Body Weight Dynamics Kevin D. Hall, Ph.D. NIDDK May 2, 2013 The - - PowerPoint PPT Presentation

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Body Weight Dynamics Kevin D. Hall, Ph.D. NIDDK May 2, 2013 The - - PowerPoint PPT Presentation

Apr 16, 2023 517 likes •907 views

The Calculus of Calories Quantifying Human Body Weight Dynamics Kevin D. Hall, Ph.D. NIDDK May 2, 2013 The Old Math of Weight Loss 3500 kcal per pound Practical Guide to the Identification, Evaluation, and Treatment of Overweight and

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SLIDE 1

The Calculus of Calories

Quantifying Human Body Weight Dynamics

Kevin D. Hall, Ph.D. NIDDK May 2, 2013

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SLIDE 2

Practical Guide to the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. NHLBI Obesity Education Initiative (2000).

3500 kcal per pound

The Old Math of Weight Loss

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SLIDE 3

70 72 74 76 78 80 82 1 2 3 4 5 Time (years) Body Weight (kg)

3500 kcal per lb rule

Soda Taxes & Obesity Reversal?

TA Smith, BH Lin, HY Lee. USDA ERS Research Report 100 (2010)

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SLIDE 4

Human Macronutrient Metabolism

Carbohydrate Intake Fat Intake Protein Intake Food Intake

Mathematical Model

  • f Human Metabolism

Body Weight Lean Mass Fat Mass Body Water Body Composition Resting Metabolic Rate Total Energy Expenditure Energy Expenditure Carbohydrate Oxidation Fat Oxidation Nitrogen Excretion Fuel Selection Glucose Turnover Gluconeogenesis Lipolysis Ketogenesis Lipogenesis Metabolic Fluxes Physical Activity

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SLIDE 5

( )

{ }

( )

( )

( )

{ } ( )

( ) ( )

( )

min

ˆ ( ) 0, 1 ˆ ˆ 0, 1 exp

G G G C C b C F F F F P sig P P A A b b P sig PI P b sig

w D D w MAX S CI CI G G G f Z w D D f Z w MAX P D D S k f Z dP S PI PI P dt δ υ δ υ τ + + ∆ + = = + + − + + = = ∆ −  

Model Equations

( )

3 3 1

C P F F FFA TG d excr k P P

dG CI DNL GNG GNG G P CarbOx dt dF M FI M DNL KU KTG FatOx dt dP PI GNG ProtOx dt ρ ρ ε ε ρ = − + + − − = + − − − − = − − ˆ (1 ) (1 )

P G

FFM BM ECF ECP LCM BM ECF ECP ICW P G ICS BM ECF ECP ICW P h G h ICS = + + + = + + + + + + = + + + + + + + +

[ ] ( ) ( )

( )

( )

1 1

diet Na init CI b BW BW init

dECF Na ECF ECF CI CI ECF dt Na d ECF BW BW ECF dt ξ ξ τ ξ = ∆ − − − − + ∆ ∆ = − − ∆ TEE TEF PAE RMR = + + CI PI FI TEF

C P F

α α α + + =

( ) ( )

1 2

, if , else

b b T b

EI EI T EI EI dT EI EI T dt λ τ λ   ∆ − <   =   ∆ −    

( )

1 PAE T BW BW δ σ υ = + +

( ) (

) ( )

1 (1 ) (1 )( ) 1 ( )

c B B FFM B g init F d g F P K N excr P P P P F F F G G G

RMR E M FFM M G h ECF ECF F DNL GNG GNG KTG dP dF dG N D D D dt dt dt γ γ γ ε ε ε η η ε η η η η η   = + + − − ∆ + − − +   + − + − + + − + + + + + + + +

( )

ˆ 1 1

FFM FFM

T γ γ σ   = + −   ˆ

i FFM i i

dM dFFM γ γ =∑

[ ]

2 3

ˆ

F F diet PA Keys

F D D L L F   = +      

( ) ( )

( )

{ }

1 exp 0, 1

L L L

S L L L L b L diet L diet S S L Keys

K A B k CI CI B dL L dt K MAX F F τ   + − × − +   = − + − 1

PA init init

L δ υ ψ δ υ   + = −   +   ˆ exp exp ˆ

F F K F K P G b init K F F

D D PI G KTG D A k k PI G K D D ρ         = − −         +          

( ) ( )

max max

0, if , else

K thresh excr K K thresh thresh

KTG KTG KU KU KTG KTG KTG KTG ρ ρ ρ <     = −     −   ˆ

P P Keys b

P PI D D P PI χ       ∆ = +                 ˆ

G G init

G D D G   =    

C G G F F C F TG TG

M M GNG FI D M M ρ ρ ρ     = +        

( )

ˆ

P P C P Keys b b

P CI PI GNG GNG P CI PI χ         ∆ ∆ = − Γ + Γ +                    

( ) ( )

d init d d init DNL

CI G G DNL G G K × = + 3

f p C F P

CarbOx GNG GNG G P f TEE FatOx KetOx f TEE ProtOx f TEE = + − + × = + × = ×   

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SLIDE 6

Model Validation

Compare model predictions with data from independent experiments only changing the initial conditions of the model to match the study & no parameter fitting!

KD Hall. Am J Physiol. 298(3): E449-66 (2010). KD Hall. Am J Physiol 291: E23–E37 (2006).

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SLIDE 7

Data from F. Benedict A study of prolonged fasting (1915)

Weight Loss during Fasting

KD Hall. In Comparative Physiology of Fasting, Starvation, and Food Limitation (2012).

45 50 55 60 65

  • 5

5 10 15 20 25 30 35 Days of Fasting Body Weight (kg) BW data BW model

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SLIDE 8
  • 10
  • 8
  • 6
  • 4
  • 2

2

  • 5

5 10 15 20 25 30 35 Days of Fasting Mass Change (kg) Fat Mass Fat-free Mass

Fasting & Body Composition

Fat-free Mass Fat Mass

KD Hall. In Comparative Physiology of Fasting, Starvation, and Food Limitation (2012).

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SLIDE 9

Fasting & Fuel Mobilization

50 100 150 200 250 300 350 400 450

  • 5

5 10 15 20 25 30 35 Days of Fasting Metabolic Flux (g/d) Glycogenolysis Lipolysis Proteolysis

Glycogenolysis Lipolysis Proteolysis

KD Hall. In Comparative Physiology of Fasting, Starvation, and Food Limitation (2012).

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SLIDE 10

Fasting & Fuel Utilization

250 500 750 1000 1250 1500

  • 5

5 10 15 20 25 30 35 Days of Fasting Oxidation Rate (kcal/d) Carbohydrate Fat + Ketones Protein

Carbohydrate Oxidation Fat + Ketone Oxidation Protein Oxidation

KD Hall. In Comparative Physiology of Fasting, Starvation, and Food Limitation (2012).

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SLIDE 11

Data from F. Benedict A study of prolonged fasting (1915)

Fasting & Respiratory Quotient

0.7 0.75 0.8 0.85 0.9 0.95 1

  • 5

5 10 15 20 25 30 35 Days of Fasting Respiratory Quotient

Burning Fat Burning Carbs

KD Hall. In Comparative Physiology of Fasting, Starvation, and Food Limitation (2012).

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SLIDE 12

Data from F. Benedict A study of prolonged fasting (1915)

Fasting & Energy Expenditure

1000 1200 1400 1600 1800 2000 2200 2400

  • 5

5 10 15 20 25 30 35 Days of Fasting Energy Rate (kcal/d) TEE model TEE data RMR model RMR data

Total Energy Expenditure Resting Metabolic Rate

KD Hall. In Comparative Physiology of Fasting, Starvation, and Food Limitation (2012).

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SLIDE 13

Data from F. Benedict A study of prolonged fasting (1915)

Fasting & Ketone Excretion

2 4 6 8

  • 5

5 10 15 20 25 30 35 Days of Fasting Ketone Excretion (g/d)

KD Hall. In Comparative Physiology of Fasting, Starvation, and Food Limitation (2012).

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SLIDE 14

Data from F. Benedict A study of prolonged fasting (1915)

Fasting & Nitrogen Excretion

2 4 6 8 10 12 14 16

  • 5

5 10 15 20 25 30 35 Days of Fasting N excretion (g/d)

KD Hall. In Comparative Physiology of Fasting, Starvation, and Food Limitation (2012).

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SLIDE 15

500 1000 1500 2000 2500 3000 3500 4 8 12 16 20 24 28 32 36 40 Time (weeks) Energy Rate (kcal/d)

Leibel et al. NEJM 1995

Energy Intake 10% Weight Loss 20% Weight Loss

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SLIDE 16

20 40 60 80 100 120 140 4 8 12 16 20 24 28 32 36 40 Time (weeks) Mass (kg)

Leibel et al. NEJM 1995

Fat-Free Mass Body Weight Fat Mass

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SLIDE 17

500 1000 1500 2000 2500 3000 3500 4 8 12 16 20 24 28 32 36 40 Time (weeks) Energy Rate (kcal/d)

Leibel et al. NEJM 1995

Resting Metabolic Rate Total Energy Expenditure Physical Activity

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SLIDE 18

The Biggest Loser Competition

Johannsen, Knuth, Huizenga, Ravussin, Hall. JCEM (2012) K.D. Hall. Obesity (2013)

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SLIDE 19
  • 80
  • 60
  • 40
  • 20

20

  • 4

4 8 12 16 20 24 28 32 Time (weeks) Mass Change (kg)

Body Weight Fat Mass

Biggest Loser Model Simulations

At Home Isolated on Ranch

K.D. Hall. Obesity (2013)

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SLIDE 20

1000 2000 3000 4000 5000 6000

  • 4

4 8 12 16 20 24 28 32 Time (weeks) Energy Rate (kcal/d)

Total Energy Expenditure Resting Metabolic Rate Energy Intake

Biggest Loser Model Simulations

Exercise

K.D. Hall. Obesity (2013)

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SLIDE 21

Mathematical Model

  • f Human Metabolism

Baseline Demographics & Anthropometrics Body Weight Energy Intake

Inverse Problem: Estimating Intake

KD Hall. Am J Physiol. 298(3): E449-66 (2010) KD Hall, CC Chow. AJCN 94:66-74 (2011)

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SLIDE 22
  • 20
  • 15
  • 10
  • 5

5 10

  • 6

6 12 18 24 30 36 Time (months) Weight Change (kg) Data from LP Svetky et al. JAMA. 299:1139-1148 (2008)

Weight Plateau and Regain

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SLIDE 23

1500 1750 2000 2250 2500

  • 6

6 12 18 24 30 36 Time (months) Energy Rate (kcal/d)

Energy Intake Total Energy Expenditure Progressive Loss of Diet Adherence!

Energy Balance Interpretation

KD Hall. Am J Physiol. 298(3): E449-66 (2010).

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SLIDE 24
  • 14
  • 12
  • 10
  • 8
  • 6
  • 4
  • 2
  • 6

6 12 18 24 30 36 Time (months) Mass Change (kg)

Weight Loss Maintenance

Fat Mass Change Body Weight Change

KD Hall. Am J Physiol. 298(3): E449-66 (2010).

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SLIDE 25

1500 1750 2000 2250 2500

  • 6

6 12 18 24 30 36 Time (months) Energy Rate (kcal/d)

Energy Intake Total Energy Expenditure

Energy Intake for Maintenance

~200 kcal/d

KD Hall. Am J Physiol. 298(3): E449-66 (2010).

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SLIDE 26

5% Weight Loss vs. Maintenance

BMI = 35 kg/m2 BMI = 50 kg/m2 5% Weight Loss in 6 months Maintenance of 5% Weight Loss

  • 300 kcal/d
  • 450 kcal/d
  • 90 kcal/d
  • 100 kcal/d
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SLIDE 27

http://bwsimulator.niddk.nih.gov

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SLIDE 28

70 72 74 76 78 80 82 1 2 3 4 5 Time (years) Body Weight (kg)

3500 kcal per lb rule Dynamic Model

KD Hall et al. The Lancet (2011)

Soda Taxes & Obesity Reversal?

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SLIDE 29

0.5 0.55 0.6 0.65 0.7 1 2 3 4 5 Time (years) Prevalence BMI > 25

BH Lin, TA Smith, HY Lee, KD Hall. Econ Hum Biol (2011)

N = 4293

3500 kcal per lb rule Dynamic Model

Predicted Change in Obesity Prevalence

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SLIDE 30

70 72 74 76 78 80 82 1970 1975 1980 1985 1990 1995 2000 2005 Year Average Body Weight (kg) Data from National Health and Nutrition Examination Survey (NHANES)

  • Ave. Body Weight

Modeling the Rise of Adult Obesity

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SLIDE 31

1900 2400 2900 3400 3900 1970 1975 1980 1985 1990 1995 2000 2005 2010 Year Per Capita Food Energy (kcal/d)

U.S. Food Supply

Food Intake (model) FAO Food Supply

KD Hall, J Guo, M Dore, CC Chow. PLoS ONE (2009)

USDA Loss Adjusted Food Availability

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SLIDE 32

70 75 80 85 90 95 100 1970 1975 1980 1985 1990 1995 2000 2005 2010 Year Average Body Weight (kg)

If we had eaten all of the USDA Food Available…

Simulated Body Weight NHANES Body Weight

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SLIDE 33

1900 2400 2900 3400 3900 1970 1975 1980 1985 1990 1995 2000 2005 2010 Year Per Capita Food Energy (kcal/d)

Food Intake (model) FAO Food Supply Wasted Food!

KD Hall, J Guo, M Dore, CC Chow. PLoS ONE (2009)

Food Supply, Intake, and Waste

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SLIDE 34

600 800 1000 1200 1400 1600 1800 1970 1975 1980 1985 1990 1995 2000 2005 2010 Year Per Capita Food Waste (kcal/d)

Food Loss (USDA)

KD Hall, J Guo, M Dore, CC Chow. PLoS ONE (2009)

Food Waste (model)

Progressive Increase of Food Waste

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SLIDE 35

Food Waste (model) Solid Food Waste (EPA)

KD Hall, J Guo, M Dore, CC Chow. PLoS ONE (2009) 600 800 1000 1200 1400 1600 1800 1970 1975 1980 1985 1990 1995 2000 2005 2010 Year Per Capita Food Waste (kcal/d) 40 50 60 70 80 90 100 110 120 Per Capita Solid Food Waste (kg/yr)

Progressive Increase of Food Waste

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SLIDE 36

The Push Hypothesis

KD Hall, J Guo, M Dore, CC Chow. PLoS ONE (2009)

Agriculture Research, Subsidies, & Policy Increased production More Cheap food Increased food waste Obesity

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SLIDE 37

Intramural NIDDK

Thomas Bemis Dhruva Chandramohan Kong Chen I-Ling Chen Helen Cheung Carson Chow Stephanie Goodwin Juen Guo Gail Hall Peter Jordan Nick Knuth Bernard Miller Laura Musse Vipul Periwal Carla Prado Arjun Sanghvi Mario Siervo Monica Skarulis Wayne Staton Terri Wakefield

Intramural NIH

Amber Courville (CC) Peter Herscovitch (CC) John Ingeholm (NIMH) Seth Kallman (NIMH) Alex Martin (NIMH) Lydia Milbury (NIMH) Kristina Rapuano (NIMH) Nancy Sebring (CC)

  • W. Kyle Simmons (NIMH)

Nora Volkow (NIDA)

Extramural Collaborators

Graham Finlayson (Leeds) Dympna Gallagher (Columbia) Steve Gortmaker (Harvard) Robert Huizenga (UCLA) Darcy Johannsen (Pennington) Biing Lin (USDA) Peter Murgatroyd (MRC Cambridge) Eric Ravussin (Pennington) Leanne Redman (Pennington) Boyd Swinburn (Deakin) Steven R. Smith (Sanford Burnham)

Special Thanks

Nursing Staff at the NIH MCRU Volunteer Study Subjects