Key metabolic impairments in obesity are reduced skeletal muscle and systemic fatty acid oxidation (FAO). Few clinical trials in severely obese adults examined how the BMI classification relates to FAO and how the addition of exercise to weight loss interventions impacts FAO. PURPOSE: To examine how BMI levels that include severely obese relate to FAO. To examine how weight loss interventions with or without exercise in severely obese adults impact FAO. METHODS: Adults (BMI:20-52 kg/m2) were recruited to examine skeletal muscle FAO with histochemical analysis of muscle biopsies and systemic FAO at rest and during submaximal exercise with indirect calorimetry. Changes in skeletal muscle and systemic FAO of severely obese adults randomized to one of the following weight loss interventions were examined: surgery (S), surgery plus exercise (SE) and diet plus exercise (DE). RESULTS: BMI was not significantly related to skeletal muscle or systemic FAO at rest. During exercise at an absolute workload, BMI only had a significant moderate, positive association with systemic absolute FAO (mg/min) in the univariate analysis (r=0.46,p<0.01). During exercise at the relative workload, BMI had a moderate, negative association with respiratory exchange ratio (RER; r=0.54,p<0.01) and moderate, positive associations with absolute FAO (r=0.45,p<0.01) and proportion of energy derived from fat (EF; r=0.55,p<0.01). When controlling for confounders (age, gender, race, cardiovascular fitness and physical activity), BMI only maintained significance with RER, explaining 21% of the variance (p<0.01). Upon completion of weight loss interventions, change in skeletal muscle or systemic FAO at rest was not significantly different across intervention groups. DE had greater positive changes in RER and EF during submaximal exercise bouts compared to the other groups (p<0.05). SE had significantly greater positive changes compared to S only with FAO normalized to fat free mass during the relative submaximal workload (p<0.01). CONCLUSIONS: BMI does not explain the variance in FAO at rest, but is associated with higher FAO during submaximal exercise bouts. Inclusion of exercise to weight loss induced by caloric restriction results in more favorable changes in FAO during sumbaximal exercise compared to surgery induced weight loss with or without exercise.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-12102010-084858 |
| Date | 06 January 2011 |
| Creators | Hames, Kazanna Calais |
| Contributors | John Jakicic, Bret Goodpaster, Elizabeth Nagle, Wendy King |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-12102010-084858/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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