Metabolic response to feeding in weight-losing pancreatic cancer patients and its modulation by a fish-oil-enriched nutritional supplement

2000 ◽  
Vol 98 (4) ◽  
pp. 389-399 ◽  
Author(s):  
Matthew D. BARBER ◽  
Donald C. MCMILLAN ◽  
Tom PRESTON ◽  
James A. ROSS ◽  
Kenneth C. H. FEARON
Keyword(s):  
Pancreatic Cancer ◽  
Body Weight ◽  
Energy Expenditure ◽  
Fish Oil ◽  
Cancer Patients ◽  
Metabolic Response ◽  
Resting Energy Expenditure ◽  
Fat Oxidation ◽  
Nutritional Supplement ◽  
Healthy Control

Weight-losing patients with advanced cancer often fail to gain weight with conventional nutritional support. This suboptimal response might be explained, in part, by an increased metabolic response to feeding. It has been suggested that eicosapentaenoic acid (EPA) can modify beneficially the metabolic response to cancer. The aim of the present study was to examine the metabolic response to feeding in cancer and the effects of an EPA-enriched oral food supplement on this response. A total of 16 weight-losing, non-diabetic patients with unresectable pancreatic adenocarcinoma and six healthy, weight-stable controls were studied by indirect calorimetry in the fasting and fed states. Body composition was estimated by bioimpedence analysis. Cancer patients were then given a fish-oil-enriched nutritional supplement providing 2 g of EPA and 2550 kJ daily, and underwent repeat metabolic study after 3 weeks of such supplementation. At baseline, resting energy expenditure whether expressed per kg body weight, lean body mass or body cell mass was significantly greater in the cancer patients compared with controls. Fat oxidation was significantly higher in the fasting state in cancer patients [median 1.26 g·kg-1·min-1 (interquartile range 0.95–1.38)] than in controls [0.76 g·kg-1·min-1 (0.62–0.92); P < 0.05]. Over the 4 h feeding period, changes in insulin and glucose concentrations in cancer patients suggested relative glucose intolerance. In response to oral meal feeding, the percentage change in the area under the curve of energy expenditure was significantly lower in the cancer patients [median 7.9% (interquartile range 3.4–9.0)] than in controls [12.6% (9.9–15.1); P < 0.01]. After 3 weeks of the EPA-enriched supplement, the body weight of the cancer patients had increased and the energy expenditure in response to feeding had risen significantly [9.6% (6.3–12.4)], such that it was no different from baseline healthy control values. Similarly, fasting fat oxidation fell to 1.02 g·kg-1·min-1 (0.8–1.18), again no longer significantly different from baseline healthy control values. While weight-losing patients with advanced pancreatic cancer have an increased resting energy expenditure and increased fat oxidation, the energy cost of feeding is, in fact, reduced. Provision of a fish-oil-enriched nutritional supplement results in some normalization of the metabolic response in both the fasted and fed states, in association with an improvement in nutritional status.

Metabolic response to feeding in weight-losing pancreatic cancer patients and its modulation by a fish-oil-enriched nutritional supplement

2000 ◽  
Vol 98 (4) ◽  
pp. 389 ◽  
Author(s):  
Matthew D. BARBER ◽  
Donald C. MCMILLAN ◽  
Tom PRESTON ◽  
James A. ROSS ◽  
Kenneth C.H. FEARON
Keyword(s):  
Pancreatic Cancer ◽  
Fish Oil ◽  
Cancer Patients ◽  
Metabolic Response ◽  
Nutritional Supplement

scholarly journals Metabolic, gastrointestinal, and CNS neuropeptide effects of brain leptin administration in the rat

1999 ◽  
Vol 276 (5) ◽  
pp. R1425-R1433 ◽  
Author(s):  
Gertjan van Dijk ◽  
Randy J. Seeley ◽  
Todd E. Thiele ◽  
Mark I. Friedman ◽  
Hong Ji ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Body Weight ◽  
Energy Expenditure ◽  
Neuropeptide Y ◽  
Caloric Restriction ◽  
Resting Energy Expenditure ◽  
Corticotropin Releasing Hormone ◽  
Plasma Fatty Acids ◽  
The Third ◽  
Ad Libitum

To investigate whether brain leptin involves neuropeptidergic pathways influencing ingestion, metabolism, and gastrointestinal functioning, leptin (3.5 μg) was infused daily into the third cerebral ventricular of rats for 3 days. To distinguish between direct leptin effects and those secondary to leptin-induced anorexia, we studied vehicle-infused rats with food available ad libitum and those that were pair-fed to leptin-treated animals. Although body weight was comparably reduced (−8%) and plasma glycerol was comparably increased (142 and 17%, respectively) in leptin-treated and pair-fed animals relative to controls, increases in plasma fatty acids and ketones were only detected (132 and 234%, respectively) in pair-fed rats. Resting energy expenditure (−15%) and gastrointestinal fill (−50%) were reduced by pair-feeding relative to the ad libitum group, but they were not reduced by leptin treatment. Relative to controls, leptin increased hypothalamic mRNA for corticotropin-releasing hormone (CRH; 61%) and for proopiomelanocortin (POMC; 31%) but did not reduce mRNA for neuropeptide Y. These results suggest that CNS leptin prevents metabolic/gastrointestinal responses to caloric restriction by activating hypothalamic CRH- and POMC-containing pathways and raise the possibility that these peripheral responses to CNS leptin administration contribute to leptin’s anorexigenic action.

scholarly journals Resting Energy Expenditure in Controls and Cancer Patients with Localized and Diffuse Disease

1984 ◽  
Vol 199 (3) ◽  
pp. 292-298 ◽  
Author(s):  
JEFFREY M. ARBEIT ◽  
DAVID E. LEES ◽  
ROLAND CORSEY ◽  
MURRAY F. BRENNAN
Keyword(s):  
Energy Expenditure ◽  
Cancer Patients ◽  
Resting Energy Expenditure ◽  
Diffuse Disease ◽  
Resting Energy

scholarly journals Energy Expenditure, Fat Oxidation, and Body Weight Regulation: A Study of Metabolic Adaptation to Long- Term Weight Change

2000 ◽  
Vol 85 (3) ◽  
pp. 1087-1094 ◽  
Author(s):  
Christian Weyer ◽  
Richard E. Pratley ◽  
Arline D. Salbe ◽  
Clifton Bogardus ◽  
Eric Ravussin ◽  
...  
Keyword(s):  
Body Weight ◽  
Energy Expenditure ◽  
Weight Change ◽  
Fat Oxidation ◽  
Metabolic Adaptation ◽  
Weight Regulation ◽  
Body Weight Regulation

ENERGY EXPENDITURE IN 21-HYDROXYLASE CONGENITAL ADRENAL HYPERPLASIA PATIENTS AND COMPARISON WITH PREDICTIVE EQUATIONS

2020 ◽  
Vol 26 (4) ◽  
pp. 388-398
Author(s):  
Daniel Minutti de Oliveira ◽  
Ana Carolina Junqueira Vasques ◽  
Ezequiel Moreira Gonçalves ◽  
Sofia Helena Valente de Lemos-Marini ◽  
Gil Guerra-Junior ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Energy Expenditure ◽  
Congenital Adrenal Hyperplasia ◽  
Body Mass ◽  
Indirect Calorimetry ◽  
Resting Energy Expenditure ◽  
Adrenal Hyperplasia ◽  
Predictive Equations ◽  
17 Hydroxyprogesterone

Objective: To characterize resting energy expenditure (REE) in patients with classic 21-hydroxylase congenital adrenal hyperplasia (21-OH CAH) using indirect calorimetry and compare it to the most commonly used REE predictive equations. Methods: This case-control study comprised 29 post-pubertal 21-OH CAH patients regularly followed at the University of Campinas. Elevated serum 17-hydroxyprogesterone and CYP21 gene molecular analysis confirmed the diagnosis. A healthy control group paired by age, gender, and body mass index was examined. Dual-energy X-ray absorptiometry (DEXA) measured body compositions. A bioimpedance analyzer determined fat-free mass, and indirect calorimetry using a metabolic cart measured REE. Results: Unlike our initial hypothesis, REE was similar between the groups (18.7 ± 3.1 kcal/kg/day in CAH vs. 20.3 ± 3.5 kcal/kg/day in controls; P = .728). No predictive equations reached the stipulated accuracy criteria, thus lacking validity in REE assessment in adults with the characteristics of the group studied. DEXA analysis revealed higher body fat and diminished nonbone lean mass in 21-OH CAH. Anthropometric and bioelectrical impedance parameters were not significantly different. Conclusion: Classic 21-OH CAH is generally followed in reference centers, which may facilitate indirect calorimetry use for REE measurement. Alternatively, considering our REE findings in adult 21-OH CAH patients, nutrition management based on 25 kcal/body weight/day (measured REE × activity factor 1.2 to 1.3) may be reasonable for current body weight maintenance in these patients. Abbreviations: 17-OHP = 17-hydroxyprogesterone; 21-OH CAH = classic 21-hydroxylase deficiency congenital adrenal hyperplasia; BMI = body mass index; REE = resting energy expenditure; VO2 = volume of oxygen; VCO2 = volume of carbon dioxide

scholarly journals Lower Resting Energy Expenditure and Fat Oxidation in Native American and Hispanic Infants Born to Mothers with Diabetes

2015 ◽  
Vol 166 (4) ◽  
pp. 884-889 ◽  
Author(s):  
Kevin R. Short ◽  
April M. Teague ◽  
David A. Fields ◽  
Timothy Lyons ◽  
Steven D. Chernausek
Keyword(s):  
Native American ◽  
Energy Expenditure ◽  
Resting Energy Expenditure ◽  
Fat Oxidation ◽  
Resting Energy

scholarly journals Changes in Resting Energy Expenditure following Gastric Bypass Surgery: Impact on Total Body Weight.

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Fathimath Naseer ◽  
Ruth Price ◽  
Adele McElroy ◽  
Carel Le Roux ◽  
Tamsyn Redpath ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Body Weight ◽  
Energy Expenditure ◽  
Resting Energy Expenditure ◽  
Total Body Weight ◽  
Post Surgery ◽  
Significant Difference ◽  
Total Body ◽  
Ree Group

AbstractBariatric surgery, including Gastric Bypass (GBP) Surgery, is the most efficient modality to manage severe obesity. Resting Energy Expenditure (REE) is an area of interest in the context of weight loss (WL) as it has been postulated to be an independent predictor of WL success following GBP. As such, the aim of this study is to investigate the impact of REE on WL following GBP. 31 GBP patients (77.4% females BMI 45.5 ± 7.0kg/m2 ; 47.3 ± 11.6y) and 32 weight-stable controls (46.9% females; BMI 27.0 ± 4.6kg/m2 ; 41.1 ± 13.5y) were assessed at one-month pre-surgery and at 3 and 12-months post-surgery. Fat mass (FM) and fat-free mass (FFM) were measured using dual energy X-ray absorptiometry (Lunar iDXA, GE Healthcare). REE was measured under standardised conditions using indirect calorimetry (ECAL, Metabolic Health Solutions). Statistical analyses were performed with SPSS v24.0, Armonk, NY. Multiple regression analysis showed that FM (P = 0.001), FFM (P < 0.0001) and gender (P = 0.012) significantly predicted the interindividual variability in REE. Total body weight (TBW) was removed from the model due to collinearity. Adjusted-REE values were then generated using the above predictor variables. Low-REE and high-REE groups were created using within-group adjusted-REE split. At both follow-ups (3- and 12-months post-surgery), patients had a greater reduction in TBW, FM, FFM, measured-REE and adjusted-REE values compared with controls (P < 0.0001). There was also no significant difference between measured and adjusted-REE values at all time-points (P > 0.05). Patients with high REEs at baseline lost more TBW than those in the low-REE group at 3-months post-surgery (-24.9 ± 6.5 kg vs. -16.6 ± 7.0 kg; P = 0.005) and 12-months post-surgery (-41.3 ± 12.5 kg vs. -25.8 ± 10.4.0 kg; P = 0.003). There was no significant difference in mean TBW changes for controls in the low-and high-REE groups at both follow-ups. Patients with high REEs at 3-months post-surgery did not lose more TBW than those in the low-REE group at 12-months post-surgery (-30.1 ± 12.8 kg vs. -38.6 ± 14.4 kg; P = 0.155). Similarly, there was no difference in mean TBW reduction between controls in the low- and high-REE groups (P = 0.115). Thus while patients with a high adjusted-REE value at baseline (> 9746.6kJ/day) lost more weight at 3- and 12-months post-GBP, it is plausible that from the third to the 12th month post-surgery, other key drivers of weight loss, particularly the reduction in energy intake are more important in predicting WL. Further research with a larger sample size is required to increase the chances of detecting a true effect.

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