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Pediatrics

Improved walking energy efficiency might persist in presence of simulated full weight regain after multidisciplinary weight loss in adolescents with obesity: the POWELL study

International Journal of Obesity volume 48, pages 384–393 (2024)Cite this article

Subjects

Abstract

Aim

Weight loss leads to a reduction of the energy cost of walking but the respective implications of the metabolic and mechanic changes remain unknown. The present study compares the post-weight loss energy cost of walking (Cw) with and without a total reload of the induced weight reduction in adolescents with obesity.

Methods

Energy cost of walking and substrate use were evaluated during a graded walking exercise (4×6-min at 0.75, 1, 1.25, 1.5 m.s−1) before (V1) and after a 12-week intervention in 21 adolescents with obesity (11 girls; 13.8 ± 1.4 y). After weight loss, the walking exercise was randomly repeated once without weight reload (V2) and once with a loading corresponding to the total induced weight loss during the program (V2L). Body composition was assessed before and after the intervention.

Results

Body weight and fat mass decreased in response to the 12-week intervention (p < 0.001), while FFM did not change. The absolute gross Cw (ml.m−1) was higher on V1 compared with V2 at every speed. The absolute net Cw (ml.m−1) was higher on V1 compared to V2L at 0.75 m.s−1 (p = 0.04) and 1 m.s−1 (p = 0.02) and higher on V2L compared with V2 at 1.5 m.s−1 (p = 0.03). Net Cw (ml.m−1.kg−1) on V1 being higher than V2 (p < 0.001), and V2L higher than V2 (p = 0.006). The absolute CHO oxidation (mg.min−1) did not show any condition effect (p = 0.12) while fat utilization was higher on V1 compared to V2 and V2L (p < 0.001). Relative to body weight CHO oxidation was lower on V1 compared to V2 (p = 0.04) and V2L (p = 0.004) while relative to body weight fat oxidation was higher on V1 than V2 (p = 0.002).

Conclusion

Adolescents with obesity might not show an entire rise back to pre-weight loss values of their metabolic cost of walking when weight gain is simulated. These new findings suggest metabolic and physiological adaptations to weight loss of the energy metabolism that remain to be clarified.

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Fig. 1: Energy cost of walking.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors want to thank the adolescents who took part in the study and their educators. We also thank the French National University Institute (IUF).

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Authors and Affiliations

  1. Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Clermont Auvergne University, 63000, Clermont-Ferrand, France

    D. Thivel, G. Ennequin, J. Siroux, S. Ratel, A. Boscaro, L. Pelissier & L. Isacco

  2. International Research Chair Health in Motion, Clermont Auvergne University Foundation, 63000, Clermont-Ferrand, France

    D. Thivel, G. Ennequin, M. Duclos & L. Isacco

  3. Biostatistics Unit, DRCI, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France

    C. Lambert & B. Pereira

  4. CHU Clermont-Ferrand, Clermont-Ferrand, France; Department of Sport Medicine and Functional and Respiratory Rehabilitation, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France

    V. Julian & M. Duclos

  5. Children Medical Center, 63450, Romagnat, France

    C. Cardenoux

  6. Department of Medicine, School of Sport Sciences, University of Udine, 33058, Udine, Italy

    S. Lazzer

  7. CSO-CALORIS, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; Department of Human Nutrition, CHU Clermont-Ferrand, 63000, Clermont-Ferrand, France

    Y. Boirie

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Contributions

TD, EG, IL, DL and YB conceptualized the study and handled the ethical and administrative processes. YB, MD, VJ, CC performed the medical inclusion and led the medical supervision of the intervention. LI, GE, JS, AB, PL performed the data collection and management. TD, LI, BP, CL performed the statistical analysis. TD, EG, LI, SL, SR interpreted the results and wrote the first draft of the paper. All authors have read and approved the final version of the manuscript, and agree with the order of presentation of the authors.

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Correspondence to D. Thivel.

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Thivel, D., Ennequin, G., Lambert, C. et al. Improved walking energy efficiency might persist in presence of simulated full weight regain after multidisciplinary weight loss in adolescents with obesity: the POWELL study. Int J Obes 48, 384–393 (2024). https://doi.org/10.1038/s41366-023-01427-w

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