A sedentary lifestyle and increased consumption of energy dense food have become more common in many parts of the world. The aim of this study was to study long term effects on body composition after a four week intervention with fast food based hyper-alimentation and limited physical activity in young normal weight subjects.
One year after a short term intervention with increased fast food based hyper-alimentation there was an increase of fat mass but unchanged fat free mass. As the change of fat mass was larger than expected from prospective epidemiological studies and as there was no increase of body weight in controls it raises the issue whether there is a long-term effect to increase fat mass of a short period of hyper-alimentation.
The aim of this study was to examine long-term changes of body composition after a four week intervention with fast food based hyper-alimentation and limited physical activity in young normal weight subjects and to compare these results with the acute changes of body composition found during the intervention.
Before starting the hyper-alimentation all participants met a dietician for documentation of their usual eating habits and their individual energy need was calculated based on gender, age and physical activity level. Three-day food records were collected and daily physical activity was 7203 (4104) steps measured with pedometer. Based on the individual calculated energy need the participants were prescribed to double their energy intake during the intervention, by eating at least two fast food based meals per day. The dietary advice was adjusted to fulfil the individually prescribed energy intake and if there was any difficulties to ingest the fast food based diet, it could be changed to any food rich in protein and saturated animal fat the participant accepted with the highest priority to achieve the calculated energy intake. During the study, energy intake was monitored by reports from the subjects and was based on receipts and individual interviews with the participants. All participants in the intervention group carried pedometers before the intervention to get a sense for how much physical activity 5000 steps includes and then during the following weeks they continued to keep low level of physical activity. The intervention has been described in detail elsewhere .
Individual weight changes up to 2.5 years after hyper-alimentation in the intervention- and control group. Individual weight changes (kg) in 18 healthy individuals before and after hyper-alimentation while simultaneously having a sedentary lifestyle for four weeks and when followed-up 2.5 years later compared with the control group of 18 individuals. Two and a half years after the intervention body weight showed a further increase (p = 0.01) in the intervention group while the weight of the controls was unchanged compared with baseline (p = 0.88). Changes in weight after 2.5 years significantly differed between the two groups (p = 0.015). The figures in the graph correspond to 6 women (a) and 12 men (b) in the intervention group and in 6 women (c) and 12 men (d) in the control group at baseline and after the intervention. Two and a half years after the intervention data was missing in 3 subjects of the intervention group and in one subject of the control group.
In conclusion, excessive hyper-alimentation and limited physical activity changes body composition with an increase of both fat mass and fat free mass. The sustained increase of fat mass can be interpreted as a common change in this age group but it was larger than expected from epidemiological studies and also the clear difference between the body weight development in the intervention group and in controls raises the question whether there is remaining effect on fat mass after a short period of hyper-alimentation.
16: Veiga P, Tap J, Derrien M. Microbiote intestinal, la clé pour une meilleurealimentation ? [Gut microbiota, the key for a better diet?]. Med Sci (Paris).2016 Nov;32(11):999-1002. French. doi: 10.1051/medsci/20163211016. Epub 2016 Dec
Clinicians and any clinical personnel engaged in follow-up should be aware that the various treatment options for OAB have different requirements for efficacy and different adverse event probabilities and severities. For example, the efficacy of some treatments (e.g., behavioral therapies, neuromodulation) depends greatly on treatment compliance, and the efficacy must be balanced against possible adverse events. For other treatments, such as the use of anti-muscarinics, adverse events are common but vary in severity across patients. Patients should be informed about and subsequently queried regarding dry mouth and its severity (i.e., sufficient to impair alimentation), constipation, fecal retention and any possible central nervous system (CNS) effects. Queries of the patient and caregiver regarding CNS effects are particularly important in elderly or frail patients; clinical experience suggests that CNS effects can be severe enough to cause loss of independent living skills in some patients. Non-responders to anti-muscarinics should be tried on at least one other anti-muscarinic or mirabegron and/or dose modification attempted to determine if a better balance between efficacy and adverse events occurs. If adverse events are severe enough to compromise patient QOL, then strategies to manage specific adverse events, such as ameliorating constipation with appropriate bowel management, should be implemented before abandoning anti-muscarinic treatment. 2b1af7f3a8