Presented by Mujan Noroozian Claude Bouchard PHD Angelo Tremblay PHD Jean Pierre Despres PHD Andre Nadeau MD Paul J Lupien MD Germain Theriault MD Jean Dussault ID: 357476
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Slide1
The Response to Long Term Overfeeding in Identical Twins
Presented by: Mujan Noroozian
Claude Bouchard, PH.D., Angelo Tremblay, PH.D., Jean Pierre
Despres
, PH.D., Andre Nadeau, M.D., Paul J.
Lupien
, M.D.,
Germain
Theriault
, M.D., Jean
Dussault
, M.D.,
Sital
Moorjani
, PH.D., Sylvie
Pinault
, M.D., and Guy Fournier, B.Sc.Slide2
BackgroundStudy done
“To determine whether there are differences in responses of different persons to long term overfeeding”Hypothesis:There are differences & there is a possibility that genotypes are involved in these differences.
Bouchard, C., Fournier, G., Tremblay, A., Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault
, S. (1990). The response to long-term overfeeding in identical twins.
The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide3
Sample
24 sedentary young men (12 pairs of Monozygotic twins)Monozygosity established on
Basis of questionnairePhysical appearance
Similarity of their antigens
& enzymes
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault
, S. (1990). The response to long-term overfeeding in identical twins.
The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide4
Inclusion/Exclusion
Between ages of 19-27 years of ageRaised and living together before studyTheir health history & family health history had stipulations
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault
, S. (1990). The response to long-term overfeeding in identical twins.
The New England Journal of Medicine, 322(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide5
Testing
Period of 18 months4 pairs of twins studied at a timeMen housed in closed area with 24
hr supervision
Each man in unit for 120 consecutive days
Base Line Test Period
Testing Before Period
Overfeeding Period
Testing After Period
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault
, S. (1990). The response to long-term overfeeding in identical twins.
The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide6
Base Line Testing
14 DaysBody weight, Skin-fold thickness, Body density measured dailyMen ate freely
Energy content of body fat about 9300 kcal/kgEnergy content of lean tissue about 1020 kcal/kg
★
The body energy content was the sum of these two
Avg. nutrient composition of food was 52% CHO, 34% lipid, and 14% proteinSlide7
Testing Before & After Overfeeding Period3 Days
Measured resting metabolic rate & thermic effect of foodUnderwater weighingAdipose tissue biopsies
Exercise tolerance testing
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault, S. (1990). The response to long-term overfeeding in identical twins. The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide8
Overfeeding Period
100 daysA Diet 1000 kcal more than base line diet for 6 days/weekDay 7 they had the base line number of caloriesTotal excess energy intake of 84,000 kcal
Nutrient composition: 50% CHO, 35% fat, and 15% protein
3 meals and 1 snack a day
Physical activity limited
Body weight, skin-fold thickness (q 5 days), & waist/hip circumference (q 25 days) measuredSlide9
Statistical AnalysisICC:
Intraclass correlation coefficiantClose to 1.0 indicates perfect w/in pair resemblance to overfeedingClose to 0 implies there is no w/in pair resemblance in response to treatment
F Ratio High # indicates high ratio of variance between pairs to variance w/in pairs.
Low # (close to 1) indicates that variance in response between pairs & w/in pairs are comparable.Slide10Slide11
Overall ResultsIncreases
Body weight (avg. gain=8.1 kg)Fat mass & fat free massSum of skin-fold thickness (about 70%)
Mean resting heart rate (from 58 to 63 beats/min)Diastolic blood pressure (from 66 to 70 mm Hg)
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault
, S. (1990). The response to long-term overfeeding in identical twins. The New England Journal of Medicine, 322(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide12
ResultsSlide13
Regional Fat Distribution
Estimated by several methodsAmount of subcutaneous fat increased on trunk & limbsTrunk to limb ratio increased from 1.26 to 1.60Waist & Hip circumference increased
Ratio of waist to hip circumference also increased
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault, S. (1990). The response to long-term overfeeding in identical twins. The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide14Slide15
Trunk & Abdominal Fat
Measured by CTIncrease in adipose tissue surface area in all subcutaneous & visceral sectionsBouchard, C., Fournier, G., Tremblay, A.,
Després, J., Nadeau, A., Lupien, P. J., . . .
Pinault
, S. (1990). The response to long-term overfeeding in identical twins.
The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide16
ResultsSlide17
DiscussionResults of this study allow assessment of the response of…
Excess total body fatExcess trunk or abdominal subcutaneous fatExcess abdominal visceral fat…to long term overfeeding
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault
, S. (1990). The response to long-term overfeeding in identical twins. The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide18
Discussion
Changes in the men’s bodies varied between the high & low weight gainers.more fat in truncal-abdominal areaSurplus intake of energy over a long time doesn’t cause identical responses in respect to body mass, body composition or regional fat distribution
Increases in total body fat correlated with gains in truncal subcutaneous fat only
Overall there was more variance between pairs of twins than within pairs
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault, S. (1990). The response to long-term overfeeding in identical twins. The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide19
Critique
Further studies would need to be done in order to see why some people more prone than others to store fat on the trunk vs. abdominal cavityWide differences between the people in response to long term overfeedingSlide20
Conclusion
There is a resemblance between identical twins in response to overfeedingDue to a person’s genotypeAll subjects in this study given same treatment conditions
2. Individual differences due to undetermined genetic characteristics
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien
, P. J., . . .
Pinault, S. (1990). The response to long-term overfeeding in identical twins. The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide21
How it will affect dietetic practice
This study shows that a person’s genes determine body weight & body compositionWith a negative energy balance & exercise, a person can reduce their weight
To keep weight, constant maintenance is needed for upkeepC
lient’s health should be the most important thing
I
mportant to help set realistic goals for your clients
Bouchard, C., Fournier, G., Tremblay, A.,
Després
, J., Nadeau, A.,
Lupien, P. J., . . . Pinault
, S. (1990). The response to long-term overfeeding in identical twins.
The New England Journal of Medicine, 322
(21), 1477-1482. doi:10.1056/NEJM199005243222101Slide22