Essential amino acid enriched meal replacement improves body composition and physical function in obese older adults: A randomized controlled trial.

BACKGROUND: Older adults are threatened by the risk of muscle atrophy and excess accumulation of adipose tissue. The objective of this study was to determine whether an essential amino acid enriched meal replacement would reduce excess fat and foster skeletal muscle retention, potentially improving physical function in this cohort. METHODS: Using a double blind, randomized controlled trial, we compared the influence of an experimental meal replacement enriched with essential amino acids (EMR) to a commercially available, widely used meal replacement (Optifast®) provided once/day (q.d.) for four weeks on body composition, skeletal muscle and physical function in obese older participants. Twenty-eight individuals completed either EMR (n = 13) or Optifast® (n = 15) supplementation protocols. Measurements of body composition, thigh skeletal muscle cross-sectional area (CSA), blood panels, intrahepatic lipid, and physical function were completed pre- and post-supplementation. RESULTS: Body fat mass, visceral fat mass and volume, and intrahepatic lipid were reduced with EMR but not with Optifast®. Thigh muscle CSA increased (Δ 2.4 ± 3.0 cm2) with EMR but not Optifast® (Δ -1.8 ± 6.0 cm2). There was a significant increase in the distance covered during the 6-min walk test with EMR (Δ 23 ± 27 m) but no change in Optifast® (Δ 11 ± 37 m). CONCLUSIONS: Beneficial alterations in fat and muscle support the use of EMR-based meal replacements in obese older adults. CLINICAL TRIAL REGISTRATION: ISRCTN registry under Reference Number ISRCTN15814848.

Alaska backcountry expeditionary hunting promotes rapid improvements in metabolic biomarkers in healthy males and females.

We have previously reported negative energy balance and health benefits during an Alaska backcountry expeditionary hunting (ABEH) immersion in two males. The purpose of our present study was to increase the number of participants, include females, and evaluate macronutrient intake and serum lipids. Four men (age: 46 ± 6 year, BMI: 26 ± 1 kg/m2 ) and three women (age: 46 ± 11 year, BMI: 25 ± 3 kg/m2 ) were recruited. Doubly labeled water methodology and dietary recall were utilized to assess energy expenditure and energy intake, respectively. Data were collected during pre- and post-ABEH visits. Body composition was measured using dual-energy x-ray absorptiometry and the cross-sectional area of skeletal muscle in the upper leg (XT), and intrahepatic lipid (IHL) was determined using magnetic resonance imaging and/or spectroscopy (MRI/MRS). Blood parameters were measured by LabCorp. Paired T-tests were used for statistical analysis. Data are reported as mean ± SD and considered significant at p < 0.05. Total energy intake was 7.7 ± 3.4 MJ/day and total energy expenditure was 17.4 ± 2.6 MJ/day, resulting in a negative energy balance of -9.7 ± 3.4 MJ/day. Protein intake(grams)/body weight(kilograms)/day was 1.0 ± 0.4. There were reductions in body weight (Δ-1.5 ± 0.7 kg), BMI (Δ-0.3 ± 0.2 kg/m2 ), fat mass (Δ-1.7 ± 0.9 kg), and IHL (Δ-0.3 ± 0.3% water peak). There were no changes in lean tissue mass (Δ0.6 ± 1.4 kg) or XT (Δ-1.3 ± 3.3 cm2 ). There were significant reductions in total cholesterol (Δ-44 ± 35 mg/dl), LDL-cholesterol (Δ-25 ± 14 mg/dl), VLDL-cholesterol (Δ-7 ± 7 mg/dl), and triglycerides (Δ-35 ± 33 mg/dl). The ABEH immersion resulted in considerable negative energy balance and provided comprehensive benefits in metabolic health without any reduction in skeletal muscle.

Composition and photo-reactivity of organic matter from permafrost soils and surface waters in interior Alaska.

Yedoma permafrost soils are especially susceptible to abrupt thaw due to their exceptional thickness and high ice content. Compared to other mineral soils, yedoma has a high organic carbon content, which has shown to be particularly biolabile. The organic carbon in these deposits needs to be characterised to provide an identification toolkit for detecting and monitoring the thaw, mobilisation and mineralisation of yedoma permafrost. This study characterised organic carbon isolates from thermokarst lakes (either receiving inputs from thaw of original yedoma or refrozen-thermokarst deposits, or lacking recent thaw) during winter and summer seasons within the Goldstream Creek watershed, a discontinuous permafrost watershed in interior Alaska, to identify the extent to which thermokarst-lake environments are impacted by degradation of yedoma permafrost. Waters from lakes of varied age and thermokarst activity, as well as active layer and undisturbed yedoma permafrost soils were isolated and characterised by functional group abundance (multiCP-MAS 13C and SPR-W5-WATERGATE 1H NMR), absorbance and fluorescence, and photobleaching ability. DOM isolated from winter and summer seasons revealed differing composition and photoreactivity, suggesting varied active layer and permafrost influence under differing ground water flow regimes. Water extractable organic matter isolates from permafrost leachates revealed variation in terms of photoreactivity and photolability, with the youngest sampled permafrost isolate being the most photoreactive and photolabile. As temperatures increase, release of permafrost organic matter is inevitable. Obtaining a holistic understanding of DOM composition and photoreactivity will allow for a better prediction of permafrost thaw impacts in the coming decades.

Essential Amino Acid Supplement Lowers Intrahepatic Lipid despite Excess Alcohol Consumption.

Excess alcohol consumption is a top risk factor for death and disability. Fatty liver will likely develop and the risk of liver disease increases. We have previously demonstrated that an essential amino acid supplement (EAAS) improved protein synthesis and reduced intrahepatic lipid in the elderly. The purpose of this exploratory pilot study was to initiate the evaluation of EAAS on intrahepatic lipid (IHL), body composition, and blood lipids in individuals with mild to moderate alcohol use disorder (AUD). Following consent, determination of eligibility, and medical screening, 25 participants (18 males at 38 ± 15 years/age and 7 females at 34 ± 18 years/age) were enrolled and randomly assigned to one of two dosages: a low dose (LD: 8 g of EAAS twice/day (BID)) or high dose (HD: 13 g of EAAS BID). Five of the twenty-five enrolled participants dropped out of the intervention. Both groups consumed the supplement BID for 4 weeks. Pre- and post-EAAS administration, IHL was determined using magnetic resonance imaging/spectroscopy, body composition was analyzed using dual-energy X-ray absorptiometry, and blood parameters were measured by LabCorp. T-tests were used for statistical analysis and considered significant at p < 0.05. While there was no significant change in IHL in the LD group, there was a significant 23% reduction in IHL in the HD group (p = 0.02). Fat mass, lean tissue mass, bone mineral content, and blood lipids were not altered. Post-EAAS phosphatidylethanol was elevated and remained unchanged in LD at 407 ± 141 ng/mL and HD at 429 ± 196 ng/mL, indicating chronic and excess alcohol consumption. The HD of the proprietary EAAS formulation consumed BID seemed to lower IHL in individuals with mild to moderate AUD. We suggest that further studies in a larger cohort be conducted to more completely address this important area of investigation.

Wildland Firefighting: Adverse Influence on Indices of Metabolic and Cardiovascular Health.

OBJECTIVE: The purpose of this study was to evaluate pre- and postseason measures of body composition, skeletal muscle, and blood parameters/liver lipid in wildland firefighters (WLFF) over the fire season. METHODS: Alaskan WLFF (N = 27) crews were evaluated pre- and postwildfire season, which included 63 ±â€Š10 operational days. Body composition, thigh muscle area, and liver lipid were quantified using dual-energy radiograph absorptiometry and magnetic resonance imaging, respectively. Blood metabolic and lipid panels were also collected and analyzed. RESULTS: Total body, fat, and visceral fat mass increased from pre- to postseason (P < 0.05). Total cholesterol, LDL, and total globulin also increased (P < 0.05). There was a trend (P = 0.06) towards an increase in intrahepatic lipid. CONCLUSIONS: The observed maladaptive changes in adipose tissue, blood lipids, and hepatic function may reflect adaptations/consequences to occupational demands/conditions and warrant evaluation of appropriate countermeasures.

The energy requirements and metabolic benefits of wilderness hunting in Alaska.

The purported healthy aspects of subsistence foods have led to the popularity of the Paleo diet. There has been very little focus, surprisingly, on health benefits derived from the nomadic nature of humans during the Paleolithic era. The purpose of our study was to examine total energy expenditure (TEE), total energy intake (TEI), body composition, blood lipids, and intrahepatic lipid in humans during a 12-day Alaskan backcountry expeditionary hunting (ABEH) immersion. Four healthy men (age: 42 ± 3 year, BMI: 27 ± 1 kg/m2 ) were recruited for the study. TEE was measured using the doubly labeled water method and a food diary was utilized to assess TEI. Body composition was measured using dual energy X-ray absorptiometry (DXA); cross-sectional area of the thigh (XT) and intrahepatic lipid (IHL) were measured using molecular imaging. Blood samples were collected for the measurement of blood lipids. DXA, XT, IHL, and blood data were collected pre- and immediately post-ABEH. Results were analyzed using paired t-tests and considered significant at P < 0.05. TEE and TEI averaged 18.1 ± 1.2 and 9.1 ± 2.5 MJ/day, respectively, indicating substantial negative energy balance (-9.0 ± 1.3 MJ/day). There was a reduction in percent body fat (∆-3.3 ± 0.2%), total fat mass (∆-3.3 ± 0.4 kg), and visceral fat volume (Δ-261 ± 188 cm3 ). Lean tissue mass and XT was unchanged. There was a decrease in IHL (Δ-0.5 ± 0.1% water peak), and a trend (P = 0.055) toward reduction in LDL-cholesterol. We conclude that constancy of physical activity during negative energy balance may provide metabolic benefits above and beyond variations in diet that exist with the hunter-gatherer lifestyle.

Negative Energy Balance Does Not Alter Fat-Free Mass During the Yukon Arctic Ultra-The Longest and the Coldest Ultramarathon.

Purpose: The objective of this study was to determine alterations in caloric balance, body composition, metabolites, and cytokines in athletes participating in the Yukon Arctic Ultra. Methods: Ten participants traveling on foot in the 2017 692-km event were recruited for the study. Measurements and samples were obtained at pre-event, 278 km (C1), 384 km (C2), and post-event. Body composition measurements were obtained using bioelectrical impedance analysis. Accelerometer devices were utilized to provide an estimation of caloric expenditure and dietary recalls provided assessments of caloric intake. Blood serum samples were collected, processed, and analyzed using enzyme-linked immunosorbent assays or nuclear magnetic resonance. Results were analyzed using linear mixed model, presented as means ± SD, and considered significant at p < 0.05. Results: Participants (8 males, 2 females; age: 37 ± 10 years; body mass index: 24.4 ± 2.5 kg/m2) were recruited. Four males and one female completed the entire event in 260 ± 19 h. Caloric intake/expenditure was 4,126 ± 1,115 kcal/day and 6,387 ± 781 kcal/day, respectively, indicating a caloric deficit of 2,261 ± 1,543 kcal/day. Total mass, body mass index, and fat mass were reduced at each time point of the event. Fat-free mass (FFM) was unchanged throughout the event. Follistatin was increased at C1 (1,715 ± 876 pg/ml) in comparison to baseline. Acetoacetate increased significantly at post-event (6.1 ± 1.5 mg/ml). Conclusions: Despite a pronounced caloric deficit and sustained activity under extreme cold conditions, FFM was preserved with an increase in serum follistatin and acetoacetate. Future studies should be directed at the role of nutrient strategies and/or training methods on the retention of FFM under these conditions.

Metabolic Responses to the Yukon Arctic Ultra: Longest and Coldest in the World.

PURPOSE: The Yukon Arctic Ultra is considered the longest and coldest ultraendurance event in the world. Cold exposure and exercise has been reported to influence circulating levels of myokines, adipokines, and hepatokines that may influence considerable alterations in the regulation of metabolism. The purpose of the study was to evaluate the influence of the Yukon Arctic Ultra (430-mile event) on potential activators of brown fat, metabolites, and body composition in healthy individuals. METHODS: Eight male and female participants (mean ± SEM: age, 44 ± 3 yr; body mass index, 23.4 ± 0.9) were recruited for participation. Blood samples were collected at pre-event, mid-event, and post-event checkpoints. RESULTS: The temperature during the event ranged from -45°C to -8°C. Because of these extremely challenging conditions, 50% of the participants withdrew from competition by the 300-mile mark, and those that surpassed 300 miles lost a significant (P = 0.002; P = 0.01) amount of body weight (76 ± 5 kg to 73 ± 4 kg) and fat mass (13 ± 1 kg to 12 ± 3 kg), respectively. With respect to serum irisin, there was a trend (P = 0.06) toward significance from pre-event (1033 ± 88 ng·mL), mid-event (1265 ± 23 ng·mL) to post-event (1289 ± 24 ng·mL). Serum meteorin-like and fibroblast growth factor-21 remained stable throughout the event. There were no changes in creatinine, acetoacetate, acetate, and valine. Serum lactate decreased (P = 0.04) during the event. CONCLUSIONS: The influence of cold exposure and extreme physical exertion may promote substantial increases in serum irisin, and specific alterations in substrate metabolism that largely preserve skeletal muscle and physiological resilience.

1H-NMR metabolomic biomarkers of poor outcome after hemorrhagic shock are absent in hibernators.

BACKGROUND: Hemorrhagic shock (HS) following trauma is a leading cause of death among persons under the age of 40. During HS the body undergoes systemic warm ischemia followed by reperfusion during medical intervention. Ischemia/reperfusion (I/R) results in a disruption of cellular metabolic processes that ultimately lead to tissue and organ dysfunction or failure. Resistance to I/R injury is a characteristic of hibernating mammals. The present study sought to identify circulating metabolites in the rat as biomarkers for metabolic alterations associated with poor outcome after HS. Arctic ground squirrels (AGS), a hibernating species that resists I/R injury independent of decreased body temperature (warm I/R), was used as a negative control. METHODOLOGY/PRINCIPAL FINDINGS: Male Sprague-Dawley rats and AGS were subject to HS by withdrawing blood to a mean arterial pressure (MAP) of 35 mmHg and maintaining the low MAP for 20 min before reperfusing with Ringers. The animals' temperature was maintained at 37 ± 0.5 °C for the duration of the experiment. Plasma samples were taken immediately before hemorrhage and three hours after reperfusion. Hydrophilic and lipid metabolites from plasma were then analyzed via 1H-NMR from unprocessed plasma and lipid extracts, respectively. Rats, susceptible to I/R injury, had a qualitative shift in their hydrophilic metabolic fingerprint including differential activation of glucose and anaerobic metabolism and had alterations in several metabolites during I/R indicative of metabolic adjustments and organ damage. In contrast, I/R injury resistant AGS, regardless of season or body temperature, maintained a stable metabolic homeostasis revealed by a qualitative 1H-NMR metabolic profile with few changes in quantified metabolites during HS-induced global I/R. CONCLUSIONS/SIGNIFICANCE: An increase in circulating metabolites indicative of anaerobic metabolism and activation of glycolytic pathways is associated with poor prognosis after HS in rats. These same biomarkers are absent in AGS after HS with warm I/R.