Background: Obesity is becoming more frequent in children; understanding the extent to which this condition affects not only carbohydrate and lipid metabolism but also protein metabolism is of paramount importance. Objective: We evaluated the kinetics of protein metabolism in obese, prepubertal children in the static phase of obesity. Design: In this cross-sectional study, 9 obese children (x -± SE: 44 ± 4 kg, 30.9 ± 1.5% body fat) were compared with 8 lean (28 ± 2 kg ,16.8 ± 1.2% body fat), age-matched (8.5 ± 0.2 y) control children. Whole-body nitrogen flux, protein synthesis, and protein breakdown were calculated postprandially over 9 h from 15 N abundance in urinary ammonia by using a single oral dose of [ 15 N]glycine; resting energy expenditure (REE) was assessed by indirect calorimetry (canopy) and body composition by multiple skinfold-thickness measurements. Results: Absolute rates of protein synthesis and breakdown were significantly greater in obese children than in control children (x -± SE: 208 ± 24 compared with 137 ± 14 g/d, P < 0.05, and 149 ± 20 compared with 89 ± 13 g/d, P < 0.05, respectively). When these variables were adjusted for fat-free mass by analysis of covariance, however, the differences between groups disappeared. There was a significant relation between protein synthesis and fat-free mass (r = 0.83, P <0.001) as well as between protein synthesis and REE (r = 0.79, P < 0.005). Conclusions: Obesity in prepubertal children is associated with an absolute increase in whole-body protein turnover that is consistent with an absolute increase in fat-free mass, both of which contribute to explaining the greater absolute REE in obese children than in control children. Am J Clin Nutr 1999;69:857-62.
KEY WORDSEnergy metabolism, resting metabolic rate, protein metabolism, whole-body protein turnover, protein synthesis, fat-free mass, obesity, children
INTRODUCTIONAlthough much research has been conducted on human obesity in the past decades, more investigations have been performed of adult obesity than of childhood onset obesity. It is well known, however, that many obese adults were obese when they were young (1-5). Therefore, important issues to explore are whether the metabolic disturbances encountered in adult obesity (blunted postprandial thermogenesis, increased lipid oxidation, impaired glucose tolerance, and insulin resistance) can be observed at younger ages and to assess the magnitude of these disturbances and the age of onset.The postabsorptive resting metabolic rate of obese children was explored previously by several investigators (6-8). When expressed as an absolute value, the rate of resting energy expenditure (REE) was found to be greater in obese than in nonobese children or adolescents (6-8), confirming results observed in obese adolescents (9) and obese adults (10). The small increase in fat-free mass (FFM) accompanying the large inflation in adipose tissue in obese children explains the greater REE in these children than in lean children. However, this constitutes an e...