Submitted to: Journal of Nutrition
Publication Type: Peer reviewed journal
Publication Acceptance Date: 9/17/2007
Publication Date: 12/1/2007
Citation: Butte, N.F., Puyau, M.R., Vohra, F.A., Adolph, A.L., Mehta, N.R., Zakeri, I. 2007. Body size, body composition, and metabolic profile explain higher energy expenditure in overweight children. Journal of Nutrition. 137(12):2660-2667. Interpretive Summary: Energetic adaptations and altered fuel utilization have been reportedly associated with obesity. In this study, we explored whether lower relative rates of energy expenditure, higher energy efficiency, or lower fat oxidation are associated with childhood obesity. In 836 non-overweight and overweight Hispanic children, we performed 24-h room calorimetry, anthropometric, and body composition measurements. We observed higher rates of energy expenditure in overweight children which were largely explained by differences in body size and composition, with minor contributions of thyroid and sympathoadrenal systems. Fat and carbohydrate utilization did not differ between the non-overweight or overweight children. Energetic adaptations were not associated with childhood obesity.
Technical Abstract: Lower relative rates of energy expenditure (EE), increased energetic efficiency, and altered fuel utilization purportedly associated with obesity have not been demonstrated indisputably in overweight children. We hypothesized that differences in energy metabolism between nonoverweight and overweight children are attributable to differences in body size and composition, circulating thyroid hormones, sympathetic nervous system, and adrenomedullary activity. A total of 836 Hispanic children, 5-19 y old, participated in 24-h calorimetry, anthropometric, and dual-energy X-ray absorptiometry measurements. Biochemistries were determined by standard techniques. Absolute total EE (TEE) and its components (sleep EE, basal EE, sedentary EE, cycling EE, walking EE, activity EE, nonexercising activity thermogenesis) were higher in overweight children (P = 0.001). Net mechanical energetic efficiency of cycling was lower in overweight children (P = 0.001). Adjusting for body size and composition accounted for differences in TEE, its components, and energetic efficiency. Net carbohydrate and fat utilization did not differ between groups. TEE was independently influenced by sex, Tanner stage, fat free mass, fat mass (FM), fasting serum nonesterified fatty acids (NEFA), leptin, free thyroxine, triiodothyronine, and 24-h urinary norepinephrine and epinephrine. Fat utilization was independently associated with age2, sex, FM, fasting serum NEFA, triacylglycerol, adiponectin, leptin, total thyroxine, and free triiodothyronine. Higher EE in overweight children was largely explained by differences in body size and composition, with minor contributions of thyroid and sympathoadrenal systems. Alterations in EE, energetic efficiency, and substrate utilization were not evident in the overweight children.