The consistency in macronutrient oxidation and the role for epinephrine in the response to fasting and overfeeding

Abstract

CONTEXT In humans, dietary versus intra-individual determinants of macronutrient oxidation preference and the role of the sympathetic nervous system (SNS) during short-term overfeeding and fasting are unclear.
OBJECTIVE To understand the influence of diet and the SNS during 24-h of overfeeding on metabolic changes.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS While residing on a clinical research unit, 64 participants with normal glucose regulation were assessed during energy balance, fasting, and four 24-h overfeeding diets, given in random order. The overfeeding diets contained 200% of energy requirements and varied macronutrient proportions: 1) standard (50% carbohydrate, 20% protein, and 30% fat), 2) 75% carbohydrate, 3) 60% fat, and 4) 3% protein.
MAIN OUTCOME MEASURES 24-hour energy expenditure (EE) and macronutrient oxidation rates were measured in an indirect calorimeter during the dietary interventions, with concomitant measurement of urinary catecholamines and free cortisol.
RESULTS EE decreased with fasting (-7.7±4.8%, p<0.0001) and increased with overfeeding. The smallest increase occurred during the diet with 3% protein (2.7±4.5%, p=0.001) and the greatest during the diet with 75% carbohydrate (13.8±5.7%, p<0.0001). Approximately 60% of macronutrient oxidation was determined by diet and 20% by intrinsic factors (p<0.0001). Only urinary epinephrine differed between fasting and overfeeding diets (Δ=2.25±2.9 µg/24h, p<0.0001). During fasting, higher urinary epinephrine concentrations correlated with smaller reductions in EE (ρ=0.34, p=0.01).
CONCLUSIONS Independent from dietary macronutrient proportions, there is a strong individual contribution to fuel preference that remains consistent across diets. Higher urinary epinephrine may reflect the importance of epinephrine in maintaining EE during fasting.