Influence of maximal fat oxidation on long-term weight loss maintenance in humans

Impaired maximal fat oxidation has been linked to obesity and weight regain after weight loss. The aim was to investigate the relationship between maximal fat oxidation (MFO) and long-term weight loss maintenance. Eighty subjects (mean(SD)) (Age: 36(13) yrs; BMI: 38(1) kg/m²) were recruited from a total of 2420 former participants of an 11-12-week lifestyle intervention. Three groups were established based on % weight loss at follow-up (5.3(3.3) yrs): Clinical weight loss maintenance (CWL) >10% weight loss, moderate weight loss (MWL) 1-10%, and weight regain (WR). Body composition (Dual X-ray Absorptiometry) and fat oxidation (indirect calorimetry) during incremental exercise were measured at follow-up. Blood and a muscle biopsy were sampled. At follow-up, a u-shaped parabolic relationship between MFO and % weight loss was observed (r=0.448, p<0.001). Overall differences between CWL, MWL and WR were observed in MFO (mean [95%CI]) (0.46 g/min [0.41-0.52]; 0.32 [0.27-0.38]; 0.45 [0.38-0.51]; p=0.002), maximal oxygen uptake (VO_2max) (49 ml/min/FFM [46-51]; 43, [40-47]; 41 [39-44]; p=0.007), HAD-activity (123 µmol/g/min [113-133]; 104 [91-118]; 97 [88-105]; p<0.001), muscle protein content of CD36 (1.1 AU [1.0-1.2]; 0.9 [0.8-1.0]; 0.9 [0.8-0.9]; p=0.008) and FABPpm (1.0 AU [0.8-1.2]; 0.7 [0.5-0.8]; 0.7 [0.5-0.9]; p=0.008) body fat (33% [29-38]; 42 [38-46]; 52 [49-55]; p<0.001) and plasma triglycerides (0.8 mmol/l [0.7-1.0]; 1.3 [0.9-1.7]; 1.6 [1.0-2.1]; p=0.013). CWL and WR both had higher MFO compared to MWL, but based upon different mechanisms. CWL displayed higher VO_2max and intramuscular capacity for fat oxidation, while abundance of lipids at whole-body level and in plasma was higher in WR.

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