Weight Gain Is Associated with Medial Contact Site of Subthalamic Stimulation in Parkinson's Disease

The aim of our study was to assess changes in body-weight in relation to active electrode contact position in the subthalamic nucleus. Regular body weight measurements were done in 20 patients with advanced Parkinson's disease within a period of 18 months after implantation. T1-weighted (1.5T) magnetic resonance images were used to determine electrode position in the subthalamic nucleus and the Unified Parkinson's disease rating scale (UPDRS-III) was used for motor assessment. The distance of the contacts from the wall of the third ventricle in the mediolateral direction inversely correlated with weight gain (r = −0.55, p<0.01) and with neurostimulation-related motor condition expressed as the contralateral hemi-body UPDRS-III (r = −0.42, p<0.01). Patients with at least one contact within 9.3 mm of the wall experienced significantly greater weight gain (9.4±(SD)4.4 kg, N = 11) than those with both contacts located laterally (3.9±2.7 kg, N = 9) (p<0.001). The position of the active contact is critical not only for motor outcome but is also associated with weight gain, suggesting a regional effect of subthalamic stimulation on adjacent structures involved in the central regulation of energy balance, food intake or reward

The 24-h Energy Intake of Obese Adolescents Is Spontaneously Reduced after Intensive Exercise: A Randomized Controlled Trial in Calorimetric Chambers

Background: Physical exercise can modify subsequent energy intake and appetite and may thus be of particular interest in terms of obesity treatment. However, it is still unclear whether an intensive bout of exercise can affect the energy consumption of obese children and adolescents. [br/] Objective: To compare the impact of high vs. moderate intensity exercises on subsequent 24-h energy intake, macronutrient preferences, appetite sensations, energy expenditure and balance in obese adolescent. [br/] Design: This randomized cross-over trial involves 15 obese adolescent boys who were asked to randomly complete three 24-h sessions in a metabolic chamber, each separated by at least 7 days: (1) sedentary (SED); (2) Low-Intensity Exercise (LIE) (40% maximal oxygen uptake, VO(2)max); (3) High-Intensity Exercise (HIE) (75% VO(2)max). Results: Despite unchanged appetite sensations, 24-h total energy intake following HIE was 6-11% lower compared to LIE and SED (p<0.05), whereas no differences appeared between SED and LIE. Energy intake at lunch was 9.4% and 8.4% lower after HIE compared to SED and LIE, respectively (p<0.05). At dinner time, it was 20.5% and 19.7% lower after HIE compared to SED and LIE, respectively (p<0.01). 24-h energy expenditure was not significantly altered. Thus, the 24-h energy balance was significantly reduced during HIE compared to SED and LIE (p<0.01), whereas those of SED and LIE did not differ. [br/] Conclusions: In obese adolescent boys, HIE has a beneficial impact on 24-h energy balance, mainly due to the spontaneous decrease in energy intake during lunch and dinner following the exercise bout. Prescribing high-intensity exercises to promote weight loss may therefore provide effective results without affecting appetite sensations and, as a result, food frustrations

Inter-laboratory test for gas concentrations measurements of the R3C network's calorimetric chambers

Inter-laboratory test for gas concentrations measurements of the R3C network's calorimetric chambers. Recent Advances and Controversies in the Measurement of Energy Metabolism (RACMEM 2011

Inter-laboratory test for gas concentration measurements of the R3C network calorimetric chambers

absen

A weight reduction program preserves fat-free mass but not metabolic rate in obese adolescents

OBJECTIVE: To determine the effects of a multidisciplinary weight reduction program on body composition and energy expenditure (EE) in severely obese adolescents. RESEARCH METHODS AND PROCEDURES: Twenty-six severely obese adolescents, 12 to 16 years old [mean BMI: 33.9 kg/m(2); 41.5% fat mass (FM)] followed a 9-month weight reduction program including moderate energy restriction and progressive endurance and resistance training. Body composition was assessed by DXA, basal metabolic rate by indirect calorimetry, and EE by whole-body indirect calorimetry with the same activity program over 36-hour periods before starting and 9 months after the weight reduction period. RESULTS: Adolescents gained (least-square mean +/- SE) 2.9 +/- 0.2 cm in height, lost 16.9 +/- 1.3 kg body weight (BW), 15.2 +/- 0.9 kg FM, and 1.8 +/- 0.5 kg fat-free mass (FFM) (p < 0.001). Basal metabolic rate, sleeping, sedentary, and daily EE were 8% to 14% lower 9 months after starting (p < 0.001) and still 6% to 12% lower after adjustment for FFM (p < 0.05). Energy cost of walking decreased by 22% (p < 0.001). The reduction in heart rate during sleep and sedentary activities (-10 to -13 beats/min), and walking (-20 to -25 beats/min) (p < 0.001) resulted from both the decrease in BW and physical training. DISCUSSION: A weight reduction program combining moderate energy restriction and physical training in severely obese adolescents resulted in great BW and FM losses and improvement of cardiovascular fitness but did not prevent the decline in EE even after adjustment for FFM

Comparison of methods for determining energy expenditure of elderly people in free-living conditions

International audienc

Assessment of energy expenditure associated with physical activities in free-living obese and nonobese adolescents

BACKGROUND:Information on activity patterns and the energy cost of activities is critically missing. OBJECTIVE:We measured the energy cost of and time devoted to various activities in obese and nonobese adolescents. DESIGN:Daily energy expenditure (DEE) and its main components were determined in 27 obese and 50 nonobese adolescents aged 12-16 y by using whole-body calorimetry with the same activity program and the heart rate-recording method in free-living conditions. RESULTS:In whole-body calorimetry, energy expenditures (EEs) during sleep and sedentary activities were 18.9% and 21.5%, respectively, higher in obese subjects than in nonobese subjects (P < 0.001), but not significantly different after adjustment for fat-free mass (FFM). EEs during walking and DEEs were significantly higher in obese than in nonobese subjects, both absolutely (71% and 33%, respectively) and after adjustment for body weight or FFM (16% and 11%, respectively). In free-living conditions, EEs associated with physical activities did not differ significantly between obese and nonobese subjects, but they were 51% lower in obese subjects after adjustment for body weight (P < 0.001). The obese adolescents spent more time in light physical activities but much less time in moderate activities and sports than did the nonobese subjects. The activity-related time equivalent corrected for sedentary EE (ARTE EE(2)) averaged 69 and 122 min/d in obese and nonobese subjects, respectively (P < 0.01). CONCLUSION:Physical activity is low in obese subjects and can be assessed satisfactorily in both obese and nonobese adolescents by using ARTE EE(2) when DEE and the basal metabolic rate are known

Usefulness of calorimetric chambers for measuring changes of energy expenditure in Parkinson disease patients

International audienceBackground: The most important clinical disorders in patients with Parkinson disease (PD) are akinesia which seriously deprive patients from motor skills. The implantation of subthalamic stimulation electrodes is an interesting therapeutical option to reduce these symptoms. PD patients have a frequent and significant weight gain after surgery. A first study highlighted energy expenditure (EE) alterations confirmed in a recent study, both based on our 2 calorimetric chambers (CC). We used jointly data from CC and from wearable device like Actiheart (AH). AH records heart rate and physical activity, and calculates EE from these parameters added with gender, age and weight. The objective was to compare the EE results obtained by the 2 measurement systems (CC and AH).Methods: The total duration of the measurements was 24 hours during the exact same observation periods for simultaneous recording data from the CC and from the AH. The periods included 1) sleep for sleeping metabolic rate (SMR) during the quietest 197.55 (± 62.07) consecutive minutes of the night, 2) the quiet period of wakefulness excluding activity and meals. For this quiet awake period, we compared the EE from CC and AH when the patients were in 2 distinct states: EE in patients with medications and no blockade (EEon), and EE in patients off medications with akinesia (EEoff). 19 PD patients were observed before surgery, and 11 of them after surgery.Results: Both measurement methods (CC and AH) showed an increase in SMR after surgery (6.80% ± 12.88%, P=0.036 and 4.17% ± 4.24%, P=0.001, respectively). After surgery, weight gain (5.14% ± 6.21%, P=0.004) led to an increase in the BMR (3.12% ± 3.45%, P=0.002) calculated with Schofield equations which are used by AH for the calculation of the EE when the patients were inactive. For the EEon and EEoff periods, the CC made it possible to highlight an EEoff greater than the EEon at equal posture of the volunteers (7.89% ± 10.85%, P=0.002), whereas the AH did not detect any modification (1.61 ± 9.93, P=NS).Conclusion: If AH make it possible to perform estimates of EE on an outpatient basis at home, there are situations for which CC represent an indispensable tool. This is the case to obtain a real value of SMR or to highlight a difference in metabolism with patients having different states of motor disorders (ON vs OFF) and no change in physical activity