Effects of short-term hypercaloric nutrition on orthostatic tolerance in healthy individuals: a randomized controlled crossover study

Abstract

Reduced-caloric intake lowers blood pressure through sympathetic inhibition, and worsens orthostatic tolerance within days. Conversely, hypercaloric nutrition augments sympathetic activity and blood pressure. Because dietary interventions could be applied in patients with syncope, we tested the hypothesis that short-term hypercaloric dieting improves orthostatic tolerance. In a randomized crossover trial, 20 healthy individuals (7 women, 26.7 ± 8 years, 22.6 ± 2 kg/m2) followed a 4-day hypercaloric (25% increase of energy intake by fat) or normocaloric nutritional plan, with a washout period of at least 23 days between interventions. We then performed head-up tilt table testing with incremental lower body negative pressure while recording beat-by-beat blood pressure and heart rate. The primary endpoint was orthostatic tolerance defined as time to presyncope. Time to presyncope during combined head-up tilt and lower body negative pressure did not differ between hypercaloric and normocaloric dieting (median 23.19 versus 23.04 min, ratio of median 1.01, 95% CI of ratio 0.5–1.9). Heart rate, blood pressure, heart rate variability, and blood pressure variability in the supine position and during orthostatic testing did not differ between interventions. We conclude that 4 days of moderate hypercaloric nutrition does not significantly improve orthostatic tolerance in healthy individuals. Nevertheless, given the important interaction between energy balance and cardiovascular autonomic control in the brain, caloric intake deserves more attention as a potential contributor and treatment target for orthostatic intolerance.

Glucose-sensitive hypothalamic nuclei traced through functional magnetic resonance imaging

“…The group data also did not reveal statistically significant differences between diets. The finding is in line with our previous findings that four days moderate hypercaloric diet do neither alter orthostatic tolerance, nor blood pressure and heart rate regulation which are controlled at the level of the brainstem (De Gioannis et al, 2022 ).…”

“…A detailed description of the procedures can be found in our previous publication (De Gioannis et al, 2022 ).…”

Effects of daily artificial gravity training on orthostatic tolerance following 60-day strict head-down tilt bedrest

“…The methodology has been previously applied to elucidate orthostatic intolerance mechanisms and to test potential countermeasures for space-fight associated orthostatic intolerance [ 25 ]. However, influences of head-down tilt bedrest could be confounded by changes in sodium intake, in fluid intake, or in energy balance among other environmental influences [ 26 – 28 ]. In our study, rigorous standardization of the bed rest protocol including controlled sodium, fluid, and energy intake removed these confounders, which is a particular strength [ 18 ].…”

Новітні Стратегії Лікування Та Профілактики Синкопе В Дітей

“…Як відомо, зменшене споживання калорій знижує артеріальний тиск через симпатичне гальмування та погіршує ортостатичну толерантність протягом кількох днів [29]. У одному з досліджень De Gioannis et al [30] припустили, що підвищене споживання калорій може покращити ортостатичну толерантність. Автори провели контрольоване, подвійне сліпе, рандомізоване, перехресне дослідження, у якому здорові люди отримували або нормокалорійну дієту, або дієту з високим вмістом жиру та перевищенням добової норми у 550 калорій.…”