Clermont Auvergne University, UPR 3533, Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions, CRNH Auvergne, Clermont-Ferrand, France.
Department of Medicine, University of Udine, Udine, Italy.
Int J Obes (Lond). 2022 Nov;46(11):2021-2028. doi: 10.1038/s41366-022-01218-9. Epub 2022 Aug 31.
BACKGROUND/OBJECTIVES: Body composition and protein-energy partitioning changes are important factors of body weight regulation, but have not been studied in the context of clinical obesity treatment setting. Thus, the aim of the present study was to investigate the pattern of body weight loss, body composition, and energy partitioning changes during a 9-month multidisciplinary weight loss program and 4-month follow up and to test the associations among these changes in adolescents with severe obesity.
SUBJECTS/METHODS: Twenty-five adolescents (14.1 ± 1.5 years old; 13 girls) with severe obesity joined a pediatric obesity center for a 9-month inpatient multidisciplinary weight loss program. All participants performed body composition assessment (i.e. fat mass-FM, and fat-free mass-FFM) and completed a 36-h session in indirect calorimetric chamber before the start (T0), at the end of the intervention (T1) and 4 months follow-up to the intervention (T2). The protein-energy partitioning (P ratio) was calculated as urinary nitrogen loss/total energy expenditure over 24 hours.
9-month individualized multidisciplinary weight loss program consisting of lifestyle education, psychological support, physical activity, and dietary intervention.
Initial P ratio was positively associated with changes in body weight from T0 to T1 (p = 0.038). The changes in FFM/FM were negatively associated with body weight changes in boys (p = 0.006) from T0 to T1 and in girls (p < 0.001) from T1 to T2. Urinary nitrogen excretion (p < 0.001) and total energy expenditure (p < 0.001) significantly decreased during the weight loss program while the P ratio did not significantly change.
The present results suggest that baseline and changes in energy partitioning may be associated with changes in body weight in adolescents with severe obesity. In addition, sexual dimorphism in these patterns of change suggest the need for specific dietary and physical activity strategies in boys and girls to optimize body weight loss and to prevent or slow weight regain.
背景/目的：身体成分和蛋白质-能量分配的变化是体重调节的重要因素，但在临床肥胖治疗环境中尚未进行研究。因此，本研究的目的是调查 9 个月多学科减肥计划期间和 4 个月随访期间青少年体重减轻、身体成分和能量分配变化的模式，并测试严重肥胖青少年中这些变化之间的相关性。
25 名患有严重肥胖症的青少年（14.1±1.5 岁；13 名女孩）参加了一家儿科肥胖症中心的 9 个月住院多学科减肥计划。所有参与者在开始前（T0）、干预结束时（T1）和干预结束后 4 个月（T2）进行了身体成分评估（即脂肪量-FM 和去脂体重-FFM），并完成了间接热量测定室的 36 小时疗程。蛋白质-能量分配（P 比）是通过 24 小时的尿氮损失/总能量消耗来计算的。
9 个月的个体化多学科减肥计划，包括生活方式教育、心理支持、体育活动和饮食干预。
初始 P 比与 T0 至 T1 期间体重变化呈正相关（p=0.038）。男孩 T0 至 T1 期间和女孩 T1 至 T2 期间，FFM/FM 的变化与体重变化呈负相关（p=0.006 和 p<0.001）。在减肥计划期间，尿氮排泄（p<0.001）和总能量消耗（p<0.001）显著下降，而 P 比没有显著变化。
本研究结果表明，基线和能量分配的变化可能与严重肥胖青少年的体重变化有关。此外，这些变化模式中的性别差异表明，需要针对男孩和女孩制定特定的饮食和体育活动策略，以优化体重减轻，并预防或减缓体重反弹。
