Endogenous versus exogenous carbohydrate oxidation measured by stable isotopes in pre-pubescent children plus 13C abundances in foods consumed three days prior

Purpose: The purposes of the present study were to (a) examine resting metabolism, substrate utilization, and endogenous versus exogenous carbohydrate (CHO) oxidation before and after 30-g rapidly-digesting carbohydrate (RDC) ingestion using indirect calorimetry and breath test analysis of stable isotope concentrations in pre-pubescent children and (b) report the 13C abundances in foods consumed for three days prior. Methods: Nineteen children (n 1⁄4 10 boys, n 1⁄4 9 girls) at Tanner stage I or II participated (mean age ± 95% CI 1⁄4 9.84 ± 0.77 y) in this study. Food was administered to the children for three days preceding their scheduled breath tests. Breath tests and indirect calorimetry were performed after an 8-h fast before and 60 min following consumption of a 30-g simple RDC drink consisting of maltodextrin and sucrose. Open circuit spirometry and indirect calorimetry monitored resting metabolism and CHO oxidation. Separate breath samples were taken every 15 min. Samples of all foods and breath samples were analyzed for 13C and 12C abundances with a stable-isotope mass spectrometer. Results: 13C in expired breath samples were 23.81 + 1.64‰ at baseline and increased every 15 min after consumption of the CHO drink (p \u3c 0.001e0.009). Cumulative total, endogenous, and exogenous CHO utilization increased during the post-prandial period (p \u3c 0.001). Endogenous CHO oxidation was consistently greater than exogenous CHO oxidation (p \u3c 0.001e0.002). Blood glucose was elevated from baseline at 30- and 60-min post-prandial (p \u3c 0.001). Insulin did not change over time (p 1⁄4 0.184). Conclusions: The foods provided during the 3-day controlled diet effectively minimized 13C variation prior to metabolic testing. The 13C abundances of foods reported herein should serve as practical recommendations to reduce 13C intake before breath tests. While endogenous CHO oxidation remained greater in proportion to exogenous CHO oxidation, these findings suggest that even a relatively small amount of RDC can increase exogenous CHO oxidation and blood glucose in normal-weight children. To further examine shifts in endogenous versus exogenous CHO utilization, we recommend that future studies take steps to minimize 13C variation before breath tests and examine changes in substrate metabolism at rest and during exercise in normal weight and overweight pre-pubescent children. Clinical trial registration number: NCT03185884

Body Mass Index and Employment-Based Health Insurance

<p>Abstract</p> <p>Background</p> <p>Obese workers incur greater health care costs than normal weight workers. Possibly viewed by employers as an increased financial risk, they may be at a disadvantage in procuring employment that provides health insurance. This study aims to evaluate the association between body mass index [BMI, weight in kilograms divided by the square of height in meters] of employees and their likelihood of holding jobs that include employment-based health insurance [EBHI].</p> <p>Methods</p> <p>We used the 2004 Household Components of the nationally representative Medical Expenditure Panel Survey. We utilized logistic regression models with provision of EBHI as the dependent variable in this descriptive analysis. The key independent variable was BMI, with adjustments for the domains of demographics, social-economic status, workplace/job characteristics, and health behavior/status. BMI was classified as normal weight (18.5–24.9), overweight (25.0–29.9), or obese (≥ 30.0). There were 11,833 eligible respondents in the analysis.</p> <p>Results</p> <p>Among employed adults, obese workers [adjusted probability (AP) = 0.62, (0.60, 0.65)] (<it>P </it>= 0.005) were more likely to be employed in jobs with EBHI than their normal weight counterparts [AP = 0.57, (0.55, 0.60)]. Overweight workers were also more likely to hold jobs with EBHI than normal weight workers, but the difference did not reach statistical significance [AP = 0.61 (0.58, 0.63)] (<it>P </it>= 0.052). There were no interaction effects between BMI and gender or age.</p> <p>Conclusion</p> <p>In this nationally representative sample, we detected an association between workers' increasing BMI and their likelihood of being employed in positions that include EBHI. These findings suggest that obese workers are more likely to have EBHI than other workers.</p

Stature, Body Mass, and BMI in High School American Football Players: Appropriate determinants of obesity prevalence?

The purpose of this study was to evaluate stature (HT), weight (WT), body mass index (BMI), and obesity prevalence based on BMI categories in a large sample (n = 7,175) of high school American football players enrolled as freshmen, sophomores, or juniors. Players were categorized by their positions: offensive linemen (OL), defensive linemen (DL), tight end (TE), defensive end (DE), linebacker (LB), running back (RB), quarterback (QB), defensive back (DB), and wide receiver (WR). HT, WT, and BMI increased as grade increased among all positions. OL and DL had the greatest HT, WT, and BMI (p≤0.05). Obesity prevalence was greatest in OL and DL. When accounting for age-related increases in BMI, WT increased to a greater degree than HT. If HT is an indirect indicator of skeletal size, while WT is more influenced by soft tissue, then the age-related BMI increases in the present study may be largely accounted for by soft tissue changes rather than skeletal growth. Even though obesity prevalence in OL (94.5%) and DL (78.4%) positions was greater than all other positions as determined from BMI, it is impossible to know the allocations of fat-free and fat mass—particularly in American football athletes. If obesity continues to be defined as an unhealthy accumulation of fat, then athletes who may have a greater relative proportion of lean soft tissue should not be classified as obese using BMI (WT÷HT²). More sophisticated, reliable, and sensitive measure of body composition, such as skinfolds, may be more appropriate field measurements

Endogenous versus exogenous carbohydrate oxidation measured by stable isotopes in pre-pubescent children plus 13C abundances in foods consumed three days prior

Purpose: The purposes of the present study were to (a) examine resting metabolism, substrate utilization, and endogenous versus exogenous carbohydrate (CHO) oxidation before and after 30-g rapidly-digesting carbohydrate (RDC) ingestion using indirect calorimetry and breath test analysis of stable isotope concentrations in pre-pubescent children and (b) report the 13C abundances in foods consumed for three days prior. Methods: Nineteen children (n 1⁄4 10 boys, n 1⁄4 9 girls) at Tanner stage I or II participated (mean age ± 95% CI 1⁄4 9.84 ± 0.77 y) in this study. Food was administered to the children for three days preceding their scheduled breath tests. Breath tests and indirect calorimetry were performed after an 8-h fast before and 60 min following consumption of a 30-g simple RDC drink consisting of maltodextrin and sucrose. Open circuit spirometry and indirect calorimetry monitored resting metabolism and CHO oxidation. Separate breath samples were taken every 15 min. Samples of all foods and breath samples were analyzed for 13C and 12C abundances with a stable-isotope mass spectrometer. Results: 13C in expired breath samples were 23.81 + 1.64‰ at baseline and increased every 15 min after consumption of the CHO drink (p \u3c 0.001e0.009). Cumulative total, endogenous, and exogenous CHO utilization increased during the post-prandial period (p \u3c 0.001). Endogenous CHO oxidation was consistently greater than exogenous CHO oxidation (p \u3c 0.001e0.002). Blood glucose was elevated from baseline at 30- and 60-min post-prandial (p \u3c 0.001). Insulin did not change over time (p 1⁄4 0.184). Conclusions: The foods provided during the 3-day controlled diet effectively minimized 13C variation prior to metabolic testing. The 13C abundances of foods reported herein should serve as practical recommendations to reduce 13C intake before breath tests. While endogenous CHO oxidation remained greater in proportion to exogenous CHO oxidation, these findings suggest that even a relatively small amount of RDC can increase exogenous CHO oxidation and blood glucose in normal-weight children. To further examine shifts in endogenous versus exogenous CHO utilization, we recommend that future studies take steps to minimize 13C variation before breath tests and examine changes in substrate metabolism at rest and during exercise in normal weight and overweight pre-pubescent children. Clinical trial registration number: NCT03185884

Peripheral artery disease affects the function of the legs of claudicating patients in a diffuse manner irrespective of the segment of the arterial tree primarily involved

Different levels of arterial occlusive disease (aortoiliac, femoropopliteal, multi-level disease) can produce claudication symptoms in different leg muscle groups (buttocks, thighs, calves) in patients with peripheral artery disease (PAD). We tested the hypothesis that different locations of occlusive disease uniquely affect the muscles of PAD legs and produce distinctive patterns in the way claudicating patients walk. Ninety-seven PAD patients and 35 healthy controls were recruited. PAD patients were categorized to aortoiliac, femoropopliteal and multi-level disease groups using computerized tomographic angiography. Subjects performed walking trials both pain-free and during claudication pain and joint kinematics, kinetics, and spatiotemporal parameters were calculated to evaluate the net contribution of the calf, thigh and buttock muscles. PAD patients with occlusive disease affecting different segments of the arterial tree (aortoiliac, femoropopliteal, multi-level disease) presented with symptoms affecting different muscle groups of the lower extremity (calves, thighs and buttocks alone or in combination). However, no significant biomechanical differences were found between PAD groups during the pain-free conditions with minimal differences between PAD groups in the claudicating state. All statistical differences in the pain-free condition occurred between healthy controls and one or more PAD groups. A discriminant analysis function was able to adequately predict if a subject was a control with over 70% accuracy, but the function was unable to differentiate between PAD groups. In-depth gait analyses of claudicating PAD patients indicate that different locations of arterial disease produce claudication symptoms that affect different muscle groups across the lower extremity but impact the function of the leg muscles in a diffuse manner generating similar walking impairments