Open Access
Reproducibility of the energy metabolism response to an oral glucose tolerance test: influence of a postcalorimetric correction procedure
(Springer, 2022) Alcántara Alcántara, Juan Manuel; Sánchez Delgado, Guillermo; Jurado Fasoli, Lucas; Galgani, José E.; Labayen Goñi, Idoia; Ruiz, Jonatan R.; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Purpose Metabolic fexibility (MetF), which is a surrogate of metabolic health, can be assessed by the change in the respiratory exchange ratio (RER) in response to an oral glucose tolerance test (OGTT). We aimed to determine the day-to-day reproducibility of the energy expenditure (EE) and RER response to an OGTT, and whether a simulation-based postcalorimetric correction of metabolic cart readouts improves day-to-day reproducibility. Methods The EE was assessed (12 young adults, 6 women, 27±2 years old) using an Omnical metabolic cart (Maastricht Instruments, Maastricht, The Netherlands) after an overnight fast (12 h) and after a 75-g oral glucose dose on 2 separate days (48 h). On both days, we assessed EE in 7 periods (one 30-min baseline and six 15-min postprandial). The ICcE was performed immediately after each recording period, and capillary glucose concentration (using a digital glucometer) was determined. Results We observed a high day-to-day reproducibility for the assessed RER (coefcients of variation [CV]<4%) and EE (CVs<9%) in the 7 diferent periods. In contrast, the RER and EE areas under the curve showed a low day-to-day reproducibility (CV=22% and 56%, respectively). Contrary to our expectations, the postcalorimetric correction procedure did not infuence the day-to-day reproducibility of the energy metabolism response, possibly because the Omnical’s accuracy was~100%. Conclusion Our study demonstrates that the energy metabolism response to an OGTT is poorly reproducible (CVs>20%) even using a very accurate metabolic cart. Furthermore, the postcalorimetric correction procedure did not infuence the day-to-day reproducibility. Trial registration NCT04320433; March 25, 2020.
Open Access
Adults with metabolically healthy overweight or obesity present more brown adipose tissue and higher thermogenesis than their metabolically unhealthy counterparts
(Elsevier, 2024) Jurado Fasoli, Lucas; Sánchez Delgado, Guillermo; Alcántara Alcántara, Juan Manuel; Acosta, Francisco M.; Sánchez Sánchez, Rocío; Labayen Goñi, Idoia; Ortega, Francisco B.; Martínez Téllez, Borja; Ruiz, Jonatan R.; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Background: There is a subset of individuals with overweight/obesity characterized by a lower risk of cardiometabolic complications, the so-called metabolically healthy overweight/obesity (MHOO) phenotype. Despite the relatively higher levels of subcutaneous adipose tissue and lower visceral adipose tissue observed in individuals with MHOO than individuals with metabolically unhealthy overweight/obesity (MUOO), little is known about the differences in brown adipose tissue (BAT). Methods: This study included 53 young adults (28 women) with a body mass index (BMI) ¿25 kg/m2 which were classified as MHOO (n = 34) or MUOO (n = 19). BAT was assessed through a static 18F-FDG positron emission tomography/computed tomography scan after a 2-h personalized cooling protocol. Energy expenditure, skin temperature, and thermal perception were assessed during a standardized mixed meal test (3.5 h) and a 1-h personalized cold exposure. Body composition was assessed by dual-energy x-ray absorptiometry, energy intake was determined during an ad libitum meal test and dietary recalls, and physical activity levels were determined by a wrist-worn accelerometer. Findings: Participants with MHOO presented higher BAT volume (+124%, P = 0.008), SUVmean (+63%, P = 0.001), and SUVpeak (+133%, P = 0.003) than MUOO, despite having similar BAT mean radiodensity (P = 0.354). In addition, individuals with MHOO exhibited marginally higher meal-induced thermogenesis (P = 0.096) and cold-induced thermogenesis (+158%, P = 0.050). Moreover, MHOO participants showed higher supraclavicular skin temperature than MUOO during the first hour of the postprandial period and during the cold exposure, while no statistically significant differences were observed in other skin temperature parameters. We observed no statistically significant differences between MHOO and MUOO in thermal perception, body composition, outdoor ambient temperature exposure, resting metabolic rate, energy intake, or physical activity levels. Interpretation: Adults with MHOO present higher BAT volume and activity than MUOO. The higher meal- and cold-induced thermogenesis and cold-induced supraclavicular skin temperature are compatible with a higher BAT activity. Overall, these results suggest that BAT presence and activity might be linked to a healthier phenotype in young adults with overweight or obesity.
Open Access
Impact of methods for data selection on the day-to-day reproducibility of resting metabolic rate assessed with four different metabolic carts
(Elsevier, 2023) Alcántara Alcántara, Juan Manuel; Jurado Fasoli, Lucas; Dote-Montero, Manuel; Merchán Ramírez, Elisa; Amaro Gahete, Francisco J.; Labayen Goñi, Idoia; Ruiz, Jonatan R.; Sánchez Delgado, Guillermo; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Background and aims: Accomplishing a high day-to-day reproducibility is important to detect changes in resting metabolic rate (RMR) and respiratory exchange ratio (RER) that may be produced after an intervention or for monitoring patients’ metabolism over time. We aimed to analyze: (i) the influence of different methods for selecting indirect calorimetry data on RMR and RER assessments; and, (ii) whether these methods influence RMR and RER day-to-day reproducibility. Methods and results: Twenty-eight young adults accomplished 4 consecutive RMR assessments (30-min each), using the Q-NRG (Cosmed, Rome, Italy), the Vyntus CPX (Jaeger-CareFusion, Höchberg, Germany), the Omnical (Maastricht Instruments, Maastricht, The Netherlands), and the Ultima CardiO2 (Medgraphics Corporation, St. Paul, Minnesota, USA) carts, on 2 consecutive mornings. Three types of methods were used: (i) short (periods of 5 consecutive minutes; 6e10, 11e15, 16e20, 21e25, and 26e30 min) and long time intervals (TI) methods (6e25 and 6 e30 min); (ii) steady state (SSt methods); and, (iii) methods filtering the data by thresholding from the mean RMR (filtering methods). RMR and RER were similar when using different methods (except RMR for the Vyntus and RER for the Q-NRG). Conversely, using different methods impacted RMR (all P 0.037) and/or RER (P 0.009) day-to-day reproducibility in all carts. The 6e25 min and the 6e30 min long TI methods yielded more reproducible measurements for all metabolic carts. Conclusion: The 6e25 min and 6e30 min should be the preferred methods for selecting data, as they result in the highest day-to-day reproducibility of RMR and RER assessments.
Open Access
Deciphering the constrained total energy expenditure model in humans by associating accelerometer-measured physical activity from wrist and hip
(Nature Research, 2021) Fernández-Verdejo, Rodrigo; Alcántara Alcántara, Juan Manuel; Galgani, José E.; Acosta, Francisco M.; Migueles, Jairo H.; Amaro Gahete, Francisco J.; Labayen Goñi, Idoia; Ortega, Francisco B.; Ruiz, Jonatan R.; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Ciencias de la Salud
The constrained total energy expenditure (TEE) model posits that progressive increases in physical activity (PA) lead to increases in TEE; but after certain PA threshold, TEE plateaus. Then, a compensatory reduction in the expenditure of non-essential activities constrains the TEE. We hypothesized that high PA levels as locomotion associate with a compensatory attenuation in arm movements. We included 209 adults (64% females, mean [SD] age 32.1 [15.0] years) and 105 children (40% females, age 10.0 [1.1] years). Subjects wore, simultaneously, one accelerometer in the non-dominant wrist and another in the hip for ≥ 4 days. We analyzed the association between wrist-measured (arm movements plus locomotion) and hip-measured PA (locomotion). We also analyzed how the capacity to dissociate arm movements from locomotion influences total PA. In adults, the association between wrist-measured and hip-measured PA was better described by a quadratic than a linear model (Quadratic-R2 = 0.54 vs. Linear-R2 = 0.52; P = 0.003). Above the 80th percentile of hip-measured PA, wrist-measured PA plateaued. In children, there was no evidence that a quadratic model fitted the association between wrist-measured and hip-measured PA better than a linear model (R2 = 0.58 in both models, P = 0.25). In adults and children, those with the highest capacity to dissociate arm movements from locomotion—i.e. higher arm movements for a given locomotion—reached the highest total PA. We conclude that, in adults, elevated locomotion associates with a compensatory reduction in arm movements (probably non-essential fidgeting) that partially explains the constrained TEE model. Subjects with the lowest arm compensation reach the highest total PA.
Open Access
Energy expenditure and macronutrient oxidation in response to an individualized nonshivering cooling protocol
(Wiley, 2020) Sánchez Delgado, Guillermo; Alcántara Alcántara, Juan Manuel; Acosta, Francisco M.; Martínez Téllez, Borja; Amaro Gahete, Francisco J.; Merchán Ramírez, Elisa; Löf, Marie; Labayen Goñi, Idoia; Ravussin, Eric; Ruiz, Jonatan R.; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
Objective This study aimed to describe the energy expenditure (EE) and macronutrient oxidation response to an individualized nonshivering cold exposure in young healthy adults. Methods Two different groups of 44 (study 1: 22.1 [SD 2.1] years old, 25.6 [SD 5.2] kg/m(2), 34% men) and 13 young healthy adults (study 2: 25.6 [SD 3.0] years old, 23.6 [SD 2.4] kg/m(2), 54% men) participated in this study. Resting metabolic rate (RMR) and macronutrient oxidation rates were measured by indirect calorimetry under fasting conditions in a warm environment (for 30 minutes) and in mild cold conditions (for 65 minutes, with the individual wearing a water-perfused cooling vest set at an individualized temperature adjusted to the individual's shivering threshold). Results In study 1, EE increased in the initial stage of cold exposure and remained stable for the whole cold exposure (P < 0.001). Mean cold-induced thermogenesis (9.56 +/- 7.9 kcal/h) was 13.9% +/- 11.6% of the RMR (range: -14.8% to 39.9% of the RMR). Carbohydrate oxidation decreased during the first 30 minutes of the cold exposure and later recovered up to the baseline values (P < 0.01) in parallel to opposite changes in fat oxidation (P < 0.01). Results were replicated in study 2. Conclusions A 1-hour mild cold exposure individually adjusted to elicit maximum nonshivering thermogenesis induces a very modest increase in EE and a shift of macronutrient oxidation that may underlie a shift in thermogenic tissue activity.
Open Access
Energy expenditure differences across lying, sitting, and standing positions in young healthy adults
(PLoS, 2019) Amaro Gahete, Francisco J.; Sánchez Delgado, Guillermo; Alcántara Alcántara, Juan Manuel; Martínez Téllez, Borja; Acosta, Francisco M.; Merchán Ramírez, Elisa; Löf, Marie; Labayen Goñi, Idoia; Ruiz, Jonatan R.; Ciencias de la Salud; Osasun Zientziak
The time spent in sedentary behaviour represents an important public health burden. To reduce sedentary time in the general population, the simplest, most effective, and most accessible method is to decrease lying and sitting time. We aimed to compare differences on energy expenditure (EE) across lying, sitting, and standing positions; and to analyse the associations between the change on EE of changing from one position to another and anthropometric and body composition parameters in young healthy adults. A total of 55 (69% women) young healthy adults aged 21.7 ± 2.2 participated in the study. We measured EE by indirect calorimetry across lying, sitting, and standing positions following the standard procedures. The EE was significantly higher in standing than in both lying and sitting positions (mean difference: 0.121±0.292 and 0.125±0.241 kcal/min, respectively; all P<0.001), and no differences were observed between lying and sitting positions (P = 1.000). There was a negative association between the EE differences in sitting vs. standing position and lean body mass (P = 0.048), yet no associations between EE differences with the rest of the anthropometric and body composition parameters were observed in each position pair studied (all P>0.321). Our findings support the fact that increasing the time spent standing could be a simple strategy to slightly increase EE. Therefore, our results have important clinical implications including a better monitoring, characterizing, and promoting countermeasures to sedentariness through low-level physical activities.
Open Access
Effects of exercise on bone marrow adipose tissue in children with overweight/obesity: role of liver fat
(Oxford University Press, 2024-08-07) Labayen Goñi, Idoia; Cadenas-Sánchez, Cristina; Idoate, Fernando; Gracia-Marco, Luis; Medrano Echeverría, María; Alfaro-Magallanes, Víctor Manuel; Alcántara Alcántara, Juan Manuel; Rodríguez Vigil, Beatriz; Osés Recalde, Maddi; Ortega, Francisco B.; Ruiz, Jonatan R.; Cabeza Laguna, Rafael; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Agronomía, Biotecnología y Alimentación; Agronomia, Bioteknologia eta Elikadura; Ciencias de la Salud; Osasun Zientziak; Institute of Smart Cities - ISC; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Gobierno de Navarra / Nafarroako Gobernua
Context: Exercise reduces adiposity, but its influence on bone marrow fat fraction (BMFF) is unknown; nor is it known whether a reduction in liver fat content mediates this reduction. Objectives: This work aimed to determine whether incorporating exercise into a lifestyle program reduces the lumbar spine (LS) BMFF and to investigate whether changes in liver fat mediate any such effect.Methods Ancillary analysis of a 2-arm, parallel, nonrandomized clinical trial was conducted at primary care centers in Vitoria-Gasteiz, Spain. A total of 116 children with overweight/obesity were assigned to a 22-week family-based lifestyle program (control group [n = 57]) or the same program plus an exercise intervention (exercise group [n = 59]). The compared interventions consisted of a family-based lifestyle program (two 90-minute sessions/month) and the same program plus supervised exercise (three 90-minute sessions/week). The primary outcome examined was the change in LS-BMFF between baseline and 22 weeks, as estimated by magnetic resonance imaging. The effect of changes in hepatic fat on LS-BMFF were also recorded.Results Mean weight loss difference between groups was 1.4 +/- 0.5 kg in favor of the exercise group. Only the children in the exercise group experienced a reduction in LS-BMFF (effect size [Cohen d] -0.42; CI, -0.86 to -0.01). Importantly, 40.9% of the reductions in LS-BMFF were mediated by changes in percentage hepatic fat (indirect effect: beta=-0.104; 95% CI, -0.213 to -0.019). The effect of changes in hepatic fat on LS-BMFF was independent of weight loss.Conclusion The addition of exercise to a family-based lifestyle program designed to reduce cardiometabolic risk improves bone health by reducing LS-BMFF in children with overweight or obesity. This beneficial effect on bone marrow appears to be mediated by reductions in liver fat.
Open Access
Reliability of resting metabolic rate measurements in young adults: impact of methods for data analysis
(Elsevier, 2018) Sánchez Delgado, Guillermo; Alcántara Alcántara, Juan Manuel; Ortiz Álvarez, Lourdes; Xu, Huiwen; Martínez Téllez, Borja; Labayen Goñi, Idoia; Ruiz, Jonatan R.; Ciencias de la Salud; Osasun Zientziak
Background and aims: a high inter-day reliability is a key factor to analyze the magnitude of change in resting metabolic rate (RMR) after an intervention, and the impact of using different methods for data analysis is not known. The aims of this study were: i) to analyze the impact of methods for data analysis on RMR and respiratory exchange ratio (RER) estimation; ii) to analyze the impact of methods for data analysis on inter-day RMR and RER reliability; iii) to compare inter-day RMR and RER reliability across methods for data analysis in participants who achieved steady state (SS) vs. participants who did not achieve SS. Methods: Seventeen young healthy adults completed two 30-min indirect calorimetry (IC) measures on two consecutive mornings, using two metabolic carts each day. Two methods for data analysis were used: i) Selection of a predefined time interval (TI) every 5 min (1-5 min, 6-10 min, 11-15 min, 16-20 min, 21-25 min, 26-30 min); and TI representing the whole measurement period (0-30 min, 5-30 min, 5-25 min); and ii) Methods based on the selection of the most stable period (SSt methods) (3 min SSt, 4 min SSt, 5 min SSt, 10 min SSt). Additionally, participants were classified as those achieving SS (CV < 10% for VO2, VCO2 and VE, and CV < 5% for RER) and those who did not. Results: RMR and RER measurements were lower when following SSt methods than when following TI methods (all P < 0.01). Although no significant differences were found between different lengths of SSt, 5 min SSt presented the lowest RMR. There were no differences on the inter-day reliability across methods for data analysis (TI and SSt) (all P > 0.2), and there was no systematic bias when comparing RMR and RER day 1 and day 2 measurements (all P > 0.1). Inter-day reliability was similar in individuals who achieved the SS and individuals who did not achieve it. The results were consistent independently of the metabolic cart used. Conclusions: The 5 min SSt approach should be the method of choice for analyzing IC measures with metabolic carts. However, achieving SS should not be an inclusion criterion in an IC study with young healthy adults.
Embargo
Impact of 24-week supervised concurrent exercise on S-Klotho and vitamin D levels: a randomized controlled trial
(Taylor & Francis, 2025-01-20) Amaro Gahete, Francisco J.; Espuch-Oliver, Andrea; Cano-Nieto, Amalia; Alcántara Alcántara, Juan Manuel; García-Lario, José Vicente; Haro Muñoz, Tomás de; Llamas Elvira, José M.; Muñoz Torres, Manuel; Castillo, Manuel J.; Labayen Goñi, Idoia; Ruiz, Jonatan R.; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD
This study aimed to investigate the effects 24 weeks of supervised exercise training at different intensities on S-Klotho and 25-hydroxyvitamin D plasma levels in young adults. This report was based on a secondary analysis from the ACTIBATE single-center unblinded randomized controlled trial (ClinicalTrials.gov ID: NCT02365129). A total of 144 young adults (~34% men and ~66% women) aged between 18 and 25 years took part in the study. The participants were randomly assigned to 3 different groups: (i) concurrent exercise training program based on the international physical activity recommendations at vigorous intensity (Ex-Vigorous group), (ii) at moderate intensity (Ex-Moderate group), and (iii) control group (no exercise). S-Klotho and 25-hydroxyvitamin D plasma levels were determined before and after the 24-week intervention programme. A significant decrease of 25-hydroxyvitamin D plasma levels were identified across time in all groups (p < 0.001), whereas no significant differences across time were observed in S-Klotho plasma levels (p = 0.497). There was no time x group interaction neither in S-Klotho nor in 25-hydroxyvitamin D plasma levels (all p > 0.7). In summary, our results showed that 24 weeks of supervised concurrent exercise training does not induce significant changes on S-Klotho and 25-hydroxyvitamin D independently of the exercise intensity in young adults.
Open Access
Impact of lifestyle moderate-to-vigorous physical activity timing on glycemic control in sedentary adults with overweight/obesity and metabolic impairments
(Wiley, 2024-06-10) Clavero-Jimeno, Antonio; Dote-Montero, Manuel; Migueles, Jairo H.; Camacho-Cardenosa, Alba; Osés Recalde, Maddi; Echarte Medina, Jon; Alcántara Alcántara, Juan Manuel; Muñoz Torres, Manuel; Labayen Goñi, Idoia; Ruiz, Jonatan R.; Ciencias de la Salud; Osasun Zientziak; Institute on Innovation and Sustainable Development in Food Chain - ISFOOD; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Objective: Moderate-to-vigorous physical activity (MVPA) improves glucose levels; however, whether its timing affects daily glycemic control remains unclear. This study aims to investigate the impact of lifestyle MVPA timing on daily glycemic control in sedentary adults with overweight/obesity and metabolic impairments. Methods: A total of 186 adults (50% women; age, 46.8 [SD 6.2] years) with overweight/obesity (BMI, 32.9 [SD 3.5] kg/m2) and at least one metabolic impairment participated in this cross-sectional study. MVPA and glucose patterns were simultaneously monitored over a 14-day period using a triaxial accelerometer worn on the nondominant wrist and a continuous glucose-monitoring device, respectively. Each day was classified as “inactive” if no MVPA was accumulated; as “morning,” “afternoon,” or “evening” if >50% of the MVPA minutes for that day were accumulated between 0600 and 1200, 1200 and 1800, or 1800 and 0000 hours, respectively; or as “mixed” if none of the defined time windows accounted for >50% of the MVPA for that day. Results: Accumulating >50% of total MVPA during the evening was associated with lower 24-h (mean difference [95% CI], −1.26 mg/dL [95% CI: −2.2 to −0.4]), diurnal (−1.10 mg/dL [95% CI: −2.0 to −0.2]), and nocturnal mean glucose levels (−2.16 mg/dL [95% CI: −3.5 to −0.8]) compared with being inactive. This association was stronger in those participants with impaired glucose regulation. The pattern of these associations was similar in both men and women. Conclusions: These findings suggest that timing of lifestyle MVPA is significant. Specifically, accumulating more MVPA during the evening appears to have a beneficial effect on glucose homeostasis in sedentary adults with overweight/obesity and metabolic impairments.