Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
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Am J Clin Nutr. 2000 Aug;72(2 Suppl):533S-7S. Unique Identifier : AIDSLINE MED/20380500
Pi-Sunyer FX; Obesity Research Center, St Luke's-Roosevelt Hospital Center,; Columbia University, New York, NY 10025, USA. fxp1@columbia.edu
Abstract: Both overnutrition and undernutrition affect energy metabolism, with overnutrition raising energy expenditure and undernutrition lowering it. Fever is a powerful stimulator of thermogenesis. In diseases such as cancer, AIDS, diabetes mellitus, and rheumatoid arthritis, whether energy expenditure is increased or decreased often depends on how advanced the disorder is. Early on, when the greater protein turnover characteristic of these conditions is paramount, energy expenditure is increased. In addition, in diseases such as cancer, AIDS, and rheumatoid arthritis in which cytokines are released, the cytokines' thermogenic effect initially increases the metabolic rate. However, as the disease becomes more advanced and leads to cachexia, energy expenditure drops below normal. Acute conditions such as burns and trauma significantly raise energy expenditure, primarily by increasing sympathetic response and the release of catecholamines, which are powerful stimulators of energy expenditure.
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