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Energy intake and energy expenditure during the menstrual cycle in short-term smoking cessation.

The effect of short-term smoking abstinence on energy intake and expenditure parameters was investigated for women in different phases of the menstrual cycle (follicular or late luteal) in a rigorous inpatient laboratory setting. Twenty-one participants were randomized to a continued smoking (n = 5) or a smoking abstinence (n = 16) group and admitted for 2 7-day inpatient periods during alternate cycle phases. The smoking abstinence group experienced 2 days of baseline smoking and 5 days of smoking abstinence. Measurements included caloric intake (kcal/24 hours), energy expenditure (by indirect calorimetry), and weight. Results of within-subject analyses indicated no smoking abstinence effect on mean daily total kilocalorie intake, sweet kilocalorie intake, or resting metabolic rate. However, a significant cycle phase effect was observed, with increased kilocalorie intake and expenditure-as well as minor weight gain-occurring during the late luteal phase when premenstrual symptoms are highest. In light of this phase effect, women smokers might benefit by attempting to quit smoking during the follicular phase of their cycle.

Adult↗

PubMed2006

Are the eating and exercise habits of successful weight losers changing?

OBJECTIVE: The purpose of this study was to examine whether the diet and exercise behaviors of successful weight losers entering the National Weight Control Registry (NWCR) have changed between 1995 and 2003. RESEARCH METHOD AND PROCEDURES: Participants (N = 2708) were members of the NWCR who enrolled in intermittent years since 1995. Participants had lost an average of 33.1 kg and maintained a 13.6-kg loss for 5.8 years before enrollment. Evaluations of diet and physical activity were conducted at entry into the NWCR and prospectively over 1 year. RESULTS: From 1995 to 2003, the daily percentage of calories from fat increased from 23.8% to 29.4%, saturated fat intake increased from 12.3 to 154.0 g/d, and calories from carbohydrate decreased from 56.0% to 49.3% (p < 0.0001). The proportion consuming <90 grams of carbohydrate (considered a low-carbohydrate diet) increased from 5.9% to 17.1% (p = 0.0001). Physical activity was elevated in 1995 (mean = 3316 kcal/wk) but comparable in all other years (mean = 2620 kcal/wk). Stepwise regression collapsing across cohorts indicated that weight regain over 1 year was related to higher levels of caloric intake, fast food consumption, and fat intake and lower levels of physical activity (p < 0.03). DISCUSSION: The macronutrient composition of the diet of NWCR members has shifted over the past decade. Still, only a minority consumes a low-carbohydrate diet. Despite changes in the diet over time, the variables associated with long-term maintenance of weight loss were the same: continued consumption of a low-calorie diet with moderate fat intake, limited fast food, and high levels of physical activity.

Adult↗

PubMed2001

Management of catabolism in metabolically stressed patients: a literature survey about growth hormone application.

In the effort to improve the long-term outcome in critically ill patients, the utilization of anabolic agents, such as human recombinant growth hormone, has been proposed in order to reduce catabolism and improve nutritional status. A recent multicentre study regarding the use of human recombinant growth hormone in intensive care unit patients showed an unexpected increase in the mortality rate in human recombinant growth hormone-treated patients. This finding is in contrast with previous literature data reporting either no differences or an even lower mortality rate with the administration of human recombinant growth hormone. This review evaluates the possible reasons for this dramatic difference in outcomes between the multicentre study and the existing literature. Articles dealing with human recombinant growth hormone administration either in intensive care unit patients (n=26) or in postoperative patients (n=16) have been reviewed. Our analysis suggests that the low caloric intake given to patients enrolled in the multicentre study might have been inadequate to compensate for the hypermetabolism of these patients, and could not support the prolonged and delayed administration of high doses of human recombinant growth hormone. Whether the beneficial metabolic effects of human recombinant growth hormone translate into better clinical outcomes deserves further investigation. In addition, the careful selection of patients to be treated, and close monitoring of both the adequacy of caloric support and modality of human recombinant growth hormone administration would favour the safety of human recombinant growth hormone utilization in critical care settings.

Critical Illness↗

PubMed1996

Anorexia/cachexia in patients with HIV: lessons for the oncologist.

Early intervention and attention to nutritional status are essential in patients with cachexia. Identification of reversible causes of decreased energy intake and/or weight loss is the first step in treatment. When such factors cannot be identified, pharmacologic interventions should be considered. To date, megestrol acetate is the most effective appetite stimulant. Appetite and weight gain occur to a greater and more rapid degree as megestrol dose increases. Unfortunately, the weight gain is due predominantly to an increase in fat mass. Whether this is due to a lack of exercise in the face of increased caloric intake and/or to the hypogonadal effects of megestrol acetate is being tested in ongoing clinical trials. Anabolic agents, particularly growth hormone, are exciting potential therapies. No data are yet available on alternate doses and schedules of growth hormone or on its effect in patients with decreased oral intake. Current studies addressing combination therapy with anabolic agents and appetite stimulants should clarify their respective therapeutic roles.

Adipose Tissue↗

PubMed2005

Commercial rodent diets contain more sodium than rats need.

The dietary sodium requirements for rats have been a matter of debate. Our hypothesis was that normal commercial rodent chow contains sodium in excess of dietary needs and that this could have a significant impact on cardiovascular and renal physiology. To investigate dietary sodium requirements, 3-wk-old weanling Sprague-Dawley rats were fed a custom pelleted diet containing no sodium that was isocaloric to normal commercial rodent chow. These rats were provided with two drinking bottles; one contained water, and the other contained 0.5% NaCl. Thus they could choose and consume sodium as needed. Age-matched controls received normal pelleted Harlan Teklad 22/5 rodent diet (0.5% sodium content) and water ad libitum. Body weight and liquid intake were monitored over 7 wk until the rats were 10 wk old. At the end of the study, blood pressure was recorded. Weekly sodium intake in the experimental group was only 15% of that reported for rats fed normal rodent chow beginning in the first week postweaning. Growth was identical in the two groups (7.8 +/- 0.1 vs. 7.6 +/- 0.1 g/day), as was the total fluid volume intake. Blood pressure was significantly lower in the experimental rats compared with controls (96 +/- 4 vs. 122 +/- 4 mmHg, P < 0.05). These data suggest that, when given the choice, rats will consume significantly less sodium than provided in commercial chow, without any alteration in their growth rate. Rats fed standard commercial rodent chow may consume at least seven times more sodium than is necessary. This suggests commercial rodent diets may force excess sodium to accommodate caloric intake.

Animal Feed↗

PubMed1950

Considerations of postoperative electrolyte and fluid replacement.

The most important postoperative fluid considerations are maintenance of adequate urinary output, of blood volume, and of extracellular and interstitial cell water and electrolytes. Normal urinary output is between 1,000 and 1,500 cc. daily. A fluid intake of 2,000 cc. of 5 per cent dextrose in distilled water, plus 500 cc. of normal saline solution, will insure this amount of urinary output. The use of 5 per cent dextrose solutions in distilled water provides fluid, retards the protein catabolism of the body, and spares electrolytes. Irradiated plasma is the only intravenous solution which will adequately supply protein in amounts to maintain nitrogen equilibrium. Protein hydrolysates in the absence of adequate caloric intake do not provide enough protein for nitrogen balance. The role of the potassium ion is ordinarily not a consideration in postoperative fluid management. It becomes a consideration in the presence of a large amount of drainage from wounds or abscess cavities, nasogastric suction, or intestinal fistulae. It also must be given attention in cases in which parenteral administration of fluids is necessary for a prolonged period.

Blood Volume↗

PubMed1988

Nutritional management of horses competing in 160 km races.

A survey was taken of dietary management and training schedules of 54 horses competing in two 160 km endurance races. A total of 52 owners, representing 54 horses, responded to a questionnaire distributed prior to the races. Diet and training schedules were compared between horses that successfully completed the races and those that were eliminated for metabolic reasons. Horses that completed the races were 11.5 +/- 4 years old, weighed 429 +/- 4.5 kg and were ridden 61 +/- 32 km a week when training. Feed intake was reported as "free choice hay or pasture" by 34 of the respondents. Dry matter (DM) hay intake in these horses was estimated to be 3% body weight (kg) minus the kg DM of grain fed, assuming a maximum intake. They were fed 12.3 +/- 2.3 kg feed per day consisting of 10 +/- 2.3 kg hay and 2.3 +/- 1.4 kg of grain. Most had free access to salt and were fed 1 +/- 1 vitamin/mineral supplement per day. Based on Nutritional Research Council (NRC) values for nutrient content of the reported feeds, diets contained 60 +/- 5% total digestible nutrients (TDN), 12 +/- 2% crude protein, 27 +/- 4% crude fiber, 0.72 +/- 0.4% calcium and 0.29 +/- 0.06% phosphorus. Maximum caloric intake was estimated to be 31.9 Mcal per day. Ratios of nutrients fed per kilometer trained were: kg TDN/km = .14 +/- .08, kg crude protein/km trained = .03 +/- .02, and kg crude fiber/km trained = .06 +/- .04.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Nutritional Physiological Phenomena↗

PubMed1983

Growth retardation in the early developing rat exposed to continuous hypobaric hypoxia.

Weanling male rats weighing 48.5 +/- 1.4 g were divided into two groups, hypoxic and normoxic. The former was placed into an altitude chamber and maintained at a pressure equivalent to 0.45 atm. (6 100 m) over a period of 23 days. The normoxic group was maintained at sea level conditions. Food intake, body weight, body length and tail length were recorded every day. Body weight gain in hypoxic rats was 35% of that seen in normoxic controls at the end of the experimental period. Body length gain was 55% and tail length gain was 59% of normal at the same time. The amount of food eaten by the hypoxic animals during the entire exposure period was 55% of that consumed by normoxic ones. The average daily caloric intake related to metabolic body weight (appetite quotient) of hypoxic rats was 60% of the normoxic control value. Efficiency of protein utilization was not significantly different between both groups of rats. These results indicate that exposure to hypobaric hypoxia induces growth retardation in the rat, which appears to be the result of a diminution in food intake because of a decreased appetite.

Animals↗

PubMed2006

Resistance to high-fat diet in the female progeny of obese mice fed a control diet during the periconceptual, gestation, and lactation periods.

With the worldwide epidemic of metabolic syndrome (MetS), the proportion of women that are overweight/obese and overfed during pregnancy has increased. The resulting abnormal uterine environment may have deleterious effects on fetal metabolic programming and lead to MetS in adulthood. A balanced/restricted diet and/or physical exercise often improve metabolic abnormalities in individuals with obesity and type 2 diabetes mellitus (T2D). We investigated whether reducing fat intake during the periconceptual/gestation/lactation period in mothers with high-fat diet (HFD)-induced obesity could be used to modify fetal/neonatal MetS programming positively, thereby preventing MetS. First generation (F1) C57BL/6J female mice with HFD-induced obesity and T2D were crossed with F1 males on control diet (CD). These F1 females were switched to a CD during the periconceptual/gestation/lactation period. At weaning, both male and female second generation (F2) mice were fed a HFD. Weight, caloric intake, lipid parameters, glucose, and insulin sensitivity were assessed. Sensitivity/resistance to the HFD differed significantly between generations and sexes. A similar proportion of the F1 and F2 males (80%) developed hyperphagia, obesity, and T2D. In contrast, a significantly higher proportion of the F2 females (43%) than of the previous F1 generation (17%) were resistant (P<0.01). Despite having free access to the HFD, these female mice were no longer hyperphagic and remained lean, with normal insulin sensitivity and glycemia but mild hypercholesterolemia and glucose intolerance, thus displaying a "satiety phenotype." This suggests that an appropriate dietary fatty acid profile and intake during the periconceptual/gestation/lactation period helps the female offspring to cope with deleterious intrauterine conditions.

Animals↗

PubMed1980

Route of pediatric parenteral nutrition: proposed criteria revision.

This study reviews the experience of the Nutrition Support Service at the Children's Hospital of Philadelphia over a 13-mo period from 1977 to 1979. Parenteral nutrition was administered to 585 children, 385 by peripheral vein infusion and 200 by central vein infusion. Weight gain was seen in 63% of those patients receiving peripheral vein infusions and 82.5% of those receiving central vein nutrients, and this apparent difference is likely due to the longer duration of therapy in the central vein recipients (33.7 versus 11.4 mean days) and the greater caloric intake delivered to these same patients (128 Kcal/kg/day versus 63.2 Kcal/kg/day). The complication rates were calculated for the more than 11,000 patient days of therapy surveyed; 35 of the 385 peripheral vein patients developed complications, the primary type being solution administration soft tissue sloughs. This amounted to an incidence of 9.08%. Central vein patients in 40 circumstances likewise had complications, 21 being infectious and 12 being metabolic. This accounted for 20% of all central vein recipients, a difference from the peripheral vein group significant to a p value of less than .01. However, when total days of therapy are considered in this complication incidence, a per diem complication rate between these two groups is not different, and in fact, is somewhat worse for the peripheral vein nutrient recipients. Vascular access in this group of patients was via peripheral vein cannulation or via central venous catheter placement, the latter more recenty done exclusively by percutaneous subclavian vein catheter insertions. This technique was safe and allowed repeated access to the central venous system. These data suggest that the only legitimate determining factor for selecting proper nutritional support of the pediatric patient is the caloric need of the individual.

Amino Acids↗

PubMed1995

Changes in nutritional pattern, insulin sensitivity and glucose tolerance during weight loss in obese patients from a Mediterranean area.

In order to study the nutritional pattern in obese subjects living in an area with a Mediterranean diet, as well as the modifications in nutritional behaviour, cardiovascular risk factors and insulin sensitivity induced by changes in nutritional pattern, 54 obese patients completed a 20-week behaviour programme. They prospectively fulfilled a food records diary in order to ascertain their nutritional pattern. Weight, body mass index (BMI). waist-to-hip ratio (WHR), blood pressure (BP), cholesterol, HDL-c, LDL-c, triglycerides, fasting and 2 h-post glucose load plasma glucose were determined at the onset and at the end of the study. Insulin sensitivity index (SI), and glucose effectiveness (Sg) were assessed by using the modified FSIVGTT. The usual diet in obese patients living in a Mediterranean country is low in carbohydrates (35%) and high in fats (43%), 55% of the latter being monounsaturated fatty acids (MUFAs), especially olive oil. After the educational programme they decreased the caloric intake to slightly over 700 Kcal/day, with a reduction of 36% in carbohydrates consumption, 18% in proteins and 43% in fats (46% in MUFAs). These modifications resulted in a decrease in weight, BMI, WHR, BP, and fasting and 2 h-post glucose load plasma glucose (all p < 0.05), whereas the lipoprotein profile did not change. In a similar way SI and Kg (glucose disappearance rate) increased, while fasting plasma insulin (FPI) decreased (p < 0.05) and Sg and I1+3 remained unaffected. Our results indicate that weight loss induced by caloric restriction improves insulin sensitivity rather insulin secretory capacity or glucose effectiveness, and all the cardiovascular risk factors but lipoproteic profile, that remains unchanged, probably because of the lower MUFAs consumption. These facts should be taken into account when recommending changes in the diet of obese patients with a Mediterranean-style diet.

Adult↗

PubMed1997

[Consumption of sweets and snacks by a population of school children in the Autonomous Community of Madrid. The CAENPE Group].

BACKGROUND: In our society advertising compaigns promote consumption of superfluous foods, such as sweets and snacks, displacing the intake of other basic nutrients. The aim of this study is to assess the intake of these foods by children, their relative contribution to overall macronutrient intake and their effects on health. SUBJECTS AND METHODS: A dietary assessment was performed on a representative sample of scholar children from the Autonomous Community of Madrid. It reflects food consumption for a 4-days period (3 week-days and 1 weekend day) in 2,698 boys and girls aged 6 to 15 years. The intake is expressed as grams per 1,000 kcal to standardize nutrient consumption in boys and girls. Lipid profile and several markers of nutritional status are also determined. RESULTS: The consumption of sweets and snacks items per 1,000 kcal is higher in boys than in girls (35.8 +/- 20.0 and 34.2 +/- 19.6 g/1,000 kcal, respectively; p = 0.01) and increases during adolescence (12 and 13 years) in both sexes. Sweets and snacks provide 16.1% of dietary total caloric intake, 7.1% of saturated fatty acids, 10.7% of monounsaturated fatty acids, 10.4% of polyunsaturated fatty acids and 11.3% of cholesterol. Children of ages 6, 7, 8 and 9 years with high calculated LDL-cholesterol levels (> or = 120 mg/dl) consume significative higher amounts of sweet foods than children with low calculated LDL-cholesterol levels (< or = 90 mg/dl). CONCLUSIONS: Children from the Autonomous Community of Madrid, Spain consume excessive sweets, which could be responsible for a higher prevalence of diseases related to this intake, such as caries, obesity and obesity-related associate diseases.

Adolescent↗

PubMed1989

Effects of ovarian hormones on eating behaviors, body weight, and glucoregulation in rhesus monkeys.

The influences of ovarian hormones on food intake, taste preferences, and glucoregulation were examined in intact and ovariectomized rhesus monkeys. Intake of intact monkeys was lowest in the preovulatory stage of the cycle, when estrogen levels are elevated, and exogenous estradiol transiently suppressed food intake of ovariectomized monkeys in a dose-related manner, confirming previous observations. Progesterone treatment did not affect food intake when given alone, but it did attenuate the effect of estradiol when both hormones were given concurrently. Preferences for sweet solutions were not detectably influenced by chronic treatment with estradiol or progesterone, and compensatory responses to ingestion of sugar were unaltered by hormone treatment. Glucose tolerance tests did not reveal significant influences of ovarian hormones on glycemia, but insulin levels were elevated during periods of progesterone treatment. These results do not support the suggestion that fluctuations in caloric intake during the menstrual cycle are secondary to changes in taste preference or glucoregulation. However, possible changes in sweet preference and glucoregulation shortly after initiation of estrogen treatment, i.e., during the time of suppressed food intake, remain to be examined.

Animals↗

PubMed1991

Effect of intravenous or intragastric nutrients on food intake in rats.

A series of experiments were performed to determine which components of total parenteral nutrition (TPN) reduce spontaneous food intake (SFI) and to what degree. In Experiment 1, rats were infused with TPN (15% dextrose + 5% fat + 4.3% amino acid) or with one of its three components given independently at the final concentration of TPN for 3 days via an intravenous (iv) catheter. Each solution, at 3 ml/hr, provided a different amount of calories (TPN = 85, dextrose = 37, fat = 36, and amino acid = 12 kcal/day), representing about 120, 50, 50, and 20% of the rat's spontaneous caloric intake, respectively. TPN, dextrose, and fat significantly reduced SFI compared to the infusion of normal saline; however, amino acid failed to reduce SFI. Experiment 2 was carried out to investigate the relative contributions that pre- and postabsorptive mechanisms make in the regulation of SFI. Each rat in four different groups was infused with one of four isocaloric nutrient solutions through an iv catheter and a gastrostomy (ig) for separated periods of time. Nutrient solutions at 3 ml/hr provided each 32 kcal/day (50% of requirements): 13% dextrose, 4.5% fat, 11.4% amino acid, and a mixture (6.4% dextrose + 1.6% fat + 1.7% amino acid). Each solution, either iv or ig, reduced SFI compared to normal saline infused via the same route. However, neither the route of administration nor the nature of different nutrients caused significant differences in SFI reduction.

Animal Nutritional Physiological Phenomena↗

PubMed2002

Planning strategies for development of effective exercise and nutrition countermeasures for long-duration space flight.

Exercise and nutrition represent primary countermeasures used during space flight to maintain or restore maximal aerobic capacity, musculoskeletal structure, and orthostatic function. However, no single exercise, dietary regimen, or combination of prescriptions has proven entirely effective in maintaining or restoring cardiovascular and musculoskeletal functions to preflight levels after prolonged space flight. As human space flight exposures increase in duration, identification, assessment, and development of various effective exercise- and nutrition-based protective procedures will become paramount. The application of adequate dietary intake in combination with effective exercise prescription will be based on identification of basic physiologic stimuli that maintain normal function in terrestrial gravity, and understanding how specific combinations of exercise characteristics (e.g., duration, frequency, intensity, and mode) can be combined with minimal nutritional requirements that mimic the stimuli normally produced by living in Earth's gravity environment. This can be accomplished only with greater emphasis of research on ground-based experiments targeted at understanding the interactions between caloric intake and expenditure during space flight. Future strategies for application of nutrition and exercise countermeasures for long-duration space missions must be directed to minimizing crew time and the impact on life-support resources.

Cardiovascular Physiological Phenomena↗

PubMed1993

Diet and carcinogenesis.

In summary there is a wealth of information on dietary and nutritional effects on carcinogenesis in laboratory rodents. Experimental studies based on epidemiological evidence, earlier experimental studies and known or predicted cellular, biochemical and molecular effects of nutrients have produced clear evidence that carcinogenesis in laboratory rodents is influenced by dietary intake of calories, fat, lipotropes (choline, methionine), vitamin A and related retinoids, Se, calcium, zinc, fiber, ethanol and a large number of non-nutrient components of foods. For these substances or groups of substances mechanistic hypotheses supported by experimental data and are leading to further research. The information provided will contribute to understanding of basic processes in carcinogenesis as well as of the specific interactions studied, and should contribute to significant advances in preventive medicine. Restriction of caloric intake of rodents by amounts > 10% over a significant portion of their lifetime reduces tumorigenesis. That level of restriction reduces the rate of growth and maturation, and most experiments in this area employ greater restrictions that virtually abolish growth from a young age. Therefore, the observations are of interest in mechanistic studies, but their applicability to preventive medicine requires better definition of the degree and duration of restriction required for a significant effect and the age at which it must be imposed. Restriction of total fat intake and modifications to increase the intake of omega-3 fats have a reasonably consistent effect on tumorigenesis in rodents but a much less consistently demonstrable effect in humans. Again, the observations in rodents are providing a major stimulus to mechanistic studies. The lipotropes are extremely valuable as tools for investigating mechanisms of carcinogenesis in rodents. Their importance in the epidemiology of human cancer has yet to be demonstrated clearly and is a subject of research at present. The naturally occurring vitamins and minerals, as well as fiber, derive their importance in this context from investigations to explain the consistent epidemiological demonstrations of reduction of tumor risk with increased consumption of fruits and vegetables. The activity of the isolated nutrients as anticarcinogens in rodents has generally not matched the activity expected from epidemiological studies. The anticarcinogenic activity of many of the non-nutrient components of fruits and vegetables is remarkable in particular models, however, as is the activity of natural and synthetic retinoids. At present the results must be interpreted to indicate an important effect of combinations of the whole foods with identification of particular nutrients or non-nutrients in specific cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Alcohol Drinking↗

PubMed1995

Very early onset nonorganic failure to thrive in infants.

Nonorganic failure to thrive (NOFTT) occurs in absence of any gastrointestinal, endocrine, or other chronic diseases. It is usually associated with psychosocial deprivation, although behavior problems may also contribute to its occurrence in absence of maternal pathology. We report seven infants and children between the ages of 13 and 30 months at the time of presentation, who failed to consume adequate calories and suffered from delayed growth. All were born at term after normal pregnancies with birth weights and lengths between the 50th and 95th percentiles except in one. None had any history of perinatal problems. Decreased intake was encountered almost immediately after birth, with lack of interest in consuming adequate calories. The evaluations performed did not reveal any specific etiology for the decreased intake. None had any developmental delay nor were there any psychiatric conditions in mothers. Changes in formulas or psychologic intervention were unsuccessful in modifying feeding habits except in two infants. All were supplemented with enteral supplements (Pediasure-five, Ensure-one, and Osmolite-one). Three did not consume enough orally and needed nasogastric tube infusions with eventual placement of gastrostomy tubes in two, and the third one has continued with nasogastric infusions. A significant increase in caloric intake caused improvement in growth percentiles. Height and weight percentiles improved in all and crept into the normal curve in four and five patients, respectively. Head circumference of two stayed at < 5th percentile despite nutritional rehabilitation. Attempts at weaning off the supplements actually resulted in weight loss in all. Our data suggest that there is a critical need for early, aggressive nutritional intervention in such infants.

Body Height↗

PubMed1991

Relation of obesity and diet to sympathetic nervous system activity.

The hypothesis that dietary intake and obesity stimulate the sympathetic nervous system was investigated in a cross-sectional study of 572 men aged 43-85 years from the Normative Aging Study. Habitus was represented by body mass index, as a measure of overall adiposity, and by the ratio of abdomen-to-hip circumference (abdomen/hip ratio), as a measure of centripetal fat distribution. Sympathetic activity was assessed by measurement of 24-hour urinary norepinephrine excretion. Increased body mass index and total caloric intake were independently associated with increased 24-hour urinary norepinephrine excretion (p = 0.0001 and p = 0.0055, respectively). In addition, mean urinary norepinephrine excretion was higher in subjects classified as either hyperglycemic (serum fasting glucose greater than or equal to 113 mg/dl) and hyperinsulinemic (serum fasting insulin greater than or equal to 19 microIU/ml) (p = 0.0023) or in subjects classified as either hyperglycemic or hyperinsulinemic (p = 0.0063) than the mean urinary norepinephrine excretion in normal subjects. These relations were demonstrated to be independent of age, smoking status, and physical activity. Our results are consistent with the hypothesis that insulin mediates sympathetic stimulation in response to dietary intake and increases sympathetic nervous system activity in the obese.

Adipose Tissue↗