Reduktionsdiäten und Gewichtsverlust bewirken eine Drosselung des zellulären Energieverbrauchs; diese wird als Adaptive Thermogenese (AT) bezeichnet. Bei kontrollierter Kalorienrestriktion erklärt die AT anteilig die nichtlineare Gewichtsabnahme. Vice versa begünstigt ein niedriger Energieverbrauch die Gewichtszunahme in der Ernährungstherapie von Patientinnen mit Anorexia nervosa. Das Ausmaß der AT beträgt etwa 100 kcal/Tag. Die AT ist reproduzierbar, die inter-individuelle Varianz der Stoffwechselanpassung ist allerdings hoch, während Gewichtsreduktion ist sie bei bis zu 60 % der Menschen nachweisbar. Die AT ist unabhängig von der Strategie der Gewichtsabnahme und innerhalb von drei Tagen Kalorienrestriktion messbar, während einer Diät und bei nachhaltiger Gewichtsreduktion bleibt sie erhalten. Nach Gewichtszunahme ist die AT jedoch innerhalb von zwei Wochen reversibel. Der Abfall der Insulinsekretion und die in “frühen” Stadien der Reduktionsdiät durch Mobilisation der hepatischen Glykogenspeicher erklärte negative Flüssigkeitsbilanz sind zur AT assoziiert. Demgegenüber zeigen die bei Gewichtsabnahme reduzierten Plasmaspiegel von Leptin und Triiodothyronin sowie die niedrige Aktivität des sympathischen Nervensystems eine Beziehung zum Erhalt des reduzierten Körpergewichts, nicht aber zur Regulation der Adaptiven Thermogenese.
Summary
Caloric restriction (CR) and weight loss result in a decrease in cellular energy expenditure, i.e. the so-called adaptive thermogenesis (AT). During controlled CR AT adds to explain the non-linear weight loss. Vice versa AT may add to weight gain in feeding underweight patients with anorexia nervosa. AT is about 100 kcal/d, it is reproducible but the interindividual variance is high. During CR AT becomes measurable within three days and can be detected in up to 60 % of subjects. AT is independent of the weight loss strategy. AT persisted after stabilization of reduced body weight. With re-feeding AT is reversible within two weeks. During CR AT is associated with decreases in insulin secretion and negative fluid balance due to mobilization of hepatic glycogen. Negative energy balance associated decreases in plasma concentrations of leptin and triiodothyronine as well as reduced activity of the sympathetic nervous system reflect maintenance of reduced body weight rather than regulation of AT.
Energy balance -
energy expenditure -
body composition -
sympathetic nervous system -
thyroid hormones -
leptin
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