Positive energy balance is associated with accelerated muscle atrophy and increased erythrocyte glutathione turnover during 5 wk of bed rest

Biolo, Gianni; Agostini, Francesco; Šimunič, Boštjan; Sturma, Mariella; Torelli, Lucio; Preiser, Jean Charles; Deby‐Dupont, G.; Magni, Paolo; Strollo, Felice; Prampero, P. E. di; Guarnieri, Gianfranco; Mekjavic, Igor B.; Pišot, Rado; Narici, Marco V.

doi:10.1093/ajcn/88.4.950

Cited by 120 publications

(120 citation statements)

References 32 publications

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“…Progressive reduction of physical activity is further observed with disease progression due to worsening obesity and its joint and musculoskeletal complications [22], with direct negative impact on muscle protein turnover and muscle oxidative and performance capacity [39,40]. …”

Section: Introduction: What We Knowmentioning

confidence: 99%

“…The latter include muscle fat accumulation that reduces muscle density and quality with lower contractile protein content per unit tissue [35,53,54], mitochondrial dysfunction that may cause impaired ATP production, and maximal oxygen consumption leading to both reduced strength and endurance [21]. Physical inactivity that reduces muscle mass, mitochondrial biogenesis and function, and tissue lipid oxidation, also leads to reduced strength and endurance potentially enhancing tissue and systemic inflammation and oxidative stress [39,40,55]. …”

Section: Introduction: What We Knowmentioning

confidence: 99%

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Sarcopenic Obesity: Time to Meet the Challenge

et al. 2018

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The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social, and multidisciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures, and cancer as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability, and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term ‘sarcopenic obesity' has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification, and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria, and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has a strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.

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Section: Introduction: What We Knowmentioning

confidence: 99%

Section: Introduction: What We Knowmentioning

confidence: 99%

Sarcopenic Obesity: Time to Meet the Challenge

et al. 2018

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“…Further the concept of counting only non-protein calories, but not including the energy from proteins, contributed to overfeeding. Th is way to calculate energy intake should defi nitively be banned: All energy sources should be included in the total energy counts [23,24]. Finally, a computerized information system is needed to be aware of the rather important amounts of energy infused for non-nutritional purpose, including glucose 5% solutions and fat soluble sedatives [25].…”

Section: Consequences Of Under-and Over-feedingmentioning

confidence: 99%

“…Th e problem is that all patients were overfed, the pseudo-lowcalorie group being less overfed than the other, so of course doing better! As previously stated, all substrates must be included in the calculations [24]! After a study by Fong et al in volunteers given endotoxin [27], parenteral nutrition became considered a poison, because its delivery had primed a stronger infl ammatory response compared with enteral nutrition.…”

Section: Underfeeding and Pseudo-underfeedingmentioning

confidence: 99%

Best Timing for Energy Provision during Critical Illness

Berger¹,

Pichard²

2012

Annual Update in Intensive Care and Emergency Medicine 2012

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“…However, the determination of nutritional requirements in critical illness remains controversial. There is some limited data from the bed rest (aerospace) literature suggesting that overfeeding may be harmful, with increased inflammatory markers and accelerated muscle atrophy in participants who do not reduce caloric intake after the initiation of bed rest (Biolo et al, 2008). Congruent with this, a recent study in critical illness found that permissive underfeeding (goal 60-70% of estimated nutritional requirements) resulted in lower hospital mortality compared to those fed with a goal of 100% of estimated requirements (Arabi et al, 2011).…”

Section: Nutritionmentioning

confidence: 99%

Inspiratory muscle training to enhance recovery from invasive mechanical ventilation

Bissett¹

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Inspiratory muscle weakness is a consequence of prolonged mechanical ventilation and may contribute to the residual physical disability which has been observed in intensive care survivors. Inspiratory muscle weakness is associated with duration of mechanical ventilation, with those ventilated for 7 days or longer most at risk of developing both strength and endurance deficits.Specific resistance training of the inspiratory muscles (inspiratory muscle training) improves inspiratory muscle strength and endurance in normal people, athletes and patients with a wide variety of underlying pathologies. Mechanisms of improvement include proliferation of both Type 1 and Type 2 inspiratory muscle fibres, enhanced metabolism resulting in reduced lactate production, attenuation of a fatigue-induced metaboreflex, adaptations to neural pathways and modulation of the perception of dyspnoea.Furthermore, inspiratory muscle training enhances exercise tolerance and reduces dyspnoea in both patients and athletes, while improving quality of life for patients with chronic lung or heart disease.There is a lack of evidence for inspiratory muscle training in intensive care patients, despite the potential benefits of training in this group. This project explores the feasibility, safety and efficacy of inspiratory muscle training in intensive care patients who have been mechanically ventilated for 7 days or longer, as this subset of patients is most likely to demonstrate inspiratory muscle weakness and therefore benefit from specific training. This project includes patient-centred outcome measures, as most studies of inspiratory muscle training to date have focused solely on impairments, rather than the patient experiences of quality of life, physical function or dyspnoea.Study 1 establishes the safety and feasibility of high-intensity interval-based inspiratory muscle training in selected ventilator-dependent patients. Across 195 inspiratory muscle training sessions, there were no adverse events recorded during or immediately following the treatment. No significant changes were observed in heart rate, blood pressure, respiratory rate or oxygen saturation. Furthermore, mean training pressures increased by a mean difference of 18.6 cm H2O across the 10 patients studied. Thus Study 1 confirms that inspiratory muscle training is safe in selected ventilator-dependent patients.-ii- (mean difference 11%), but not endurance, while quality of life improved more in the experimental group than the control (mean difference 12%). Improvements in physical function and dyspnoea were equivalent. Thus 2 weeks of inspiratory muscle training improves inspiratory muscle strength and quality of life in the post-weaning period.-iiiFinally, Study 5 is a protocol for a randomised trial of inspiratory muscle training performed by patients while mechanically-ventilated. Study 5 measures the impact of inspiratory muscle training on duration of mechanical ventilation, as well as residual inspiratory muscle strength and endurance, quality of life, physical f...

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Positive energy balance is associated with accelerated muscle atrophy and increased erythrocyte glutathione turnover during 5 wk of bed rest

Abstract: Positive energy balance during inactivity is associated with greater muscle atrophy and with activation of systemic inflammation and of antioxidant defenses. Optimizing caloric intake may be a useful strategy for mitigating muscle loss during period of chronic inactivity.

Cited by 120 publications

References 32 publications

Sarcopenic Obesity: Time to Meet the Challenge

Sarcopenic Obesity: Time to Meet the Challenge

Best Timing for Energy Provision during Critical Illness

Inspiratory muscle training to enhance recovery from invasive mechanical ventilation

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