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Energy Expenditure Roger D. Cone, Ph.D. MPB 333 I. Energy Expenditure in the Context of Energy Homeostasis II. Forms of Energy Expenditure A. Resting Metabolic Rate 1. Homeotherms and adaptive thermogenesis a. non-shivering thermogenesis b. shivering B. Voluntary and Involuntary Physical Activity 1. Exercise 2. NEAT C. Diet-Induced Thermogenesis III. Techniques for Measuring Energy Expenditure IV. Regulation of Energy Expenditure V. Pathophysiology A. Cachexia B. Fever/Hypothermia C. Anorexia – Running Anorexia Model D. Obesity Epidemic 1. Epidemiology 2. Therapeutic Approaches II. Forms of Energy Expenditure Basal Metabolism 60% Thermic Effect of Food 8-10% Physical Activity 30-32% RMR is primarily regulated by the thyroid axis and autonomic tone Leptin regulates the thyroid axis to maintain energy homeostasis Anatomy of the Thyroid Axis Leptin regulates the thyroid axis to maintain energy homeostasis Symptoms of Hyperthyroidism Weight Loss Tachycardia Sweating Hypertension Nervousness Regulation of Adaptive Thermogenesis UCP-1 generates heat in brown adipocytes by facilitating a proton leak Thyroid Hormone and Sympathetic Tone Regulate UCP-1 Activity Adaptive Thermogenesis – Acute Response to Cold Does Inherent Variability in NEAT Determine Obesity? Creating a NEAT Intensive Environment B. Voluntary and Involuntary Physical Activity 1. Exercise 2. NEAT Few people exercise regularly, NEAT varies by up to 2000kcal/day, therefore NEAT is very important! Percentage of All Trips Made From Home by Walking, 1977 - 1995 Percent 10 9 8 7 6 5 4 3 2 1 0 9.3% 8.5% 7.2% 5.5% 1977 1983 Source: National Personal Transportation Survey, 1995 1990 1995 Percentage of U.S. High School Students Who Attended Physical Education Classes Daily, 1991 - 1999 60 Percent 50 42% 40 34% 30 25% 27% 29% 1995 1997 1999 20 10 0 1991 1993 Source: CDC, National Youth Risk Behavior Survey School Health Policies and Programs Study 2000: Physical Education Requirements by Grade Percent of schools 60 51 51 51 52 50 50 40 40 32 26 30 20 25 13 10 10 6 5 0 K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Average Daily Time Children Spent Using Media, by Medium and Age, 1999 Medium Ages 2-18 Ages 2-7 Ages 8-18 Television 2:46 1:59 3:16 Videotapes 0:39 0:29 0:45 Video games 0:20 0:08 0:27 Computer 0:21 0:07 0:31 N = 3,155 children, ages 2-18 (nationally representative); margin of error = +3-5% Source: Kaiser Family Foundation. Kids and Media at the New Millenium, 1999 Televisions in the Home 1970 1999 % of children who live in homes with 3 or more TVs 6% 60% % of 6th graders with a TV in their bedroom 6% 77% Nearly a third (32%) of children live in homes with 4 or more TVs 53% of all children, ages 2-18, have a TV in their bedroom N = 3,155 children, ages 2-18 (nationally representative); margin of error = +3-5% Source: Kaiser Family Foundation. Kids and Media at the New Millenium, 1999 C. Diet-Induced Thermogenesis (DIT) or Thermic Effect of Food The energy expended as a function of differential food consumed, controlling for RMR and activity Probably composed of actual energy required for digestion plus a regulatory response to caloric intake Defective Diet-induced Thermogenesis in the MC4-R -/ ob/ob mice have significantly lower VO2 than wildtype and mc4r-/mice. male wt (n=17) and ob/ob (n=13) increase basal and total VO2 on high-fat diet. male mc4r-/- mice (n=18) do not show significant response to change in diet. MC4-R is Required for High Fat Diet Induced Upregulation of UCP-1 III. Techniques for Measuring Energy Expenditure 1. In indirect calorimetry, oxygen consumption and/or carbon dioxide production is measured and converted to energy expenditure using formulae 2. In direct calorimetry, the rate of heat loss from the subject to the calorimeter is measured. 3. A number of non-calorimetric techniques have been used to predict the energy expenditure by extrapolation from physiological measurements and observations. Comparing Energy Expenditure in Different Animals is Highly Problematic Comparing Metabolic Rates in Different Animals is Highly Problematic How to normalize? Weight is misleading because lean mass is more metabolically active than fat mass Estimates are based on: Weight 0.66 Weight 0.75 Determination of lean mass Best Method – relationship of EE to fat free mass within group, then comparison of groups IV. Regulation of Energy Expenditure Stability of Body Weight 400 350 300 250 200 150 100 50 0 0 1 2 3 4 5 Time (years) 6 7 8 Short and Long Term Weight Regulation Counter regulation Weight gain Usual weight Weight loss Counter regulation Energy Expenditure Response to Weight Gain and Loss Leibel RL, et al. N Engl J Med 1995;332:621-628 10% gain Mean (+/- SD) Observed minus Predicted Total Energy Expenditure (Kcal/day) 110 600 100 % of Initial Weight 90 400 10% loss 0 Initial Weight – 400 10% loss 80 200 – 200 Initial Weight 10% gain 70 Time Effect of Exercise on Body Weight in Overweight Men and Women Irwin, et al. Obes Res. 15(6):1496-1512, 2007. Target of ~ 60-minutes moderate-intensity, aerobic exercise 6-days a week x 1 yr. Verified by increased V02 max. Men, Ave 370 min / wk -3 kg FM +1.2 kg FFM Women, Ave 295 min / wk -1.9 kg FM +0.5 kg FFM NO difference in food intake between exercisers and controls after 12 months. V. Pathophysiology A. Cachexia B. Fever/Hypothermia C. Anorexia – Running Anorexia Model D. Obesity Epidemic 1. Epidemiology 2. Therapeutic Approaches Illness-Induced Cachexia Appetite Decreases (even in a starved state) Metabolic Rate Elevated Increased Wasting of Lean Body Tissues Diminished Protective Endocrine Response Cachexia in Disease Cancer Renal Failure - 26,000 deaths/yr, 87,534 new cases/yr, 245, 910 on dialysis, current cost of treatment: $16.74b (1998). HIV Infection Tuberculosis Cystic Fibrosis Failure to Thrive - 5% of peds. admissions Cong. Heart Failure COPD - 16% incidence 50% incidence Anorexia Nervosa -1% of young women Anorexia of Aging to 60% of hospitalized elderly 22% of 70yr olds, up MC4-R Signaling is Involved in Cachexigenic Signaling MC4-RKO Mice 1000 750 500 Saline LPS 250 0 MC4-RKO MC4 WT Examples of a experimental models of cachexia Marks et al., Endocrinology 144, 2003 D. Obesity Epidemic 1. Epidemiology 2. Therapeutic Approaches Is BMR Reduced in Obesity? After tens of thousands of measurements, it is a universal observation that BMR is raised not suppressed in obese people because of the fact that they have a greater lean body mass (LBM) than their lean counterparts Does Reduced BMR Cause Obesity? Do Differences in TEF Cause Obesity? Could we even measure them accurately enough? 20 year old male 170 lb. 50 year old male 200 lb. 1 lb. per year = 3500 kcal / 365 days…or… about 10 kcal / day = 2 lifesavers or 1 potato chip The Adipostat Does Not Seem to Respond to Slow Weight gain D. Obesity Epidemic 1. Epidemiology 2. Therapeutic Approaches b3 adrenergic agonists to activate fat Non-cardiac acting thyroid hormone analogues but……. Any compounds that increase energy expenditure may increase heart rate as the body requires additional oxygen