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Meal-Induced Thermogenesis and Obesity: Is a Fat Meal a Risk Factor for Fat Gain in Children?¹

Department of Pediatrics, University of Verona, 37134 Verona, Italy; and Institute of Physiology, University of Lausanne (Y.S.), 1011 Lausanne, Switzerland

Address all correspondence and requests for reprints to: Claudio Maffeis, M.D., Department of Pediatrics, University of Verona, Polyclinic, 37134 Verona, Italy. E-mail: maffeis{at}borgoroma.univr.it

Diet composition, in particular fat intake, has been suggested to be a risk factor for obesity in humans. Several mechanisms may contribute to explain the impact of fat intake on fat gain. One factor may be the low thermogenesis induced by a mixed meal rich in fat. In a group of 11 girls (10.1 ± 0.3 yr), 6 obese (body mass index, 25.6 ± 0.6 kg/m²), and 5 nonobese (body mass index, 19 ± 1.6 kg/m²), we tested the hypothesis that a mixed meal rich in fat can elicit energy saving compared with an isocaloric and isoproteic meal rich in carbohydrate. The postabsorptive resting energy expenditure and the thermic effect of a meal (TEM) after a low fat (LF; 20% fat, 68% carbohydrate, and 12% protein) or an isocaloric (2500 kJ or 600 Cal) and isoproteic high fat (HF; 48% fat, 40% carbohydrate, and 12% protein) meal were measured by indirect calorimetry. Each girl repeated the test with a different, randomly assigned menu (HF or LF) 1 week after the first test. TEM, expressed as a percentage of energy intake was significantly higher after a LF meal than after a HF meal (6.5 ± 0.7% vs. 4.3 ± 0.4%; P < 0.01). The postprandial respiratory quotient (RQ) was significantly higher after a LF meal than after a HF meal (0.86 ± 0.013 vs. 0.83 ± 0.014; P < 0.001). The HF low carbohydrate meal induced a significantly lower increase in carbohydrate oxidation than the LF meal (20.3 ± 6.2 vs. 61.3 ± 7.8 mg/min; P < 0.001). On the contrary, fat oxidation was significantly higher after a HF meal than after a LF meal (-1.3 ± 2.4 vs. -15.1 ± 3.6 mg/min; P < 0.01). However, the postprandial fat storage was 8-fold higher after a HF meal than after a LF meal (17.2 ± 1.7 vs. 1.9 ± 1.8 g; P < 0.001). These results suggest that a high fat meal is able to induce lower thermogenesis and a higher positive fat balance than an isocaloric and isoproteic low fat meal. Therefore, diet composition per se must be taken into account among the various risk factors that induce obesity in children.

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