Loss of fat, water, and protein during very low calorie diets and complete starvation

Weck, M; Fischer, Siegmund; Hanefeld, Markolf; Leonhardt, W.; Julius, Ulrich; Gräser, W.; Schneider, B. H.; Haller, Hermann

doi:10.1007/bf01734837

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…Clinical data. Earlier studies of changes in body composition of obese women during caloric restriction, using nitrogen balance and total body water measurements with tritiated water, showed that from day 10 and thereafter, nearly half of the body weight loss during VLCD is caused by loss of fat (26). The characteristics of the obese subjects before and during caloric restriction are shown in Tables 1 and 2.…”

Section: Methodological Experimentsmentioning

confidence: 99%

Evidence for a Major Role of Skeletal Muscle Lipolysis in the Regulation of Lipid Oxidation During Caloric Restriction In Vivo

Hagström-Toft¹,

Thörne

Reynisdottir³

et al. 2001

Diabetes

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A lipolytic process in skeletal muscle has recently been demonstrated. However, the physiological importance of this process is unknown. We investigated the role of skeletal muscle lipolysis for lipid utilization during caloric restriction in eight obese women before and after 11 days of very low-calorie diet (VLCD) (2.2 MJ per day). Subjects were studied with indirect calorimetry and microdialysis of skeletal muscle and adipose tissue in order to analyze substrate utilization and glycerol (lipolysis index) in connection with a two-step euglycemic-hyperinsulinemic (12 and 80 mU/m 2 ⅐ min) clamp. Local blood flow rates in the two tissues were determined with 133 Xe-clearance. Circulating free fatty acids and glycerol decreased to a similar extent during insulin infusion before and during VLCD, and there was a less marked insulin-induced reduction in lipid oxidation during VLCD. Adipose tissue glycerol release was hampered by insulin infusion to the same extent (ϳ40%) before and during VLCD. Skeletal muscle glycerol release was not influenced by insulin before VLCD. However, during VLCD insulin caused a marked (fivefold) (P < 0.01) increase in skeletal muscle glycerol release. The effect was accompanied by a fourfold stimulation of skeletal muscle blood flow (P < 0.01). We propose that, during short-term caloric restriction, the reduced ability of insulin to inhibit lipids, despite a preserved antilipolytic effect of the hormone in adipose tissue, is caused by an augmented mobilization of fat from skeletal muscle, and that a physiological role of muscle lipolysis provides a local source of fatty acids.

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Section: Methodological Experimentsmentioning

confidence: 99%

Evidence for a Major Role of Skeletal Muscle Lipolysis in the Regulation of Lipid Oxidation During Caloric Restriction In Vivo

Hagström-Toft¹,

Thörne

Reynisdottir³

et al. 2001

Diabetes

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“…It is commonly assumed that the decline in body weight affects all body compartments with an ensuing general effect on various body functions. Studies on the mechanisms behind weight loss associated with starvation, semistarvation, tumor burden, cardiac cachexia, and liver cirrhosis [5][6][7][8][9][10] have shown a variety of changes in body composition; but because there have been few observations after gastrectomy [11] our primary aim was to obtain detailed information on the changes in body composition (fourcompartment model) occurring concomitantly with the weight loss that is a regular phenomenon during the first year after gastrectomy. Although the mechanisms behind this weight loss are multifactorial, one is most likely semistarvation due to impaired food intake [5,12,13].…”

mentioning

confidence: 99%

“…Studies on the mechanisms behind weight loss associated with starvation, semistarvation, tumor burden, cardiac cachexia, and liver cirrhosis [5][6][7][8][9][10] have shown a variety of changes in body composition; but because there have been few observations after gastrectomy [11] our primary aim was to obtain detailed information on the changes in body composition (fourcompartment model) occurring concomitantly with the weight loss that is a regular phenomenon during the first year after gastrectomy. Although the mechanisms behind this weight loss are multifactorial, one is most likely semistarvation due to impaired food intake [5,12,13]. Surgical interest has therefore focused on the significance of retaining or reconstructing a gastric reservoir after gastrectomy to counteract these adverse consequences, but clinical data so far have been contradictory.…”

mentioning

confidence: 99%

Changes in Body Composition after Gastrectomy: Results of a Controlled, Prospective Clinical Trial

et al. 1997

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To elucidate mechanisms involved in weight development after gastrectomy we have prospectively determined changes in body composition during the first year after similar operations. A total of 75 patients were enrolled who had a "curative operation" for gastric carcinoma; 42 were randomized to have a total gastrectomy, 23 total gastrectomy with a gastric substitute, and 10 subtotal gastrectomy. All reconstructions were done with a Roux-en-Y loop of the jejunum. Body composition was assessed preoperatively and at 6 and 12 months after gastrectomy by determining total body potassium and total body water. From these estimates, body cell mass, extracellular water, fat-free extracellular solids, and body fat were calculated with knowledge of the actual body weight and length. Triceps skinfold, arm muscle circumference, and grip strength were also measured. Weight loss (10% of preoperative weight) occurred early after the operations, after which body weight stabilized. Body cell mass remained essentially unchanged over the entire study period in contrast to body fat, which decreased by 40% during the first 6 months after gastrectomy. In accordance with the selective loss of body fat, we recorded a significant decrease in triceps skinfold figures and only a minor decrease of arm muscle circumference without obvious deterioration in hand grip strength. Weight loss after gastrectomy seems to be characterized by selective loss of body fat in contrast to other known clinical situations associated with impaired nutritional intake. Our observations form a basis for future clinical research aimed at preventing weight loss after these operations.

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“…We performed additional measurements during the initial stages of fasting with VLED and during the initial stages of refeeding with conventional food. Different methods have shown that marked changes in body water compartments occur during this time (14,21,28). Thus, we hypothesized that greater discrepancy between the two methods potentially could occur at that point.…”

Section: Discussionmentioning

confidence: 97%

“…It has been well demonstrated that a profound natruresis and shifts in body water compartments occur during treatment especially with the beginning of a very-low-energy diet (VLED) and with the reintroduction of conventional food (14, 21,28). Because most methods for estimating FFM are based on specific assumptions about the hydration of tissues or body compartments, it is difficult to know how these measures are affected during these times.…”

Section: Introductionmentioning

confidence: 99%

Serial Measurements of Body Composition in Obese Subjects During a Very‐Low‐Energy Diet (VLED) Comparing Bioelectrical Impedance with Hydrodensitometry

et al. 1997

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Bioelectrical impedance analysis (BIA) is a convenient, inexpensive, and noninvasive technique for measuring body composition. BIA has been strongly correlated with total body water (TBW) and also has been validated against hydrodensitometry (HD). The accuracy and clinical utility of BIA and HD during periods of substantial weight loss remain controversial. We measured body composition in moderately and severely obese patients serially using both methods during a very-low-energy diet (VLED). Mean initial weight in these patients was 116 (+ 30) kg (range, 74-196 kg). Mean weight loss was 24 (+ 13) kg with a decrease in fat mass (FM) by HD of 20 kg (peO.001) and a decrease in fat-free mass (FFM) of 3.6 kg beO.05). Loss of FFM is best predicted by the rate (kg/wk) of weight loss (?=0.86, peO.0001). FFM, as predicted from BIA equations, was highly correlated with FFM as estimated by HD during all testing sessions (r=0.92-0.98). Although highly correlated, BIA overestimated FFM relative to HD and this difference appeared to be more pronounced for taller patients with greater truncal obesity. Although 250-256.Submitted for publication September 9, 1996. Accepted for publication January 3, 1997. the discrepancy was no greater during weight-loss treatment, the level of disagreement was considerable. Therefore, the two methods cannot be used interchangeably to monitor relative changes in body composition in patients with obesity during treatment with VLED. The discrepancy between BIA and HD may be caused by body mass distribution considerations and by perturbations in TBW which affect the hydration quotient for FFM (BIA) and/or which affect the density constants for FFM and FM (HD).

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Loss of fat, water, and protein during very low calorie diets and complete starvation

Cited by 6 publications

References 17 publications

Evidence for a Major Role of Skeletal Muscle Lipolysis in the Regulation of Lipid Oxidation During Caloric Restriction In Vivo

Evidence for a Major Role of Skeletal Muscle Lipolysis in the Regulation of Lipid Oxidation During Caloric Restriction In Vivo

Changes in Body Composition after Gastrectomy: Results of a Controlled, Prospective Clinical Trial

Serial Measurements of Body Composition in Obese Subjects During a Very‐Low‐Energy Diet (VLED) Comparing Bioelectrical Impedance with Hydrodensitometry

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