Why are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytown children from Sao Paulo, Brazil

Background: Previous research suggested that nutritionally stunted children may have increased risk of obesity, but little is known about potential underlying mechanisms.Objective: We sought to test the hypothesis that stunted children have a low metabolic rare and impaired fat oxidation relative to...

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Detalles Bibliográficos
Autores: Hoffman, Daniel J., Sawaya, Ana Lydia [UNIFESP], Verreschi, Ieda Therezinha do Nascimento [UNIFESP], Tucker, Katherine L., Roberts, Susan B.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2000
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/42265
Acceso en línea:http://ajcn.nutrition.org/content/72/3/702.full
http://repositorio.unifesp.br/handle/11600/42265
Access Level:acceso abierto
Palabra clave:fat oxidation
obesity
stunting
energy expenditure
Children
metabolic rate
respiratory quotient
malnutrition
undernutrition
Brazil
Descripción
Sumario:Background: Previous research suggested that nutritionally stunted children may have increased risk of obesity, but little is known about potential underlying mechanisms.Objective: We sought to test the hypothesis that stunted children have a low metabolic rare and impaired fat oxidation relative to nonstunted children.Design: The subjects were 58 prepubertal boys and girls aged 8-11 y from the shantytowns of Sao Paulo, Brazil. Twenty-eight were stunted (height-for-age z score <-1.5) and 30 had similar weight-for-height but normal height (height-for-age z score >-1.5). Parents of children in the 2 groups had equivalent height and body mass index values. Pasting and postprandial energy expenditure, respiratory quotient (RQ), and substrate oxidation were measured with indirect calorimetry in a 3-d resident study in which all food was provided and body composition was measured with dual-energy X-ray absorptiometry.Results: Stunted children had normal resting energy expenditure relative to body composition compared with control children (4559 +/- 90 and 4755 +/- 86 kJ/d, respectively; P = 0.14) and had normal postprandial thermogenesis (2.4 +/- 0.3% and 2.0 +/- 0.3% of meal load, respectively; P = 0.42). However, fasting RQ was significantly higher in the stunted group (0.92 +/- 0.009 compared with 0.89 +/- 0.007, P = 0.04) and consequently, fasting fat oxidation was significantly lower (25 +/- 2% compared with 34 +/- 2% of energy expenditure; P < 0.01).Conclusions: Childhood nutritional stunting is associated with impaired fat oxidation, a factor that predicted obesity in other at risk populations. This finding may help explain recent increases in body fatness and the prevalence of obesity among stunted adults and adolescents in developing countries.