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      Establishing energy requirements for body weight maintenance: validation of an intake-balance method

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          Abstract

          Background

          Experimentally establishing a group’s body weight maintenance energy requirement is an important component of metabolism research. At present, the reference approach for measuring the metabolizable energy intake (MEI) from foods required for body weight maintenance in non-confined subjects is the doubly-labeled water (DLW)–total energy expenditure (TEE) method. In the current study, we evaluated an energy-intake weight balance method as an alternative to DLW that is more flexible and practical to apply in some settings.

          Methods

          The hypothesis was tested that MEI from foods observed in a group of subjects maintaining a constant energy intake while keeping their weight within ±1 kg over 10 days is non-significantly different from DLW-measured TEE (TEE DLW). Six non-obese subjects evaluated as part of an earlier study completed the inpatient protocol that included a 3-day initial adjustment period.

          Results

          The group body weight coefficient of variation (X ± SD) during the 10-day balance period was 0.38 ± 0.10% and the slope of the regression line for body weight versus protocol day was non-significant at 1.8 g/day (R 2, 0.002, p = 0.98). MEI from foods observed during the 10-day balance period (2390 ± 543 kcal/day) was non-significantly different (p = 0.96) from TEE measured by DLW (2373 ± 713 kcal/day); the MEI/TEE DLW ratio was 1.03 ± 0.15 (range 0.87–1.27) and the correlation between MEI from foods and TEE DLW was highly significant (R 2, 0.88, p = 0.005).

          Conclusions

          A carefully managed 10-day protocol that includes a constant MEI level from foods with weight stability (±1 kg) will provide a group’s body weight maintenance energy requirement similar to that obtained with DLW. This approach opens the possibility of conducting affordable weight balance studies, shorter in duration than those previously reported, that are needed to answer a wide range of questions in clinical nutrition.

          Trial registration The study is registered at http://www.clinicaltrials.gov (NCT01672632; August 20, 2012).

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13104-017-2546-4) contains supplementary material, which is available to authorized users.

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          Most cited references27

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          Changes in energy expenditure resulting from altered body weight.

          No current treatment for obesity reliably sustains weight loss, perhaps because compensatory metabolic processes resist the maintenance of the altered body weight. We examined the effects of experimental perturbations of body weight on energy expenditure to determine whether they lead to metabolic changes and whether obese subjects and those who have never been obese respond similarly. We repeatedly measured 24-hour total energy expenditure, resting and nonresting energy expenditure, and the thermic effect of feeding in 18 obese subjects and 23 subjects who had never been obese. The subjects were studied at their usual body weight and after losing 10 to 20 percent of their body weight by underfeeding or gaining 10 percent by overfeeding. Maintenance of a body weight at a level 10 percent or more below the initial weight was associated with a mean (+/- SD) reduction in total energy expenditure of 6 +/- 3 kcal per kilogram of fat-free mass per day in the subjects who had never been obese (P < 0.001) and 8 +/- 5 kcal per kilogram per day in the obese subjects (P < 0.001). Resting energy expenditure and nonresting energy expenditure each decreased 3 to 4 kcal per kilogram of fat-free mass per day in both groups of subjects. Maintenance of body weight at a level 10 percent above the usual weight was associated with an increase in total energy expenditure of 9 +/- 7 kcal per kilogram of fat-free mass per day in the subjects who had never been obese (P < 0.001) and 8 +/- 4 kcal per kilogram per day in the obese subjects (P < 0.001). The thermic effect of feeding and nonresting energy expenditure increased by approximately 1 to 2 and 8 to 9 kcal per kilogram of fat-free mass per day, respectively, after weight gain. These changes in energy expenditure were not related to the degree of adiposity or the sex of the subjects. Maintenance of a reduced or elevated body weight is associated with compensatory changes in energy expenditure, which oppose the maintenance of a body weight that is different from the usual weight. These compensatory changes may account for the poor long-term efficacy of treatments for obesity.
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            A Biometric Study of Human Basal Metabolism.

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              Low-dose leptin reverses skeletal muscle, autonomic, and neuroendocrine adaptations to maintenance of reduced weight.

              Maintenance of a reduced body weight is accompanied by decreased energy expenditure that is due largely to increased skeletal muscle work efficiency. In addition, decreased sympathetic nervous system tone and circulating concentrations of leptin, thyroxine, and triiodothyronine act coordinately to favor weight regain. These "weight-reduced" phenotypes are similar to those of leptin-deficient humans and rodents. We examined metabolic, autonomic, and neuroendocrine phenotypes in 10 inpatient subjects (5 males, 5 females [3 never-obese, 7 obese]) under 3 sets of experimental conditions: (a) maintaining usual weight by ingesting a liquid formula diet; (b) maintaining a 10% reduced weight by ingesting a liquid formula diet; and (c) receiving twice-daily subcutaneous doses of leptin sufficient to restore 8 am circulating leptin concentrations to pre-weight-loss levels and remaining on the same liquid formula diet required to maintain a 10% reduced weight. During leptin administration, energy expenditure, skeletal muscle work efficiency, sympathetic nervous system tone, and circulating concentrations of thyroxine and triiodothyronine returned to pre-weight-loss levels. These responses suggest that the weight-reduced state may be regarded as a condition of relative leptin insufficiency. Prevention of weight regain might be achievable by strategies relevant to reversing this leptin-insufficient state.
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                Author and article information

                Contributors
                225-763-2541 , Steven.Heymsfield@pbrc.edu
                Cpeterso@UAB.edu
                Diana.Thomas@usma.edu
                mghirezi@gmail.com
                bzhan1@lsuhsc.edu
                Steven.R.Smith.MD@flhosp.org
                George.Bray@pbrc.edu
                Leanne.Redmani@pbrc.edu
                Journal
                BMC Res Notes
                BMC Res Notes
                BMC Research Notes
                BioMed Central (London )
                1756-0500
                26 June 2017
                26 June 2017
                2017
                : 10
                : 220
                Affiliations
                [1 ]ISNI 0000 0001 2159 6024, GRID grid.250514.7, , Pennington Biomedical Research Center, LSU System, ; 6400 Perkins Road, 70808 Baton Rouge, LA USA
                [2 ]ISNI 0000000106344187, GRID grid.265892.2, , University of Alabama, ; Birmingham, AL USA
                [3 ]ISNI 0000 0001 2287 2270, GRID grid.419884.8, , United States Military Academy, ; West Point, NY USA
                [4 ]ISNI 0000 0004 0447 7121, GRID grid.414935.e, , Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Sanford-Burnham Medical Research Institute, ; Orlando, FL USA
                Author information
                http://orcid.org/0000-0003-1127-9425
                Article
                2546
                10.1186/s13104-017-2546-4
                5485536
                28651559
                ad2bf9f8-7a38-473a-857f-aad01262bb5c
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 2 August 2016
                : 17 June 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000062, National Institute of Diabetes and Digestive and Kidney Diseases;
                Award ID: P30DK072476
                Award ID: p30dk040561
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100007917, Agricultural Research Service;
                Award ID: 2010-34323-21052
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/100000057, National Institute of General Medical Sciences;
                Award ID: U54 GM104940
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Medicine
                proof study,metabolic rate,food intake,energy expenditure,doubly-labeled water,energy balance
                Medicine
                proof study, metabolic rate, food intake, energy expenditure, doubly-labeled water, energy balance

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