Body Composition and Lipid Metabolism at Rest and During Exercise: A Cross-Sectional Analysis.

NCT ID: NCT03029364

Last Updated: 2024-05-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

114 participants

Study Classification

OBSERVATIONAL

Study Start Date

2018-01-08

Study Completion Date

2024-05-11

Brief Summary

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The ability to upregulate fat oxidation at appropriate times such as during fasting, low to moderate intensity exercise and after a high fat meal, is popularly advocated. This is presumably due to the perception that a high capacity to utilise fat may improve (ultra) endurance performance and help in the regulation of body fat and metabolic diseases. In accordance, impaired fat use at rest has been associated with obesity and insulin resistance (Kelley et al., 1999). However, there is inconclusive and / or a lack of systematic evidence, especially in a large diverse range of adults, exploring:

1\) Whether whole body fat use during exercise is altered in individuals with overweight or obesity compared to lean individuals

3\) The intra-individual variability in whole-body fat use at rest and during exercise

4\) Physiological, metabolic, lifestyle and genetic characteristics that are associated with whole-body fat use at rest and during exercise

Therefore, the objectives of this study are three-fold:

1. To explore whether whole body fat use is associated with body composition
2. To explore associations between whole-body fat use and physiological, metabolic, lifestyle and genetic variables
3. To assess the intra-individual variability of whole-body fat use.

This study is an observational, exploratory cross-sectional study. A wide range of 'healthy' and 'at-risk of metabolic disease' adults will be recruited.

Participants will be asked to visit a laboratory at the University of Bath four times. Visit 1 is a screening and study familiarisation visit. Visits 2 and 3 are to be completed within 7-14 days and involve lifestyle monitoring (dietary and physical activity), a one-off urine and blood sample, assessment of fuel use at rest and during exercise (the latter through an incremental graded cycling exercise test to exhaustion). Visit 4 is to assess body composition via a dual-energy x-ray absorptiometry (DEXA) scan in addition to an optional skeletal muscle and / or fat tissue biopsy.

Detailed Description

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Metabolic flexibility broadly refers to the ability to utilize the right fuel source for energy (primarily either carbohydrate or fat) at the right time (Kelley and Mandarino, 2000). This was first conceptualised at the level of skeletal muscle (Kelley and Mandarino, 1990; Andres et al., 1956). A main tenant originally captured by 'metabolic flexibility' is the predominant utilization of fat as an energy source under rested post-absorptive conditions in 'healthy' individuals (Kelley et al., 1999; Kelley and Mandarino, 1990). Recently, there has been a call to extend the concept of 'metabolic flexibility' to exercising conditions (Goodpaster and Sparks, 2017; Rynders et al., 2017). Similarly to at rest, fat provides an important source of energy during low-to-moderate intensity exercise (van Loon et al., 2001; Romijn et al., 1993). Thus, in healthy individuals at the whole-body and skeletal muscle level, it is robustly characterised and accepted that fat is an important and predominant fuel source for energy under such conditions.

However, it is commonly proposed that a lower reliance upon fat as a fuel source is present in individuals with obesity and type 2 diabetes and consequently, has been implicated in the pathogenesis of such conditions (Rynders et al., 2017; Kelley and Mandarino, 2000). Alternatively, a high capacity to utilize fat under the aforementioned two situations is advocated to be a desirable trait for both athletes and non-athletes, presumably due to the perception that high rates of fat utilization may improve endurance performance and/or assist with the regulation of body fat and metabolic health. As such, much interest has been generated into upregulating fat utilization at appropriate times e.g. during fasting and low-to-moderate intensity exercise.

Correspondingly, lower resting and exercising fat use has been reported in individuals with obesity vs lean (e.g. Lanzi et al., 2014; Perez-Martin et al., 2001; Kelley et al., 1999). Furthermore, greater fat use at rest has been associated with lower future body weight and fat gain / regain (e.g. Shook et al., 2016; Seidell et al., 1992), and during exercise with reduced short term post-exercise energy intake / balance (e.g. Hopkins et al., 2012), exercise-induced fat loss (Barwell et al., 2008) and weight loss / maintenance (Dandadell et al., 2017). Importantly, however, this relationship is not always apparent with similar (e.g. Blaize et a., 2014; Croci et al., 2014) or higher (e.g. Ara et al., 2011; Goodpaster et al., 2002; Horowtiz et al., 2000) rates of fat use at rest and during exercise reported in individuals with obesity compared to lean counterparts. Furthermore, cross-sectional and prospective associations do not always exist between lower fat use and greater body weight / fat mass gain or regain (e.g. Dandanell et al., 2017; Ellis et al., 2010). Thus, despite being popularly advocated, it is currently unclear whether lower fat use at rest or during exercise predisposes or is a characteristic of excess adiposity (i.e. obesity).

The inconsistent findings could partly be due to numerous methodological discrepancies between studies such as participant characteristics, matching of comparative groups, the exercise protocol utilised and / or the assessment of body composition, lipid oxidation and cardio-respiratory fitness levels.

Therefore, through the use of well-established and respected techniques, we aim to comprehensively and systematically explore whether whole-body fat use at rest and during exercise is:

1. Altered in individuals with overweight or obesity compared to lean individuals
2. Further determinants / factors that may influence fat use
3. The intra-individual variation in fat use which will help to more confidently determine the above objectives.

Conditions

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Lipid Metabolism Substrate Metabolism Exercise

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Male and Female Adults

Completion of Study Protocol

Study Protocol

Intervention Type BEHAVIORAL

Participants will complete three study protocols 7 - 28 days apart which includes:

* 3 x main trial days (max. 150 mins) involving body composition analysis, indirect calorimetry, a blood sample, optional muscle and / or adipose tissue biopsies and a maximal cardiorespiratory fitness test.
* 2 x lifestyle monitoring periods (physical activity and diet) for the prior 7 days before each main trial day.
* Maintenance of habitual habits, dietary and physical activity behaviour patterns

We are observing biological / health parameters in a group of individuals who will be assessed under resting and exercising conditions. The current study does not involve an intervention.

Interventions

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Study Protocol

Participants will complete three study protocols 7 - 28 days apart which includes:

* 3 x main trial days (max. 150 mins) involving body composition analysis, indirect calorimetry, a blood sample, optional muscle and / or adipose tissue biopsies and a maximal cardiorespiratory fitness test.
* 2 x lifestyle monitoring periods (physical activity and diet) for the prior 7 days before each main trial day.
* Maintenance of habitual habits, dietary and physical activity behaviour patterns

We are observing biological / health parameters in a group of individuals who will be assessed under resting and exercising conditions. The current study does not involve an intervention.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* be between 18 - 65 years of age
* male or female
* body mass index between 18.9 - 35 kg/m2
* be able and willing to give informed oral and written consent
* complete and meet the defined criteria of pre-study questionnaires and screens

Exclusion Criteria

* Currently have or have a previous history of metabolic, cardio-pulmonary or musculoskeletal disease
* BMI below 18.9 or above 35 kg/m2
* Have plans to change lifestyle (diet and/or physical activity) during the study period ( 7 - 21 days)
* Unwillingness or unable to sufficiently meet study demands
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Bath

OTHER

Sponsor Role lead

Responsible Party

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Javier Gonzalez

Lecturer (Assistant Professor) in Human Physiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Javier T Gonzalez, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Bath

Locations

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Department for Health, University of Bath

Bath, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Lanzi S, Codecasa F, Cornacchia M, Maestrini S, Salvadori A, Brunani A, Malatesta D. Fat oxidation, hormonal and plasma metabolite kinetics during a submaximal incremental test in lean and obese adults. PLoS One. 2014 Feb 11;9(2):e88707. doi: 10.1371/journal.pone.0088707. eCollection 2014.

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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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17/SW/0269

Identifier Type: -

Identifier Source: org_study_id

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