Clinical Science, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
Department of Radiology, Bioengineering, Physiology and Biophysics, University of Washington, Seattle, WA 98195, USA.
Am J Clin Nutr. 2019 Oct 1;110(4):805-813. doi: 10.1093/ajcn/nqz108.
A metabolic adaptation, defined as an increase in energy expenditure (EE) beyond what is expected with weight gain during overfeeding (OF), has been reported but also refuted. Much of the inconsistency stems from the difficulty in conducting large, well-controlled OF studies in humans.
The primary aim of this study was to determine whether a metabolic adaptation to OF exists and if so, attenuates weight gain.
Thirty-five young adults consumed 40% above their baseline energy requirements for 8 wk, and sleeping metabolic rate (SMR) and 24-h sedentary energy expenditure (24h-EE) were measured before and after OF. Subjects were asked to return for a 6-mo post-OF follow-up visit to measure body weight, body composition, and physical activity.
After adjusting for gains in fat-free mass and fat mass, SMR increased by 43 ± 123 kcal/d more than expected (P = 0.05) and 24h-EE by 23 ± 139 kcal/d (P = 0.34), indicating an overall lack of metabolic adaptation during OF despite a wide variability in the response. Among the 30 subjects who returned for the 6-mo follow-up visit, those who had a lower-than-predicted SMR (basal EE) retained more of the fat gained during OF. Likewise, subjects displaying a higher-than-predicted sedentary 24h-EE lost significantly more fat during the 6-mo follow-up.
Metabolic adaptation to OF was on average very small but variable between subjects, revealing "thrifty" or "spendthrift" metabolic phenotypes related to body weight loss 6 mo later. This trial was registered at clinicaltrials.gov as NCT01672632.
代谢适应是指在过量喂养(OF)期间体重增加所预期的能量消耗(EE)增加,虽然已经有报道,但也有反驳。造成这种不一致的主要原因是很难在人类中进行大型、对照良好的 OF 研究。
本研究的主要目的是确定 OF 是否存在代谢适应,如果存在,是否会减轻体重增加。
35 名年轻人在 8 周内摄入比基线能量需求高出 40%的热量,在 OF 前后测量静息代谢率(SMR)和 24 小时静息能量消耗(24h-EE)。要求受试者在 OF 后 6 个月进行随访,以测量体重、身体成分和身体活动。
在调整瘦体重和脂肪量增加后,SMR 比预期增加了 43±123kcal/d(P=0.05),24h-EE 增加了 23±139kcal/d(P=0.34),表明尽管反应存在很大差异,但在 OF 期间整体缺乏代谢适应。在 30 名返回进行 6 个月随访的受试者中,那些 SMR(基础 EE)低于预测值的人保留了更多在 OF 期间获得的脂肪。同样,显示出高于预测值的久坐 24h-EE 的受试者在 6 个月的随访期间显著减少了更多的脂肪。
OF 引起的代谢适应平均非常小,但个体之间存在差异,揭示了与 6 个月后体重减轻相关的“节俭”或“挥霍”代谢表型。本试验在 clinicaltrials.gov 上注册为 NCT01672632。