Insulin Sensitivity, Metabolic Disease, Obesity
Conditions
Brief summary
Our goal is to examine linkages between physical activity, appetite control, and energy metabolism in adolescents. The investigators will assess metabolic function and appetite control in male and female adolescents stratified by bodyweight and physical activity using across-sectional study design.
Detailed description
Childhood obesity is the most serious public health problem of the 21st century, given the prevalence, global reach, and widespread health, economic, and social consequences. While weight gain at the most basic level is due to a chronic energy surplus, there are a host of influences that act on the energy balance system that remain largely unknown. Thus, there is a critical need to identify previously unexamined factors that may influence the energy balance system in order to develop effective interventions for prevention and treatment. Our long-term goal is to quantify the dynamic relationships between various physiological and psychological components of the energy balance system. Our short-term goal is to examine linkages between physical activity, appetite control, and energy metabolism in adolescents. The status quo as it relates to appetite control is that body weight status and related peripheral signals are a key regulator of energy intake. In contrast to body weight playing a primary role in energy regulation, our working hypothesis is that high levels of regular moderate-to-vigorous physical activity (MVPA) result in a metabolic phenotype consisting of enhanced metabolic function and proper regulation of appetite, which prevents the development of obesity. The investigators have reported that adults with low levels of MVPA have dysregulated appetite control, evidenced by higher levels of energy intake and elevated levels of dietary disinhibition. Additionally, the investigators have observed that rats with low fitness possess dysregulated control of appetite and reduced hepatic fat oxidation compared to rats with high fitness. Based on these findings in adults and rodents, in addition to supportive work by others, the investigators hypothesize that low levels of MVPA create a metabolic phenotype, leading to dysregulated appetite control which predisposes individuals to weight gain. To test this hypothesis the investigators will perform a study focused on the links between physical activity and appetite. The investigators will assess metabolic function and appetite control in male and female adolescents stratified by bodyweight (normal vs overweight/obese) and physical activity (sedentary vs. active) using a 2 x 2 cross-sectional study design (N=44). The specific aim of the proposed study is: 1) To examine the association between physical activity and appetite control in adolescents, with metabolic function serving as a mediator. At the completion of the study, it is our expectation that the investigators will have described the independent effects of physical activity and body weight on energy metabolism and appetite in adolescents. This study will have a significant positive impact on the understanding of energy balance in adolescents, and will inform public health interventions that specifically target mechanisms associated with weight gain in youth.
Interventions
This is a cross-sectional study; no intervention
Sponsors
Study design
Eligibility
Inclusion criteria
* Tanner Stage III-V * Non-smoking * Not currently involved in any other research study
Exclusion criteria
* Restrained eater (\>13) on the restraint section of the three-factor eating questionnaire; Current/past diagnosis of an eating disorder * Gave birth in the past 12 months or \<6 months post-lactation. * Self-reported medical conditions (diabetes, Crohn's disease, etc.) that may affect adherence to the protocol or exercising safely or alter metabolism * Medications known to affect exercise performance or metabolism (e.g. thyroid medication, beta-blockers, or stimulants)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Appetite- Subjective | Baseline | The investigators will measure subjective appetite ratings using visual analog scales related to hunger following a fixed-calorie meal: Hunger, Area Under the Curve (AUC) Hunger and palatability were assessed using self-rated visual analogue scales (Rogers, P. J., & Blundell, J. E. (1993). Intense sweeteners and appetite. The American Journal of Clinical Nutrition, 58(1), 120-122.) Scale is 0-100, with 0 equaling 'I am not hungry at all' and 100 equaling 'I have never been more hungry'. Area under the curve (AUC) was calculated for appetite variables by calculating the area of the response as you would a trapezoid. |
| Appetite- Objective | Baseline | The investigators will measure objective appetite responses using plasma ghrelin following a fixed-calorie meal. |
| Appetite- Adjusted | Baseline | The investigators will measure objective and subjective appetite responses as described above adjusted by insulin sensitivity (glucose infusion rate, mg/kg/min) as assessed in the euglycemic hyperinsulinemic clamp technique. Hunger score on a scale\*min adjusted for glucose infusion rate (mL/kgFFM/min) and sex |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Normal Weight, Active Male and female adolescents (age 14-17 years), BMI percentile \>=5th to \<75th for age/sex, \>=60 min/day of moderate/vigorous physical activity.
No intervention: This is a cross-sectional study; no intervention | 13 |
| Normal Weight, Sedentary Male and female adolescents (age 14-17 years), BMI percentile \>=5th to \<75th for age/sex, \<60 min/day of moderate/vigorous physical activity.
No intervention: This is a cross-sectional study; no intervention | 11 |
| Overweight/Obese, Active Male and female adolescents (age 14-17 years), BMI percentile \>=85th to \<99th for age/sex, \>=60 min/day of moderate/vigorous physical activity.
No intervention: This is a cross-sectional study; no intervention | 12 |
| Overweight/Obese, Sedentary Male and female adolescents (age 14-17 years), BMI percentile \>=85th to \<99th for age/sex, \<60 min/day of moderate/vigorous physical activity.
No intervention: This is a cross-sectional study; no intervention | 10 |
| Total | 46 |
Baseline characteristics
| Characteristic | Normal Weight, Active | Normal Weight, Sedentary | Overweight/Obese, Active | Overweight/Obese, Sedentary | Total |
|---|---|---|---|---|---|
| Age, Categorical <=18 years | 13 Participants | 11 Participants | 12 Participants | 10 Participants | 46 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous | 15.9 years STANDARD_DEVIATION 0.3 | 16.0 years STANDARD_DEVIATION 0.4 | 16.4 years STANDARD_DEVIATION 0.4 | 16.4 years STANDARD_DEVIATION 0.4 | 16.0 years STANDARD_DEVIATION 0.2 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 3 Participants | 4 Participants | 0 Participants | 9 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 11 Participants | 8 Participants | 8 Participants | 10 Participants | 37 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 0 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Black or African American | 2 Participants | 3 Participants | 1 Participants | 5 Participants | 11 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 10 Participants | 8 Participants | 11 Participants | 5 Participants | 34 Participants |
| Region of Enrollment United States | 13 Participants | 11 Participants | 12 Participants | 10 Participants | 46 Participants |
| Sex: Female, Male Female | 7 Participants | 10 Participants | 8 Participants | 6 Participants | 31 Participants |
| Sex: Female, Male Male | 6 Participants | 1 Participants | 4 Participants | 4 Participants | 15 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 13 | 0 / 11 | 0 / 12 | 0 / 10 |
| other Total, other adverse events | 2 / 13 | 2 / 11 | 2 / 12 | 1 / 10 |
| serious Total, serious adverse events | 0 / 13 | 0 / 11 | 0 / 12 | 0 / 10 |
Outcome results
Appetite- Adjusted
The investigators will measure objective and subjective appetite responses as described above adjusted by insulin sensitivity (glucose infusion rate, mg/kg/min) as assessed in the euglycemic hyperinsulinemic clamp technique. Hunger score on a scale\*min adjusted for glucose infusion rate (mL/kgFFM/min) and sex
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Normal Weight, Active | Appetite- Adjusted | 8686 score on a scale*min | Standard Deviation 1414 |
| Normal Weight, Sedentary | Appetite- Adjusted | 7885 score on a scale*min | Standard Deviation 1442 |
| Overweight/Obese, Active | Appetite- Adjusted | 6534 score on a scale*min | Standard Deviation 1528 |
| Overweight/Obese, Sedentary | Appetite- Adjusted | 8703 score on a scale*min | Standard Deviation 1537 |
Appetite- Objective
The investigators will measure objective appetite responses using plasma ghrelin following a fixed-calorie meal.
Time frame: Baseline
Population: Plasma ghrelin values were not assessed. Blood samples needed for assessment were not obtained due to lack of staff. Samples will not be collected in the future.
Appetite- Subjective
The investigators will measure subjective appetite ratings using visual analog scales related to hunger following a fixed-calorie meal: Hunger, Area Under the Curve (AUC) Hunger and palatability were assessed using self-rated visual analogue scales (Rogers, P. J., & Blundell, J. E. (1993). Intense sweeteners and appetite. The American Journal of Clinical Nutrition, 58(1), 120-122.) Scale is 0-100, with 0 equaling 'I am not hungry at all' and 100 equaling 'I have never been more hungry'. Area under the curve (AUC) was calculated for appetite variables by calculating the area of the response as you would a trapezoid.
Time frame: Baseline
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Normal Weight, Active | Appetite- Subjective | 9239.4 score on a scale*min | Standard Deviation 3635.1 |
| Normal Weight, Sedentary | Appetite- Subjective | 7879.6 score on a scale*min | Standard Deviation 5343.5 |
| Overweight/Obese, Active | Appetite- Subjective | 6130.5 score on a scale*min | Standard Deviation 4279.7 |
| Overweight/Obese, Sedentary | Appetite- Subjective | 8970.0 score on a scale*min | Standard Deviation 3664.9 |