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The role of high-fat diets and physical activity in the regulation of body weight

Published online by Cambridge University Press:  09 March 2007

Patrick Schrauwen*
Affiliation:
Department of Human Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
Klaas R. Westerterp
Affiliation:
Department of Human Biology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
*
*Corresponding author: Dr Patrick Schrauwen, fax +31 43 3670976, email [email protected]
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Abstract

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The prevalence of obesity is increasing in westernized societies. In the USA the age-adjusted prevalence of BMI ≫30 kg/m2 increased between 1960 and 1994 from 13 % to 23 % for people over 20 years of age. This increase in the prevalence of obesity has been attributed to an increased fat intake and a decreased physical activity. However, the role of the impact of the level of dietary fat intake on human obesity has been challenged. High-fat diets, due to their high energy density, stimulate voluntary energy intake. An increased fat intake does not stimulate its own oxidation but the fat is stored in the human body. When diet composition is isoenergetically switched from low to high fat, fat oxidation only slowly increases, resulting in positive fat balances on the short term. Together with a diminished fat oxidation capacity in pre-obese subjects, high-fat diets can therefore be considered to be fattening. Another environmental factor which could explain the increasing prevalence of obesity is a decrease in physical activity. The percentage of body fat is negatively associated with physical activity and exercise has pronounced effects on energy expenditure and substrate oxidation. High-intensity exercise, due to a lowering of glycogen stores, can lead to a rapid increase in fat oxidation, which could compensate for the consumption of high-fat diets in westernized societies. Although the consumption of high-fat diets and low physical activity will easily lead to the development of obesity, there is still considerable inter-individual variability in body composition in individuals on similar diets. This can be attributed to the genetic background, and some candidate genes have been discovered recently. Both leptin and uncoupling protein have been suggested to play a role in the prevention of diet-induced obesity. Indeed, leptin levels are increased on a high-fat diet but this effect can be attributed to the increased fat mass observed on the high-fat diet. No effect of a high-fat diet per se on leptin levels is observed. Uncoupling proteins are increased by high-fat diets in rats but no data are available in human subjects yet. In conclusion, the increased intake of dietary fat and a decreasing physical activity level are the most important environmental factors explaining the increased prevalence of obesity in westernized societies.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2000

References

Abbott, WG, Howard, BV, Ruotolo, G and Ravussin, E (1990) Energy expenditure in humans: effects of dietary fat and carbohydrate. American Journal of Physiology 258, E347E351.Google ScholarPubMed
Astrup, A, Buemann, B, Christensen, NJ and Toubro, S (1994) Failure to increase lipid oxidation in response to increasing dietary fat content in formerly obese women. American Journal of Physiology 266, E592E599.Google ScholarPubMed
Bennett, C, Reed, GW, Peters, JC, Abumrad, NN, Sun, M and Hill, JO (1992) Short-term effects of dietary-fat ingestion on energy expenditure and nutrient balance. American Journal of Clinical Nutrition 55, 10711077.CrossRefGoogle ScholarPubMed
Blaak, EE, Baak, MAv, Kemerink, GJ, Pakbiers, MTW, Heidendal, GAK and Saris, WHM (1994) ß-Adrenergic stimulation of energy expenditure and forearm skeletal muscle metabolism in lean and obese men. American Journal of Physiology 267, E306E315.Google Scholar
Blundell, JE, Burley, VJ, Cotton, JR and Lawton, CL (1993) Dietary fat and the control of energy intake: evaluating the effects of fat on meal size and postmeal satiety. American Journal of Clinical Nutrition 57, 772S777S.CrossRefGoogle ScholarPubMed
Blundell, JE and Macdiarmid, JI (1997) Fat as a risk factor for overconsumption: satiation, satiety, and patterns of eating. Journal of the American Dietetic Association 97, S63S69.CrossRefGoogle ScholarPubMed
Boss, O, Samec, S, Paoloni-Giacobino, A, Rossier, C, Dulloo, A, Seydoux, J, Muzzin, P and Giacobino, J-P (1997) Uncoupling protein-3: a new member of the mitochondrial carrier family with tissue-specific expression. FEBS Letters 408, 3942.CrossRefGoogle ScholarPubMed
Boyle, CA, Dobson, AJ, Egger, G and Magnus, P (1994) Can the increasing weight of Australians be explained by the decreasing prevalence of cigarette smoking?. International Journal of Obesity and Related Metabolic Disorders 18, 5560.Google ScholarPubMed
Clément, K, Vaisse, C, Lahlou, N, Cabrol, S, Pelloux, V, Cassuto, D, Gourmelen, M, Dina, C, Chambaz, J, Lacorte, JM, Basdevant, A, Bougneres, P, Lebouc, Y, Froguel, P and Guy-Grand, B (1998) A mutation in the human leptin receptor gene causes obesity and pituitary dysfunction. Nature 392, 398401.CrossRefGoogle ScholarPubMed
Dallosso, HM and James, WP (1984) Whole-body calorimetry studies in adult men. 1. The effect of fat over-feeding on 24 h energy expenditure. British Journal of Nutrition 52, 4964.CrossRefGoogle ScholarPubMed
Davis, JR, Tagliaferro, AR, Kertzer, R, Gerardo, T, Nichols, J and Wheeler, J (1983) Variations in dietary-induced thermogenesis and body fatness with aerobic capacity. European Journal of Applied Physiology 50, 319329.CrossRefGoogle ScholarPubMed
Eck, LH, Hackett-Renner, C and Klesges, LM (1992) Impact of diabetic status, dietary intake, physical activity, and smoking status on body mass index in NHANES II. American Journal of Clinical Nutrition 56, 329333.CrossRefGoogle ScholarPubMed
Ferraro, RT, Eckel, RH, Larson, DE, Fontvieille, A, Rising, R, Jensen, DR and Ravussin, E (1993) Relationship between skeletal muscle lipoprotein lipase activity and 24-hour macronutrient oxidation. Journal of Clinical Investigation 92, 441445.CrossRefGoogle ScholarPubMed
Flatt, JP (1987) Dietary fat, carbohydrate balance, and weight maintenance: effects of exercise. American Journal of Clinical Nutrition 45, 296306.CrossRefGoogle ScholarPubMed
Flatt, JP (1987) The difference in the storage capacities for carbohydrate and for fat, and its implications in the regulation of body weight. Annals of the New York Academy of Science 499, 104123.CrossRefGoogle ScholarPubMed
Flatt, JP (1988) Importance of nutrient balance in body weight regulation. Diabetes Metabolism Reviews 4, 571581.CrossRefGoogle ScholarPubMed
Flatt, JP, Ravussin, E, Acheson, KJ and Jequier, E (1985) Effects of dietary fat on postprandial substrate oxidation and on carbohydrate and fat balances. Journal of Clinical Investigation 76, 10191024.CrossRefGoogle ScholarPubMed
Flegal, KM, Carroll, MD, Kuczmarski, RJ and Johnson, CL (1998) Overweight and obesity in the United States: prevalence and trends 1960–1994. International Journal of Obesity 22, 3947.CrossRefGoogle ScholarPubMed
Fleury, C, Neverova, M, Collins, S, Raimbault, S, Champigny, O, Levi-Meyrueis, C, Bouillaud, F, Seldin, MF, Surwit, RS, Ricquier, D and Warden, CH (1997) Uncoupling protein-2: a novel gene linked to obesity and hyperinsulinemia. Nature Genetics 15, 269273.CrossRefGoogle ScholarPubMed
Frederich, RC, Hamann, A, Anderson, S, Löllmann, B, Lowell, BB and Flier, JS (1995) Leptin levels reflect body lipid content in mice: evidence for diet-induced resistance to leptin action. Nature Medicine 1, 13111314.CrossRefGoogle ScholarPubMed
Gimeno, RE, Dembski, M, Weng, X, Deng, N, Shyjan, AW, Gimeno, CJ, Iris, F, Ellis, SJ, Woolf, EA and Tartaglia, LA (1997) Cloning and characterization of an uncoupling protein homolog: a potential molecular mediator of human thermogenesis. Diabetes 46, 900906.CrossRefGoogle ScholarPubMed
Gore, CJ and Whither, RT (1990) The effect of exercise intensity and duration on the oxygen deficit and excess post-exercise oxygen consumption. European Journal of Applied Physiology 60, 169174.CrossRefGoogle ScholarPubMed
Hill, JO, Peters, JC, Reed, GW, Schlundt, DG, Sharp, T and Greene, HL (1991) Nutrient balance in humans: effects of diet composition. American Journal of Clinical Nutrition 54, 1017.CrossRefGoogle ScholarPubMed
Horton, TJ, Drougas, H, Brachey, A, Reed, GW, Peters, JC and Hill, JO (1995) Fat and carbohydrate overfeeding in humans: Different effects on energy storage. American Journal of Clinical Nutrition 62, 1929.CrossRefGoogle ScholarPubMed
Hurni, M, Burnand, B, Pittet, P and Jequier, E (1982) Metabolic effects of a mixed and a high-carbohydrate low-fat diet in man, measured over 24 h in a respiration chamber. British Journal of Nutrition 47, 3343.CrossRefGoogle Scholar
Katan, MB, Grundy, SM and Willett, WC (1997) Beyond low-fat diets. New England Journal of Medicine 337, 563566.Google ScholarPubMed
Keil, U and Kuulasmaa, K (1989) WHO MONICA project: risk factors. International Journal of Epidemiology 18, S46S55.Google ScholarPubMed
Kiens, B, Essen-Gustavsson, B, Gad, P and Lithell, H (1987) Lipoprotein lipase activity and intramuscular triglyceride stores after long-term high-fat and high-carbohydrate diets in physically trained men. Clinical Physiology 7, 19.CrossRefGoogle ScholarPubMed
Klesges, RC, Klesges, LM, Haddock, CK and Eck, LH (1992) A longitudinal analysis of the impact of dietary intake and physical activity on weight change in adults. American Journal of Clinical Nutrition 55, 818822.CrossRefGoogle ScholarPubMed
Kuczmarski, RJ, Flegal, KM, Campbell, SM and Johnson, CL (1994) Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. Journal of the American Medical Association 272, 205211.CrossRefGoogle ScholarPubMed
Lean, ME and James, WP (1988) Metabolic effects of isoenergetic nutrient exchange over 24 hours in relation to obesity in women. International Journal of Obesity 12, 1527.Google ScholarPubMed
Lean, ME, James, WP, Jennings, G and Trayhurn, P (1986) Brown adipose tissue uncoupling protein content in human infants, children and adults. Clinical Science 71, 291297.CrossRefGoogle ScholarPubMed
Lissner, L and Heitmann, BL (1995) Dietary fat and obesity: evidence from epidemiology. European Journal of Clinical Nutrition 49, 7990.Google ScholarPubMed
Lissner, L, Levitsky, DA, Strupp, BJ, Kalkwarf, HJ and Roe, DA (1987) Dietary fat and the regulation of energy intake in human subjects. American Journal of Clinical Nutrition 46, 886892.CrossRefGoogle ScholarPubMed
McNeill, G, Bruce, AC, Ralph, A and James, WP (1988) Inter-individual differences in fasting nutrient oxidation and the influence of diet composition. International Journal of Obesity 12, 455463.Google ScholarPubMed
Masuzaki, H, Ogawa, Y, Hosoda, K, Kawada, T, Fushiki, T and Nakao, K (1995) Augmented expression of the. obese gene in the adipose tissue from rats fed high-fat diet. Biochemical and Biophysical Research Communications 216, 355358.CrossRefGoogle ScholarPubMed
Matsuda, J, Hosoda, K, Itoh, H, Son, C, Doi, K, Tanaka, T, Fukunaga, Y, Inoue, G, Nishimura, H, Yoshimasa, Y, Yamori, Y and Nakao, K (1997) Cloning of rat uncoupling protein-3 and uncoupling protein-2 cDNAs: their gene expression in rats fed high-fat diet. FEBS Letters 418, 200204.CrossRefGoogle ScholarPubMed
Millar, WJ and Stephens, T (1993) Social status and health risks in Canadian adults: 1985 and 1991. Health Reports 5, 143156.Google ScholarPubMed
Miller, WC, Lindeman, AK, Wallace, J and Niederpruem, M (1990) Diet composition, energy intake, and exercise in relation to body fat in men and women. American Journal of Clinical Nutrition 52, 426430.CrossRefGoogle ScholarPubMed
Montague, CT, Farooqi, IS, Whitehead, JP, Soos, MA, Rau, H, Wareham, NJ, Sewter, CP, Digby, JE, Mohammed, SN, Hurst, JA, Cheetham, CH, Earley, AR, Barnett, AH, Prins, JB and O'Rahilly, S (1997) Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature 387, 903908.CrossRefGoogle ScholarPubMed
Monteiro, CA, Mondini, L, de Souza, AL and Popkin, BM (1995) The nutrition transition in Brazil. European Journal of Clinical Nutrition 49, 105113.Google ScholarPubMed
Nicholls, D, Bernson, V and Heaton, G (1978) The identification of the component in the inner membrane responsible for regulating energy dissipation. In Effectors of Thermogenesis 89-93. Basel: BirkhauserCrossRefGoogle Scholar
Pan, DA, Lillioja, S, Kriketos, AD, Milner, MR, Baur, LA, Bogardus, C, Jenkins, AB and Storlien, LH (1997) Skeletal muscle triglyceride levels are inversely related to insulin action. Diabetes 46, 983989.CrossRefGoogle ScholarPubMed
Phelain, JF, Reinke, E, Harris, MA and Melby, CL (1997) Postexercise energy expenditure and substrate oxidation in young women resulting from exercise bouts of different intensity. Journal of the American College of Nutrition 16, 140146.CrossRefGoogle ScholarPubMed
Philips, DIW, Caddy, S, Ilic, V, Fielding, BA, Frayn, KN, Borthwick, AC and Taylor, R (1996) Intramuscular triglyceride and muscle insulin sensitivity: evidence for a relationship in nondiabetic subjects. Metabolism 45, 947950.CrossRefGoogle Scholar
Poehlman, ET, Melby, CL, Bradylak, SF and Calles, J (1988) Resting metabolic rate and postprandial thermogenesis in highly trained and untrained males. American Journal of Clinical Nutrition 47, 793798.CrossRefGoogle ScholarPubMed
Poppitt, SD (1995) Energy density of diets and obesity. International Journal of Obesity 19, S20S26.Google ScholarPubMed
Prewitt, TE, Schmeisser, D, Bowen, PE, Aye, P, Dolecek, TA, Langenberg, P, Cole, T and Brace, L (1991) Changes in body weight, body composition, and energy intake in women fed high- and low-fat diets. American Journal of Clinical Nutrition 54, 304310.CrossRefGoogle ScholarPubMed
Ravussin, E, Lillioja, S, Anderson, TE, Christin, L and Bogardus, C (1986) Determinants of 24-hour energy expenditure in man. Methods and results using a respiratory chamber. Journal of Clinical Investigation 78, 15681578.CrossRefGoogle ScholarPubMed
Ravussin, E, Pratley, RE, Maffei, M, Wang, H, Friedman, JM, Bennett, PH and Bogardus, C (1997) Relatively low plasma leptin concentrations precede weight gain in Pima Indians. Nature Medicine 3, 238240.CrossRefGoogle ScholarPubMed
Ravussin, E, Valencia, ME, Esparza, J, Bennett, PH and Schulz, LO (1994) Effects of a traditional lifestyle on obesity in Pima Indians. Diabetes Care 17, 10671074.CrossRefGoogle ScholarPubMed
Romieu, I, Willett, WC, Stampfer, MJ, Colditz, GA, Sampson, L, Rosner, B, Hennekens, CH and Speizer, FE (1988) Energy intake and other determinants of relative weight. American Journal of Clinical Nutrition 47, 406412.CrossRefGoogle ScholarPubMed
Romijn, JA, Coyle, EF, Sidossis, LS, Gastaldelli, A, Horowitz, JF, Endert, E and Wolfe, RR (1993) Regulation of endogenous fat and carbohydrate metabolism in relation to exercise intensity and duration. American Journal of Physiology 265, E380E391.Google ScholarPubMed
Saltzman, E, Dallal, GE and Roberts, SB (1997) Effect of high-fat and low-fat diets on voluntary energy intake and substrate oxidation: studies in identical twins consuming diets matched for energy density, fiber, and palatability. American Journal of Clinical Nutrition 66, 13321339.CrossRefGoogle ScholarPubMed
Saris, WHM (1996) Physical activity and body weight regulation. In Regulation of Body Weight: Biological and Behavioral Mechanisms 135147, New York, NY: John Wiley & sons Ltd.Google Scholar
Schrauwen, P, Marken, Lichtenbelt WDv, Saris, WHM and Westerterp, KR (1997) Changes in fat oxidation in response to a high-fat diet. American Journal of Clinical Nutrition 66, 276282.CrossRefGoogle ScholarPubMed
Schrauwen, P, Marken, Lichtenbelt WDv, Saris, WHM and Westerterp, KR (1997) Role of glycogen-lowering exercise in the change of fat oxidation in response to a high-fat diet. American Journal of Physiology 273, E623E629.Google ScholarPubMed
Schrauwen, P, Marken, Lichtenbelt WDv, Saris, WHM and Westerterp, KR (1998) Fat balance in obese subjects: Role of glycogen stores. American Journal of Physiology 274, E1027E1033.Google ScholarPubMed
Schrauwen, P, Marken, Lichtenbelt WDv and Westerterp, KR (1997) Energy balance in a respiration chamber: individual adjustment of energy intake to energy expenditure. International Journal of Obesity 21, 769774.CrossRefGoogle Scholar
Schrauwen, P, Marken, Lichtenbelt WDv, Westerterp, KR and Saris, WHM (1997) The effect of diet composition on leptin concentration in lean subjects. Metabolism 46, 420424.CrossRefGoogle ScholarPubMed
Schrauwen, P, Wagenmaker, AJM, Marken, Lichtenbelt WDv, Saris, WHM and Westerterp, KR (2000) The increase in fat oxidation on a high-fat diet is accompanied by an increase in triglyceride-derived fatty acid oxidation. Diabetes 49, 640646.CrossRefGoogle ScholarPubMed
Schrauwen, P, Xia, J, Bogardus, C, Pratley, R and Ravussin, E (1999) Skeletal muscle UCP3 expression is a determinant of energy expenditure in Pima Indians. Diabetes 48, 146149.CrossRefGoogle ScholarPubMed
Schulz, LO, Nyomba, BL, Alger, S, Anderson, TE and Ravussin, E (1991) Effect of endurance training on sedentary energy expenditure measured in a respiratory chamber. American Journal of Physiology 260, E257E261.Google Scholar
Schulz, LO and Schoeller, DA (1994) A compilation of total daily energy expenditures and body weights in healthy adults. American Journal of Clinical Nutrition 60, 676681.CrossRefGoogle ScholarPubMed
Schutz, Y, Flatt, JP and Jequier, E (1989) Failure of dietary fat intake to promote fat oxidation: a factor favoring the development of obesity. American Journal of Clinical Nutrition 50, 307314.CrossRefGoogle ScholarPubMed
Sedlock, DA (1991) Effect of exercise intensity on postexercise energy expenditure in women. British Journal of Sports Medicine 25, 3840.CrossRefGoogle ScholarPubMed
Sedlock, DA, Fissinger, JA and Melby, CL (1989) Effect of exercise intensity and duration on postexercise energy expenditure. Medicine and Science in Sports Exercise 21, 662666.CrossRefGoogle ScholarPubMed
Seidell, JC (1995) Obesity in Europe: scaling an epidemic. International Journal of Obesity and Related Metabolic Disorders 19 (Suppl. 3), S1S4.Google ScholarPubMed
Seidell, JC and Rissanen, AM (1997) Time trends in the worldwide prevalence of obesity Handbook of Obesity. In Handbook of Obesity, 7991. New York NY: Marcel Dekker Inc.Google Scholar
Shimabukuro, M, Koyama, K, Chen, G, Wang, MM, Trieu, F, Lee, Y, Newgard, CB and Unger, RH (1997) Direct antidiabetic effect of leptin through triglyceride depletion of tissues. Proceedings of the National Academy of Sciences, USA 94, 46374641.CrossRefGoogle ScholarPubMed
Smith, J and Naughton, L (1993) The effects of intensity of exercise on excess postexercise oxygen consumption and energy expenditure in moderately trained men and women. European Journal of Applied Physiology 67, 420425.CrossRefGoogle ScholarPubMed
Sonne-Holm, S and Sorensen, TI (1977) Post-war course of the prevalence of extreme overweight among Danish young men. Journal of Chronic Diseases 30, 351358.CrossRefGoogle ScholarPubMed
Starling, RD, Trappe, TA, Parcell, AC, Kerr, CG, Fink, WJ and Costill, DL (1997) Effects of diet on muscle triglyceride and endurance performance. Journal of Applied Physiology 82, 11851189.CrossRefGoogle ScholarPubMed
Stephens, TW, Basinski, M, Bristow, PK, Bue-Valleskey, JM, Burgett, SG, Craft, L, Hale, J, Hoffmann, J, Hsiung, HM, Kriauciunas, A, MacKellar, W, Rosteck, PR, Schoner, B, Smith, D, Tinsley, FC, Zhang, X-Y and Heiman, M (1995) The role of neuropeptide Y in the antiobesity action of the obese gene product. Nature 377, 530532.CrossRefGoogle ScholarPubMed
Strobel, A, Issad, T, Camoin, L, Ozata, M and Strosberg, AD (1998) A leptin missense mutation associated with hypogonadism and morbid obesity. Nature Genetics 18, 213215.CrossRefGoogle ScholarPubMed
Stunkard, AJ, Harris, JR, Pedersen, NL and McClearn, GE (1990) The body-mass index of twins who have been reared apart. New England Journal of Medicine 322, 14831487.CrossRefGoogle ScholarPubMed
Stunkard, AJ, Sorensen, TIA, Hanis, C, Teasdale, TW, Chakraborty, R, Schull, WJ and Schulsinger, F (1986) An adoption study of human obesity. New England Journal of Medicine 314, 193198.CrossRefGoogle ScholarPubMed
Thomas, CD, Peters, JC, Reed, GW, Abumrad, NN, Sun, M and Hill, JO (1992) Nutrient balance and energy expenditure during ad libitum feeding of high-fat and high-carbohydrate diets in humans. American Journal of Clinical Nutrition 55, 934942.CrossRefGoogle ScholarPubMed
Tremblay, A, Fontaine, E, Poehlman, ET, Mitchell, D, Perron, L and Bouchard, C (1986) The effect of exercise-training on resting metabolic rate in lean and obese moderately obese individuals. International Journal of Obesity 10, 511517.Google ScholarPubMed
Tremblay, A, Simoneau, J-A and Bouchard, C (1994) Impact of exercise intensity on body fatness and skeletal muscle metabolism. Metabolism 43, 814818.CrossRefGoogle ScholarPubMed
Treuth, MS, Hunter, GR and Williams, M (1996) Effects of exercise intensity on 24 h-energy expenditure and substrate oxidation. Medicine and Science in Sports Exercise 28, 11381144.CrossRefGoogle ScholarPubMed
Verboeket-van de Venne, WPHG, Westerterp, KR, Hermans-Limpens TJFMB, Graaf, Cd, Hof Kvh and Weststrate, JA (1996) Long-term effects of consumption of full-fat or reduced-fat products in healthy non-obese volunteers: assessment of energy expenditure and substrate oxidation. Metabolism 45, 10041010.CrossRefGoogle ScholarPubMed
Verboeket-van de Venne, WPHG, Westerterp, KR and ten Hoor, F (1994) Substrate utilization in man: effects of dietary fat and carbohydrate. Metabolism 43, 152156.CrossRefGoogle ScholarPubMed
Wang, J, Rong, L, Hawkins, M, Barzilai, N and Rossetti, L (1998) A nutrient-sensing pathway regulates leptin gene expression in muscle and fat. Nature 393, 684688.CrossRefGoogle ScholarPubMed
Weigle, DS, Selfridge, LE, Schwartz, MW, Seeley, RJ, Cummings, DE, Havel, PJ, Kuijper, JL and BertrandelRio, H (1998) Elevated free fatty acids induce uncoupling protein 3 expression in muscle. A potential explanation for the effect of fasting. Diabetes 47, 298302.CrossRefGoogle ScholarPubMed
Westerterp, KR (1999) Obesity and physical activity. International Journal of Obesity 23, 5964.CrossRefGoogle ScholarPubMed
Westerterp, KR and Goran, MI (1997) Relationship between physical activity related energy expenditure and body composition: a gender difference. International Journal of Obesity 21, 184188.CrossRefGoogle ScholarPubMed
Westerterp, KR, Meijer, GAL, Schoffelen, P and Janssen, E (1994) Body mass, body composition and sleeping metabolic rate before, during and after endurance training. European Journal of Applied Physiology 69, 203208.CrossRefGoogle ScholarPubMed
Westerterp, KR, Verboeket-van de Venne, WPHG and Bouten, C (1996) Energy expenditure and physical activity in subjects consuming full- or reduced-fat products as part of their normal diet. British Journal of Nutrition 76, 785795.CrossRefGoogle ScholarPubMed
Westerterp, KR, Verboeket-van de Venne, WPHG, Westerterp-Plantenga, MS, Velthuis-te, Wierik EJM, Graaf, Cd and Weststrate, JA (1996) Dietary fat and body fat: an intervention study. International Journal of Obesity 20, 10221026.Google ScholarPubMed
Westerterp-Plantenga, MS, Pasman, WJ and Wijckmans-Duijsens, NEG (1996) Energy intake adaptation of food intake to extreme energy densities of food by obese and non-obese women. European Journal of Clinical Nutrition 50, 401407.Google ScholarPubMed
Westerterp-Plantenga, MS, Verwegen, CRT, Ijedema, MJW, Wijckmans, NEG and Saris, WHM (1997) Acute effects of exercise or sauna on appetite in obese and nonobese men. Physiology & Behavior 62, 13451354.CrossRefGoogle ScholarPubMed
Zhang, Y, Proenca, R, Maffei, M, Barone, M, Leopold, L and Friedman, JM (1994) Positional cloning of the mouse. obese gene and its human homologue. Nature 372, 425432.CrossRefGoogle ScholarPubMed