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Biomedical subjects

E Ravussin

Publications and source records attributed to E Ravussin.

At least 145 records · Page 8Linked to original sources

Insulin resistance and insulin secretory dysfunction as precursors of non-insulin-dependent diabetes mellitus. Prospective studies of Pima Indians.

BACKGROUND: The relative roles of obesity, insulin resistance, insulin secretory dysfunction, and excess hepatic glucose production in the development of non-insulin-dependent diabetes mellitus (NIDDM) are controversial. We conducted a prospective study to determine which of these factors predicted the development of the disease in a group of Pima Indians. METHODS: A body-composition assessment, oral and intravenous glucose-tolerance tests, and a hyperinsulinemic--euglycemic clamp study were performed in 200 non-diabetic Pima Indians (87 women and 113 men; mean [+/- SD] age, 26 +/- 6 years). The subjects were followed yearly thereafter for an average of 5.3 years. RESULTS: Diabetes developed in 38 subjects during follow-up. Obesity, insulin resistance (independent of obesity), and low acute plasma insulin response to intravenous glucose (with the degree of obesity and insulin resistance taken into account) were predictors of NIDDM: The six-year cumulative incidence of NIDDM was 39 percent in persons with values below the median for both insulin action and acute insulin response, 27 percent in those with values below the median for insulin action but above that for acute insulin response, 13 percent in those with values above the median for insulin action and below that for acute insulin response, and 0 in those with values originally above the median for both characteristics. CONCLUSIONS: Insulin resistance is a major risk factor for the development of NIDDM: A low acute insulin response to glucose is an additional but weaker risk factor.

Adult↗

Norepinephrine turnover and energy expenditure in Pima Indian and white men.

There is growing evidence of the involvement of sympathetic nervous system (SNS) activity in determining metabolic rate. Whole-body plasma norepinephrine turnover and its relationship to resting metabolic rate (RMR) and 24-hour energy expenditure (24EE) were compared in 14 Pima Indian men (25 +/- 4 years, 96 +/- 33 kg, 25% +/- 9% fat) and nine white men (25 +/- 3 years, 88 +/- 43 kg, 17% +/- 13% fat). Plasma norepinephrine turnover rate correlated strongly with body surface area (r = .76 and .54 for clearance and appearance, respectively) and fat-free mass (r = .74 and .52, respectively). However, independent of body size, there was no difference in either norepinephrine clearance or appearance rates between Pima Indian and white men. Norepinephrine appearance rate correlated positively with absolute values of 24EE and RMR, but not when adjusted for differences in body surface area or fat-free mass. However, norepinephrine appearance rate adjusted for differences in body size correlated with spontaneous physical activity. The results indicate that Pima Indian and white men have similar plasma norepinephrine appearance rates, but Pima Indians tend to be more resistant to beta-adrenergic stimulation. Although energy expenditure and SNS activity were not directly related, a higher SNS tone may either promote or reflect elevated levels of spontaneous physical activity and therefore influence both energy balance and body composition.

Adult↗

Daily energy expenditure by five-year-old children, measured by doubly labeled water.

Current recommendations for daily energy requirements in 5-year-old children (90 kcal/kg per day) are based on energy intake associated with normal growth. It is not known, however, how these recommendations compare with total free-living energy expenditure (TEE) and how much of TEE is related to physical activity. The TEE and the resting metabolic rate (RMR) were measured in 28 white children, aged 5 years (15 boys, 13 girls; mean (+/- SD) weight 20.1 +/- 3.4 kg; height 113 +/- 6 cm; fat 20% +/- 5%). The TEE was calculated during a 7-day period from urinary elimination rates of deuterium (2H) and heavy oxygen (18O) by using a modification of the two-point slope-intercept method; RMR was measured by a ventilated-hood indirect calorimeter. Physical activity indexes were also collected from questionnaires completed by the parents. Measured TEE was considerably lower than the recommended dietary allowances (1370 +/- 222 kcal/day vs 1807 +/- 310 kcal/day; p < 0.0001), whereas measured RMR was slightly higher than predicted RMR (1001 +/- 119 kcal/day vs 952 +/- 78 kcal/day; p < 0.001). The energy cost of physical activity accounted for only 16% +/- 7% of TEE. An index of activity, assessed as the difference between the measured TEE and the predicted TEE, correlated positively with past-year sport-leisure activity assessed by questionnaire (r = 0.40; p < 0.05). We conclude that measured TEE in 5-year-old children yields lower values (approximately 400 kcal/day) than current estimates. A minute part of this difference (20 to 30 kcal/day) is related to the changes in energy stores during growth, but most seems due to lower-than-expected levels of physical activity. This might be related to increased television viewing, which replaces activities requiring energy.

Calorimetry, Indirect↗

Metabolic rate and body composition of Pima Indian and Caucasian children.

A low metabolic rate for a given body size and body composition may be a risk factor for body weight gain. Because the prevalence of obesity exceeds 75% in the Pima Indian population, we investigated whether Pima Indian children have a low resting metabolic rate (RMR) when compared with Caucasian children. Body composition (bioelectrical resistance) and RMR were measured in 43 Pima Indian children (22 male/21 female, means +/- SD = 9.9 +/- 1.1 year) and 42 Caucasian children (21 male/21 female, 9.7 +/- 1.2 year). Pima Indian children were taller (p < 0.001), heavier (p < 0.001), and fatter (p < 0.0001) than Caucasian children. Absolute values of RMR were higher in the Pimas than in the Caucasians (p < 0.001), but were similar when adjusted for differences in body size, body composition, and sex. In Pima Indian girls before puberty (< 10 years; n = 8), adjusted values of RMR were negatively correlated with the mean body mass index (BMI) of the parents (r = -0.88; p < 0.005). Inasmuch as resting metabolic rate was not low in Pima children, the data suggest that the major factors in the weight gain of 10-year-old Pima children may be reduced physical activity and/or excess energy intake. However, this study does not exclude the possibility that a low metabolic rate may be a predisposing factor at an earlier age.

Asian People↗

Effect of phenylpropanolamine on energy expenditure and weight loss in overweight women.

The effect of phenylpropanolamine (PPA), a noncatecholamine sympathomimetic weight-loss agent, on energy expenditure (EE) and substrate oxidation was measured in a respiratory chamber in 24 overweight women after 4 d of treatment (PPA or placebo) during weight maintenance and after 7 wk of treatment on a hypoenergetic diet (70% of measured baseline 24-h EE). Twelve women (37 +/- 2 y, 74 +/- 6 kg, 33 +/- 1% body fat) were randomly assigned to the PPA group [75 mg osmotic release oral system (OROS)-PPA/d] and 12 (mean +/- SEM: 38 +/- 2 y, 79 +/- 1 kg, 37 +/- 1% body fat) to the placebo group. Baseline measurements of 24-h EE (7849 +/- 226 vs 7834 +/- 142 kJ/d), basal metabolic rate (BMR) and 24-h respiratory quotient (RQ) were comparable between PPA and placebo groups. After 4 d of treatment, there was no significant effect of PPA on 24-h EE, BMR, and 24-h RQ compared with placebo. Over the 7-wk diet period, however, the PPA group (n = 8) had greater weight loss than the placebo group (n = 10): -5.0 +/- 0.5 vs -3.0 +/- 0.4 kg (P < 0.05). The changes in 24-h EE and 24-h RQ over the 7 wk were not different between the groups. We conclude that weight loss is enhanced by OROS-PPA, but this change was not explained by changes in 24-h EE or 24-h RQ. The small number of subjects may have hindered detection of subtle differences in energy metabolism.

Adolescent↗

Energy balance or fat balance?

Under normal conditions, carbohydrate, protein, and alcohol are not converted to fat. Glycogen and protein stores are closely controlled, and increasing the intake of nonfat nutrients stimulates their oxidation rates proportionally. Thus, chronic imbalance between intake and oxidation of nonfat nutrients cannot lead to obesity. On the other hand, fat stores are not controlled and their capacity for expansion is enormous. Because an increase in fat intake does not stimulate fat oxidation, a positive fat balance results, which has the potential to become chronic. Obesity is therefore due to a long-standing positive fat balance, which may simply be due to a high-fat diet. The use of the fat-balance equation instead of the energy-balance equation adds another option for the treatment of obesity--that of changing the quality of the diet, ie, lowering the fat content.

Alcohol Drinking↗

Estimating body composition of young children by using bioelectrical resistance.

It is currently unclear whether age-specific equations should be used for assessing body composition from bioelectrical resistance. Kushner et al. (Am. J. Clin. Nutr. 56: 835-839, 1992) showed that the relationship between height2/resistance and total body water (TBW) is robust across a wide age range, although uncertainty remained over the relationship in preschool children. We therefore cross-validated the Kushner equation for predicting total body water in 4- to 6-yr-old children in two independent laboratories. TBW was measured from H2 18O dilution, and bioelectrical resistance and reactance were measured using an RJL 101A analyzer in 31 children (15 females, 16 males; 5 +/- 0.8 yr) studied in Burlington, Vermont, and 30 children (14 females, 16 males; 5 +/- 0.2 yr) studied in Phoenix, Arizona. There was no significant difference between TBW predicted from the Kushner equation and that measured in children in Burlington (11.76 +/- 2.00 vs. 11.91 +/- 2.46 kg; r = 0.94) or in Phoenix (11.53 +/- 1.64 vs. 11.66 +/- 1.90 kg; r = 0.94). The Kushner equation for TBW can be transformed into an equation for fat-free mass (FFM) by using published age- and gender-specific constants for the hydration of FFM: hydration of FFM = 76.9 - 0.25 age (yr) - 1.9 gender where female equals 0 and male equals 1. The intraclass reliability for estimates of fat mass and FFM with the use of bioelectrical resistance in an independent group of 26 children (5.0 +/- 0.8 yr, 20.2 +/- 3.0 kg) was > 0.99 for duplicate observations performed 2 wk apart.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Relationship between skeletal muscle lipoprotein lipase activity and 24-hour macronutrient oxidation.

A low ratio of whole-body 24-h fat/carbohydrate (CHO) oxidation has been shown to be a predictor of subsequent body weight gain. We tested the hypothesis that the variability of this ratio may be related to differences in skeletal muscle metabolism. Since lipoprotein lipase (LPL) plays a pivotal role in partitioning lipoprotein-borne triglycerides to adipose (storage) and skeletal muscle (mostly oxidation), we postulated that a low ratio of fat/CHO oxidation was associated with a low skeletal muscle LPL (SMLPL) activity. As an index of substrate oxidation, 24-h RQ was measured under sedentary and eucaloric conditions in 16 healthy nondiabetic Pima males. During a 6-h euglycemic, hyperinsulinemic clamp, muscle biopsies were obtained at baseline, 3, and 6 h. Heparin-elutable SMLPL activity was 2.92 +/- 0.56 nmol free fatty acids/g.min (mean +/- SD) at baseline, was unchanged (2.91 +/- 0.51) at the third hour, and increased significantly (P < 0.05) to 3.13 +/- 0.57 at the sixth hour of the clamp. The mean (of baseline and 3-h) SMLPL activity correlated inversely with 24-h RQ (r = 0.57, P < 0.03) but not with body size, body composition, or insulin-mediated glucose uptake. Since SMLPL activity is related to the ratio of whole body fat/CHO oxidation rate, a decreased muscle LPL activity may, therefore, predispose to obesity.

Carbohydrate Metabolism↗

Reduced sympathetic nervous activity. A potential mechanism predisposing to body weight gain.

The sympathetic nervous system is recognized to play a role in the etiology of animal and possibly human obesity through its impact on energy expenditure and/or food intake. We, therefore, measured fasting muscle sympathetic nerve activity (MSNA) in the peroneal nerve and its relationship with energy expenditure and body composition in 25 relatively lean Pima Indian males (means +/- SD; 26 +/- 6 yr, 82 +/- 19 kg, 28 +/- 10% body fat) and 19 Caucasian males (29 +/- 5 yr, 81 +/- 13 kg, 24 +/- 9% body fat). 24-h energy expenditure, sleeping metabolic rate, and resting metabolic rate were measured in a respiratory chamber, whereas body composition was estimated by hydrodensitometry. Pima Indians had lower MSNA than Caucasians (23 +/- 6 vs 33 +/- 10 bursts/min, P = 0.0007). MSNA was significantly related to percent body fat in Caucasians (r = 0.55, P = 0.01) but not in Pimas. MSNA also correlated with energy expenditure adjusted for fat-free mass, fat mass, and age in Caucasians (r = 0.51, P = 0.03; r = 0.54, P = 0.02; and r = 0.53, P = 0.02 for adjusted 24-h energy expenditure, sleeping metabolic rate, and resting metabolic rate, respectively) but not in Pima Indians. In conclusion, the activity of the sympathetic nervous system is a determinant of energy expenditure in Caucasians. Individuals with low resting MSNA may be at risk for body weight gain resulting from a lower metabolic rate. A low resting MSNA and the lack of impact of MSNA on metabolic rate might play a role in the etiology of obesity in Pima Indians.

Adult↗

Energy metabolism in obesity. Studies in the Pima Indians.

OBJECTIVE: To review the major data collected over the past 8 yr regarding energy expenditure in relationship to obesity and the development of obesity in the Pima Indian population. RESEARCH DESIGN AND METHODS: The different components of 24-h energy expenditure (i.e., the RMR, the thermic effect of food, and the energy cost of spontaneous physical activity) were measured in a respiratory chamber after a few days on a weight-maintenance diet. RESULTS: Fat-free body mass, the major determinant of RMR, explains 82% of its variance. However, an extra 7% of the variance in RMR observed between people is related to family membership. The variability of RMR for a given body size and composition is of importance, because a low metabolic rate is a major risk factor for weight gain in man. Also, genetic factors seem to be the cause of the familial aggregation of metabolic rate in man. CONCLUSIONS: The high prevalence of obesity and NIDDM in the Pima Indian community might be the consequence of a "thrifty genotype." The increasing evidence that obesity cannot always be attributed to gluttony and sloth forces us to consider obesity as a "real metabolic disease" that needs to be treated as such, using new behavioral and pharmacological therapies.

Arizona↗

Energy cost of arousal: effect of sex, race and obesity.

The basal (BMR) to sleeping metabolic rate (SMR) ratio might represent an estimate of the activation of the nervous system (central/sympathetic) from sleeping to basal state. Since this activation might be influenced by the degree of obesity, and might be different between sexes, we retrospectively analysed energy expenditure data collected for a large number of subjects. Twenty-four hour energy expenditure (24EE), BMR and SMR were measured in a respiratory chamber in 122 Caucasians (63 males/59 females, 32 +/- 10 years, 94 +/- 33 kg, 29 +/- 11% fat) (means +/- s.d.) and in 123 Pima Indians (68 males/55 females, 29 +/- 7 years, 100 +/- 25 kg, 34 +/- 9% fat). The BMR/SMR ratio varied greatly between individuals (1.05 +/- 0.08; range 0.87-1.34). In Pima Indians, BMR/SMR was inversely correlated to both fat mass (r = -0.26; P < 0.01) and BMI (r = -0.22; P < 0.05), whereas, in Caucasians, BMR/SMR was inversely correlated to waist/thigh circumference ratio (r = -0.28; P < 0.01). On average, the BMR/SMR was higher in Pima Indians than in Caucasians (1.06 +/- 0.08 vs. 1.03 +/- 0.07, P < 0.01) and higher in Pima Indian males than in Pima Indian females (1.08 +/- 0.09 vs. 1.04 +/- 0.06, P < 0.05). Studies are needed to investigate whether these differences in the increase in energy expenditure from the sleeping to the basal state are related to differences in the activation of the nervous system and/or to other metabolic factors.

Adolescent↗

Metabolic predictors of obesity: cross-sectional versus longitudinal data.

In prospective studies in Pima Indians, four metabolic parameters, which are known to have a familial component, have been found to predict weight gain. These are: (i) low relative resting metabolic rate (RMR, relative to the average predicted rate for body size), (ii) low level of spontaneous physical activity (SPA), (iii) high 24 h respiratory quotient (RQ) and (iv) high insulin sensitivity (IS). Cross-sectional studies show that all four parameters correlate with body size: RMR vs. fat-free mass (FFM), r = 0.87, P < 0.0001; energy cost of SPA vs. weight, r = 0.69, P < 0.001; RQ vs. body fat, r = -0.23, P < 0.05; IS vs. weight, r = -0.38, P < 0.001. When these parameters are adjusted for differences in body size, then the initial value predicts the rate of change in body weight over the subsequent years: RMR (adjusted for FFM, fat mass, age and sex), r = -0.39, P < 0.001; SPA, r = -0.35, P < 0.005 (males); RQ (adjusted for fat mass), r = 0.24, P < 0.01; IS (adjusted for weight), r = 0.34, P < 0.0001. After gaining weight, the original deviation from the value predicted on the basis of the population (e.g. low relative RMR, high RQ and high IS) tends to diminish, suggesting a progressively decreasing physiological drive for further body weight gain. Thus, the high RMR, high energy cost of SPA, low RQ and low IS seen in obesity may act to limit additional weight gain.

Basal Metabolism↗

Decreased physical activity in Pima Indian compared with Caucasian children.

Since reduced physical activity might be a risk factor for body weight gain, we studied the relationship between physical activity and body composition in 43 Pima Indian children (22 male/21 female, mean +/- s.d.: 9.9 +/- 1.1 years) and 42 Caucasian children (21 male/21 female, 9.7 +/- 1.2 years). A list of usual sport leisure activities was established (e.g. bicycling, swimming, basketball) and the subjects were asked how much time they had devoted to each activity over the past week and the last year. Data on time spent playing outside (excluding sport leisure activities for the estimation of physical activity) and watching television/videos were also collected. Pima Indians were taller (143 +/- 9 vs. 137 +/- 8 cm, P < 0.001), heavier (48.6 +/- 15.8 vs. 32.9 +/- 7.8 kg, P < 0.0001) and fatter (39 +/- 16 vs. 24 +/- 7% fat, P < 0.001) than Caucasians. Pima Indian girls showed significantly lower past year and past week sport leisure activity than Caucasian girls (P < 0.01) and spent significantly more time watching television/videos (P < 0.05). Pima boys also showed significantly lower past week sport leisure activity than Caucasian boys (P < 0.05). In Pima Indian boys, past year sport leisure activity correlated negatively (P < 0.05) with body mass index (r = -0.49) and percentage body fat (r = -0.56). However, such correlations were not found in Pima Indian girls, possibly due their very low levels of activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗

Twenty-four-hour energy expenditure in Pima Indians with type 2 (non-insulin-dependent) diabetes mellitus.

To assess the impact of Type 2 (non-insulin-dependent) diabetes mellitus on energy metabolism, 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were measured in a respiratory chamber in 151 Pima Indians, 102 with normal glucose tolerance (67 male/35 female, (mean +/- SD) 28 +/- 7 years, 99 +/- 24 kg, 32 +/- 9% body fat) and in 49 with Type 2 diabetes (22 male/27 female, 35 +/- 11 years, 107 +/- 33 kg, 39 +/- 7% body fat), after at least 3 days on a weight maintaining diet. After adjustment for differences in fat-free mass, fat mass, age and sex, 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were significantly higher in diabetic patients than in control subjects (72 kcal/day, p less than 0.05; 99 kcal/day, p less than 0.005; 99 kcal/day, p less than 0.001 respectively). Spontaneous physical activity was similar in both groups whereas the thermic effect of food, calculated as the mean energy expenditure corrected for activity throughout the day above sleeping metabolic rate and expressed as a percentage of energy intake, was significantly lower in Type 2 diabetic patients (17.1 +/- 7.1 vs 19.8 +/- 5.6%, p less than 0.05). Adjusted values of 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were correlated with hepatic endogenous glucose production (r = 0.22, p less than 0.05; r = 0.22, p less than 0.05; r = 0.31, p less than 0.01 respectively). Therefore, increased basal and sleeping metabolic rates, resulting in increased 24-h sedentary energy expenditure may play a role in the weight loss so often observed in Type 2 diabetic subjects in addition to the energy loss from glycosuria.

Adult↗

National working conference on smoking and body weight. Task Force 1: Mechanisms relevant to the relations between cigarette smoking and body weight.

Careful, comprehensive, and empirical observations provide the building blocks of the sciences, whereas theory and mechanisms provide the "cement" to hold the blocks together and serve as blueprints to direct future building. This article resulted from several days of discussion regarding theories that may underlie the relation between cigarette smoking and body weight and the relation between smoking cessation and body weight. The working group composed of social and biological scientists who addressed this assignment considered what is already known within the smoking and body weight literature and also considered relevant findings from studies of smoking or body weight regulation that have not directly addressed the interaction of these variables. As expected, we were successful at listing some of what is not known and what is worth knowing. We also tried to identify fruitful possibilities for research activity that might clarify mechanisms of action and eventually lead to theoretical development. Because we do not believe that the present state of our deliberations merits the label of theories, we decided, instead, to report the summary of these deliberations as potential mechanisms relevant to the relation between smoking and body weight.

Adult↗

A brief overview of human energy metabolism and its relationship to essential obesity.

Twenty-four hour energy expenditure (24EE) can be measured in a respiratory chamber. 24EE is comprised of the basal metabolic rate, the thermic effect of food, and the energy cost of physical activity. The major determinant of 24EE, fat-free mass, accounts for approximately 80% of the variance observed between individuals. Genetic factors seem to be the cause of the familial aggregation of 24EE in man. The variability of 24EE for a given body size and composition is of importance because a low metabolic rate is a major risk factor for weight gain in man. There is increasing evidence that obesity, often an inherited disorder, cannot always be attributed to gluttony and sloth. Similar to the need to treat essential hypertension, there is a need to treat a disorder perhaps best called essential obesity.

Basal Metabolism↗