Factors Influencing Energy Intake: A Study on Physical Activity and Digestive Hormones, Lecture notes of Physiology

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Regula'on  of  Human  Energy   Intake   Emily  Dhurandhar,  PhD   1/31/14  Energe'cs  Course   Outline   I.  Evidence  that  energy  intake  is  regulated   II.  Factors  that  influence  energy  intake   I.  Physiological   II.  Environmental   III.  Food         Biometric  Regula'on   •  Is  there  an  upper  limit  to  energy  intake?     – Tour  de  France  Cyclists  expend  approximately   7,000  kcal/day  and  maintain  energy  balance.   – Metabolic  Scope  for  ac've  wild  animals  ranges   from  1.3  to  7.0  (Hammond  &  Diamond,  Nature   1997).   •  Metabolic  Scope  =  SusMR/RMR   •  Tour  de  France  Athletes=  3.5-­‐5.5  (Westerterp  et  al  J.   Appl.  Physiol.  61,  2162–2167)   Does  Energy  Intake  Reflect  Energy  Output?   In  adult  rats,  increasing  energy  expenditure  increases  food   intake  to  maintain  body  weight  to  a  point.     Mayer  et  al.  1954,  The  American  journal  of  physiology  (0002-­‐9513),  177  (3),  p.  544.   Does  Energy  Intake  Reflect  Energy  Output?   Response  to  day-­‐to-­‐day  varia'ons  in  expenditure     Edholhm  et  al.  Bri'sh  Journal  of  Nutri'on.  1955.  9(3):286-­‐300.     Turner et al. (2010). Nonprescribed physical activity energy expenditure is maintained with structured exercise and implicates a compensatory increase in energy intake. Am J Clin Nutr 92: 1009-1016. Compensating during exercise regimen by increased EI, not decreased EE Control Exercise Intervention Prescribed EE Figure 1. Physical activity energy expenditure (PAEE) throughout the study, no exercise group vs. prescribed exercise •  Sample: 54 middle-aged men with sedentary lifestyles (BMI: 28±3) •  Methods: Used synchronized accelerometry and heart rate to observe prescribed and non- prescribed PAEE during an 18-week exercise intervention, plus 2 week “detraining period” •  Results: No significant decrease in non-prescribed PAEE to compensate for prescribed PAEE •  Conclusion: Losing less weight than predicted by PAEE likely a result of increased energy intake (both groups were allowed to eat ad libidum) PAEE differences between control and exercise groups, across time points Westerterp.  Nutri'on  Reviews.  2010.  68(3):148-­‐154.     “In  conclusion,  an  exercise-­‐induced  increase  in  energy  expenditure   induces  increased  energy  intake,  thus  compensa'ng  for  the   addi'onal  requirement,  especially  at  higher  exercise  loads.”     Does  Energy  Intake  Reflect  Energy  Output?   Response  to  exercise     •  Why  do  exercise  studies  not  result  in  more   weight  loss?  (Thomas  et  al.  Obes  Rev.  2012   Oct;13(10):835-­‐47.)   – Decrease  in  RMR,  decrease  in  non-­‐exercise  energy   expenditure,  increase  in  lean  mass,  and  increase   in  energy  intake  may  all  be  responsible   –  Individuals  training  for  a  marathon  increase   energy  intake  (Westerterp  et  al.  Br  J  Nutr.  1992   Jul;68(1):21-­‐30.)     Does  Energy  Intake  Reflect  Energy  Output?   Response  to  exercise     Evidence  for  Recovery  from  Errors  in  Energy  Balance  System   Recovery  aher  underfeeding   The  Biosphere  2  experiment  (Weyer  et  al.  Am  J  Clin  Nutr  October  2000  vol.  72   no.  4  946-­‐953)   The  Biosphere  2  experiment  (Weyer  et  al.  Am  J  Clin  Nutr  October  2000  vol.  72   no.  4  946-­‐953)   Evidence  for  Recovery  from  Errors  in  Energy  Balance  System   Recovery  aher  underfeeding   •  There  is  a  lower  limit  to  energy  intake.   •  Theory  and  animal  evidence  supports  an   upper  limit  to  energy  intake.   •  Energy  intake  is  adjusted  to  output,  but  there   is  a  'me  lag  in  response  and  output  dose  may   majer.   •  Correc'on  for  perturba'ons  in  energy  balance   by  long-­‐term  successive  compensa'ons  does   occur.   Is  Energy  Intake  Regulated?   Summary   •  One  of  the  first  theories  to  explain  long-­‐term   regula'on  of  food  intake   •  Proposed  by  Jean-­‐Mayer,  1955   •  Proposes  that  energy  intake  is  regulated  over   the  long-­‐term  by  body  fat  stores   Factors  that  influence  energy  intake:  Physiological   Liposta'c  Theory   •  The  brain  integrates  many  signals  to  regulate   feeding  behavior  (reviewed  in  Morton  et  al.  Nature  443,  289-­‐295  (21   September  2006)   – Adiposity  signals   – Food  reward   – Signals  from  the  G.I.  Tract     Factors  that  influence  energy  intake:  Physiological   Central  Control  of  Food  Intake   Factors  that  influence  energy  intake:  Physiological   Central  Control  of  Food  Intake   Woods.  AJP.  2004.  Vol.  286  no.  G7-­‐G13.   Factors  that  influence  energy  intake:  Physiological   Central  Control  of  Food  Intake   Nega've  feedback  from  adipose  'ssue     Schwartz  et  al.  Nature  404,  661-­‐671(6  April  2000)     “Sa'ety  center”  “Hunger  center”   Food  Reward   Percep'on  of  pleasure  associated  with  consump'on  of  a  palatable  food  involves  neuronal   ac'va'on  in  the  NAc  and  striatum,  which  through  ac'va'on  of  opiate  pep'de  receptors   disinhibits  the  lateral  hypothalamic  area  and  thereby  s'mulates  feeding.   Factors  that  influence  energy  intake:  Physiological   Central  Control  of  Food  Intake   Schwartz  et  al.  Nature  404,  661-­‐671(6  April  2000)     Without  feedback  signals  from  the  G.I.  tract   (sham  feeding),  meals  are  considerably  larger.   Factors  that  influence  energy  intake:  Physiological   The  Role  of  Diges'on  and  Gastrointes'nal  Factors  in  Controlling   Meal  Intake   Davis  et  al.  1990.  Am  J  Physiol  259(6  Pt  2):  R1228-­‐1235.     •  Cholecystokinin  (CCK)   – Secreted  from  the  duodenum  in  response  to   nutrients   –  Intravenous  administra'on  reduces  meal  size   – CCK  receptors  on  vagal  nerve  send  signal  to  NTS  in   hindbrain     Factors  that  influence  energy  intake:  Physiological   The  Role  of  Diges'on  and  Gastrointes'nal  Factors  in  Controlling   Meal  Intake   •  If  CCK  reduces  meal  size,  can  it  change  overall  energy  intake  and  body   weight?  (West  et  al.  Am  J  Physiol  246(5  Pt  2):  R776-­‐787.)   Factors  that  influence  energy  intake:  Physiological   The  Role  of  Diges'on  and  Gastrointes'nal  Factors  in  Controlling   Meal  Intake   -­‐        Ini'a'on  of  meal  intake,  mo'va'on  to  con'nue  ea'ng   -­‐  Sensory  specific  sa'ety   Factors  that  influence  energy  intake:  Physiological   The  importance  of  oral,  olfactory  and  visual  cues         Rolls  et  al.  Eur  J  Neurosci,  1  (1989),  pp.  53–60.   •  Flavor-­‐nutrient  sa'ety  learning  (Booth  et  al.  1993.  53(1):  51–57)     Factors  that  influence  energy  intake:  Physiological   The  importance  of  taste,  smell  and  sight       Trained  with     orange   Trained  with    grape   Day  1   25%  CHO   both   grape  and   orange     Day  2   10%  CHO  (1/2    grape,   1/2  orange)  OR  45%   CHO  (1/2    grape,  1/2   orange)     Day  3   10%  CHO  (1/2    grape, 1/2  orange)  OR  45%   CHO  (1/2    grape,  1/2   orange)     Day  4   25%  CHO   both   grape  and   orange   Intake   reflects   chow   intake   Intake  reflects   chow  intake   Intake  of  10%   increases,  Intake  of   45%  increases     Intake   reflects   chow   intake   Intake  reflects   chow  intake   Intake  of  10%   increases,  Intake  of   45%  increases   If  trained  with  10%   CHO  increased   intake  of  orange   flavor,  If  trained   with  45%   decreased  intake  of   orange   If  trained  with  10%   CHO  increased  intake   of  grape  flavor,  If   trained  with  45%   decreased  intake  of   grape   Factors  that  influence  energy  intake:  Physiological   The  importance  of  taste,  smell  and  sight      Flavor-­‐nutrient  sa'ety  learning:  flavor  is  crucial       Flavors  of  LED  and  HED  different   No  flavor  to  HED  or  LED   Open  bars  before  training,  filled  bars  aher  training   Yeomens  et  al.  2009.  Appe'te  52(2):  469-­‐478.     0 50 100 150 200 250 300 Hi-Cal Lo-Cal Snack (kcal) 0 200 400 600 800 1000 1200 1400 Other food T1 Total T1 Hi-Cal Lo-Cal 0 200 400 600 800 1000 1200 1400 Other Food T2 Total T2 Hi-Cal Lo-Cal Factors  that  influence  energy  intake:  Physiological   The  importance  of  taste,  smell  and  sight       Day  1   ANer  4  days  of  consumpPon   Implica'ons  of  learned  flavor-­‐nutrient  sa'a'on  for  low  calorie  foods   Factors  that  influence  energy  intake:  Environmental   Por'on  Sizes   Rolls  et  al.  2002  AJCN.  vol.  76  no.  6:1207-­‐1213.   Open  circles  =  serving  dish  with  plate,   closed  circles  =  plate  only   A  30%  (161  kcal)  increase  in  intake  occurred  between  the  largest  and   smallest  por'on.   •  Plate,  bowl,  or  glass  size:   – Serves  as  an  anchor  for  judging  por'on  size   – Smaller  plate  sizes  mean  less  food  is  taken  and   consumed  without  the  percep'on  of  less   (Wansink  et  al.  J  Exp  Psychol  Appl.  2013  Dec; 19(4):320-­‐32)   – Height  of  fill  of  a  glass  is  reference-­‐  tall,  thin  glass   with  the  same  amount  of  liquid  as  a  short,  stout   glass  will  be  perceived  to  contain  more  liquid   (Wansink.  Annu.  Rev.  Nutr.  2004.  24:455–79)   Factors  that  influence  energy  intake:  Environmental   Visual  Cues  &  Es'ma'on  of  Por'on  Sizes   Factors  that  influence  energy  intake:  Environmental   Visual  Cues  &  Es'ma'on  of  Por'on  Sizes   Wansink  et  al.  2012.  Obesity   Research  Volume  13,  Issue  1,  pages   93-­‐100.   “Bojomless”   bowls  increase   soup  intake,  but   not  perceived   soup  intake.   •  Consistent  exposure  to  variety  increases   energy  intake  and  weight  gain  in  rats     •  Effect  wears  off  for  a  single  set  of  food   op'ons;  new  varie'es  must  be  introduced  to   produce  consistent  increases  in  EI   •  (Le  Magnen  J.  Hunger.  Cambridge  (UK):   Cambridge  Univ.  Press;  1985.)       Factors  that  influence  energy  intake:  Environmental   Variety  and  choice  structure   •  In-­‐shell  pistachios  reduce  consump'on  by  86   kcal  (41%)  compared  to  shelled  nuts  during  an   ad  libitum  snack.  (Honselman  CS.  Appe'te.   2011  Oct;57(2):414-­‐7.)   Factors  that  influence  energy  intake:  Environmental   Effort   Preordering   Avoiding  environmental  cues  that  s'mulate   intake  may  reduce  “unhealthy”  choices     Factors  that  influence  energy  intake:  Environmental     From: Preordering School Lunch Encourages Better Food Choices by Children! JAMA Pediatr. 2013;167(7):673-674. doi:10.1001/jamapediatrics.2013.82" Factors  that  influence  energy  intake:  Food   Energy  Density   There  is  an  interac'on  between  por'on  size  and  energy  density.   (Kral  et  al.  Am  J  Clin  Nutr  2004;79:962–8.)       •  Animals  do  reasonably  well  at  self-­‐selec'on  of   a  “balanced  diet”     •  Macronutrient  self-­‐selec'on  is  rela'vely   consistent  within  species,  and  highly   consistent  day-­‐to-­‐day  for  a  given  animal     Factors  that  influence  energy  intake:  Food   Macronutrients   (Ritcher  et  al.  Amer.  J.  Physiol.,  1938,  122,  734-­‐744.)   •  “High  fat”  (low  carb,  similar  protein)  diets  increase  energy  intake   Factors  that  influence  energy  intake:  Food   Macronutrients   Lissner  et  al.  Am  J  Clin  Nutr  46(6):  886-­‐892.   (Poppij  et  al.  Physiol  Behav  64(3):  279-­‐285.)   Factors  that  influence  energy  intake:  Food   Macronutrients   *   Factors  that  influence  energy  intake:  Food   Macronutrients   Ad  libitum  high  protein  diets  reduce  calorie  intake  and  the  effect  is   persistent  for  90  days.   Weigle  et  al,  AJCN.  2005;82:41-­‐48.     Factors  that  influence  energy  intake:  Food   Macronutrients   High  levels  of  protein   suppress  food  intake,   but  lower  levels  may  not   increase  it.  (Martens  et   al.  Am  J  Clin  Nutr  97(1):   86-­‐93.)   •  Meta-­‐analysis  of  RCTs  that  added  nutri'vely  sweetened   beverages  to  diet  suggest  they  may  lead  to  some  weight  gain   (Majes  et  al.  2011  Obes  Rev.  2011  May;12(5):346-­‐65)   Factors  that  influence  energy  intake:  Food   Food  Form:  Liquid  vs.  Solid   •  We  can  make  conclusions  about  diets  of  a   par=cular  macronutrient  composi=on:   – Diets  with  high  levels  of  protein  tend  to  suppress   energy  intake   – Diets  high  in  fat/energy  density  tend  to  increase   energy  intake   •  High  calorie  liquid  added  to  the  diet  may  not  be   well  compensated  for,  increase  energy  intake,   and  lead  to  a  small  amount  of  weight  gain   Factors  that  influence  energy  intake:  Food   Summary   Conclusions     •  What  is  something  new  that  you  learned   today?     •  What  overarching  conclusions  &  principles  did   you  draw  from  this  lecture?