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Role of Energy Excretion in Human Body Weight Regulation.
Lund, J, Gerhart-Hines, Z, Clemmensen, C
Trends in endocrinology and metabolism: TEM. 2020;(10):705-708
Abstract
Food intake and energy expenditure are the typical determinants of body weight. Yet, recent observations underscore that a third and often-neglected factor, fecal energy loss, can influence energy balance. Here, we explore how macronutrient excretion modulates human energy homeostasis and highlight its potential impact on the propensity to gain weight.
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A word of caution against excessive protein intake.
Mittendorfer, B, Klein, S, Fontana, L
Nature reviews. Endocrinology. 2020;(1):59-66
Abstract
Dietary protein is crucial for human health because it provides essential amino acids for protein synthesis. In addition, dietary protein is more satiating than carbohydrate and fat. Accordingly, many people consider the protein content when purchasing food and beverages and report 'trying to eat more protein'. The global market for protein ingredients is projected to reach approximately US$90 billion by 2021, largely driven by the growing demand for protein-fortified food products. This Perspective serves as a caution against the trend of protein-enriched diets and provides an evidence-based counterpoint that underscores the potential adverse public health consequences of high protein intake.
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Assessment of energy expenditure: are calories measured differently for different diets?
Sanchez-Delgado, G, Ravussin, E
Current opinion in clinical nutrition and metabolic care. 2020;(5):312-318
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Abstract
PURPOSE OF REVIEW The prevalence and burden of obesity has reached alarming levels. The assessment of human energy expenditure enables the identification of obesity-prone and obesity-resistant individuals and helps to explain the short and long-term success of weight loss treatments. In this review, we describe the state-of-the-art methods used in the assessment of human energy expenditure and the impact of dietary intake on the interpretation of the data. RECENT FINDINGS The reference techniques to assess energy expenditure in humans have not significantly changed during the last century. Today, indirect calorimetry, either using a metabolic chamber or a metabolic cart, is the favored method to assess human energy expenditure and is the only method enabling the assessment of macronutrient oxidation. The doubly labeled water method however provides accurate assessment of human energy expenditure under free living conditions. SUMMARY Although energy expenditure and macronutrient oxidation can be assessed by simple calculations from oxygen consumption and carbon dioxide production, these calculations can provide erroneous results or require corrections and/or more complex interpretation when several biochemical pathways are simultaneously engaged. Such physiological mechanisms are often elicited by dietary interventions including, among other, gluconeogenesis, lipogenesis, ketogenesis, alcohol oxidation and under or overfeeding.
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[The controversial effects of low-calorie sweeteners].
Pepin, A, Imbeault, P
Medecine sciences : M/S. 2020;(5):472-478
Abstract
Substantial reviews of the most recent evidence report a strong relationship between the consumption of sugar-sweetened beverages and adverse health effects, such as the prevalence of obesity and metabolic diseases. Various public policies were recently undertaken by many countries in the hope of reducing sugar-sweetened beverage consumption amongst their population. This has led the food industries to promote low-calorie sweeteners (sugar substitutes) as a healthy alternative that would limit caloric intake without compromising the sweet taste of food and beverages. However, is the use of low-calorie sweeteners as a means of limiting or reducing energy intake without consequences for our health? This review aims to discuss the effects of low-calorie sweeteners consumption on health and to elucidate whether their use should be recommended by health professionals to their patients as part of weight management.
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Effects of Time-Restricted Feeding during Ramadan on Dietary Intake, Body Composition and Metabolic Outcomes.
Osman, F, Haldar, S, Henry, CJ
Nutrients. 2020;(8)
Abstract
Ramadan fasting is a form of time-restricted feeding which combines a fast and feast period daily for a duration of one month every year. During Ramadan, Muslims abstain from food and drink consumption from dawn till sunset and this change in the meal schedule and frequency results in significant changes to the composition of the diet, such as energy and nutrient intake. These changes in dietary habits and their corresponding effects on cardiometabolic disease risk are compiled in this review. Ramadan fasting shows limited benefits to body composition via reductions in body mass in both healthy and obese individuals, although the results are often found to be transient and heterogeneous. There is, however, a more consistent improvement in blood lipid profile during Ramadan fasting, which often lasts beyond the Ramadan period. The results for glucose homeostasis, on the contrary, are more conflicting and inconclusive. The heterogeneity in the findings from the various studies can be generally attributed to cultural variations in dietary habits, differences in the duration of fasting due to seasonal/climatic differences at various geographical locations, age, gender and socioeconomic status, as well as other health and lifestyle factors of the various study populations.
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A practical guide for the use of very low calorie diets in adults with chronic kidney disease.
Lambert, K, Bahceci, S, Lucan, B, Ryan, M
Nephrology (Carlton, Vic.). 2020;(4):281-289
Abstract
Obesity is increasingly common in individuals with chronic kidney disease (CKD). Being overweight or obese is associated with both the development and progression of kidney disease. Lifestyle interventions such as the use of very low-calorie diets (VLCD) are being used increasingly for patients with CKD despite warnings from manufacturers that they should be avoided or used with caution. Whilst these diets are effective and can induce rapid weight loss and suppress appetite, their use in patients with chronic and end stage kidney disease is more complex than in the general population. VLCD use in adults with kidney disease requires a more nuanced approach to prescription and closer monitoring for unintended side effects. This review describes the indications and clinical management of patients with CKD undertaking a very low-calorie diet and provides practical guidance regarding how to manage a VLCD, particularly for the latter stages of CKD.
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Eating during the Hemodialysis Session: A Practice Improving Nutritional Status or a Risk Factor for Intradialytic Hypotension and Reduced Dialysis Adequacy?
Fotiadou, E, Georgianos, PI, Chourdakis, M, Zebekakis, PE, Liakopoulos, V
Nutrients. 2020;(6)
Abstract
Historically, eating during the hemodialysis treatment has been associated with increased risk for adverse intradialytic symptoms and events, risks that have resulted in the implementation of restrictive in-center nutrition policies. Recent studies, however, have recorded a shift in clinical practice with a higher proportion of physicians following the view that administration of intradialytic meals and supplements represents a simple and effective approach to enhance caloric intake and improve nutritional status among patients on hemodialysis. This shift towards less restrictive in-center nutrition practices is mainly supported by evidence from observational studies associating intradialytic nutritional supplementation with improvements in protein-energy wasting, inflammatory state, and health-related quality of life. In sharp contrast, earlier and recent interventional studies have documented that feeding during the hemodialysis treatment provokes a rapid postprandial decline in blood pressure and raises the incidence of symptomatic intradialytic hypotension. Furthermore, other studies have shown that postprandial redistribution in intravascular volume and enhanced blood supply to the gastrointestinal circulation may interfere with the adequacy of the delivered hemodialysis. Those who defend the position that intradialytic nutritional support is beneficial do not dispute the physiology of postprandial hemodynamic response, but they argue against its clinical significance. In this article, we provide an overview of studies that explored the effect of eating during the hemodialysis treatment on intradialytic hemodynamic stability and adequacy of the delivered hemodialysis. We reason that these risks have important clinical implications that are not counteracted by anticipated benefits of this strategy on caloric intake and nutritional status.
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How Important Is Eating Rate in the Physiological Response to Food Intake, Control of Body Weight, and Glycemia?
Argyrakopoulou, G, Simati, S, Dimitriadis, G, Kokkinos, A
Nutrients. 2020;(6)
Abstract
The link between eating rate and energy intake has long been a matter of extensive research. A better understanding of the effect of food intake speed on body weight and glycemia in the long term could serve as a means to prevent weight gain and/or dysglycemia. Whether a fast eating rate plays an important role in increased energy intake and body weight depends on various factors related to the studied food such as texture, viscosity and taste, but seems to be also influenced by the habitual characteristics of the studied subjects as well. Hunger and satiety quantified via test meals in acute experiments with subsequent energy intake measurements and their association with anorexigenic and orexigenic regulating peptides provide further insight to the complicated pathogenesis of obesity. The present review examines data from the abundant literature on the subject of eating rate, and highlights the main findings in people with normal weight, obesity, and type 2 diabetes, with the aim of clarifying the association between rate of food intake and hunger, satiety, glycemia, and energy intake in the short and long term.
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Nutrient Timing: A Garage Door of Opportunity?
Arent, SM, Cintineo, HP, McFadden, BA, Chandler, AJ, Arent, MA
Nutrients. 2020;(7)
Abstract
Nutrient timing involves manipulation of nutrient consumption at specific times in and around exercise bouts in an effort to improve performance, recovery, and adaptation. Its historical perspective centered on ingestion during exercise and grew to include pre- and post-training periods. As research continued, translational focus remained primarily on the impact and outcomes related to nutrient consumption during one specific time period to the exclusion of all others. Additionally, there seemed to be increasing emphasis on outcomes related to hypertrophy and strength at the expense of other potentially more impactful performance measures. As consumption of nutrients does not occur at only one time point in the day, the effect and impact of energy and macronutrient availability becomes an important consideration in determining timing of additional nutrients in and around training and competition. This further complicates the confining of the definition of "nutrient timing" to one very specific moment in time at the exclusion of all other time points. As such, this review suggests a new perspective built on evidence of the interconnectedness of nutrient impact and provides a pragmatic approach to help frame nutrient timing more inclusively. Using this approach, it is argued that the concept of nutrient timing is constrained by reliance on interpretation of an "anabolic window" and may be better viewed as a "garage door of opportunity" to positively impact performance, recovery, and athlete availability.
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Cannabis effects on lipoproteins.
Lazarte, J, Hegele, RA
Current opinion in lipidology. 2019;(2):140-146
Abstract
PURPOSE OF REVIEW The endocannabinoid system affects several physiological functions. A family of endocannabinoid receptors is susceptible to cannabis constituents. Cannabis is widely used in our society and following its recent legalization in Canada, we focus on how exposure to cannabis and pharmacologic cannabinoid receptor type 1 (CB1) inhibition affect lipoprotein levels. RECENT FINDINGS Several groups have reported that exposure to cannabis does not increase weight despite the marked increase in caloric intake. In observational studies, the effect of smoked cannabis exposure on plasma lipids is variable. Some studies in specific patient populations with longer exposure to cannabis seemed to identify slightly more favorable lipoprotein profiles in the exposed group. Several larger controlled clinical trials using orally administered rimonabant, a CB1 receptor antagonist, have consistently shown relative improvements in weight and plasma levels of triglyceride and high-density lipoprotein cholesterol among patients receiving the treatment. SUMMARY The widely variable findings on the relationship of cannabis in various forms with plasma lipids preclude any definitive conclusions. Cannabis has complex effects on the cardiovascular system and its effects on lipid profile must be considered in this overall context. Further properly controlled research is required to better understand this topic.