Obesity and Diabetes Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.
Department of Information Engineering, University of Pisa, Pisa, Italy.
Obesity (Silver Spring). 2022 Mar;30(3):639-644. doi: 10.1002/oby.23332. Epub 2022 Feb 15.
Weight change is a dynamic function of whole-body energy balance resulting from the interplay between energy intake and energy expenditure (EE). Recent reports have provided evidence for the existence of a causal effect of EE on energy intake, suggesting that increased EE may drive overeating, thereby promoting future weight gain. This study investigated the relationships between ad libitum energy intake and 24-hour EE (24-h EE) in sedentary conditions versus long-term, free-living weight change using a mediation analysis framework.
Native American individuals (n = 61, body fat by dual-energy x-ray absorptiometry: 39.7% [SD 9.5%]) were admitted to the clinical inpatient unit and had baseline measurements as follows: 1) 24-h EE accurately measured in a whole-room indirect calorimeter during energy balance and weight stability; and 2) ad libitum energy intake objectively assessed for 3 days using computerized vending machines. Free-living weight change was assessed after a median follow-up time of 1.7 years (interquartile range: 1.2-2.9).
The total effect of 24-h EE on weight change (-0.23 kg per 100-kcal/d difference in EE at baseline) could be partitioned into the following two independent and counterbalanced effects: higher EE protective against weight gain (-0.46 kg per 100-kcal/d difference in EE at baseline) and an orexigenic effect promoting overeating, thereby favoring weight gain (+0.23 kg per 100-kcal/d difference in EE at baseline).
The overall impact of EE on body weight regulation should be evaluated by also considering its collateral effect on energy intake. Any weight loss intervention aimed to induce energy deficits by increasing EE should take into account any potential orexigenic effects that promote compensatory overeating, thereby limiting the efficacy of these obesity therapies.
体重变化是全身能量平衡的动态功能，是由能量摄入和能量消耗（EE）的相互作用产生的。最近的报告提供了 EE 对能量摄入存在因果影响的证据，表明增加 EE 可能会导致暴饮暴食，从而促进未来体重增加。本研究采用中介分析框架，调查了久坐不动条件下和长期自由生活状态下的能量摄入与 24 小时 EE（24-h EE）之间的关系，以评估其与体重变化之间的关系。
美国原住民个体（n = 61，体脂用双能 X 射线吸收法测量：39.7%[SD 9.5%]）入住临床住院部，基线测量如下：1）在能量平衡和体重稳定期间，在整个房间间接测热仪中准确测量 24-h EE；2）使用计算机自动售货机客观评估 3 天的自由能量摄入。自由生活体重变化在中位数随访时间 1.7 年后（四分位距：1.2-2.9 年）进行评估。
24-h EE 对体重变化的总效应（基线时 EE 每增加 100 千卡/天，体重变化-0.23 公斤）可以分为以下两个独立且相互平衡的效应：更高的 EE 有助于预防体重增加（基线时 EE 每增加 100 千卡/天，体重增加-0.46 公斤）和食欲促进效应，从而有利于体重增加（基线时 EE 每增加 100 千卡/天，体重增加+0.23 公斤）。
评估 EE 对体重调节的整体影响时，还应考虑其对能量摄入的间接影响。任何旨在通过增加 EE 来诱导能量不足的减肥干预措施都应考虑到任何可能促进代偿性暴饮暴食的食欲促进作用，从而限制这些肥胖症治疗的效果。
