared with NP‐AM. No differences in postprandial energy expenditure (PPEE) occurred between meals. When combining acute meals, respiratory exchange ratio was lower (p < 0.05) and protein oxidation (p < 0.001) was higher in the HP‐CD vs. NP‐CD. An acute meal‐by‐chronic diet interaction was observed with PPEE such that HP‐AM led to greater PPEE in the HP‐CD vs. NP‐CD (28.7 ± 2.7 vs. 19.9 ± 2.7 kcal/min for 195 minutes; p < 0.05). Conclusions: During weight loss, thermogenesis and protein use appear to be influenced by chronic protein intake, while appetite and ghrelin are more responsive to acute protein intake.     

Prior Exercise Increases Dietary Oleate,but Not Palmitate Oxidation

Objective: Higher levels of physical activity have been associated with body weight maintenance, but previous work in our laboratory suggests that this is not purely related to energy balance. We hypothesize that this may be related to the partitioning of dietary fat between oxidation and storage. Research Methods and Procedures: Healthy women (age 24 ± 1 years, BMI = 21.2 ± 0.4 kg/m²) were recruited to participate in rest (n = 10) or exercise sessions of light (n = 11), moderate (n = 10), and heavy (n = 7) exercise. All exercises (1250 kJ above rest) were performed on a stationary cycle inside of a whole‐body calorimeter. [1‐¹³C]oleate and [d₃₁]palmitate were given in a liquid meal 30 minutes post‐exercise. An additional study was done with identical exercise sessions, but with administration of an oral dose of [1‐¹³C]acetate and [d₃]acetate 30 minutes post‐exercise to determine label sequestration. Results: Cumulative oxidation of [1‐¹³C]oleate was significantly greater after light (45 ± 3%), moderate (54 ± 4%), and heavy (51 ± 4%) exercise than that with rest (33 ± 3%) (p = 0.0008). Cumulative oxidation of [d₃₁]palmitate did not differ among trials (12 ± 2%, 14 ± 1%, 17 ± 2%, and 14 ± 2% for rest, light, moderate, and heavy, respectively; p = 0.30). Discussion: Exercise standardized for energy expenditure increases monounsaturated fat oxidation more than saturated fat oxidation and that the increase occurs regardless of intensity. Recommendations for physical activity for the purposes of weight control may be specific for dietary fat composition.     

Labor Saved,Calories Lost: The Energetic Impact of Domestic Labor‐saving Devices

Objective: As the prevalence of obesity has increased, so has sedentariness. Progressive sedentariness has been attributed to greater use of labor saving devices, such as washing machines, and less nonexercise walking (e.g., walking to work). However, there is a paucity of data to support this conclusion. In this study, we address the hypothesis that domestic mechanization of daily tasks has resulted in less energy expenditure compared with performing the same tasks manually. Research Methods and Procedures: Energy expenditure was measured in four groups of subjects (122 healthy adult men and women total) from Rochester, Minnesota. Energy expenditure was measured using indirect calorimetry while subjects performed structured tasks such as cleaning dishes and clothes, stair climbing, and work‐associated transportation, and these values were compared with the respective mechanized activity. Results: Energy expenditure was significantly greater and numerically substantial when daily domestic tasks were performed without the aid of machines or equipment (clothes washing: 45 ± 14 vs. 27 ± 9 kcal/d; dish washing: 80 ± 28 vs. 54 ± 19 kcal/d; transportation to work: 83 ± 17 vs. 25 ± 3 kcal/d; stair climbing: 11 ± 7 vs. 3 ± 1 kcal/d; p < 0.05). The combined impact of domestic mechanization was substantial and equaled 111 kcal/d. Discussion: The magnitude of the energetic impact of the mechanized tasks we studied was sufficiently great to contribute to the positive energy balance associated with weight gain. Efforts focused on reversing sedentariness have the potential to impact obesity.     

Increased Food Intake and Energy Expenditure Following Administration of Olanzapine to Healthy Men

Atypical antipsychotic medications like olanzapine (OLZ) induce weight gain and increase the risk of diabetes in patients with schizophrenia. The goal of this study was to assess potential mechanisms of OLZ‐induced weight gain and accompanying metabolic effects. Healthy, lean, male volunteers received OLZ and placebo (PBO) in a randomized, double‐blind, crossover study. In periods 1 and 2, subjects received OLZ (5 mg for 3 days then OLZ 10 mg for 12 days) or matching PBO separated by a minimum 12‐day washout. Twenty‐four hour food intake (FI), resting energy expenditure (REE), activity level, metabolic markers, and insulin sensitivity (IS) were assessed. In total, 30 subjects were enrolled and 21 completed both periods. Mean age and BMI were 27 years (range: 18–49 years) and 22.6 ± 2.2 kg/m², respectively. Relative to PBO, OLZ resulted in a 2.62 vs. 0.08 kg increase in body weight (P < 0.001) and 18% (P = 0.052 or 345 kcal) increase in FI. Excluding one subject with nausea and dizziness on the day of OLZ FI measurement, the increase in FI was 547 kcal, (P < 0.05). OLZ increased REE relative to PBO (113 kcal/day, P = 0.003). Significant increases in triglycerides, plasminogen activator inhibitor‐I (PAI‐I), leptin, and tumor necrosis factor‐α (TNF‐α) were observed. No significant differences in activity level or IS were observed. This study provides evidence that OLZ pharmacology drives the early increase in weight through increased FI, without evidence of decreased energy expenditure (EE), activity level, or short‐term perturbations in IS.     

MedGem hand-held indirect calorimeter is valid for resting energy expenditure measurement in healthy children

Objective: To assess the validity of a new hand‐held indirect calorimeter [MedGem (MG)] in the determination of resting energy expenditure (REE; kilocalories per day) in children. Research Methods and Procedures: One hundred male (n = 54) and female (n = 46) children (10.6 ± 3.2 years, 43.9 ± 19.0 kg, 146.1 ± 18.8 cm, 19.6 ± 4.9 kg/m²) participated. Children arrived at the University of Oklahoma body composition laboratory between 5:30 am and 6:15 am after an overnight fast. On arrival, subjects voided and remained quietly in the supine position for 15 minutes before testing. REE was measured by indirect calorimetry (in random order), with both the MG (sitting upright) and the criterion Delta Trac II (DT) (supine). Data are reported as the mean ± standard deviation. Results: The mean MG REE (1452 ± 355 kcal/d) was significantly higher than DT REE (1349 ± 296 kcal/d, p < 0.001). Bland‐Altman analysis revealed a mean bias (MG ? DT) of 104 kcal/d, with limits of agreement of ?241 to +449 kcal/d. To examine the difference in subject positioning, an independent sample of 38 subjects performed the MG in its normal position (sitting) and holding the MG in a supine position. REE by the MG in the sitting position (1475 ± 350 kcal/d) was significantly (p < 0.05) higher than the MG in the supine position (1419 ± 286 kcal/d). Discussion: The mean difference in REE between MG and DT was relatively small (103 kcal/d) but significant; however, a portion of this difference may have been related to differences in subject positioning. These preliminary data indicate that the MG shows promise as a valid tool in the assessment of REE in children.     

The Effect of Repeated Episodes of Dietary Restriction and Refeeding on Systolic Blood Pressure and Food Intake in Exercise‐Trained Normotensive Rats

Objective: To explore the effects of weight cycling and exercise on blood pressure and macronutrient intake in Sprague‐Dawley rats. Research Methods and Procedures: Female Sprague‐Dawley rats (n = 62; 5 months old) were assigned to an ad libitum (Con) or weight‐cycled (Cyc) group. They were either sedentary (Con‐Sed and Cyc‐Sed) or exercise‐trained (Con‐Ex and Cyc‐Ex) on a motorized treadmill (20 m/minute; 60 minutes/day; 6 days/week). The Cyc groups underwent 2 cycles of 3 weeks of 60% food restriction followed by 5 weeks of ad libitum refeeding using a macronutrient self‐selection diet. Body mass and food intake were analyzed weekly. Systolic blood pressure (SBP) was measured at baseline and during the first and fifth weeks of each refeeding. Results: For both cycling periods, SBP was elevated in Cyc vs. Con groups at Week 1 of refeeding, but was similar among groups by Week 5 of refeeding. Both Con groups had greater total energy intake than the Cyc groups for both cycling periods (Cycle 1: 2882.2 ± 75.1, Con‐Sed; 2916.1 ± 67.1, Con‐Ex; 2692.2 ± 58.7, Cyc‐Sed; and 2780.5 ± 52.4 kcal, Cyc‐Ex) (Cycle 2: 2815.8 ± 75.1, Con‐Sed; 2938.8 ± 49.4, Con‐Ex; 2577.1 ± 60.5, Cyc‐Sed; and 2643.5 ± 65.9 kcal, Cyc‐Ex). Relative fat intake (percentage of total kcal/week) was significantly less for Con‐Ex and Cyc‐Ex than Con‐Sed and Cyc‐Sed throughout both refeeding periods. Discussion: Weight cycling failed to produce significant sustained effects on SBP, body mass, or food intake. Exercise training, irrespective of diet, lowered dietary fat intake.     

Aerobic exercise alone results in clinically significant weight loss for men and women: Midwest exercise trial 2

Exercise is recommended by public health agencies for weight management; however, the role of exercise is generally considered secondary to energy restriction. Few studies exist that have verified completion of exercise, measured the energy expenditure of exercise, and prescribed exercise with equivalent energy expenditure across individuals and genders.

Objective:

The objective of this study was to evaluate aerobic exercise, without energy restriction, on weight loss in sedentary overweight and obese men and women.

Design and Methods:

This investigation was a randomized, controlled, efficacy trial in 141 overweight and obese participants (body mass index, 31.0 ± 4.6 kg/m²; age 22.6 ± 3.9 years). Participants were randomized (2:2:1 ratio) to exercise at either 400 kcal/session or 600 kcal/session or to a nonexercise control. Exercise was supervised, 5 days/week, for 10 months. All participants were instructed to maintain usual ad libitum diets. Because of the efficacy design, completion of ≥90% of exercise sessions was an a priori definition of per protocol, and these participants were included in the analysis.

Results:

Weight loss from baseline to 10 months for the 400 and 600 kcal/session groups was 3.9 ± 4.9 kg (4.3%) and 5.2 ± 5.6 kg (5.7%), respectively, compared with weight gain for controls of 0.5 ± 3.5 kg (0.5%) (P < 0.05). Differences for weight loss from baseline to 10 months between the exercise groups and differences between men and women within groups were not statistically significant.

Conclusions:

Supervised exercise, with equivalent energy expenditure, results in clinically significant weight loss with no significant difference between men and women.     

Comparison of Regional Fat Distribution and Health Risk Factors in Middle‐Aged White and African American Women: The Healthy Transitions Study

Objective: Both ethnicity and menopause appear to influence intra‐abdominal fat distribution. This study evaluated intra‐abdominal fat distribution and obesity‐related health risks in perimenopausal white and African American women. Research Methods and Procedures: Baseline data from a longitudinal study of changes in body composition and energy balance during menopause are reported. Healthy women (55 African Americans and 103 whites) who were on no medication and had at least five menstrual cycles in the previous 6 months were recruited. Body composition was assessed by DXA, and visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were assessed by computed tomography scan. SAT was divided into deep and superficial layers demarcated by the fascia superficialis. Results: African American women were slightly younger (46.7 ± 0.2 vs. 47.7 ± 0.2 years, p = 0.002) and fatter (42.4% ± 1.0% vs. 39.4% ± 0.8% body fat, p = 0.02) than white women. In unadjusted data, African Americans had significantly more total abdominal fat and total, deep, and superficial SAT than whites. After adjustment for percent body fat and age, only total and superficial SAT remained significantly higher in African Americans. VAT although slightly less in African American women, did not differ significantly by race. In multiple regression analysis, VAT was the strongest predictor of serum lipids, glucose, and insulin in women of both races, although superficial SAT was significantly associated with fasting glucose in whites. Conclusions: Middle‐aged African American women have larger SAT depots, adjusted for total body fatness, but do not differ from white women with regard to VAT. The complexity of the relationship between abdominal fat and metabolic risk is increased by ethnic differences in such associations.     

Effect of a thermogenic beverage on 24-hour energy metabolism in humans

Objective: To test whether consumption of a beverage containing active ingredients will increase 24‐hour energy metabolism in healthy, young, lean individuals. Research Method and Procedures: Thirty‐one male and female subjects consumed 3 × 250‐mL servings of a beverage containing green tea catechins, caffeine, and calcium for 3 days in a single‐center, double‐blind, placebo‐controlled, cross‐over design study. On the 3rd day, 23‐hour energy metabolism, extrapolated to 24‐hour, was measured in a calorimeter chamber. Blood pressure and heart rate were measured, and total day and night urines were analyzed for urea and catecholamine excretion. Results: Twenty‐four‐hour energy expenditure (EE) and 24‐hour fat oxidation were lower in women than in men (p < 0.0001 and p < 0.015, respectively). Although there were no treatment or treatment/gender effects on substrate oxidation, treatment increased 24‐hour EE by 106 ± 31 kcal/24 hours (p = 0.002), equivalent to 4.7 ± 1.6 kcal/h (day; p = 0.005) and 3.3 ± 1.5 kcal/h (night; p = 0.04). No significant differences were observed in hemodynamic parameters. Discussion: The present study provides evidence that consumption of a beverage containing green tea catechins, caffeine, and calcium increases 24‐hour EE by 4.6%, but the contribution of the individual ingredients cannot be distinguished. Although this increase is modest, the results are discussed in relation to proposed public health goals, indicating that such modifications are sufficient to prevent weight gain. When consumed regularly as part of a healthy diet and exercise regime, such a beverage may provide benefits for weight control.     

Effects of Sibutramine Plus Orlistat in Obese Women Following 1 Year of Treatment by Sibutramine Alone: A Placebo‐Controlled Trial

Objective: This study assessed whether adding orlistat to sibutramine would induce further weight loss in patients who previously had lost weight while taking sibutramine alone. Research Methods and Procedures: Patients were 34 women with a mean age of 44.1 ± 10.4 years, weight of 89.4 ± 13.8 kg, and body mass index (BMI) of 33.9 ± 4.9 kg/m² who had lost an average of 11.6 ± 9.2% of initial weight during the prior 1 year of treatment by sibutramine combined with lifestyle modification. Patients were randomly assigned, in double‐blind fashion, to sibutramine plus orlistat or sibutramine plus placebo. In addition to medication, participants were provided five brief lifestyle modification visits during the 16‐week continuation trial. Results: Mean body weight did not change significantly in either treatment condition during the 16 weeks. The addition of orlistat to sibutramine did not induce further weight loss as compared with treatment by sibutramine alone (mean changes = +0.1 ± 4.1 kg vs. +0.5 ± 2.1 kg, respectively). Discussion: These results must be interpreted with caution because of the study's small sample size. The findings, however, suggest that the combination of sibutramine and orlistat is unlikely to have additive effects that will yield mean losses ≥15% of initial weight, as desired by many obese individuals.