Fasting substrate oxidation in relation to habitual dietary fat intake and insulin resistance in non-diabetic women: a case for metabolic flexibility
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BACKGROUND: Metabolic flexibility described as "the capacity of the body to match fuel oxidation to fuel availability" has been implicated in insulin resistance. We examined fasting substrate oxidation in relation to dietary macronutrient intake, and markers of insulin resistance in otherwise healthy women, with and without a family history of diabetes mellitus (FH DM). METHODS: We measured body composition (dual x-ray absorptiometry), visceral and subcutaneous adipose tissue area (VAT, SAT, using Computerised Tomography), fasting [glucose], [insulin], [free fatty acids], [blood lipids], insulin resistance (HOMA-IR), resting energy expenditure (REE), respiratory exchange ratio(RER) and self-reported physical activity in a convenience sample of 180 women (18-45 yrs). A food frequency questionnaire was used to assess energy intake (EI) and calculate the RER: Food Quotient (FQ) ratio. Only those with EI:REE (1.05 -2.28) were included (N=140). Insulin resistance was defined HOMA-IR (>1.95). RESULTS: The Insulin Resistant (IR) group had higher energy, carbohydrate and protein intakes (p < 0.05) and lower PA levels than Insulin Sensitive (IS) group (P < 0.001), but there were no differences in RER or RER:FQ between groups. However, nearly 50% of the variance in HOMA-IR was explained by age, body fat %, VAT, RER:FQ and FH DM (adjusted R2 = 0.50, p < 0.0001). Insulin-resistant women, and those with FH DM had a higher RER:FQ than their counterparts (p < 0.01), independent of body fat % or distribution. CONCLUSION: In these apparently healthy, weight-stable women, insulin resistance and FH DM were associated with lower fat oxidation in relation to dietary fat intake, suggesting lower metabolic flexibility.
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Metabolic flexibility can be understood as an adaptive response of an organism's metabolism to maintain energy homeostasis by matching fuel availability and demand to periodic fasting, varying meal composition, physical activity, and environmental fluctuations.
“Taken together, metabolic flexibility can be understood as an adaptive response of an organism’s metabolism to maintain energy homeostasis by matching fuel availability and demand to periodic fasting, varying meal composition, physical activity, and environmental fluctuations (13, 14).”
From Metabolic Flexibility as an Adaptation to Energy Resources and Requirements in Health and Disease (2018) · cites this paper as [13]
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References 49 · Cited by 34
- Authors
- Carstens, M. T., Goedecke, J. H., Dugas, L., Evans, J., Kroff, J., Levitt, N. S., & Lambert, E. V.
- Affiliations
- University of Cape Town (ZA)
- South African Medical Research Council (ZA)
- Corresponding author
- Lambert, Estelle V
- Venue
- Nutrition & Metabolism
- Published
- 2013-01-14
- Volume
- 10
- Issue
- 1
- Pages
- 8-8
- ISSN
- 1743-7075 (ISSN-L)
- PMC
- PMC3561280
- OpenAlex
- W2103926068
- Cited by
- 34
- References
- 49
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 1
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Nutrition & Metabolism (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
- Funders
- National Research Foundation
- University of Cape Town
- Medical Research Council
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Keywords
- metabolic flexibility, insulin resistance, dietary fat intake, substrate oxidation, fat oxidation, respiratory exchange ratio, family history of diabetes, visceral adipose tissue, women, physical activity, HOMA-IR
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