Dataset Information

Increased energy expenditure during posture maintenance and exercise in early Parkinson disease.

ABSTRACT:

Background

Evidence for the effects of Parkinson disease on energy expenditure is incomplete and contradictory. A number of studies showed increased resting energy expenditure among patients with Parkinson disease whereas others did not. It was hypothesized that energy expenditure increases during exercise, based on findings in patients with a variable regime of anti-parkinsonian therapies and at different stages of the disease. However, energy expenditure during posture maintenance has been neglected. To better understand these issues, we studied energy expenditure in a homogenous population of Parkinson patients in an early stage of the disease and different states of activity.

Methods

Oxygen consumption was assessed in a group of 10 males with early Parkinson disease without dopaminergic treatment and controls matched for age and body composition. Oxygen consumption was measured at rest, during trunk unsupported sitting, and during exercise at different intensities (unloaded and loaded cycling).

Results

Resting energy expenditure was similar between groups. Higher energy consumption was observed during maintenance of trunk posture at rest and during light intensity aerobic exercise (P < .05 for all conditions). The increment in energy expenditure associated with increased physical demand tended to be steeper in Parkinson disease.

Conclusion

Resting energy expenditure is normal in Parkinson disease. However, energy expenditure increases during physical activity and even during the maintenance of unsupported posture among patients with Parkinson disease.

SUBMITTER: Margaliot Kalifa T

PROVIDER: S-EPMC6266470 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Publications

Increased energy expenditure during posture maintenance and exercise in early Parkinson disease.

Margaliot Kalifa Tal T Ziv Nadav N Bergman Hagai H Nusair Samir S Arkadir David D

Health science reports 20170822 1

<h4>Background</h4>Evidence for the effects of Parkinson disease on energy expenditure is incomplete and contradictory. A number of studies showed increased resting energy expenditure among patients with Parkinson disease whereas others did not. It was hypothesized that energy expenditure increases during exercise, based on findings in patients with a variable regime of anti-parkinsonian therapies and at different stages of the disease. However, energy expenditure during posture maintenance has ...[more]

PMID: 30623033

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Project description:BackgroundDespite growing scientific interest in the benefits of breaking up sedentary time with intermittent standing or walking, few studies have investigated the energy cost of posture transitions. This study aimed to determine whether posture transitions are associated with increased energy expenditure in preschool children.MethodsForty children (mean age 5.3 ± 1.0y) completed a ~150-min room calorimeter protocol involving sedentary, light, and moderate- to vigorous-intensity activities. This study utilised data from ~65-min of the protocol, during which children were undertaking sedentary behaviours (TV viewing, drawing/colouring in, and playing with toys on the floor). Posture was coded as sit/lie, stand, walk, or other using direct observation; posture transitions were classified as sit/lie to stand/walk, sit/lie to other, stand/walk to other, or vice versa. Energy expenditure was calculated using the Weir equation and used to calculate individualised MET and activity energy expenditure (AEE) values. Spearman's rank correlations were used to compare the number of posture transitions, in the individual activities separately and combined, with corresponding MET and AEE values. Participants were divided into tertiles based on the number of posture transitions; MET and AEE values of children in the lowest and highest tertiles of posture transitions were compared using unpaired t-tests. Effect sizes (Cohen's d) were calculated.ResultsThere was a positive correlation between the total number of posture transitions and average METs (rs = 0.42, p = 0.02) and AEE (rs = 0.43, p = 0.02). MET differences between the lowest and highest tertiles of posture transitions resulted in a small effect size for playing with toys (d = 0.27), and moderate effect sizes for TV viewing, drawing and all three activities combined (d = 0.61, 0.50 and 0.64 respectively). Similar results were found for AEE.ConclusionsResults from this study showed that variation in posture transitions may be associated with variation in energy expenditure in preschool children. The findings suggest that the concept that variation in posture transitions may have meaningful biological or health effects in early childhood is worth investigating further.

Project description:ContextReduced energy expenditure following weight loss is thought to contribute to weight gain. However, the effect of dietary composition on energy expenditure during weight-loss maintenance has not been studied.ObjectiveTo examine the effects of 3 diets differing widely in macronutrient composition and glycemic load on energy expenditure following weight loss.Design, setting, and participantsA controlled 3-way crossover design involving 21 overweight and obese young adults conducted at Children's Hospital Boston and Brigham and Women's Hospital, Boston, Massachusetts, between June 16, 2006, and June 21, 2010, with recruitment by newspaper advertisements and postings.InterventionAfter achieving 10% to 15% weight loss while consuming a run-in diet, participants consumed an isocaloric low-fat diet (60% of energy from carbohydrate, 20% from fat, 20% from protein; high glycemic load), low-glycemic index diet (40% from carbohydrate, 40% from fat, and 20% from protein; moderate glycemic load), and very low-carbohydrate diet (10% from carbohydrate, 60% from fat, and 30% from protein; low glycemic load) in random order, each for 4 weeks.Main outcome measuresPrimary outcome was resting energy expenditure (REE), with secondary outcomes of total energy expenditure (TEE), hormone levels, and metabolic syndrome components.ResultsCompared with the pre-weight-loss baseline, the decrease in REE was greatest with the low-fat diet (mean [95% CI], -205 [-265 to -144] kcal/d), intermediate with the low-glycemic index diet (-166 [-227 to -106] kcal/d), and least with the very low-carbohydrate diet (-138 [-198 to -77] kcal/d; overall P = .03; P for trend by glycemic load = .009). The decrease in TEE showed a similar pattern (mean [95% CI], -423 [-606 to -239] kcal/d; -297 [-479 to -115] kcal/d; and -97 [-281 to 86] kcal/d, respectively; overall P = .003; P for trend by glycemic load < .001). Hormone levels and metabolic syndrome components also varied during weight maintenance by diet (leptin, P < .001; 24-hour urinary cortisol, P = .005; indexes of peripheral [P = .02] and hepatic [P = .03] insulin sensitivity; high-density lipoprotein [HDL] cholesterol, P < .001; non-HDL cholesterol, P < .001; triglycerides, P < .001; plasminogen activator inhibitor 1, P for trend = .04; and C-reactive protein, P for trend = .05), but no consistent favorable pattern emerged.ConclusionAmong overweight and obese young adults compared with pre-weight-loss energy expenditure, isocaloric feeding following 10% to 15% weight loss resulted in decreases in REE and TEE that were greatest with the low-fat diet, intermediate with the low-glycemic index diet, and least with the very low-carbohydrate diet.Trial registrationclinicaltrials.gov Identifier: NCT00315354.

Project description:ObjectiveThis study assessed longitudinal changes in body composition, fat distribution and energy balance in perimenopausal women. We hypothesized that total fat and abdominal body fat would increase at menopause due to decreased energy expenditure (EE) and declining estrogen, respectively.DesignObservational, longitudinal study with annual measurements for 4 years.SubjectsHealthy women (103 Caucasian; 53 African-American), initially premenopausal. During follow-up, lack of menstruation for 1 year and follicle-stimulating hormone >30 mIU ml(-1) defined a subject as postmenopausal.MeasurementsFat and lean mass (dual-energy X-ray absorptiometry), visceral (VAT) and subcutaneous abdominal fat (SAT) (computed tomography), dietary intake (4-day food record), serum sex hormones and physical activity (tri-axial accelerometry). Twenty-four hour EE was measured by whole-room calorimeter in a subset of 34 women at baseline and at year 4.ResultsBody fat and weight increased significantly over time only in those women who became postmenopausal by year 4 (n=51). All women gained SAT over time; however, only those who became postmenopausal had a significant increase in VAT. The postmenopausal group also exhibited a significant decrease in serum estradiol. Physical activity decreased significantly 2 years before menopause and remained low. Dietary energy, protein, carbohydrate and fiber intake were significantly higher 3-4 years before the onset of menopause compared with menopause onset. Twenty-four hour EE and sleeping EE decreased significantly with age; however, the decrease in sleeping EE was 1.5-fold greater in women who became postmenopausal compared with premenopausal controls (-7.9 vs -5.3%). Fat oxidation decreased by 32% in women who became postmenopausal (P<0.05), but did not change in those who remained premenopausal.ConclusionMiddle-aged women gained SAT with age, whereas menopause per se was associated with an increase in total body fat and VAT. Menopause onset is associated with decreased EE and fat oxidation that can predispose to obesity if lifestyle changes are not made.

Project description:ObjectiveTo determine the effects of diets varying in carbohydrate to fat ratio on total energy expenditure.DesignRandomized trial.SettingMulticenter collaboration at US two sites, August 2014 to May 2017.Participants164 adults aged 18-65 years with a body mass index of 25 or more.InterventionsAfter 12% (within 2%) weight loss on a run-in diet, participants were randomly assigned to one of three test diets according to carbohydrate content (high, 60%, n=54; moderate, 40%, n=53; or low, 20%, n=57) for 20 weeks. Test diets were controlled for protein and were energy adjusted to maintain weight loss within 2 kg. To test for effect modification predicted by the carbohydrate-insulin model, the sample was divided into thirds of pre-weight loss insulin secretion (insulin concentration 30 minutes after oral glucose).Main outcome measuresThe primary outcome was total energy expenditure, measured with doubly labeled water, by intention-to-treat analysis. Per protocol analysis included participants who maintained target weight loss, potentially providing a more precise effect estimate. Secondary outcomes were resting energy expenditure, measures of physical activity, and levels of the metabolic hormones leptin and ghrelin.ResultsTotal energy expenditure differed by diet in the intention-to-treat analysis (n=162, P=0.002), with a linear trend of 52 kcal/d (95% confidence interval 23 to 82) for every 10% decrease in the contribution of carbohydrate to total energy intake (1 kcal=4.18 kJ=0.00418 MJ). Change in total energy expenditure was 91 kcal/d (95% confidence interval -29 to 210) greater in participants assigned to the moderate carbohydrate diet and 209 kcal/d (91 to 326) greater in those assigned to the low carbohydrate diet compared with the high carbohydrate diet. In the per protocol analysis (n=120, P<0.001), the respective differences were 131 kcal/d (-6 to 267) and 278 kcal/d (144 to 411). Among participants in the highest third of pre-weight loss insulin secretion, the difference between the low and high carbohydrate diet was 308 kcal/d in the intention-to-treat analysis and 478 kcal/d in the per protocol analysis (P<0.004). Ghrelin was significantly lower in participants assigned to the low carbohydrate diet compared with those assigned to the high carbohydrate diet (both analyses). Leptin was also significantly lower in participants assigned to the low carbohydrate diet (per protocol).ConclusionsConsistent with the carbohydrate-insulin model, lowering dietary carbohydrate increased energy expenditure during weight loss maintenance. This metabolic effect may improve the success of obesity treatment, especially among those with high insulin secretion.Trial registrationClinicalTrials.gov NCT02068885.

Dataset Information

Increased energy expenditure during posture maintenance and exercise in early Parkinson disease.

Background

Methods

Results

Conclusion

Publications

Increased energy expenditure during posture maintenance and exercise in early Parkinson disease.

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