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Dietary assessment methods not relying on self-report are needed. The Automatic Ingestion Monitor 2 (AIM-2) combines a wearable camera that captures food images with sensors that detect food intake. We compared energy intake (EI) estimates of meals derived from AIM-2 chewing sensor signals, AIM-2 images, and an internet-based diet diary, with researcher conducted weighed food records (WFR) as the gold standard.Thirty adults wore the AIM-2 for meals self-selected from a university food court on one day in mixed laboratory and free-living conditions. Daily EI was determined from a sensor regression model, manual image analysis, and a diet diary and compared with that from WFR. A posteriori analysis identified sources of error for image analysis and WFR differences.Sensor-derived EI from regression modeling (REstimation of daily EI from meals using sensor-derived features offers a promising alternative to overcome limitations of self-report. Image analysis may benefit from computerized analytical procedures to reduce identified sources of error.

Obesity and adult weight gain are linked to increased breast cancer risk and poorer clinical outcomes in postmenopausal women, particularly for hormone-dependent tumors. Menopause is a time when significant weight gain occurs in many women, and clinical and preclinical studies have identified menopause (or ovariectomy) as a period of vulnerability for breast cancer development and promotion. We hypothesized that preventing weight gain after ovariectomy (OVX) may be sufficient to prevent the formation of new tumors and decrease growth of existing mammary tumors. Here, we tested this hypothesis in a rat model of obesity and carcinogen-induced postmenopausal mammary cancer and validated our findings in a murine xenograft model with implanted human tumors. In both models, preventing weight gain after OVX significantly decreased obesity-associated tumor development and growth. Importantly, we did not induce weight loss in these animals, but simply prevented weight gain. In both lean and obese rats, preventing weight gain reduced visceral fat accumulation and associated insulin resistance. Similarly, the intervention decreased circulating tumor-promoting growth factors and inflammatory cytokines (ie, BNDF, TNFα, FGF2), with greater effects in obese compared to lean rats. In obese rats, preventing weight gain decreased adipocyte size, adipose tissue macrophage infiltration, reduced expression of the tumor-promoting growth factor FGF-1, and reduced phosphorylated FGFR in tumors. Together, these findings suggest that the underlying mechanisms associated with the anti-tumor effects of weight maintenance are multifactorial, and that weight maintenance during the peri-/post-menopausal period may be a viable strategy for reducing obesity-associated breast cancer risk and progression in women.

Exercise is a potent facilitator of long-term weight loss maintenance (WLM), whereby it decreases appetite and increases energy expenditure beyond the cost of the exercise bout. We have previously shown that exercise may amplify energy expenditure through energetically expensive nutrient deposition. Therefore, we investigated the effect of exercise on hepatic de novo lipogenesis (DNL) during WLM and relapse to obesity. Obese rats were calorically restricted with (EX) or without (SED) treadmill exercise (1 h/day, 6 days/wk, 15 m/min) to induce and maintain weight loss. After 6 wk of WLM, subsets of WLM-SED and WLM-EX rats were allowed ad libitum access to food for 1 day to promote relapse (REL). An energy gap-matched group of sedentary, relapsing rats (REL-GM) were provided a diet matched to the positive energy imbalance of the REL-EX rats. During relapse, exercise increased enrichment of hepatic DN-derived lipids and induced hepatic molecular adaptations favoring DNL compared with the gap-matched controls. In the liver, compared with both REL-SED and REL-GM rats, REL-EX rats had lower hepatic expression of genes required for cholesterol biosynthesis; greater hepatic expression of genes that mediate very low-density lipoprotein synthesis and secretion; and greater mRNA expression of Cyp27a1, which encodes an enzyme involved in the biosynthesis of bile acids. Altogether, these data provide compelling evidence that the liver has an active role in exercise-mediated potentiation of energy expenditure during early relapse.

The purpose of this study was to determine whether obesity and/or exercise training alters weight regain and musculoskeletal health after ovariectomy (OVX). Female rats were fed high-fat diet (HFD) to reveal obesity-prone (OP) and obesity-resistant (OR) phenotypes. The OP and OR exercising (EX) and sedentary (SED) rats were calorically restricted to lose 15% of body weight using medium-fat diet. Rats were then maintained in energy balance for 8 wk before OVX. After OVX and a brief calorically limited phase, rats were allowed to eat ad libitum until body weight plateaued. Starting at weight loss, EX ran 1 h·d, 6 d·wk, 15 m·min. Energy intake, spontaneous physical activity (SPA), and total energy expenditure were evaluated at the end of weight maintenance pre-OVX, and at three time points post-OVX: before weight regain, during early regain, and after regain. Data are presented as mean ± SE. Exercise attenuated weight regain after OVX in OP only (OP-EX, 123 ± 10 g; OP-SED, 165 ± 12 g; OR-EX, 121 ± 6 g; OR-SED, 116 ± 6 g), which was primarily an attenuation of fat gain. The early post-OVX increase in energy intake explained much of the weight regain, and was similar across groups. Exercising improved bone strength, as did maintaining SPA. Group differences in muscle mitochondrial respiration were not significant. The large decrease in SPA due to OVX was persistent, but early weight regain was dependent on decreased SPA. In conclusion, leanness and exercise do not necessarily protect from OVX-induced weight gain. Exercise prevented weight gain in obese rats, but loss of SPA was the greatest contributor to post-OVX weight gain. Thus, understanding the mechanisms resulting in reduction in SPA after ovarian hormone loss is critical in the prevention of menopause-associated metabolic dysfunction.

Background: Physiologic aging has been associated with gut dysbiosis. Although short exercise interventions have been linked to beneficial changes in gut microbiota in younger adults, limited data are available from older populations. We hypothesized that exercise would produce beneficial shifts in microbiota and short-chain fatty acid (SCFA) levels in older persons. Methods: Stool samples were collected before and at completion of a supervised 24-week cardiovascular and resistance exercise intervention among 50–75-year-old participants. SCFA levels were analyzed by gas chromatography and microbiome by 16S rRNA gene sequencing. Negative binomial regression models compared pre- and post-differences using false discovery rates for multiple comparison. Results: A total of 22 participants provided pre-intervention samples; 15 provided samples at study completion. At baseline, the majority of participants were men (95%), mean age 58.0 (8.8) years, mean body mass index 27.4 (6.4) kg/m2. After 24 weeks of exercise, at the genus level, exercise was associated with significant increases in Bifidobacterium (and other unidentified genera within Bifidobacteriaceae), Oscillospira, Anaerostipes, and decreased Prevotella and Oribacterium ( p Conclusion: Our pilot study suggested that an exercise intervention is associated with changes in the microbiome of older adults and a key bacterial metabolite, butyrate. Although some of these changes could potentially reverse age-related dysbiosis, future studies are required to determine the contribution of changes to the microbiome in the beneficial effect of exercise on overall health of older adults. Clinical Trials NCT02404792

Poor metabolic health, characterized by insulin resistance and dyslipidemia, is higher in people living with HIV and has been linked with inflammation, antiretroviral therapy (ART) drugs, and ART-associated lipodystrophy (LD). Metabolic disease is associated with gut microbiome composition outside the context of HIV but has not been deeply explored in HIV infection or in high-risk men who have sex with men (HR-MSM), who have a highly altered gut microbiome composition. Furthermore, the contribution of increased bacterial translocation and associated systemic inflammation that has been described in HIV-positive and HR-MSM individuals has not been explored. We used a multiomic approach to explore relationships between impaired metabolic health, defined using fasting blood markers, gut microbes, immune phenotypes, and diet. Our cohort included ART-treated HIV-positive MSM with or without LD, untreated HIV-positive MSM, and HR-MSM. For HIV-positive MSM on ART, we further explored associations with the plasma metabolome. We found that elevated plasma lipopolysaccharide binding protein (LBP) was the most important predictor of impaired metabolic health and network analysis showed that LBP formed a hub joining correlated microbial and immune predictors of metabolic disease. Taken together, our results suggest the role of inflammatory processes linked with bacterial translocation and interaction with the gut microbiome in metabolic disease among HIV-positive and -negative MSM. IMPORTANCE The gut microbiome in people living with HIV (PLWH) is of interest since chronic infection often results in long-term comorbidities. Metabolic disease is prevalent in PLWH even in well-controlled infection and has been linked with the gut microbiome in previous studies, but little attention has been given to PLWH. Furthermore, integrated analyses that consider gut microbiome, together with diet, systemic immune activation, metabolites, and demographics, have been lacking. In a systems-level analysis of predictors of metabolic disease in PLWH and men who are at high risk of acquiring HIV, we found that increased lipopolysaccharide-binding protein, an inflammatory marker indicative of compromised intestinal barrier function, was associated with worse metabolic health. We also found impaired metabolic health associated with specific dietary components, gut microbes, and host and microbial metabolites. This study lays the framework for mechanistic studies aimed at targeting the microbiome to prevent or treat metabolic endotoxemia in HIV-infected individuals.

Moderate weight loss improves numerous risk factors for cardiometabolic disease; however, long-term weight loss maintenance (WLM) is often thwarted by metabolic adaptations that suppress energy expenditure and facilitate weight regain. Skeletal muscle has a prominent role in energy homeostasis; therefore, we investigated the effect of WLM and weight regain on skeletal muscle in rodents. In skeletal muscle of obesity-prone rats, WLM reduced fat oxidative capacity and downregulated genes involved in fat metabolism. Interestingly, even after weight was regained, genes involved in fat metabolism genes were also reduced. We then subjected mice with skeletal muscle lipoprotein lipase overexpression (mCK-hLPL), which augments fat metabolism, to WLM and weight regain and found that mCK-hLPL attenuates weight regain by potentiating energy expenditure. Irrespective of genotype, weight regain suppressed dietary fat oxidation and downregulated genes involved in fat metabolism in skeletal muscle. However, mCK-hLPL mice oxidized more fat throughout weight regain and had greater expression of genes involved in fat metabolism and lower expression of genes involved in carbohydrate metabolism during WLM and regain. In summary, these results suggest that skeletal muscle fat oxidation is reduced during WLM and regain, and therapies that improve skeletal muscle fat metabolism may attenuate rapid weight regain.

Purpose of Review This paper presents a review of the current literature in support of a model explaining the relationships between sleep health and risk for type 2 diabetes in adolescents. Recent Findings Short sleep duration is associated with risk of developing obesity in youth. Sleep restriction increases energy expenditure, but also increases hunger, appetite, and food intake, causing positive energy balance, impacting appetite-regulating hormones, and leading to increased eating late at night. Insufficient sleep may lead to reduced physical activity and greater sedentary behaviors. In addition, short sleep duration is associated with reduced insulin sensitivity. The cumulative negative consequences of insufficient sleep increase risk for type 2 diabetes. Applications to clinical care, public policy, and future research are discussed. Summary Insufficient sleep in adolescence increases risk for type 2 diabetes directly through impact on insulin sensitivity and indirectly through increased dietary intake, sedentary activity, and weight gain.

Study Objectives Insufficient sleep is believed to promote positive energy balance (EB) and weight gain. Increasing weekend sleep duration to “recover” from weekday sleep loss is common, yet little is known regarding how weekend recovery sleep influences EB. We conducted a randomized controlled trial to assess how: (1) 2 days and 8 days of insufficient sleep and (2) ad libitum weekend recovery sleep impact EB (energy intake [EI] – energy expenditure [EE]). Methods Following ten baseline days with 9 h per night sleep opportunities, participants completed one of three 10-day experimental protocols with ad libitum EI: control (9 h sleep opportunities; n = 8; 23 ± 5 years [mean ± SD]); sleep restriction (SR; 5 h sleep opportunities; n = 14; 25 ± 5 years); sleep restriction with weekend recovery sleep (SR + WR; 5 days insufficient sleep, 2 days ad libitum weekend recovery sleep, 3 days recurrent insufficient sleep; n = 14; 27 ± 4 years). Results Twenty-four hour EB increased (p < 0.001; main effect) by an average of 797.7 ± 96.7 (±SEM) kcal during the 10-day experimental protocol versus baseline with no significant differences between groups. Percent change from baseline in 24 h-EE was higher (p < 0.05) on day 2 of insufficient sleep (SR and SR + WR groups; 10 ± 1%) versus adequate sleep (control group; 4 ± 3%). Conclusions In this between-group study, the effects of adequate sleep and insufficient sleep, with or without or weekend recovery sleep, on 24 h-EB were similar. Examining EB and body weight changes using within-subject cross-over designs and “free-living” conditions outside the laboratory (e.g. sleep extension) are needed to advance our understanding of the links between insufficient sleep, weekend recovery sleep and weight-gain.

Moderate weight loss improves numerous risk factors for cardiometabolic disease; however, long-term weight loss maintenance (WLM) is often thwarted by metabolic adaptations that suppress energy expenditure and facilitate weight regain. Skeletal muscle has a prominent role in energy homeostasis; therefore, we investigated the effect of WLM and weight regain on skeletal muscle in rodents. In skeletal muscle of obesity-prone rats, WLM reduced fat oxidative capacity and downregulated genes involved in fat metabolism. Interestingly, even after weight was regained, genes involved in fat metabolism were also reduced. We then subjected mice with skeletal muscle lipoprotein lipase overexpression (mCK-hLPL), which augments fat metabolism, to WLM and weight regain and found that mCK-hLPL attenuates weight regain by potentiating energy expenditure. Irrespective of genotype, weight regain suppressed dietary fat oxidation and downregulated genes involved in fat metabolism in skeletal muscle. However, mCK-hLPL mice oxidized more fat throughout weight regain and had greater expression of genes involved in fat metabolism and lower expression of genes involved in carbohydrate metabolism during WLM and regain. In summary, these results suggest that skeletal muscle fat oxidation is reduced during WLM and regain, and therapies that improve skeletal muscle fat metabolism may attenuate rapid weight regain.

Traditional methods of self-reported food intake are characterized by limitations such as underreporting, high participant burden, and high cost. With the development of automated devices to capture food images and monitor food intake, an accurate and efficient method to estimate energy intake is needed. This study aimed to develop an accurate and time efficient method for estimating energy intake from food images by defining a simple and less burdensome way of estimating energy density (ED). Four experimental methods, exchange, food score-long, food score-short, and meal, were developed to estimate ED based on nutrient composition, water content, and relative proportion of foods in images, using different approaches. Three trained nutritionists analyzed 29 food images for ED using each method. All four experimental methods were compared to the full visual method in which a nutritionist estimated the portion size of each food consumed from dietary intake images and conducted data entry and analysis software. All experimental methods overestimated ED compared to the FVM but the meal method exhibited the closest agreement, lowest variance for ED, and significantly decreased analysis time by an average of 53 s/meal (p = 0.03). The meal method was used for full-scale validation by analyzing 213 food images against weighed food records. The meal method reduced analysis time by 69% (120 s; p ≤ 0.0001) and over-estimated ED by an average of 1.56 ± 3.17 J/g (p < 0.0001) compared to the FVM and 1.67 ± 3.09 J/g (p < 0.0001) compared to the WFR. The meal method is a novel and quick approach to calculate ED from dietary intake images.

Background HIV-1 infection and physiological aging are independently linked to elevated systemic inflammation and changes in enteric microbial communities (dysbiosis). However, knowledge of the direct effect of HIV infection on the aging microbiome and potential links to systemic inflammation is lacking. Methods In a cross-sectional study of older people living with HIV (PLWH) (median age 61.5 years, N = 14) and uninfected controls (median 58 years, n = 22) we compared stool microbiota, levels of microbial metabolites (short-chain fatty acid levels, SCFA) and systemic inflammatory biomarkers by HIV serostatus and age. Findings HIV and age were independently associated with distinct changes in the stool microbiome. For example, abundances of Enterobacter and Paraprevotella were higher and Eggerthella and Roseburia lower among PLWH compared to uninfected controls. Age-related microbiome changes also differed by HIV serostatus. Some bacteria with inflammatory potential (e.g. Escherichia) increased with age among PLWH, but not controls. Stool SCFA levels were similar between the two groups yet patterns of associations between individual microbial taxa and SCFA levels differed. Abundance of various genera including Escherichia and Bifidobacterium positively associated with inflammatory biomarkers (e.g. soluble Tumor Necrosis Factor Receptors) among PLWH, but not among controls. Interpretation The age effect on the gut microbiome and associations between microbiota and microbial metabolites or systemic inflammation differed based on HIV serostatus, raising important implications for the impact of therapeutic interventions, dependent on HIV serostatus or age.

Increased risk of obesity and diabetes in shift workers may be related to food intake at adverse circadian times. Early morning shiftwork represents the largest proportion of shift workers in the United States, yet little is known about the impact of food intake in the early morning on metabolism. Eighteen participants (9 female) completed a counterbalanced 16 day design with two conditions separated by ~1 week: 8 h sleep opportunity at habitual time and simulated early morning shiftwork with 6.5 h sleep opportunity starting ~1 h earlier than habitual time. After wake time, resting energy expenditure (REE) was measured and blood was sampled for melatonin and fasting glucose and insulin. Following breakfast, post-prandial blood samples were collected every 40 min for 2 h and the thermic effect of food (TEF) was assessed for 3.25 h. Total sleep time was decreased by ~85 min (p &lt, 0.0001), melatonin levels were higher (p &lt, 0.0001) and post-prandial glucose levels were higher (p &lt, 0.05) after one day of simulated early morning shiftwork compared with habitual wake time. REE was lower after simulated early morning shiftwork, however, TEF after breakfast was similar to habitual wake time. Insufficient sleep and caloric intake during a circadian phase of high melatonin levels may contribute to metabolic dysregulation in early morning shift workers.

Malnutrition is a major concern in low- and middle-income countries (LMIC), but the full extent of nutritional deficiencies remains unknown largely due to lack of accurate assessment methods. This study seeks to develop and validate an objective, passive method of estimating food and nutrient intake in households in Ghana and Uganda. Household members (including under-5s and adolescents) are assigned a wearable camera device to capture images of their food intake during waking hours. Using custom software, images captured are then used to estimate an individual's food and nutrient (i.e., protein, fat, carbohydrate, energy, and micronutrients) intake. Passive food image capture and assessment provides an objective measure of food and nutrient intake in real time, minimizing some of the limitations associated with self-reported dietary intake methods. Its use in LMIC could potentially increase the understanding of a population's nutritional status, and the contribution of household food intake to the malnutrition burden. This project is registered at clinicaltrials.gov (NCT03723460).

Introduction U.S. adolescents have high rates of insufficient sleep. School closures and stay-at-home orders were implemented to mitigate disease spread during the Coronavirus 2019 (COVID-19) pandemic. Without the restriction of imposed early school start times, we hypothesized that adolescents would have longer, later, and less variable sleep compared to pre-COVID-19. We further hypothesized these changes would be associated with increased and later light exposure. Methods High school students age 14–19 years with Results Participants (N=16) were 16.5 ±1.2-years-old at Pre-COVID-19, 70.6% female, 68.8% White, and 25.1% Hispanic. Youth were participating in online learning due to in-person school closures and only 2 participants (14.3%) had a set start time, while the remainder reported learning per their own schedule. Youth obtained approximately one hour more weekday sleep per night during the COVID-19 week compared to Pre-COVID-19 (p Conclusion An unintended effect of the switch to online learning may have been affording adolescents the opportunity to obtain longer and more regular sleep. Understanding the impact of these changed sleep behaviors on daytime functioning, academic performance, and health outcomes is particularly urgent as schools plan for the remainder of the academic year and eventual return to in-person learning. Support (if any) K23DK117021 to SLS

BACKGROUND: Prior data demonstrated three weeks of sleep restriction and concurrent circadian disruption uncoupled bone turnover markers (BTMs), indicating decreased bone formation and no change or increased bone resorption. The effect of insufficient sleep with or without ad libitum weekend recovery sleep on BTMs is unknown. METHODS: BTMs were measured in stored serum from 20 healthy adults randomized to one of three study groups consisting of a control group (N = 3 men; 9 h/night) or one of two nocturnal sleep restriction groups in an inpatient laboratory environment. One Sleep Restriction group (“SR”; N = 9; 4 women) had 5h sleep opportunity per night for nine nights. The other sleep restriction group had an opportunity for ad libitum Weekend Recovery sleep (“WR”; N = 8; 4 women) after four nights of 5h sleep opportunity per night. Food intake was energy balanced at baseline and ad libitum thereafter. Fasted morning BTM levels and hourly 24h melatonin levels were obtained on study days 3 (baseline), 5 (after 1 night of sleep restriction for WR and SR), and 11 (after a sleep restricted workweek with weekend recovery sleep in WR or 7 nights of sleep restriction in SR). Linear mixed-effects modeling was used to examine the effect of study duration (e.g., change over time), study condition, age, and sex on BTMs. Pearson correlations were used to determine associations between changes in BTMs and changes in weight and morning circadian misalignment (i.e., duration of high melatonin levels after wake time). RESULTS: There was no significant difference between the three study groups in change over time (p ≥ 0.4 for interaction between assigned group and time for all BTMs), adjusted for age and sex. There was no significant change in N-terminal propeptide of procollagen type I (P1NP), osteocalcin, or C-telopeptide of type I collagen (CTX) from baseline to day 11 (all p ≥ 0.3). In women

Background Little is known about the feasibility and impact of lifestyle intervention, determined by change in diet and cardiovascular fitness (CRF), on glycemic control in youth who are overweight with type 2 diabetes. This was examined in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial cohort from across 15 US centers. Subjects TODAY enrolled 699 youth aged 10 to 17 years with type 2 diabetes

Background Individual health behaviors (ie, eating habits and sedentary lifestyle) are associated with type 2 diabetes (T2D). Health behavior profiles specific to adolescents with T2D have not been described. Objective To identify health behavior profiles in adolescents with T2D and examine how these profiles change over time. Methods Diet (via food frequency questionnaire) and activity behaviors (via 3-day physical activity recall) examined at baseline, 6 months, and 24 months from participants in the the Treatment Options for T2D in Adolescents and Youth (TODAY) study were used for this analysis. Latent profile analysis identified profiles of health behaviors within three time points, and latent transition probabilities were estimated to examine the change from baseline to 6 months (n = 450) and baseline to 24 months (n = 415). Multinomial logistic regressions were used to examine if the assigned TODAY treatment group (Metformin [Met], Met + Rosiglitazone [Rosi], or Met + Lifestyle) predicted change in health behavior profiles. Results Three profiles emerged: "most sedentary," "healthy eaters," and "active and eat most." At 6 months, 50% of males and 29% of females in the Met + Lifestyle treatment group improved in their health behavior profile. Among males only, the Met + Lifestyle treatment group were more likely to improve their profiles from baseline to 6 months (P = .01). Conclusions Three health behavior profiles emerged and shifted over time. A high quality, lifestyle intervention had little effect on improving health behavior profiles. Optimizing outcomes in youth with T2D might require more robust and multifaceted interventions beyond family-level lifestyle, including more extensive psychosocial intervention, novel medication regimen, or bariatric surgery.

The in vivo net energy content of resistant starch (RS) has not been measured in humans so it has not been possible to account for the contribution of RS to dietary energy intake. We aimed to determine the in vivo net energy content of RS and examine its effect on macronutrient oxidation. This was a randomized, double-blind cross-over study. Eighteen healthy adults spent 24 h in a whole room indirect calorimeter to measure total energy expenditure (TEE), substrate oxidation, and postprandial metabolites in response to three diets: 1) digestible starch (DS), 2) RS (33% dietary fiber, RS), or 3) RS with high fiber (RSF, 56% fiber). The in vivo net energy content of RS and RSF are 2.74 &plusmn, 0.41 and 3.16 &plusmn, 0.27 kcal/g, respectively. There was no difference in TEE or protein oxidation between DS, RS, and RSF. However, RS and RSF consumption caused a 32% increase in fat oxidation (p = 0.04) with a concomitant 18% decrease in carbohydrate oxidation (p = 0.03) versus DS. Insulin responses were unaltered after breakfast but lower in RS and RSF after lunch, at equivalent glucose concentrations, indicating improved insulin sensitivity. The average in vivo net energy content of RS is 2.95 kcal/g, regardless of dietary fiber content. RS and RSF consumption increase fat and decrease carbohydrate oxidation with postprandial insulin responses lowered after lunch, suggesting improved insulin sensitivity at subsequent meals.

OBJECTIVES: Traditional dietary assessment methods in low-middle income countries (LMICs) have considerable limitations. the objective of this study was to test the feasibility of using the Automatic Ingestion Monitor (AIM), an eyeglasses-mounted wearable chewing sensor and micro-camera, to monitor food acquisition, preparation and consumption of households in a LMIC setting. METHODS: Data from households in Mampong-Akuapem (n = 5), a semi-rural community, and Kweiman (n = 7), a peri-urban community, in the Eastern and Greater Accra Regions of Ghana, respectively, were evaluated. The AIM was used to monitor household activities for one day. Within each household, the primary caregiver (mother) wore the AIM during waking hours on the chosen day as she went about her daily activities, except any activities where she wanted to preserve privacy. Mothers also responded to a socio-demographic questionnaire and evaluated their perceived burden of wearing the AIM. Images captured by the AIM were processed and annotated in custom-designed software. Time spent in major household related activities around food are described. RESULTS: Households had 1.9 ± 0.3 adults and 2.8 ± 1.6 children (mean ± SD). Primary caregivers were 30.5 ± 5.2 years of age, all were married (1 separated), and had a median of 9 years of formal education. Two mothers were breastfeeding at data collection, but only 1 household had an infant

Accurate and objective assessment of energy intake remains an ongoing problem. We used features derived from annotated video observation and a chewing sensor to predict mass and energy intake during a meal without participant self-report. 30 participants each consumed 4 different meals in a laboratory setting and wore a chewing sensor while being videotaped. Subject-independent models were derived from bite, chew, and swallow features obtained from either video observation or information extracted from the chewing sensor. With multiple regression analysis, a forward selection procedure was used to choose the best model. The best estimates of meal mass and energy intake had (mean ± standard deviation) absolute percentage errors of 25.2% ± 18.9% and 30.1% ± 33.8%, respectively, and mean ± standard deviation estimation errors of −17.7 ± 226.9 g and −6.1 ± 273.8 kcal using features derived from both video observations and sensor data. Both video annotation and sensor-derived features may be utilized to objectively quantify energy intake.

Video observations have been widely used for providing ground truth for wearable systems for monitoring food intake in controlled laboratory conditions, however, video observation requires participants be confined to a defined space. The purpose of this analysis was to test an alternative approach for establishing activity types and food intake bouts in a relatively unconstrained environment. The accuracy of a wearable system for assessing food intake was compared with that from video observation, and inter-rater reliability of annotation was also evaluated. Forty participants were enrolled. Multiple participants were simultaneously monitored in a 4-bedroom apartment using six cameras for three days each. Participants could leave the apartment overnight and for short periods of time during the day, during which time monitoring did not take place. A wearable system (Automatic Ingestion Monitor, AIM) was used to detect and monitor participants&rsquo, food intake at a resolution of 30 s using a neural network classifier. Two different food intake detection models were tested, one trained on the data from an earlier study and the other on current study data using leave-one-out cross validation. Three trained human raters annotated the videos for major activities of daily living including eating, drinking, resting, walking, and talking. They further annotated individual bites and chewing bouts for each food intake bout. Results for inter-rater reliability showed that, for activity annotation, the raters achieved an average (&plusmn, standard deviation (STD)) kappa value of 0.74 (&plusmn, 0.02) and for food intake annotation the average kappa (Light&rsquo, s kappa) of 0.82 (&plusmn, 0.04). Validity results showed that AIM food intake detection matched human video-annotated food intake with a kappa of 0.77 (&plusmn, 0.10) and 0.78 (&plusmn, 0.12) for activity annotation and for food intake bout annotation, respectively. Results of one-way ANOVA suggest that there are no statistically significant differences among the average eating duration estimated from raters&rsquo, annotations and AIM predictions (p-value = 0.19). These results suggest that the AIM provides accuracy comparable to video observation and may be used to reliably detect food intake in multi-day observational studies.

Introduction Timing of food intake has emerged as a novel risk factor for weight gain and obesity. Higher evening food intake, especially during insufficient sleep, is associated with weight gain. We aimed to explore initial changes in evening food intake and the respiratory quotient (RQ) during insufficient sleep and subsequent weight gain. We also explored sex differences. Methods 28 healthy adults (14F) aged 26.3±4.5y completed a 14–16 daylong laboratory protocol. In their home environment participants maintained one week of ~9h/night sleep schedules and consumed energy balanced diets for 3 days prior to completing the laboratory protocol. The laboratory protocol consisted of 3 baseline days of 9h/night scheduled sleep with energy balanced diets followed by 10 days of 5h/night scheduled sleep with ad-libitum food intake, with (n=14) and without (n=14) weekend recovery sleep. RQ was assessed on days 3 and 5 in a whole room calorimeter. Evening (dinner and after-dinner snacks) energy intake and body weight were assessed daily. Results A significant sex by condition effect was observed for evening food intake such that men and women were similar at baseline, but men ate more than women during insufficient sleep, when controlling for body mass (p Conclusion Findings suggest that rapid changes in evening food intake during insufficient sleep contributes to subsequent weight gain during sustained insufficient sleep, especially in men. Support NIH HL109706, DK111161, TR001082, DK048520, Sleep Research Society Foundation grant 011-JP-16 and Office of Naval Research MURI (N00014-15-1-2809).

Summary People commonly increase sleep duration on the weekend to recover from sleep loss incurred during the workweek. Whether ad libitum weekend recovery sleep prevents metabolic dysregulation caused by recurrent insufficient sleep is unknown. Here, we assessed sleep, circadian timing, energy intake, weight gain, and insulin sensitivity during sustained insufficient sleep (9 nights) and during recurrent insufficient sleep following ad libitum weekend recovery sleep. Healthy, young adults were randomly assigned to one of three groups: (1) control (CON; 9-h sleep opportunities, n = 8), (2) sleep restriction without weekend recovery sleep (SR; 5-h sleep opportunities, n = 14), and (3) sleep restriction with weekend recovery sleep (WR; insufficient sleep for 5-day workweek, then 2 days of weekend recovery, then 2 nights of insufficient sleep, n = 14). For SR and WR groups, insufficient sleep increased after-dinner energy intake and body weight versus baseline. During ad libitum weekend recovery sleep, participants cumulatively slept ∼1.1 h more than baseline, and after-dinner energy intake decreased versus insufficient sleep. However, during recurrent insufficient sleep following the weekend, the circadian phase was delayed, and after-dinner energy intake and body weight increased versus baseline. In SR, whole-body insulin sensitivity decreased ∼13% during insufficient sleep versus baseline, and in WR, whole-body, hepatic, and muscle insulin sensitivity decreased ∼9%–27% during recurrent insufficient sleep versus baseline. Furthermore, during the weekend, total sleep duration was lower in women versus men, and energy intake decreased to baseline levels in women but not in men. Our findings suggest that weekend recovery sleep is not an effective strategy to prevent metabolic dysregulation associated with recurrent insufficient sleep.

OBJECTIVE In the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study, metformin plus rosiglitazone (M + R) maintained glycemic control better than metformin alone (M) or metformin plus lifestyle (M + L) in youth with type 2 diabetes (T2D). We hypothesized that changes in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) would explain the differential treatment effects on glycemia. RESEARCH DESIGN AND METHODS In 626 youth ages 11–17 years with T2D duration RESULTS Baseline mean age was 13.9 years, 66.4% were female, 72.2% were Hispanic/non-Hispanic black, and 20.3% were non-Hispanic white (NHW). Mean BMI was 33.7 kg/m2. VAT increased more in M + R (13.1%) than M + L (3.9%, P = 0.0006) or M (6.5%, P = 0.0146). SAT also increased more in M + R (13.3%) than in M + L (5.4%, P < 0.0001) or M (6.4%, P = 0.0005), indicating no significant fat redistribution in M + R. In NHWs, VAT increased more in M + R than M (P = 0.0192) and M + L (P = 0.0482) but did not explain the race-ethnicity differences in treatment effects on glycemic control among treatment groups. VAT and SAT increases correlated with higher HbA1c, lower insulin sensitivity, and lower oral disposition index (all P < 0.05), but associations did not differ by treatment group. CONCLUSIONS In contrast to the existing reports in adults with T2D, in TODAY, M + R resulted in the most VAT accumulation compared with M + L or M. Differential effects on depot-specific indirect measures of adiposity are unrelated to treatment effects in sustaining glycemic control. Additional studies are needed to understand the clinical markers of metabolic risk profile in youth with T2D on rosiglitazone.

Free fatty acids (FFA) are a primary fuel source for heart and skeletal muscle, particularly during fasting. In addition, both high fat feeding and insufficient sleep have been shown to increase nocturnal FFA in animal and human models, respectively. However, findings from studies of insufficient sleep have been limited by a focus on male subjects. Furthermore, the impact of ad libitum food intake during insufficient sleep on FFA has not been examined. We therefore examined potential sex differences in circulating 24-hour FFA profiles during habitual sleep and insufficient sleep under ad libitum feeding conditions. Healthy adults (7 females: 23.6±3.2 y, BMI 22.1±1.1 kg/m2; 7 males: 25.7±4.6 y, BMI 22.5±1.2 kg/m2; mean±SD) were studied after five inpatient days consisting of 9h scheduled sleep per night at habitual bedtime and five inpatient days consisting of 5h scheduled sleep beginning 2 hours later than habitual bedtime in a crossover design. On the 5th day in each condition, blood was sampled hourly beginning one hour after scheduled wake-time for 24 hours. In both conditions, participants were provided 3 scheduled meals and 2 snacks designed to provide approximately 130-150% of energy requirements, and had free access to snacks during scheduled waketime. Females showed a more robust FFA response to food intake during both habitual and insufficient sleep vs. men, likely due to positive energy balance for men in both conditions. In addition, both men and women displayed altered FFA patterns during insufficient sleep such that the nocturnal peak was later in the 24hour profile. We provide evidence of sex differences in 24-hour FFA profiles in response to overeating with and without insufficient sleep. The significance of these differences and how they may affect responses to sleep and/or metabolic perturbations is unknown. Future studies are necessary to determine whether differences in FFA may lead to sex differences in metabolic impairments in response to insufficient sleep. Disclosure J.L. Broussard: None. C.M. Depner: None. R. Markwald: None. R.H. Eckel: Advisory Panel; Self; Novo Nordisk Inc., Merck & Co., Inc. L. Perreault: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S. Advisory Panel; Self; Merck & Co., Inc.. Speaker's Bureau; Self; Merck & Co., Inc., AstraZeneca, Janssen Pharmaceuticals, Inc., Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Sanofi. J. Higgins: None. E. Melanson: None. K. Wright: Research Support; Self; Philips Respironics, CurAegis Technologies, Inc., Somalogics, National Institutes of Health, Pac-12, Office of Naval Research. Consultant; Self; National Heart, Lung, and Blood Institute, CurAegis Technologies, Inc., Circadian Therapeutics, LTD. Board Member; Self; Sleep Research Society. Consultant; Self; American Academy of Sleep Medicine, American Diabetes Association, American College of Chest Physicians.

The field of sensor-based dietary assessment and behavioral monitoring is rapidly expanding. New devices and methods for detection for food intake and characterization of ingestive behavior, energy intake and nutrition have been introduced. Quite often the testing of new devices is limited to restricted meals in laboratory setting, which has the advantage of being controlled, but may not be representative of real life conditions. To illustrate the importance of field testing, we performed a statistical comparison of meal microstructure metrics acquired in laboratory versus a field-like study. In the laboratory study, individual participants ate a self-selected meal in isolation. In the field-like study, participants consumed selfselected meals in a social setting. In both studies, the participants were monitored by both video observation and wearable food intake sensors. Statistically significant differences were observed in the duration of the meals, duration of ingestion, number of bouts of ingestion, duration of pauses between ingestive bouts, number of bites and other metrics. These results suggest that field testing presents a far different picture of ingestion process and therefore is needed for any realistic assessment of the monitoring devices.

Daytime light exposure has been reported to impact or have no influence on energy metabolism in humans. Further, whether inter-individual differences in wake, sleep, 24 h energy expenditure, and RQ during circadian entrainment and circadian misalignment are stable across repeated 24 h assessments is largely unknown. We present data from two studies: Study 1 of 15 participants (7 females) exposed to three light exposure conditions: continuous typical room ~100 lx warm white light, continuous ~750 lx warm white light, and alternating hourly ~750 lx warm white and blue-enriched white light on three separate days in a randomized order; and Study 2 of 14 participants (8 females) during circadian misalignment induced by a simulated night shift protocol. Participants were healthy, free of medical disorders, medications, and illicit drugs. Participants maintained a consistent 8 h per night sleep schedule for one week as an outpatient prior to the study verified by wrist actigraphy, sleep diaries, and call-ins to a time stamped recorder. Participants consumed an outpatient energy balance research diet for three days prior to the study. The inpatient protocol for both studies consisted of an initial sleep disorder screening night. For study 1, this was followed by three standard days with 16 h scheduled wakefulness and 8 h scheduled nighttime sleep. For Study 2, it was followed by 16 h scheduled wake and 8 h scheduled sleep at habitual bedtime followed by three night shifts with 8 h scheduled daytime sleep. Energy expenditure was measured using whole-room indirect calorimetry. Constant posture bedrest conditions were maintained to control for energy expenditure associated with activity and the baseline energy balance diet was continued with the same exact meals across days to control for thermic effects of food. No significant impact of light exposure was observed on metabolic outcomes in response to daytime light exposure. Inter-individual variability in energy expenditure was systematic and ranged from substantial to almost perfect consistency during both nighttime sleep and circadian misalignment. Findings show robust and stable trait-like individual differences in whole body 24 h, waking, and sleep energy expenditure, 24 h respiratory quotient—an index of a fat and carbohydrate oxidation—during repeated assessments under entrained conditions, and also in 24 h and sleep energy expenditure during repeated days of circadian misalignment. Keywords: Shift work, Biological day, Biological night

Short sleep duration and circadian misalignment are hypothesized to causally contribute to health problems including obesity, diabetes, metabolic syndrome, heart disease, mood disorders, cognitive impairment, and accidents. Here, we investigated the influence of morning circadian misalignment induced by an imposed short nighttime sleep schedule on impaired insulin sensitivity, a precursor to diabetes. Imposed short sleep duration resulted in morning wakefulness occurring during the biological night (i.e., circadian misalignment)-a time when endogenous melatonin levels were still high indicating the internal circadian clock was still promoting sleep and related functions. We show the longer melatonin levels remained high after wake time, insulin sensitivity worsened. Overall, we find a simulated 5-day work week of 5-hr-per-night sleep opportunities and ad libitum food intake resulted in ∼20% reduced oral and intravenous insulin sensitivity in otherwise healthy men and women. Reduced insulin sensitivity was compensated by an increased insulin response to glucose, which may reflect an initial physiological adaptation to maintain normal blood sugar levels during sleep loss. Furthermore, we find that transitioning from the imposed short sleep schedule to 9-hr sleep opportunities for 3 days restored oral insulin sensitivity to baseline, but 5 days with 9-hr sleep opportunities was insufficient to restore intravenous insulin sensitivity to baseline. These findings indicate morning wakefulness and eating during the biological night is a novel mechanism by which short sleep duration contributes to metabolic dysregulation and suggests food intake during the biological night may contribute to other health problems associated with short sleep duration.

Objective This randomized, cross-over trial was designed to investigate the metabolic and appetitive responses to skipping breakfast in overweight women who were habitual breakfast Eaters or Skippers. Methods Nine Eaters and nine Skippers were studied on two separate days during which subjects ate breakfast (B) or had no breakfast (NB), followed by a standard lunch meal 4 h later. Blood sampling for hormones and metabolites was performed after lunch, and appetite was rated throughout the day. Results Interactions between day and habitual breakfast pattern were seen for area under the curve (AUC) for insulin and free fatty acids (FFA). Both insulin (P = 0.020) and FFA (P = 0.023) AUC were higher on the NB day for Eaters but similar on both days for Skippers. Eaters had higher pre lunch hunger AUC on the NB day (P = 0.015) as well as lower pre lunch satiety AUC under both conditions (P = 0.019). Conclusions Overall, this study showed that the adverse effects of skipping breakfast (higher insulin and FFA responses to lunch, increased hunger, and decreased satiety) were found primarily in habitual breakfast eaters. This suggests that meal skipping may have enhanced effects in habitual Eaters due to entrainment of metabolic and appetitive regulatory systems.

International audience; Weight regain after weight loss is one of the most significant challenges to successful obesity treatment. Regular exercise has long been touted as a strategy for weight loss maintenance, but the lack of clear evidence in clinical trials has caused some to question its effectiveness. In this review, we present the arguments both questioning and in support of exercise as an obesity therapeutic. Our purpose is to bring clarity to the literature, present a unified perspective, and identify the gaps in knowledge that need to be addressed in future studies. Critical questions remain including sex differences, individual variability and compensatory behaviors in response to exercise, exercise adherence, the role of energy flux and the molecular mechanisms mediating the beneficial effects of exercise after weight loss and during weight regain. Future research should focus on these critical questions to provide a more complete understanding of the potential benefits of exercise on weight loss maintenance.

Weight regain after weight loss is a substantial challenge in obesity therapeutics. Dieting leads to significant adaptations in the homeostatic system that controls body weight, which promotes overeating and the relapse to obesity. In this review, we focus specifically on the adaptations in white adipose tissues that contribute to the biological drive to regain weight after weight loss. Weight loss leads to a reduction in size of adipocytes and this decline in size alters their metabolic and inflammatory characteristics in a manner that facilitates the clearance and storage of ingested energy. We present the hypothesis whereby the long-term signals reflecting stored energy and short-term signals reflecting nutrient availability are derived from the cellularity characteristics of adipose tissues. These signals are received and integrated in the hypothalamus and hindbrain and an energy gap between appetite and metabolic requirements emerges and promotes a positive energy imbalance and weight regain. In this paradigm, the cellularity and metabolic characteristics of adipose tissues after energy-restricted weight loss could explain the persistence of a biological drive to regain weight during both weight maintenance and the dynamic period of weight regain.

To avoid the pitfalls of self-reported dietary intake, wearable sensors can be used. Many food ingestion sensors offer the ability to automatically detect food intake using time resolutions that range from 23 milliseconds to 8 minutes. There is no defined standard time resolution to accurately measure ingestive behavior or a meal microstructure. This paper aims to estimate the time resolution needed to accurately represent the microstructure of meals such as duration of eating episode, the duration of actual ingestion, and number of eating events. Twelve participants wore the Automatic Ingestion Monitor (AIM) and kept a standard diet diary to report their food intake in free-living conditions for 24hrs. As a reference, participants were also asked to mark food intake with a pushbutton sampled every 0.1s. The duration of eating episodes, duration of ingestion, and number of eating events were computed from the food diary, AIM and the push button resampled at different time resolutions (0.1s-30s). ANOVA and multiple comparison tests showed that the duration of eating episodes estimated from the diary differed significantly from that estimated by the AIM and the pushbutton (p-value < 0.001). There were no significant differences in the number of eating events for pushbutton resolutions of 0.1s, 1s, 5s but there were significant differences in resolutions of 10s-30s (p-value < 0.05). The results suggest that the desired time resolution of sensor-based food intake detection should be ≤5s to accurately detect meal microstructure. Furthermore, the AIM provides more accurate measurement of the eating episode duration than the diet diary.

OBJECTIVES: Traditional dietary assessment methods in low-middle income countries (LMICs) have significant limitations. The objective of this study was to test the feasibility of using the Automatic Ingestion Monitor (AIM), an eyeglasses-mounted wearable chewing sensor and micro-camera, to monitor food acquisition, preparation and consumption of a household in a LMIC setting. METHODS: This is a case of an 8-member household from Mampong-Akuapem, a semi-rural community in the Eastern Region of Ghana. The household was made up of mother (35 years), father (37 years), and six children (ages 17 years, 13 years [twins], 8 years, 5 years, and 18 months). Mother has no formal education and works as a cook, whereas the father has elementary education and is a farmer/construction worker. All members of the household consume the same prepared meals. The AIM was used to monitor household activities for a day. The primary food preparer (mother) wore the AIM during all waking hours on the chosen day as she went about her daily activities, except any activities where she wanted to preserve privacy. The mother also responded to a socio-demographic questionnaire and evaluated her perceived burden of wearing the AIM. Images captured by the AIM were processed and annotated in custom software. Major household related activities around food are reported. RESULTS: Overall, a total wear time of 776 minutes (12.9 hr; 76.1% of usual wake time) was recorded with images spanning a total of 681 minutes (11.4 hr; 87.8% of total wear time). Cooking and food preparation (four different meals) accounted for 47.9%, shopping 1.5%, breastfeeding and other child feeding 5.1%, and eating 5.4% (communal 4.9% and non-communal 0.5%), and other daily activities 40.1% of usual wake time. Three main meals captured on the AIM were breakfast (rice porridge - boiled watery rice with added sugar, milk and bread), lunch (fufu - pounded boiled cassava and plantain, and chicken soup), and dinner (kelewele - fried spiced yellow plantains). The AIM was generally accepted by the participant and household members although they preferred a smaller size version. CONCLUSIONS: The AIM has the potential of capturing household food related activities and practices that affect dietary intake and nutritional health in LMIC. FUNDING SOURCES: Funded by the Bill & Melinda Gates Foundation.

Resistant starch represents a diverse range of indigestible starch-based dietary carbohydrates. Resistant starch has been investigated in the past for its effects on bowel health (pH, epithelial thickness, and apoptosis of colorectal cancer cells); reduction in postprandial glycemia; increased insulin sensitivity; and effects on the gut microbiome. This review highlights advances as resistant starch gains clinical relevance as a potential treatment/preventive tool for diseases such as colorectal cancer (CRC) and diabetes.Recent articles have evaluated the comparative physiological effects of different types of resistant starch and investigated the effects of resistant starch on blood lipids, body weight, and defining resistant starch-induced changes to the micriobiome that may be important in health and disease. The most novel and relevant recent data describe a role for resistant starch in ameliorating inflammation; the use of resistant starch for optimal bowel health and prevention of CRC; and, further, that the systemic effects of resistant starch may be important for the treatment of other forms of cancer, such as breast cancer.This review describes advances in resistant starch research highlighting the gastrointestinal effects that are now being linked to systemic, whole body effects with clinical relevance. These effects have important implications for overall health and the prevention or amelioration of various chronic diseases.

BACKGROUND: Relationships among dietary sugars and a variety of chronic diseases have spawned interest in investigating the metabolic effects of dietary sugars. An approach developed by the Agency for Healthcare Research and Quality (AHRQ) for assessing Future Research Needs (FRN) was implemented with modifications that integrated an evidence mapping process. METHODS: A panel of 14 stakeholders across 7 pre-defined areas of expertise (lay audience, policy makers, health providers, research funders, evidence-based methodologists, product makers, and researchers) was assembled to prioritize research needs. The panel was facilitated by an independent research team. A total of 213 studies were analyzed descriptively for evidence mapping, and the results were used to inform the stakeholder panel discussions on research needs. RESULTS: The stakeholder panel identified and prioritized 14 sets of research questions. The top three high-priority FRN questions selected by the stakeholder panel focused on the effects of dietary sugars on body weight or body composition, fat deposition, and satiety and appetite. Research considerations for the top three research questions and crosscutting research design issues are discussed. CONCLUSION: Involving a multidisciplinary stakeholder panel to prioritize the direction of future research in this or other content areas has potential to add diverse perspectives to the determination of research needs, and to the development of public health policy.

Exercise is a potent strategy to facilitate long-term weight maintenance. In addition to increasing energy expenditure and reducing appetite, exercise also favors the oxidation of dietary fat, which likely helps prevent weight re-gain. It is unclear whether this exercise-induced metabolic shift is due to changes in energy balance, or whether exercise imparts additional adaptations in the periphery that limit the storage and favor the oxidation of dietary fat. To answer this question, adipose tissue lipid metabolism and related gene expression were studied in obese rats following weight loss and during the first day of relapse to obesity. Mature, obese rats were weight-reduced for 2 weeks with or without daily treadmill exercise (EX). Rats were weight maintained for 6 weeks, followed by relapse on: (a) ad libitum low fat diet (LFD), (b) ad libitum LFD plus EX, or (c) a provision of LFD to match the positive energy imbalance of exercised, relapsing animals. 24 h retention of dietary- and de novo-derived fat were assessed directly using (14)C palmitate/oleate and (3)H20, respectively. Exercise decreased the size, but increased the number of adipocytes in both retroperitoneal (RP) and subcutaneous (SC) adipose depots, and prevented the relapse-induced increase in adipocyte size. Further, exercise decreased the expression of genes involved in lipid uptake (CD36 and LPL), de novo lipogenesis (FAS, ACC1), and triacylglycerol synthesis (MGAT and DGAT) in RP adipose during relapse following weight loss. This was consistent with the metabolic data, whereby exercise reduced retention of de novo-derived fat even when controlling for the positive energy imbalance. The decreased trafficking of dietary fat to adipose tissue with exercise was explained by reduced energy intake which attenuated energy imbalance during refeeding. Despite having decreased expression of lipogenic genes, the net retention of de novo-derived lipid was higher in both the RP and SC adipose of exercising animals compared to their energy gap-matched controls. Our interpretation of this data is that much of this lipid is being made by the liver and subsequently trafficked to adipose tissue storage. Together, these concerted effects may explain the beneficial effects of exercise on preventing weight regain following weight loss.