Sa1560 – Hepatic Steatosis, Resting Metabolic Rate Changes and Metabolic Adaptation: Implications for the Risk of Weight Regain After Weight Loss Interventions for Obesity

Abstract Objectives There is persistent controversy over the extent to which different components of energy expenditure disproportionately decrease after weight loss and contribute to weight regain through decreased energy requirements. We conducted a secondary analysis of the CALERIE I study to test the hypothesis that decreased resting metabolic rate (RMR) and energy expenditure for physical activity (EEPA) after a 6-month calorie restriction intervention would predict weight regain at 12 months, with a greater decrease in RMR than EEPA. Methods Participants (n = 46) received all food and energy-containing beverages for 6 months. Outcome measures included total energy expenditure by doubly labeled water, RMR by indirect calorimetry, and body composition by BOD POD. Predictions for RMR and EEPA were derived from baseline linear regression models including age, sex, fat mass, and fat free mass. Baseline regression coefficients were used to calculate the predicted RMR and EEPA at 6 months. Residuals were calculated as the difference between measured and predicted values and were adjusted for body weight. The presence of metabolic adaptation was evaluated by a paired t-test comparing measured and predicted RMR at 6 months. Differences between 6-month RMR and EEPA residuals were evaluated by the same method. Linear regression was used to assess the association between 6-month residuals and weight loss maintenance (% weight change, 6 to 12 months). Results Mean weight loss was 6.9% at 6 months with 2.1% regain from 6 to 12 months. No adaptation in RMR was observed at 6 months (mean residual: 19 kcal; 95% confidence interval: −9, 48; P = 0.18). However, significant adaptation was observed in EEPA (mean residual: −199 kcal; −126, −272; P < 0.0001). In addition, the mean 6-month RMR residual was significantly greater than the mean 6-month EEPA residual (218 kcal; 133, 304; P < 0.0001). There was no significant association between 6-month RMR or EEPA residuals and weight regain at 12 months (P = 0.56, 0.34). Conclusions There was no measurable decrease in RMR with weight loss after adjusting for changes in fat free mass and fat mass, but there was a decrease in EEPA. Changes in RMR and EEPA with weight loss over 6 months did not predict weight regain at 12 months. Funding Sources Jean Mayer USDA Human Nutrition Research Center on Aging Doctoral Scholarship; USDA agreement #8050–51000-105–01S

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Long-term Resting Metabolic Rate Analysis in Pregnancy and Weight Loss Interventions

International Journal of Prognostics and Health Management ◽

10.36001/ijphm.2021.v12i4.3077 ◽

2021 ◽

Vol 12 (4) ◽

Author(s):

Shayok ◽

Teresa Wu ◽

Erica Forzani ◽

Corrie Whisner ◽

David Jackemeyer

Keyword(s):

Weight Loss ◽

Metabolic Rate ◽

Weight Management ◽

Resting Metabolic Rate ◽

Published Data ◽

Healthy Weight ◽

The Difference ◽

Metabolic Activities ◽

Weight Loss Interventions ◽

In Pregnancy

In this paper, we first studied the change in resting metabolic rate (RMR) of 4 women during their pregnancy period. We retrospectively analyzed published data, which lacked rigorous statistical analysis. We introduced new data that helps to define RMR baseline variabilities and further compare the RMR fluctuations in steady physiological conditions (no pregnancy, no weight/diet/exercise regime change) to assess “true” RMR changes that can guide healthy weight management in pregnancy and other conditions. For each subject, the change in the RMR values were computed as the difference between the values during the metabolic rate inspection period and the baseline values. This difference was compared against the difference values of a reference subject, using a two-sided paired t-test at the significance level of 5%. Our results indicated that some subjects exhibit a statistically significant increase, some exhibit a decrease while others show no significant statistical variation in RMR values during pregnancy. These are important findings that demystify the old idea that the RMR of a pregnant woman “always” increases since she is generating a new life; rather, individualized physiological processes can produce metabolic changes that cannot be generalized and need individual RMR measurements throughout pregnancy. The insights gained from this study were then applied to retrospectively analyze the RMR of 20 subjects during a 6-month pilot weight loss intervention with 89% efficiency in weight loss. Our analysis revealed that there was no significant decrease in metabolic activities at the end of the program. Although this contradicts the belief that weight loss is associated with a decrease in metabolic activities, our results can be explained by the fact that subjects adhered to a healthy nutritional diet and regular exercise during the pro- gram; thus, the effect of weight loss on decreasing the RMR was counter-balanced by the effect of healthier diet and exercise on increasing the RMR, which helped in maintaining a steady and healthy metabolic rate. Both studies, pregnancy and weight loss interventions indicated that changes in the metabolic rate of pregnant women and individuals undergoing weight loss interventions are unpredictable, therefore there is an urgent need to implement personalized practices of weight management by periodically measuring RMR and adjusting food caloric intakes based on the individual’s metabolic rate.

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Resting metabolic rate, fat-free mass and catecholamine excretion during weight loss in female obese patients

British Journal Of Nutrition ◽

10.1017/s0007114500001823 ◽

2000 ◽

Vol 84 (4) ◽

pp. 515-520 ◽

Cited By ~ 17

Author(s):

R. Menozzi ◽

M. Bondi ◽

A. Baldini ◽

M. G. Venneri ◽

A. Velardo ◽

...

Keyword(s):

Weight Loss ◽

Metabolic Rate ◽

Urinary Excretion ◽

Weight Maintenance ◽

Resting Metabolic Rate ◽

Fat Free Mass ◽

Metabolic Adaptation ◽

Obese Patients ◽

Maintenance Period ◽

Sympathoadrenal System

The reduction in resting metabolic rate (RMR) during weight loss exceeds that accounted for by changes in body composition by 15%, suggesting that factors other than fat-free mass (FFM) explain the metabolic adaptation during food restriction in obesity. Our study aimed to establish if changes in the sympathoadrenal system activity, as inferred from an integrated measure such as 24 h urinary excretion of catecholamines, may play a role in the RMR adaptation observed during dietary restriction in obese patients. Ninety-three obese female subjects consumed a low-energy diet (LED) (2930 kJ/d (700 kcal/d)) for a 3-week period. At the beginning and at the end of the study, 24 h urinary excretion of catecholamines, FFM and RMR were measured. The LED induced a significant reduction in body weight (-3·3 (SEM 0·4) KG; P < 0·01), FFM (-1·9 (sem 0·7) kg; P < 0·01) and in the fat mass (-1·2 (sem 0·5) kg; P < 0·01). Noradrenalin excretion (24 h) decreased during the LED from 264 (sem 26) during a weight-maintenance period to 171 (sem 19) nmol/24 h after consumption of the LED for 3 weeks (P < 0·001); mean 24 h adrenalin excretion did not change during the LED (22 (sem 3) during the weight-maintenance period v. 21 (sem 3) nmol/24 h after consumption of the LED for 3 weeks; NS). The LED induced a significant decrease in RMR (7300 (sem 218) v. 6831 (sem 138) kJ/24 h; P < 0·001). The only independent variable that significantly explained variations in RMR both before and after consumption of the LED for 3 weeks, was FFM (r2 0·79 and r2 0·80 respectively). Urinary noradrenalin excretion explained a further 4 % of the variability in RMR, but only before the diet, so that a role of sympathoadrenal system on RMR seems to be present in obese patients in basal conditions but not at the end of the LED.

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Metabolic adaptation is an illusion, only present when participants are in negative energy balance

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa220 ◽

2020 ◽

Vol 112 (5) ◽

pp. 1212-1218 ◽

Cited By ~ 2

Author(s):

Catia Martins ◽

Jessica Roekenes ◽

Saideh Salamati ◽

Barbara A Gower ◽

Gary R Hunter

Keyword(s):

Weight Loss ◽

Energy Balance ◽

Weight Regain ◽

Resting Metabolic Rate ◽

Negative Energy ◽

Metabolic Adaptation ◽

Initial Weight Loss ◽

Maintenance Program

ABSTRACT Background The existence of metabolic adaptation, following weight loss, remains a controversial issue. To our knowledge, no study has evaluated the role of energy balance (EB) in modulating metabolic adaptation. Objectives The aim of this study was to determine if metabolic adaptation, at the level of resting metabolic rate (RMR), is modulated by participants’ EB status. A secondary aim was to investigate if metabolic adaptation was associated with weight regain. Methods Seventy-one individuals with obesity (BMI: 34.6 ± 3.4 kg/m2; age: 45.4 ± 8.2 y; 33 men) enrolled in a 1000-kcal/d diet for 8 wk, followed by 4 wk of weight stabilization and a 9-mo weight loss maintenance program. Body weight/composition and RMR were measured at baseline, week 9 (W9), week 13 (W13), and 1 y (1Y). Metabolic adaptation was defined as a significantly different (lower or higher) measured compared with predicted RMR. Results Participants lost on average 14 kg by W9, followed by weight stabilization at W13, and regained 29% of their initial weight loss at 1Y. Metabolic adaptation was found at W9 (−92 ± 110 kcal/d, P < 0.001) and W13 (−38 ± 124 kcal/d, P = 0.011) but was not correlated with weight regain. A significant reduction in metabolic adaptation was seen between W9 and W13 (−53 ± 101 kcal/d, P < 0.001). In a subset of participants who gained weight between W9 and W13 (n = 33), no metabolic adaptation was seen at W13 (−26.8 ± 121.5 kcal/d, P = 0.214). In a subset of participants with data at all time points (n = 45), metabolic adaptation was present at W9 and W13 (−107 ± 102 kcal/d, P < 0.001 and −49 ± 128 kcal/d, P = 0.013) but not at 1Y (−7 ± 129, P = 0.701). Conclusion After weight loss, metabolic adaptation at the level of RMR is dependent on the EB status of the participants, being reduced to half after a period of weight stabilization. Moreover, metabolic adaptation does not predict weight regain at 1Y follow-up. These trials were registered at clinicaltrials.gov as NCT02944253 and NCT03287726.

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Metabolic adaptation is not a major barrier to weight-loss maintenance

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqaa086 ◽

2020 ◽

Vol 112 (3) ◽

pp. 558-565 ◽

Cited By ~ 6

Author(s):

Catia Martins ◽

Barbara A Gower ◽

James O Hill ◽

Gary R Hunter

Keyword(s):

Weight Loss ◽

Weight Regain ◽

Resting Metabolic Rate ◽

Compartment Model ◽

Metabolic Adaptation ◽

Major Barrier ◽

Overweight Women ◽

Fat Mass Loss ◽

Weight Stability

ABSTRACT Background The existence of metabolic adaptation, at the level of resting metabolic rate (RMR), remains highly controversial, likely due to lack of standardization of participants’ energy balance. Moreover, its role as a driver of relapse remains unproven. Objective The main aim was to determine if metabolic adaptation at the level of RMR was present after weight loss and at 1- and 2-y follow-up, with measurements taken under condition of weight stability. A secondary aim was to investigate race differences in metabolic adaptation after weight loss and if this phenomenon was associated with weight regain. Methods A total of 171 overweight women [BMI (kg/m2): 28.3 ± 1.3; age: 35.2 ± 6.3 y; 88 whites and 83 blacks] enrolled in a weight-loss program to achieve a BMI <25, and were followed for 2 y. Body weight and composition (4-compartment model) and RMR (indirect calorimetry) were measured after 4 wk of weight stability at baseline, after weight loss and at 1 and 2 y. Metabolic adaptation was defined as a significantly lower measured compared with predicted RMR (from own regression model). Results Participants lost, on average, 12 ± 2.6 kg and regained 52% ± 38% and 89% ± 54% of their initial weight lost at 1 and 2 y follow-up, respectively. Metabolic adaptation was found after weight loss (−54 ± 105 kcal/d; P < 0.001), with no difference between races and was positively correlated with fat-mass loss, but not with weight regain, overall. In a subset of women (n = 46) with data at all time points, metabolic adaptation was present after weight loss, but not at 1- or 2-y follow-up (−43 ± 119, P = 0.019; −18 ± 134, P = 0.380; and − 19 ± 166, P = 0.438 kcal/day respectively). Conclusions In overweight women, metabolic adaptation at the level of RMR is minimal when measurements are taken under conditions of weight stability and does not predict weight regain up to 2 years follow-up. The JULIET study is registered at https://clinicaltrials.gov/ct2/show/NCT00067873 as NCT00067873.

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Influence of distribution of lean body mass on resting metabolic rate after weight loss and weight regain: comparison of responses in white and black women

American Journal of Clinical Nutrition ◽

10.1093/ajcn/77.6.1368 ◽

2003 ◽

Vol 77 (6) ◽

pp. 1368-1373 ◽

Cited By ~ 41

Author(s):

Nuala M Byrne ◽

Roland L Weinsier ◽

Gary R Hunter ◽

Renee Desmond ◽

Mindy A Patterson ◽

...

Keyword(s):

Weight Loss ◽

Black Women ◽

Metabolic Rate ◽

Lean Body Mass ◽

Body Mass ◽

Weight Regain ◽

Resting Metabolic Rate

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The effect of conjugated linoleic acid supplementation after weight loss on body weight regain, body composition, and resting metabolic rate in overweight subjects

International Journal of Obesity ◽

10.1038/sj.ijo.0802304 ◽

2003 ◽

Vol 27 (7) ◽

pp. 840-847 ◽

Cited By ~ 101

Author(s):

M M J W Kamphuis ◽

M P G M Lejeune ◽

W H M Saris ◽

M S Westerterp-Plantenga

Keyword(s):

Weight Loss ◽

Body Composition ◽

Body Weight ◽

Linoleic Acid ◽

Metabolic Rate ◽

Conjugated Linoleic Acid ◽

Weight Regain ◽

Resting Metabolic Rate ◽

Acid Supplementation ◽

Overweight Subjects

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2536

Journal of Clinical and Translational Science ◽

10.1017/cts.2017.54 ◽

2017 ◽

Vol 1 (S1) ◽

pp. 11-11

Author(s):

David M. Presby ◽

Rebecca M. Foright ◽

Julie A. Houck ◽

Ginger C. Johnson ◽

L. Allyson Checkley ◽

...

Keyword(s):

Skeletal Muscle ◽

Weight Loss ◽

Energy Expenditure ◽

Metabolic Rate ◽

Total Energy ◽

Weight Regain ◽

Resting Metabolic Rate ◽

Weight Loss Maintenance ◽

Oxidative Capacity ◽

Total Energy Expenditure

OBJECTIVES/SPECIFIC AIMS: Obesity is a rapidly growing epidemic and long-term interventions aimed to reduce body weight are largely unsuccessful due to an increased drive to eat and a reduced metabolic rate established during weight loss. Previously, our lab demonstrated that exercise has beneficial effects on weight loss maintenance by increasing total energy expenditure above and beyond the cost of an exercise bout and reducing the drive to eat when allowed to eat ad libitum (relapse). We hypothesized that exercise’s ability to counter these obesogenic-impetuses are mediated via improvements in skeletal muscle oxidative capacity, and tested this using a mouse model with augmented oxidative capacity in skeletal muscle. METHODS/STUDY POPULATION: We recapitulated the exercise-induced improvements in oxidative capacity using FVB mice that overexpress lipoprotein lipase in skeletal muscle (mLPL). mLPL and wild type (WT) mice were put through a weight-loss-weight-regain paradigm consisting of a high fat diet challenge for 13 weeks, with a subsequent 1-week calorie-restricted medium fat diet to induce a ~15% weight loss. This newly established weight was maintained for 2 weeks and followed with a 24-hour relapse. Metabolic phenotype was characterized by indirect calorimetry during each phase. At the conclusion of the relapse day, mice were sacrificed and tissues were harvested for molecular analysis. RESULTS/ANTICIPATED RESULTS: During weight loss maintenance, mLPL mice had a higher metabolic rate (p=0.0256) that was predominantly evident in the dark cycle (p=0.0015). Furthermore, this increased metabolic rate was not due to differences in activity (p=0.2877) or resting metabolic rate (p=0.4881). During relapse, mLPL mice ingested less calories and were protected from rapid weight regain (p=0.0235), despite WT mice exhibiting higher metabolic rates during the light cycle (p=0.0421). DISCUSSION/SIGNIFICANCE OF IMPACT: These results highlight the importance of muscular oxidative capacity in preventing a depression in total energy expenditure during weight loss maintenance, and in curbing overfeeding and weight regain during a relapse. Moreover, our data suggest that the thermic effect of food is responsible for the differences in metabolic rate, because no differences were found in activity or resting metabolic rate. Additional studies are warranted to determine the molecular mechanisms driving the ability of oxidative capacity to assist with weight loss maintenance.

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