Energy expenditure, metabolic adaptation, physical activity and energy intake following weight loss: comparison between bariatric surgery and low-calorie diet.

IF 3.6 3区 医学 Q2 NUTRITION & DIETETICS European Journal of Clinical Nutrition Pub Date : 2024-10-30 DOI:10.1038/s41430-024-01523-8
Kaja Falkenhain, Corby K Martin, Eric Ravussin, Leanne M Redman
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Abstract

Objective: Bariatric surgery remains the most effective treatment to achieve substantial weight loss; however, total daily energy expenditure and physical activity changes in response to such interventions have been seldom explored.

Methods: In this prospective observational study, total daily energy expenditure (TDEE) using doubly labeled water and physical activity (SenseWear armband) was assessed in 17 females (mean ± SD: 48.6 ± 9.7 kg/m2, 43 ± 12 years) at baseline and 8 and 52 weeks following either bariatric surgery (BSG, N = 9) or a low-calorie diet (LCD, N = 8). Energy intake was assessed using the intake-balance method.

Results: After 8 weeks, weight loss was 16.0 ± 3.5 kg and TDEE decreased by 552 ± 319 kcal/d in BSG (P < 0.001) compared to 8.8 ± 3.4 kg and 256 ± 239 kcal/d in LCD (P < 0.05). After 52 weeks, weight loss was 44.3 ± 16.4 kg and TDEE decreased by 583 ± 418 kcal/d (P < 0.001), compared to 4.3 ± 6.7 kg and 84 ± 285 kcal/d in LCD (P > 0.05). TDEE was lower than predicted in BSG at 8 (P = 0.03) but not 52 weeks (P = 0.77). There was no evidence of metabolic adaptation in LCD. Average daily energy intake in BSG was 1403 ± 245 kcal/d compared to 2545 ± 398 kcal/d in LCD (P < 0.001). In BSG, step count and physical activity minutes were increased at 52 weeks compared to baseline (P = 0.03), whereas no significant changes were observed in LCD.

Conclusion: Bariatric surgery-induced weight loss decreased TDEE at 8 weeks and 1 year, resulting in metabolic adaptation after 8 weeks that was reversed at 1 year. These changes were accompanied by an increase in physical activity.

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减肥后的能量消耗、代谢适应、体力活动和能量摄入:减肥手术与低热量饮食的比较。
摘要减肥手术仍是实现大幅减重的最有效治疗方法;然而,很少有人探讨过此类干预措施所带来的每日总能量消耗和体力活动变化:在这项前瞻性观察研究中,对 17 名女性(平均±标清:48.6±9.7 kg/m2,43±12 岁)进行了基线以及减肥手术(BSG,9 人)或低热量饮食(LCD,8 人)后 8 周和 52 周的每日总能量消耗(TDEE)评估。能量摄入采用摄入平衡法进行评估:8 周后,BSG 的体重减轻了 16.0 ± 3.5 千克,TDEE 减少了 552 ± 319 千卡/天(P 0.05)。BSG 的 TDEE 在 8 周时低于预测值(P = 0.03),但在 52 周时不低于预测值(P = 0.77)。没有证据表明 LCD 有新陈代谢适应性。BSG患者的日平均能量摄入量为1403 ± 245千卡/天,而LCD患者为2545 ± 398千卡/天(P 结论:BSG患者的日平均能量摄入量低于LCD患者:减肥手术引起的体重减轻会在 8 周和 1 年后降低 TDEE,从而导致 8 周后的代谢适应,这种适应在 1 年后被逆转。这些变化伴随着体力活动的增加。
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来源期刊
CiteScore
10.60
自引率
2.10%
发文量
189
审稿时长
3-6 weeks
期刊介绍: The European Journal of Clinical Nutrition (EJCN) is an international, peer-reviewed journal covering all aspects of human and clinical nutrition. The journal welcomes original research, reviews, case reports and brief communications based on clinical, metabolic and epidemiological studies that describe methodologies, mechanisms, associations and benefits of nutritional interventions for clinical disease and health promotion. Topics of interest include but are not limited to: Nutrition and Health (including climate and ecological aspects) Metabolism & Metabolomics Genomics and personalized strategies in nutrition Nutrition during the early life cycle Health issues and nutrition in the elderly Phenotyping in clinical nutrition Nutrition in acute and chronic diseases The double burden of ''malnutrition'': Under-nutrition and Obesity Prevention of Non Communicable Diseases (NCD)
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