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Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats
BACKGROUND: There is currently no standard clinical refeeding diet for the treatment of anorexia nervosa (AN). To provide the most efficacious AN clinical care, it is necessary to define the metabolic effects of current refeeding diets. METHODS: An activity-based model of anorexia nervosa (AN) was u...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773993/ https://www.ncbi.nlm.nih.gov/pubmed/26937246 http://dx.doi.org/10.1186/s12986-016-0077-y |
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author | Giles, Erin D. Hagman, Jennifer Pan, Zhaoxing MacLean, Paul S. Higgins, Janine A. |
author_facet | Giles, Erin D. Hagman, Jennifer Pan, Zhaoxing MacLean, Paul S. Higgins, Janine A. |
author_sort | Giles, Erin D. |
collection | PubMed |
description | BACKGROUND: There is currently no standard clinical refeeding diet for the treatment of anorexia nervosa (AN). To provide the most efficacious AN clinical care, it is necessary to define the metabolic effects of current refeeding diets. METHODS: An activity-based model of anorexia nervosa (AN) was used in female rats. AN was induced over 7d by timed access to low fat (LF) diet with free access to a running wheel. Plasma hormones/metabolites and body composition were assessed at baseline, AN diagnosis (day 0), and following 28d of refeeding on LF diet. Energy balance and expenditure were measured via continuous indirect calorimetry on days −3 to +3. RESULTS: AN induction caused stress as indicated by higher levels of corticosterone versus controls (p < 0.0001). The rate of weight gain during refeeding was higher in AN rats than controls (p = 0.0188), despite lower overall energy intake (p < 0.0001). This was possible due to lower total energy expenditure (TEE) at the time of AN diagnosis which remained significantly lower during the entire refeeding period, driven by markedly lower resting energy expenditure (REE). AN rats exhibited lower lipid accumulation in visceral adipose tissues (VAT) but much higher liver accumulation (62 % higher in AN than control; p < 0.05) while maintaining the same total body weight as controls. It is possible that liver lipid accumulation was caused by overfeeding of carbohydrate suggesting that a lower carbohydrate, higher fat diet may be beneficial during AN treatment. To test whether such a diet would be accepted clinically, we conducted a study in adolescent female AN patients which showed equivalent palatability and acceptability for LF and moderate fat diets. In addition, this diet was feasible to provide clinically during inpatient treatment in this population. CONCLUSION: Refeeding a LF diet to restore body weight in female AN rats caused depressed TEE and REE which facilitated rapid regain. However, this weight gain was metabolically unhealthy as it resulted in elevated lipid accumulation in the liver. It is necessary to investigate the use of other diets, such as lower carbohydrate, moderate fat diets, in pre-clinical models to develop the optimal clinical refeeding diets for AN. |
format | Online Article Text |
id | pubmed-4773993 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47739932016-03-03 Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats Giles, Erin D. Hagman, Jennifer Pan, Zhaoxing MacLean, Paul S. Higgins, Janine A. Nutr Metab (Lond) Research BACKGROUND: There is currently no standard clinical refeeding diet for the treatment of anorexia nervosa (AN). To provide the most efficacious AN clinical care, it is necessary to define the metabolic effects of current refeeding diets. METHODS: An activity-based model of anorexia nervosa (AN) was used in female rats. AN was induced over 7d by timed access to low fat (LF) diet with free access to a running wheel. Plasma hormones/metabolites and body composition were assessed at baseline, AN diagnosis (day 0), and following 28d of refeeding on LF diet. Energy balance and expenditure were measured via continuous indirect calorimetry on days −3 to +3. RESULTS: AN induction caused stress as indicated by higher levels of corticosterone versus controls (p < 0.0001). The rate of weight gain during refeeding was higher in AN rats than controls (p = 0.0188), despite lower overall energy intake (p < 0.0001). This was possible due to lower total energy expenditure (TEE) at the time of AN diagnosis which remained significantly lower during the entire refeeding period, driven by markedly lower resting energy expenditure (REE). AN rats exhibited lower lipid accumulation in visceral adipose tissues (VAT) but much higher liver accumulation (62 % higher in AN than control; p < 0.05) while maintaining the same total body weight as controls. It is possible that liver lipid accumulation was caused by overfeeding of carbohydrate suggesting that a lower carbohydrate, higher fat diet may be beneficial during AN treatment. To test whether such a diet would be accepted clinically, we conducted a study in adolescent female AN patients which showed equivalent palatability and acceptability for LF and moderate fat diets. In addition, this diet was feasible to provide clinically during inpatient treatment in this population. CONCLUSION: Refeeding a LF diet to restore body weight in female AN rats caused depressed TEE and REE which facilitated rapid regain. However, this weight gain was metabolically unhealthy as it resulted in elevated lipid accumulation in the liver. It is necessary to investigate the use of other diets, such as lower carbohydrate, moderate fat diets, in pre-clinical models to develop the optimal clinical refeeding diets for AN. BioMed Central 2016-03-01 /pmc/articles/PMC4773993/ /pubmed/26937246 http://dx.doi.org/10.1186/s12986-016-0077-y Text en © Giles et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Giles, Erin D. Hagman, Jennifer Pan, Zhaoxing MacLean, Paul S. Higgins, Janine A. Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats |
title | Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats |
title_full | Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats |
title_fullStr | Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats |
title_full_unstemmed | Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats |
title_short | Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats |
title_sort | weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773993/ https://www.ncbi.nlm.nih.gov/pubmed/26937246 http://dx.doi.org/10.1186/s12986-016-0077-y |
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