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Adaptive thermogenesis: an unsolved problem in clinical physiology

International Journal of Obesity volume 31, pages 1627–1628 (2007)Cite this article

We published in the February issue of the International Journal of Obesity a paper related to the clinical significance of adaptive thermogenesis.1 In the same issue, Professor Abdul Dulloo2 wrote an Editorial describing some aspects of the clinical context surrounding this issue. More recently, Professor Jean-Pierre Flatt3 has written a letter in which he expressed a significant disagreement with the content of our paper, which he described as an exaggerated claim about the scope of adaptive thermogenesis. Taken together, these three documents integrate ideas that are representative of the ongoing debate related to adaptive thermogenesis for more than a century. In addition, they help understand why the physiologist has never been able to provide to clinicians some markers of metabolic rate ‘normality’. This contrasts with other related fields such as the definition of the metabolic syndrome, which has received international consensus about 20 years after Reaven4 described this health problem as syndrome X.

Since the main preoccupation underlying our paper was to give to health professionals an idea of variations in energy expenditure that would be clinically relevant, first we had to determine reference values from subject samples being representative of individuals not spontaneously predisposed to obesity. In a clinical setting, this type of preoccupation generally results in the establishment of reference values like those that exist for plasma glucose, hemoglobin, blood pressure and so on. With respect to energy expenditure, these reference values cannot be developed without considering the strong relationship that exists between metabolic rate and body mass or its components. We thus used reference regression lines to predict energy expenditure relative to body mass in obese and nonobese individuals being exposed to different environments, including a weight-reducing program. Under these conditions, we defined adaptive thermogenesis as being the difference between this predicted value and the value measured using indirect calorimetry. As indicated in our paper, the difference between these two values can be as large as 25% of the predicted value. This is not so surprising since this difference not only represents within individual variation but also integrates the difference between the value of a given person from that predicted in a reference group. According to this observation, it has been clearly shown that sympathetic nervous system (SNS) activity and triiodothyronine (T3) plasma levels are determinants of daily energy expenditure measured in a respiratory chamber in humans, after adjustment for fat-free mass, fat mass, age, gender and spontaneous physical activity.5 It is also known that SNS activity and T3 concentration are suppressed by a negative energy balance.

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References

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Authors and Affiliations

  1. Division de kinésiologie, Département de médecine sociale et préventive, Université Laval, Ste-Foy, Québec, Canada

    A Tremblay & G C Major

  2. School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada

    E Doucet

  3. Obesity Biology Unit, School of Clinical Sciences, University of Liverpool, Liverpool, UK

    P Trayhurn

  4. Department of Human Nutrition, Centre for Advanced Food Studies, The Royal Veterinary and Agricultural University, Frederiksberg C, Denmark

    A Astrup

Authors
  1. A Tremblay
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  2. G C Major
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  3. E Doucet
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  4. P Trayhurn
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  5. A Astrup
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Correspondence to A Tremblay.

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Tremblay, A., Major, G., Doucet, E. et al. Adaptive thermogenesis: an unsolved problem in clinical physiology. Int J Obes 31, 1627–1628 (2007). https://doi.org/10.1038/sj.ijo.0803658

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