Activity, Adiposity, and Appetite in Adolescents 2

Completed

Conditions: Insulin Sensitivity
Obesity
Metabolic Disease

Interventions: Other: No intervention

Registration Number: NCT04028921

Lead Sponsor: Children's Mercy Hospital Kansas City

Brief Summary: Our goal is to examine linkages between physical activity, appetite control, and energy metabolism in adolescents. The investigators will assess metabolic function and appetite control in male and female adolescents stratified by bodyweight and physical activity using across-sectional study design.

Detailed Description: Childhood obesity is the most serious public health problem of the 21st century, given the prevalence, global reach, and widespread health, economic, and social consequences. While weight gain at the most basic level is due to a chronic energy surplus, there are a host of influences that act on the energy balance system that remain largely unknown. Thus, there is a critical need to identify previously unexamined factors that may influence the energy balance system in order to develop effective interventions for prevention and treatment. Our long-term goal is to quantify the dynamic relationships between various physiological and psychological components of the energy balance system. Our short-term goal is to examine linkages between physical activity, appetite control, and energy metabolism in adolescents. The status quo as it relates to appetite control is that body weight status and related peripheral signals are a key regulator of energy intake. In contrast to body weight playing a primary role in energy regulation, our working hypothesis is that high levels of regular moderate-to-vigorous physical activity (MVPA) result in a metabolic phenotype consisting of enhanced metabolic function and proper regulation of appetite, which prevents the development of obesity. The investigators have reported that adults with low levels of MVPA have dysregulated appetite control, evidenced by higher levels of energy intake and elevated levels of dietary disinhibition. Additionally, the investigators have observed that rats with low fitness possess dysregulated control of appetite and reduced hepatic fat oxidation compared to rats with high fitness. Based on these findings in adults and rodents, in addition to supportive work by others, the investigators hypothesize that low levels of MVPA create a metabolic phenotype, leading to dysregulated appetite control which predisposes individuals to weight gain. To test this hypothesis the investigators will perform a study focused on the links between physical activity and appetite. The investigators will assess metabolic function and appetite control in male and female adolescents stratified by bodyweight (normal vs overweight/obese) and physical activity (sedentary vs. active) using a 2 x 2 cross-sectional study design (N=44). The specific aim of the proposed study is: 1) To examine the association between physical activity and appetite control in adolescents, with metabolic function serving as a mediator. At the completion of the study, it is our expectation that the investigators will have described the independent effects of physical activity and body weight on energy metabolism and appetite in adolescents. This study will have a significant positive impact on the understanding of energy balance in adolescents, and will inform public health interventions that specifically target mechanisms associated with weight gain in youth.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 46

Inclusion Criteria

Tanner Stage III-V
Non-smoking
Not currently involved in any other research study

Exclusion Criteria

Restrained eater (>13) on the restraint section of the three-factor eating questionnaire; Current/past diagnosis of an eating disorder
Gave birth in the past 12 months or <6 months post-lactation.
Self-reported medical conditions (diabetes, Crohn's disease, etc.) that may affect adherence to the protocol or exercising safely or alter metabolism
Medications known to affect exercise performance or metabolism (e.g. thyroid medication, beta-blockers, or stimulants)

Study & Design

Study Type: OBSERVATIONAL

Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Overweight/obese, sedentary	No intervention	Male and female adolescents (age 14-17 years), BMI percentile \>=85th to \<99th for age/sex, \<60 min/day of moderate/vigorous physical activity.
Normal weight, sedentary	No intervention	Male and female adolescents (age 14-17 years), BMI percentile \>=5th to \<75th for age/sex, \<60 min/day of moderate/vigorous physical activity.
Overweight/obese, active	No intervention	Male and female adolescents (age 14-17 years), BMI percentile \>=85th to \<99th for age/sex, \>=60 min/day of moderate/vigorous physical activity.
Normal weight, active	No intervention	Male and female adolescents (age 14-17 years), BMI percentile \>=5th to \<75th for age/sex, \>=60 min/day of moderate/vigorous physical activity.

Primary Outcome Measures

Name	Time	Method
Appetite- Subjective	Baseline	The investigators will measure subjective appetite ratings using visual analog scales related to hunger following a fixed-calorie meal: Hunger, Area Under the Curve (AUC) Hunger and palatability were assessed using self-rated visual analogue scales (Rogers, P. J., \& Blundell, J. E. (1993). Intense sweeteners and appetite. The American Journal of Clinical Nutrition, 58(1), 120-122.) Scale is 0-100, with 0 equaling 'I am not hungry at all' and 100 equaling 'I have never been more hungry'. Area under the curve (AUC) was calculated for appetite variables by calculating the area of the response as you would a trapezoid.
Appetite- Objective	Baseline	The investigators will measure objective appetite responses using plasma ghrelin following a fixed-calorie meal.
Appetite- Adjusted	Baseline	The investigators will measure objective and subjective appetite responses as described above adjusted by insulin sensitivity (glucose infusion rate, mg/kg/min) as assessed in the euglycemic hyperinsulinemic clamp technique. Hunger score on a scale\*min adjusted for glucose infusion rate (mL/kgFFM/min) and sex