Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Institute of Systems Biology, Ottawa, Ontario, Canada; National Research Council of Canada, Digital Technologies Research Centre, Ottawa, Canada.
Department of Biochemistry, Microbiology and Immunology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
EBioMedicine. 2022 Sep;83:104192. doi: 10.1016/j.ebiom.2022.104192. Epub 2022 Aug 11.
Current paradigms for predicting weight loss in response to energy restriction have general validity but a subset of individuals fail to respond adequately despite documented diet adherence. Patients in the bottom 20% for rate of weight loss following a hypocaloric diet (diet-resistant) have been found to have less type I muscle fibres and lower skeletal muscle mitochondrial function, leading to the hypothesis that physical exercise may be an effective treatment when diet alone is inadequate. In this study, we aimed to assess the efficacy of exercise training on mitochondrial function in women with obesity with a documented history of minimal diet-induced weight loss.
From over 5000 patient records, 228 files were reviewed to identify baseline characteristics of weight loss response from women with obesity who were previously classified in the top or bottom 20% quintiles based on rate of weight loss in the first 6 weeks during which a 900 kcal/day meal replacement was consumed. A subset of 20 women with obesity were identified based on diet-resistance (n=10) and diet sensitivity (n=10) to undergo a 6-week supervised, progressive, combined aerobic and resistance exercise intervention.
Diet-sensitive women had lower baseline adiposity, higher fasting insulin and triglycerides, and a greater number of ATP-III criteria for metabolic syndrome. Conversely in diet-resistant women, the exercise intervention improved body composition, skeletal muscle mitochondrial content and metabolism, with minimal effects in diet-sensitive women. In-depth analyses of muscle metabolomes revealed distinct group- and intervention- differences, including lower serine-associated sphingolipid synthesis in diet-resistant women following exercise training.
Exercise preferentially enhances skeletal muscle metabolism and improves body composition in women with a history of minimal diet-induced weight loss. These clinical and metabolic mechanism insights move the field towards better personalised approaches for the treatment of distinct obesity phenotypes.
Canadian Institutes of Health Research (CIHR-INMD and FDN-143278; CAN-163902; CIHR PJT-148634).
目前预测能量限制下体重减轻的模式具有普遍的有效性，但有一部分个体尽管有明确的饮食依从性，却不能充分响应。在接受低热量饮食后体重下降率处于最低 20%的患者（饮食抵抗者）中，发现其 I 型肌纤维较少，骨骼肌线粒体功能较低，这导致了一个假设，即当单独饮食治疗不足时，体育锻炼可能是一种有效的治疗方法。在这项研究中，我们旨在评估运动训练对有减肥史的肥胖女性线粒体功能的疗效。
从超过 5000 份患者记录中，回顾了 228 份文件，以确定肥胖女性体重减轻反应的基线特征，这些女性先前根据前 6 周期间体重减轻率被分类为最高或最低 20%五分位数，在此期间，她们食用了每天 900 卡路里的代餐。根据饮食抵抗（n=10）和饮食敏感（n=10），确定了 20 名肥胖女性的子集，进行为期 6 周的监督、渐进、有氧和阻力运动联合干预。
饮食敏感的女性基线肥胖程度较低，空腹胰岛素和甘油三酯水平较高，且代谢综合征的 ATP-III 标准更多。相反，在饮食抵抗的女性中，运动干预改善了身体成分、骨骼肌线粒体含量和代谢，而在饮食敏感的女性中，效果很小。对肌肉代谢组学的深入分析显示出明显的组间和干预间差异，包括运动训练后饮食抵抗女性的丝氨酸相关鞘脂合成降低。
运动优先增强了有轻微饮食诱导减肥史的女性的骨骼肌代谢和身体成分。这些临床和代谢机制的见解使该领域朝着更好的个体化方法发展，以治疗不同的肥胖表型。
加拿大卫生研究院（CIHR-INMD 和 FDN-143278；CAN-163902；CIHR PJT-148634）。
