Carbohydrate utilization in obese subjects after an oral load of 100 g naturally-labelled [13C] glucose

Extended indirect calorimetry with isotopic CO2 sensors for prolonged and continuous quantification of exogenous vs. total substrate oxidation in mice

Indirect calorimetry (InCa) estimates whole-body energy expenditure and total substrate oxidation based on O₂ consumption and CO₂ production, but does not allow for the quantification of oxidation of exogenous substrates with time. To achieve this, we incorporated ¹³CO₂ and ¹²CO₂ gas sensors into a commercial InCa system and aimed to demonstrate their performance and added value. As a performance indicator, we showed the discriminative oscillations in ¹³CO₂ enrichment associated with food intake in mice fed diets containing naturally low (wheat) vs high (maize) ¹³C enrichment. To demonstrate the physiological value, we quantified exogenous vs total carbohydrate and fat oxidation continuously, in real time in mice varying in fat mass. Diet-induced obese mice were fed a single liquid mixed meal containing ¹³C-isotopic tracers of glucose or palmitate. Over 13 h, ~70% glucose and ~48% palmitate ingested were oxidised. Exogenous palmitate oxidation depended on body fat mass, which was not the case for exogenous glucose oxidation. We conclude that extending an InCa system with ¹³CO₂ and ¹²CO₂ sensors provides an accessible and powerful technique for real-time continuous quantification of exogenous and whole-body substrate oxidation in mouse models of human metabolic physiology.

Nutritional Considerations for Sport Participation in Children and Adolescents With Obesity

There is a high prevalence of children with obesity who are participating in sports. Appropriate nutritional considerations are important to optimize health and training adaptations. This review focuses on macronutrient recommendations and their effect on weight management and/or benefits for athletic training for children ages 5 to 18 years. Equal distribution of protein intake throughout the day (~25-30 g/meal) and during postexercise recovery is recommended. Special attention should be given to increasing protein intake during breakfast because it is often the meal with the least protein intake. Both postexercise recommendations for protein (~0.3 g/kg of body weight) and carbohydrate (~1.0-1.2 g/kg/h) were not determined in children with obesity, and require future verification. Individual carbohydrate needs of training to meet fuel costs are recommended, but ~200 to 500 g/day of carbohydrate may be required depending on a child's level of sport participation and competition. Fat intake should follow general recommendations to meet the accepted macronutrient distribution range in children (25% to 35%) and reduce saturated fat intake. No evidence suggests that additional dietary fat modifications would improve training adaptations in children. Longitudinal studies are required to further our understanding of age and sex effects and confirm the appropriate quantity of macronutrients for active children with obesity.

Labeled CO(2) production and oxidative vs nonoxidative disposal of labeled carbohydrate administered at rest

Carbon isotopes (*C) have been extensively used in man to describe oxidative vs nonoxidative disposal of an exogenous load of labeled carbohydrate (*C-CHO) at rest in various experimental situations. It is hypothesized that V*CO(2) reflects *C-CHO oxidation. However, when glycogen is synthesized through the indirect pathway (which is responsible for approximately 50% of glycogen storage), *C could be lost, diluted, and exchanged in the pyruvate-lactate pool, in the pool of tricarboxylic acid cycle intermediates, as well as at the entrance of the tricarboxylic acid cycle, and along the pathway of gluconeogenesis. This could result in a lower *C/C in the glycogen stored than in the CHO administered, in an increased production of *CO(2), and, respectively, in an overestimation and an underestimation of the oxidative and nonoxidative disposal of the CHO load. Results from the present experiment offer a support to this hypothesis. Over a 10-hour period after ingestion of a (13)C-pasta meal (313+/-10 g dry mass or 258+/-8 g of glucose) in 12 healthy subjects (6 men and 6 women), exogenous CHO oxidation computed from V(13)CO(2) (recovery factor, 0.54) significantly exceeded total CHO oxidation computed by indirect respiratory calorimetry corrected for urea excretion: 154.2+/-2.6 vs 133.5+/-3.2 g. In an additional study conducted in rats, (13)C/(12)C in glycogen stores was significantly approximately 50% lower than in the (13)C-CHO ingested, over a wide range of enrichment. These results suggest that because of dilution, loss, and exchange of *C in the indirect pathway of glycogen synthesis, the oxidative vs nonoxidative disposal of exogenous *C-CHO cannot be accurately tracked from V*CO(2).

Stable isotopes in obesity research

Obesity is recognized as a major public health problem. Obesity is a multifactorial disease and is often associated with a wide range of comorbidities including hypertension, non-insulin dependent (Type II) diabetes mellitus, and cardiovascular disease, all of which contribute to morbidity and mortality. This review deals with stable isotope mass spectrometric methods and the application of stable isotopes to metabolic studies of obesity. Body composition and total energy expenditure (TEE) can be measured by mass spectrometry using stable isotope labeled water, and the metabolism of protein, lipid, and carbohydrate can be measured using appropriate labeled tracer molecules.

Use of 13C-labeled glucose for measuring exogenous glucose oxidation in mice

The author modified a respiratory gas analyzer to analyze the respiratory 13CO2 of 12 small laboratory animals all at once. To investigate the practical use of this system, mice were orally (OR) or intravenously (i.v.) given glucose solutions containing three different amounts of 13C-labeled glucose. Expired 13CO2 derived from exogenous glucose was detected within 10 minutes after administration in OR mice, but about 30 minutes in i.v. mice. The height of the peak of 13CO2 expiration was correlated with the administered 13C-glucose mass.

Metabolic response to small and large 13C-labelled pasta meals following rest or exercise in man

The metabolic response to a 150 or 400 g 13C-labelled pasta meal was studied for 8 h following rest or exercise at low or moderate workload (n 6). Following rest, the 400 g meal totally suppressed fat oxidation (v. 14.1 g following the 150 g meal) and a small amount of glucose was converted into fat (4.6 g), but fat oxidation remained high in subjects who had exercised following both the small (21.8 and 34.1 g) and large meal (14.1 and 32.3 g). Exogenous glucose oxidation was significantly higher in subjects who had remained at rest both following the small (67.6 g v. 60.4 and 51.3 g in subjects who exercised at low and moderate workloads) and large meal (152.2 v. 123.0 and 127.2 g). Endogenous glucose oxidation was similar in the three groups following the 150 g meal (42.3-58.0 g), but was significantly lower following the 400 g meal in subjects who had exercised at low workload (24.2 v. 72.2 g following rest; and was totally suppressed in those who had exercised at moderate workload. As a consequence, a larger positive glycogen balance was observed in subjects who exercised before the large meal (182.8-205.1 g v. 92.4 g following rest; Total fat oxidation calculated from 08.00 hours to 20.00 hours was similar in subjects who exercised at low and moderate workloads. These results indicate that: (1) de novo lipogenesis, which plays only a minor role for the disposal of an acute dietary carbohydrate load, is totally suppressed following exercise, even when a very large carbohydrate load is ingested; (2) the reduction in glycogen turnover as well as a preferential conversion of glucose into glycogen are responsible for the increase in glycogen stores following exercise; (3) for a similar energy expenditure, exercise at low workload for a longer period does not favour fat oxidation when the post-exercise period is taken into account.

Oxidation of an oral [13C]glucose load at rest and prolonged exercise in trained and sedentary subjects

The purpose of this study was to compare the oxidation of [13C]glucose (100 g) ingested at rest or during exercise in six trained (TS) and six sedentary (SS) male subjects. The oxidation of plasma glucose was also computed from the volume of 13CO2 and 13C/12C in plasma glucose to compute the oxidation rate of glucose released from the liver and from glycogen stores in periphery (mainly muscle glycogen stores during exercise). At rest, oxidative disposal of both exogenous (8.3 +/- 0.3 vs. 6.6 +/- 0.8 g/h) and liver glucose (4.4 +/- 0.5 vs. 2.6 +/- 0.4 g/h) was higher in TS than in SS. This could contribute to the better glucose tolerance observed at rest in TS. During exercise, for the same absolute workload [140 +/- 5 W: TS = 47 +/- 2.5; SS = 68 +/- 3 %maximal oxygen uptake (VO2 max)], [13C]glucose oxidation was higher in TS than in SS (39.0 +/- 2.6 vs. 33.6 +/- 1.2 g/h), whereas both liver glucose (16.8 +/- 2.4 vs. 24.0 +/- 1.8 g/h) and muscle glycogen oxidation (36.0 +/- 3.0 vs. 51.0 +/- 5.4 g/h) were lower. For the same relative workload (68 +/- 3% VO2 max: TS = 3.13 +/- 0.96; SS = 2.34 +/- 0.60 l O2/min), exogenous glucose (44.4 +/- 1.8 vs. 33.6 +/- 1.2 g/h) and muscle glycogen oxidation (73.8 +/- 7.2 vs. 51.0 +/- 5.4 g/h) were higher in TS. However, despite a higher energy expenditure in TS, liver glucose oxidation was similar in both groups (22.2 +/- 3.0 vs. 24.0 +/- 1.8 g/h). Thus exogenous glucose oxidation was selectively favored in TS during exercise, reducing both liver glucose and muscle glycogen oxidation.

Use of naturally enriched mixed food in 13C breath tests applied in young suckling calves

Utilization of three milk diets including cream, casein or whey, each naturally labelled with 13C (1 mmol 13C excess) from C4 sources, by six young male calves of the Deutsche Fleckvieh breed was investigated in a Latin-square split-plot design. Each milk diet was examined under resting conditions and during a short period of physical exercise on a treadmill. Delta 13C values (/1000) in carbon dioxide in expired air were measured at intervals of about 1 h during 6.5 h after food intake. Expired air samples for CO2 isolation, subsequent isotopic analysis, measurement of CO2 production and respiratory quotient were taken at about hourly intervals and 13C recovery rates over 6.5 h were calculated. Feeding milk containing enriched milk casein, cream, or whey resulted in maximal significant 13C enrichments over background (delta 13C) in CO2 of +1, +2.4 and +2.2 /1000, and recovery rates of 3.6, 9.9 and 12.2% respectively. This comparison shows the different kinetic behaviour of the main nutrients during the oxidation in tissues. The short exercise period (5 min at 1 J/s per kg body-weight +5 min at 2 J/s per kg body-weight) did not influence the recovery rates significantly. However, after 10 min of muscular exercise there was a brief decrease in delta 13C value of expired air which disappeared within the first 5 min of rest. These experiments demonstrate for the first time the applicability of the 13C breath test with naturally enriched diets in animal nutrition research and that quantitative results may be obtained.

Effects of dietary fat on postprandial substrate oxidation and on carbohydrate and fat balances

To study the effect of dietary fat on postprandial substrate utilization and nutrient balance, respiratory exchange was determined in seven young men for 1 h before and 9 h after the ingestion of one of three different breakfasts: i.e., bread, jam, and dried meat (482 kcal: 27% protein, 62% carbohydrate, and 11% fat); bread, jam, and dried meat plus 50 g of margarine containing long-chain triglycerides (LCT); or bread, jam, and dried meat plus 40 g medium-chain triglycerides (MCT) and 10 g LCT margarine (858 kcal: 15% protein, 35% carbohydrate, and 50% fat). Plasma glucose concentrations peaked 45 min after the start of the meals. When compared with the low fat meal, the LCT margarine supplement had no effect at any time on circulating glucose and insulin concentrations, nor on the respiratory quotient. When MCTs were consumed, plasma glucose and insulin concentrations remained lower and plasma FFA concentrations higher during the first 2 h. 9 h after the breakfasts, the amounts of substrates oxidized were similar in each case, i.e., approximately 320, 355, and 125 kcal for carbohydrate, fat, and protein, respectively. This resulted in comparable carbohydrate (mean +/- SD = -22 +/- 32, -22 +/- 37, and -24 +/- 22 kcal) and protein balances (-7 +/- 9, +7 +/- 7, and -8 +/- 11 kcal) after the low fat, LCT- and MCT-supplemented test meals, respectively. However, after the low fat meal, the lipid balance was negative (-287 +/- 60 kcal), which differed significantly (P less than 0.001) from the fat balances after the LCT- and MCT-supplemented meals, i.e., +60 +/- 33 and +57 +/- 25 kcal, respectively. The results demonstrate that the rates of fat and of carbohydrate oxidation are not influenced by the fat content of a meal.

Improved carbohydrate tolerance and stimulation of carbohydrate oxidation and lipogenesis during short-term carbohydrate overfeeding

The carbohydrate intake of seven healthy men was increased from 220-265 g/d to 620-770 g/d for 17 days, while protein and fat intake remained constant. Carbohydrate loading did not affect the preprandial plasma glucose levels after an overnight fast, but reduced the postprandial increment in plasma glucose levels after 5, 11, and 17 days of overfeeding. Preprandial plasma insulin levels were slightly increased during carbohydrate overfeeding, but no increase in the postprandial rise in insulin levels was found until 11 days after the start of carbohydrate loading. Whole-body rates of carbohydrate oxidation and of glucose conversion to fat were estimated by indirect calorimetry. Basal carbohydrate oxidation rate was increased by 95% at the end of 17 days of overfeeding, but there was no potentiation in the stimulation of the carbohydrate oxidation rate induced by a meal. There was no net fat synthesis from glucose before carbohydrate loading; carbohydrate overfeeding produced nonprotein respiratory exchange ratios greater than 1.00, suggesting net fat synthesis from glucose. Meals did not stimulate net lipogenesis from glucose, either before or after overfeeding. These results indicate that the improvement in carbohydrate tolerance associated with short-term carbohydrate loading does not appear to depend on elevated insulin levels. Increased carbohydrate oxidation and lipogenesis elevated carbohydrate disposal is more than necessary to account for the improvement in carbohydrate tolerance.