Section of Nutrition, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, United Kingdom.
Food Research Center, Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.
Am J Clin Nutr. 2023 Sep;118(3):591-604. doi: 10.1016/j.ajcnut.2023.07.002. Epub 2023 Aug 8.
The capacity of an individual to respond to changes in food intake so that postprandial metabolic perturbations are resolved, and metabolism returns to its pre-prandial state, is called phenotypic flexibility. This ability may be a more important indicator of current health status than metabolic markers in a fasting state.
In this parallel randomized controlled trial study, an energy-restricted healthy diet and 2 dietary challenges were used to assess the effect of weight loss on phenotypic flexibility.
Seventy-two volunteers with overweight and obesity underwent a 12-wk dietary intervention. The participants were randomized to a weight loss group (WLG) with 20% less energy intake or a weight-maintenance group (WMG). At weeks 1 and 12, participants were assessed for body composition by MRI. Concurrently, markers of metabolism and insulin sensitivity were obtained from the analysis of plasma metabolome during 2 different dietary challenges-an oral glucose tolerance test (OGTT) and a mixed-meal tolerance test.
Intended weight loss was achieved in the WLG (-5.6 kg, P < 0.0001) and induced a significant reduction in total and regional adipose tissue as well as ectopic fat in the liver. Amino acid-based markers of insulin action and resistance such as leucine and glutamate were reduced in the postprandial phase of the OGTT in the WLG by 11.5% and 28%, respectively, after body weight reduction. Weight loss correlated with the magnitude of changes in metabolic responses to dietary challenges. Large interindividual variation in metabolic responses to weight loss was observed.
Application of dietary challenges increased sensitivity to detect metabolic response to weight loss intervention. Large interindividual variation was observed across a wide range of measurements allowing the identification of distinct responses to the weight loss intervention and mechanistic insight into the metabolic response to weight loss.
个体对食物摄入变化做出反应的能力，以使餐后代谢紊乱得到解决，代谢恢复到餐前状态，被称为表型灵活性。这种能力可能比空腹状态下的代谢标志物更能反映当前的健康状况。
在这项平行随机对照试验研究中，采用能量限制的健康饮食和 2 种饮食挑战来评估减肥对表型灵活性的影响。
72 名超重和肥胖志愿者接受了 12 周的饮食干预。参与者被随机分为能量摄入减少 20%的减肥组（WLG）或体重维持组（WMG）。在第 1 周和第 12 周，通过 MRI 评估参与者的身体成分。同时，在 2 种不同的饮食挑战期间（口服葡萄糖耐量试验（OGTT）和混合餐耐量试验），从血浆代谢组分析中获得代谢和胰岛素敏感性的标志物。
WLG 达到了预期的减肥效果（-5.6kg，P<0.0001），并显著减少了全身和局部脂肪组织以及肝脏的异位脂肪。在体重减轻后，OGTT 餐后阶段，胰岛素作用和抵抗的氨基酸标志物，如亮氨酸和谷氨酸，分别降低了 11.5%和 28%。体重减轻与代谢对饮食挑战的反应变化幅度相关。观察到代谢对减肥干预的反应存在很大的个体间差异。
应用饮食挑战提高了检测对减肥干预代谢反应的敏感性。观察到广泛的测量范围内存在很大的个体间差异，这允许识别对减肥干预的不同反应，并深入了解减肥对代谢的反应机制。
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