Download PDF
Adipositas - Ursachen, Folgeerkrankungen, Therapie 2015; 09(03): 135-139
DOI: 10.1055/s-0037-1618932
Übersichtsarbeit
Schattauer GmbH

Bedeutung der Energiebilanz für das kardiometabolische Risiko

Impact of energy balance on cardiometabolic risk
A. Bosy-Westphal
1   Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
,
M. Lagerpusch
1   Institut für Ernährungsmedizin, Universität Hohenheim, Stuttgart
,
M. J. Müller
2   Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel
› Author Affiliations
Further Information

Publication History

Publication Date:
22 December 2017 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Eine chronisch positive Energiebilanz führt zu Veränderungen der Körperzusammensetzung und neuroendokriner Regelkreise, die zu einem erhöhten kardiometabolischen Risiko beitragen.

Veränderungen der Energiebilanz haben abhängig von Ausmaß und Dauer des Kaloriendefizits oder Überschusses eine Auswirkung auf die Partitionierung von Fett und Magermasse und den Stoffwechsel. Während der Gewichtsreduktion variieren die Abnahme von Fett- und Magermasse sowie die Partitionierung innerhalb der Fettmasse (z.B. werden das viszerale Fettgewebe und das Leberfett zu Beginn einer Gewichtsabnahme präferenziell mobilisiert).

Die Kenntnis der Determinanten von physiologischen Veränderungen der Körperzusammensetzung und der neuroendokrinen Regelkreise bei Gewichtszu- und -abnahme ermöglicht sowohl eine angemessene und zielgerichtete Therapieplanung als auch die Beurteilung des Therapieverlaufs von Patienten. Der Einfluss von Dynamik und Frequenz von Energiebilanzveränderungen auf die Körpergewichtsregulation und Risikofaktoren wie Insulinresistenz muss weiter untersucht werden, um Empfehlungen für innovative therapeutische Konzepte bei Adipositas ableiten zu können.

Summary

Cardiometabolic risk is caused by changes in body composition and neuroendocrine regulation that are consequences of a chronically positive energy balance.

The extent but also the duration and frequency of energy deficit or surplus determine partitioning of fat and lean mass and changes in metabolism with weight loss and weight gain. Visceral adipose tissue and liver fat are lost preferentially with modest weight loss, but the effect is attenuated with greater weight loss.

Prediction of physiologic changes in body composition and regulatory circuits with modulation of energy balance allows the development and monitoring of a personalized therapeutic weight loss strategy.

The impact of dynamics and frequency of changes in energy balance on body weight regulation and cardiometabolic risk requires further investigation before recommendations for clinical practice can be implemented.

Schlüsselwörter

Energiebilanz - Prädiabetes - kardiometabolisches Risiko

Keywords

Energy balance - prediabetes - cardiometabolic risk
 

  • Literatur

  • 1 Knop FK, Taylor R. Mechanism of metabolic advantages after bariatric surgery: it’s all gastrointestinal factors versus it’s all food restriction. Diabetes Care 2013; (36) (Suppl. 02) S287-291.
    PubMedGoogle Scholar
  • 2 Nazare JA, Smith JD, Borel AL, Haffner SM, Balkau B, Ross R, Massien C, Alméras N, Després JP. Ethnic influences on the relations between abdominal subcutaneous and visceral adiposity, liver fat, and cardiometabolic risk profile: the International Study of Prediction of Intra-Abdominal Adiposity and Its Relationship With Cardiometabolic Risk/Intra-Abdominal Adiposity. Am J Clin Nutr 2012; 96 (04) 714-726.
    CrossrefPubMedGoogle Scholar
  • 3 Straznicky NE, Lambert GW, McGrane MT, Masuo K, Dawood T, Nestel PJ, Eikelis N, Schlaich MP, Esler MD, Socratous F, Chopra R, Lambert EA. Weight loss may reverse blunted sympathetic neural responsiveness to glucose ingestion in obese subjects with metabolic syndrome. Diabetes 2009; 58 (05) 1126-1132.
    CrossrefPubMedGoogle Scholar
  • 4 Racette SB, Weiss EP, Schechtman KB, Steger-May K, Villareal DT, Obert KA, Holloszy JO. and the Washington University School of Medicine CALERIE Team. Influence of weekend lifestyle patterns on body weight. Obesity (Silver Spring) 2008; 16: 1826-1830.
    CrossrefPubMedGoogle Scholar
  • 5 Yanovski JA, Yanovski SZ, Sovik KN, Nguyen TT, O’Neil PM, Sebring NG. A prospective study of holiday weight gain. N Engl J Med 2000; 342 (12) 861-867.
    CrossrefPubMedGoogle Scholar
  • 6 Harvie M, Wright C, Pegington M. et al. The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women. Br J Nutr 2013; 110 (08) 1534-1547.
    CrossrefPubMedGoogle Scholar
  • 7 Harvie MN, Pegington M, Mattson MP. et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: a randomized trial in young overweight women. Int J Obes (Lond) 2011; 35 (05) 714-727.
    CrossrefPubMedGoogle Scholar
  • 8 Mattson MP, Allison DB, Fontana L, Harvie M, Longo VD, Malaisse WJ, Mosley M, Notterpek L, Ravussin E, Scheer FA, Seyfried TN, Varady KA, Panda S. Meal frequency and timing in health and disease. Proc Natl Acad Sci U S A 2014; 111 (47) 16647-16653.
    CrossrefPubMedGoogle Scholar
  • 9 Parcina M, Brune M, Kaese V, Zorn M, Spiegel R, Vojvoda V, Fleming T, Rudofsky G, Paul PNawroth. No short-term effects of calorie-controlled Mediterranean or fast food dietary interventions on established biomarkers of vascular or metabolic risk in healthy individuals. Nutr Res Pract 2015; 09 (02) 165-173.
    CrossrefPubMedGoogle Scholar
  • 10 Black RN, Spence M, McMahon RO, Cuskelly GJ, Ennis CN, McCance DR, Young IS, Bell PM, Hunter SJ. Effect of eucaloric highand low-sucrose diets with identical macronutrient profile on insulin resistance and vascular risk: a randomized controlled trial. Diabetes 2006; 55 (12) 3566-3572.
    CrossrefPubMedGoogle Scholar
  • 11 Klempel MC, Kroeger CM, Varady KA. Alternate day fasting (ADF) with a high-fat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet. Metabolism 2013; 62 (01) 137-143.
    CrossrefPubMedGoogle Scholar
  • 12 Forbes GB. Lean body mass-body fat interrelationships in humans. Nutr Rev 1987; 45 (08) 225-231.
    PubMedGoogle Scholar
  • 13 Broyles ST, Bouchard C, Bray GA, Greenway FL, Johnson WD, Newton RL, Ravussin E, Ryan DH, Smith SR, Katzmarzyk PT. Consistency of fat mass-fat-free mass relationship across ethnicity and sex groups. Br J Nutr 2011; 105 (08) 1272-1276.
    CrossrefPubMedGoogle Scholar
  • 14 Thomas D, Das SK, Levine JA, Martin CK, Mayer L, McDougall A, Strauss BJ, Heymsfield SB. New fat free mass – fat mass model for use in physiological energy balance equations. Nutr Metab (Lond) 2010; 09: 39.
    PubMedGoogle Scholar
  • 15 Schautz B, Later W, Heller M, Müller MJ, Bosy-Westphal A. Total and regional relationship between lean and fat mass with increasing adiposity--impact for the diagnosis of sarcopenic obesity. Eur J Clin Nutr 2012; 66 (12) 1356-1361.
    CrossrefPubMedGoogle Scholar
  • 16 Hall KD, Sacks G, Chandramohan D, Chow CC, Wang YC, Gortmaker SL, Swinburn BA. Quantification of the effect of energy imbalance on body weight. Lancet 2011; 378 9793 826-837.
    CrossrefPubMedGoogle Scholar
  • 17 Grinspoon S, Thomas L, Miller K, Pitts S, Herzog D, Klibanski A. Changes in regional fat redistribution and the effects of estrogen during spontaneous weight gain in women with anorexia nervosa. Am J Clin Nutr 2001; 73: 865-869.
    CrossrefPubMedGoogle Scholar
  • 18 Scalfi L, Polito A, Bianchi L, Marra M, Caldara A, Nicolai E, Contaldo F. Body composition changes in patients with anorexia nervosa after complete weight recovery. Eur J Clin Nutr 2002; 56: 15-20.
    CrossrefPubMedGoogle Scholar
  • 19 Misra M, Soyka LA, Miller KK, Grinspoon S, Levitsky LL, Klibanski A. Regional body composition in adolescents with anorexia nervosa and changes with weight recovery. Am J Clin Nutr 2003; 77: 1361-1367.
    CrossrefPubMedGoogle Scholar
  • 20 Mayer LE, Klein DA, Black E. et al. Adipose tissue distribution after weight restoration and weight maintenance in women with anorexia nervosa. Am J Clin Nutr 2009; 90 (05) 1132-1137.
    CrossrefPubMedGoogle Scholar
  • 21 Chaston TB, Dixon JB. Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systematic review. Int J Obes (Lond) 2008; 32 (04) 619-628.
    CrossrefPubMedGoogle Scholar
  • 22 Hall KD, Hallgreen CE. Increasing weight loss attenuates the preferential loss of visceral compared with subcutaneous fat: a predicted result of an allometric model. Int J Obes. 2008 32. 722ff.
    PubMedGoogle Scholar
  • 23 Browning JD, Baker JA, Rogers T, Davis J, Satapati S, Burgess SC. Short-term weight loss and hepatic triglyceride reduction: evidence of a metabolic advantage with dietary carbohydrate restriction. Am J Clin Nutr 2011; 93 (05) 1048-1052.
    CrossrefPubMedGoogle Scholar
  • 24 Jacobsson B, Smith U. Effect of cell size on lipolysis and antilipolytic action of insulin in human fat cells. J Lipid Res 1972; 13: 651-656.
    PubMedGoogle Scholar
  • 25 Laurencikiene J, Skurk T, Kulyteé A, Heden P, Åstrom G, Sjolin E, Ryden M, Hauner H, Arner P. Regulation of Lipolysis in Small and Large Fat Cells of the Same Subject. J Clin Endocrinol Metab 2011; 96: E2045-E2049.
    CrossrefPubMedGoogle Scholar
  • 26 Yang MU, van Itallie TB. Variability in body protein loss during protracted, severe caloric restriction: role of triiodothyronine and other possible determinants. Am J Clin Nutr 1984; 40 (03) 611-622.
    CrossrefPubMedGoogle Scholar
  • 27 Dow CA, Thomson CA, Flatt SW, Sherwood NE, Pakiz B, Rock CL. Predictors of improvement in cardiometabolic risk factors with weight loss in women. J Am Heart Assoc 2013; 02 (06) e000152.
    CrossrefPubMedGoogle Scholar
  • 28 Becker LKenneth. Principles and Practice of Endocrinology and Metabolism. 3rd Ed.. Lippincott Williams & Wilkins; 2001
    Google Scholar
  • 29 Lagerpusch M, Bosy-Westphal A, Kehden B, Peters A, Müller MJ. Effects of brief perturbations in energy balance on indices of glucose homeostasis in healthy lean men. Int J Obes (Lond) 2012; 36 (08) 1094-1101.
    CrossrefPubMedGoogle Scholar
  • 30 Lagerpusch M, Enderle J, Eggeling B, Braun W, Johannsen M, Pape D, Müller MJ, Bosy-Westphal A. Carbohydrate quality and quantity affect glucose and lipid metabolism during weight regain in healthy men. J Nutr 2013; 143 (10) 1593-1601.
    CrossrefPubMedGoogle Scholar
  • 31 Müller MJ, Enderle J, Pourhassan M, Braun W, Eggeling B, Lagerpusch M, Glüer C-C, Kehayias JJ, Kiosz D, Bosy-Westphal A. Metabolic adaptation to caloric restriction and subsequent refeeding: The Minnesota Starvation Experiment revisited. Am J Clin Nutr. In press 2015
    PubMedGoogle Scholar
  • 32 Lambrinoudaki I, Armeni E, Rizos D, Georgiopoulos G, Athanasouli F, Triantafyllou N, Panoulis K, Augoulea A, Creatsa M, Alexandrou A, Alevizaki M, Stamatelopoulos K. Indices of adiposity and thyroid hormones in euthyroid postmenopausal women. Eur J Endocrinol 2015; 173 (02) 237-245.
    CrossrefPubMedGoogle Scholar
  • 33 Wang J, Zheng X, Sun M, Wang Z, Fu Q, Shi Y, Cao M, Zhu Z, Meng C, Mao J, Yang F, Huang X, Xu J, Zhou H, Duan Y, He W, Zhang M, Yang T. REACTION Study Group. Low serum free thyroxine concentrations associate with increased arterial stiffness in euthyroid subjects: a population-based cross-sectional study. Endocrine. 2015 May 19. [Epub ahead of print].
    PubMedGoogle Scholar
  • 34 Dullaart RP, de Vries R, Roozendaal C, Kobold AC, Sluiter WJ. Carotid artery intima media thickness is inversely related to serum free thyroxine in euthyroid subjects. Clin Endocrinol (Oxf) 2007; 67 (05) 668-673.
    CrossrefPubMedGoogle Scholar
  • 35 Amouzegar A, Kazemian E, Gharibzadeh S, Mehran L, Tohidi M, Azizi F. Association between thyroid hormones, thyroid antibodies and insulin resistance in euthyroid individuals: A populationbased cohort. Diabetes Metab. 2015 Jun 3. pii: S1262-3636(15)00062-2. [Epub ahead of print].
    PubMedGoogle Scholar
  • 36 Gluvic Z, Sudar E, Tica J, Jovanovic A, Zafirovic S, Tomasevic R, Isenovic ER. Effects of levothyroxine replacement therapy on parameters of metabolic syndrome and atherosclerosis in hypothyroid patients: a prospective pilot study. Int J Endocrinol 2015; 2015: 147070.
    PubMedGoogle Scholar
  • 37 De Pergola G, Ciampolillo A, Paolotti S, Trerotoli P, Giorgino R. Free triiodothyronine and thyroid stimulating hormone are directly associated with waist circumference, independently of insulin resistance, metabolic parameters and blood pressure in overweight and obese women. Clin Endocrinol (Oxf) 2007; 67 (02) 265-269.
    CrossrefPubMedGoogle Scholar
  • 38 Weinbrenner T, Züger M, Jacoby GE, Herpertz S, Liedtke R, Sudhop T, Gouni-Berthold I, Axelson M, Berthold HK. Lipoprotein metabolism in patients with anorexia nervosa: a case-control study investigating the mechanisms leading to hypercholesterolaemia. Br J Nutr 2004; 91 (06) 959-969.
    CrossrefPubMedGoogle Scholar
  • 39 Wolters B, Lass N, Reinehr T. TSH and free triiodothyronine concentrations are associated with weight loss in a lifestyle intervention and weight regain afterwards in obese children. Eur J Endocrinol 2013; 168 (03) 323-329.
    CrossrefPubMedGoogle Scholar
  • 40 Santini F, Pinchera A, Marsili A, Ceccarini G, Castagna MG, Valeriano R, Giannetti M, Taddei D, Centoni R, Scartabelli G. et al. Lean body mass is a major determinant of levothyroxine dosage in the treatment of thyroid diseases. J Clin End Metab 2005; 90: 124-127.
    CrossrefPubMedGoogle Scholar
  • 41 http://www.peak.ag/blog/fettabbau-und-fettauf bau-stoffwechsel-der-adipozyten-ii (zugegriffen am 20.7.2015).
    PubMed
  • 42 Streat SJ, Brodie AH, Hill GL. Aggressive nutritional support does not prevent protein loss despite fat gain in septic intensive care patients. J Trauma 1987; 27: 262-266.
    CrossrefPubMedGoogle Scholar
  • 43 Sanchez A, Azen C, Jones B, Louie S, Sattler F. Relationship of Acute Phase Reactants and Fat Accumulation during Treatment for Tuberculosis. Tuberc Res Treat 2011; 2011: 346295.
    PubMedGoogle Scholar
  • 44 Elkan AC, Engvall IL, Tengstrand B, Cederholm T, Hafström I. Malnutrition in women with rheumatoid arthritis is not revealed by clinical anthropometrical measurements or nutritional evaluation tools. Eur J Clin Nutr 2008; 62 (10) 1239-1247.
    CrossrefPubMedGoogle Scholar
  • 45 Biolo G, Williams BD, Fleming RY, Wolfe RR. Insulin action on muscle protein kinetics and amino acid transport during recovery after resistance exercise. Diabetes 1999; 48: 949-957.
    CrossrefPubMedGoogle Scholar
  • 46 Gardner DF, Kaplan MM, Stanley CA, Utiger RD. Effect of Tri-Iodothyronine Replacement on the Metabolic and Pituitary Responses to Starvation. N Engl J Med 1979; 300: 579-584.
    CrossrefPubMedGoogle Scholar
  • 47 Bell AW, Bauman DE, Currie WB. Regulation of nutritent partitioning and metabolism during preand postnatal growth. J Anim Sci 1987; 65: 186-212.
    CrossrefPubMedGoogle Scholar
  • 48 Björntorp P. The regulation of adipose tissue distribution in humans. Int J Obes Relat Metab Disord 1996; 20 (04) 291-302.
    PubMedGoogle Scholar
  • 49 Anawalt BD, Merriam GR. Neuroendocrine aging in men. Andropause and somatopause. Endocrinol Metab Clin North Am 2001; 30 (03) 647-669.
    PubMedGoogle Scholar
  • 50 Abildgaard J, Pedersen AT, Green CJ, HarderLauridsen NM, Solomon TP, Thomsen C, Juul A, Pedersen M, Pedersen JT, Mortensen OH, Pilegaard H, Pedersen BK, Lindegaard B. Menopause is associated with decreased whole body fat oxidation during exercise. Am J Physiol Endocrinol Metab 2013; 304 (11) E1227-1236.
    CrossrefPubMedGoogle Scholar
  • 51 Wang P, Menheere PP, Astrup A. et al. Diogenes consortium. Metabolic syndrome, circulating RBP4, testosterone, and SHBG predict weight regain at 6 months after weight loss in men. Obesity (Silver Spring) 2013; 21 (10) 1997-2006.
    CrossrefPubMedGoogle Scholar
  • 52 Ströhle A, Hahn A, Sebastian A. Estimation of the diet-dependent net acid load in 229 worldwide historically studied hunter-gatherer societies. Am J Clin Nutr 2010; 91 (02) 406-412.
    CrossrefPubMedGoogle Scholar
  • 53 Barnosky AR, Hoddy KK, Unterman TG, Varady KA. Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings. Transl Res 2014; 164 (04) 302-311.
    CrossrefPubMedGoogle Scholar
  • 54 Johnson JB, Summer W, Cutler RG, Martin B, Hyun DH, Dixit VD, Pearson M, Nassar M, Telljohann R, Maudsley S, Carlson O, John S, Laub DR, Mattson MP. Alternate day calorie restriction improves clinical findings and reduces marers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radic Biol Med 2007; 42 (05) 665-674.
    CrossrefPubMedGoogle Scholar
  • 55 Scheer FA, Hilton MF, Mantzoros CS, Shea SA. Adverse metabolic and cardiovascular consequences of circadian misalignment. Proc Nat Acad Sci USA 2009; 106 (01) 4453-4458.
    CrossrefPubMedGoogle Scholar
  • 56 Jakubowicz D, Barnea M, Wainstein J, Froy O. High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women. Obesity (Silver Spring) 2013; 21 (12) 2504-2512.
    CrossrefPubMedGoogle Scholar
  • 57 Garaulet M, Gómez-Abellán P, AlburquerqueBéjar JJ, Lee YC, Ordovás JM, Scheer FA. Timing of food intake predicts weight loss effectiveness. Int J Obes 2013; 37 (04) 604-611.
    CrossrefPubMedGoogle Scholar
  • 58 Brown AW, Bohan MMBrown, Allison DB. Belief beyond the evidence: Using the proposed effect of breakfast on obesity to show 2 practices that distort scientific evidence. Am J Clin Nutr 2013; 98 (05) 1298-1308.
    CrossrefPubMedGoogle Scholar
  • 59 Dhurandhar EJ, Dawson J, Alcorn A, Larsen LH, Thomas EA, Cardel M, Bourland AC, Astrup A, St-Onge MP, Hill JO, Apovian CM, Shikany JM, Allison DB. The effectiveness of breakfast recommendations on weight loss: A randomized controlled trial. Am J Clin Nutr 2014; 100 (02) 507-513.
    CrossrefPubMedGoogle Scholar