Hostname: page-component-76fb5796d-r6qrq Total loading time: 0 Render date: 2024-04-25T08:46:36.071Z Has data issue: false hasContentIssue false
  • English
  • Français

Physical capacity, respiratory quotient and energy expenditure during exercise in male patients with schizophrenia compared with healthy controls

Published online by Cambridge University Press:  15 April 2020

B.M. Nilsson ,
R.M. Olsson ,
A. Öman ,
F.-A. Wiesel ,
L. Ekselius  and
A.H. Forslund
B.M. Nilsson*
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, 75185Uppsala, Sweden
R.M. Olsson
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, 75185Uppsala, Sweden
A. Öman
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, 75185Uppsala, Sweden
F.-A. Wiesel
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, 75185Uppsala, Sweden
L. Ekselius
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, 75185Uppsala, Sweden
A.H. Forslund
Affiliation:
Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, 75185Uppsala, Sweden
*
*Corresponding author. Tel.: +46 70 6110669; fax: +46 18 154157. E-mail addresses: bjorn.nilsson@neuro.uu.se, bjorn.nilsson@akademiska.se (B.M. Nilsson).
Get access

Abstract

Background

Despite massive research on weight gain and metabolic complications in schizophrenia there are few studies on energy expenditure and no current data on physical capacity.

Aim

To determine oxygen uptake capacity, respiratory quotient (RQ) and energy expenditure during a submaximal exercise test in patients with schizophrenia and healthy controls.

Method

Ten male patients and 10 controls were included. RQ and energy expenditure were investigated with indirect calorimetry during a cycle ergometer test. The submaximal work level was defined by heart rate and perceived exhaustion. Physical capacity was determined from predicted maximal oxygen uptake capacity (VO2-max).

Results

The patients exhibited significantly higher RQ on submaximal workloads and lower physical capacity. A significant lower calculated VO2-max remained after correction for body weight and fat free mass (FFM). Energy expenditure did not differ on fixed workloads.

Conclusion

RQ was rapidly increasing in the patients during exercise indicating a faster transition to carbohydrate oxidation and anaerobic metabolism that also implies a performance closer to maximal oxygen uptake even at submaximal loads. This may restrict the capacity for everyday activity and exercise and thus contribute to the risk for weight gain. Physical capacity was consequently significantly lower in the patients.

Keywords

SchizophreniaPhysical capacityRespiratory quotientOxygen uptake capacityEnergy expenditureBody weight
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 3 , April 2012 , pp. 206 - 212
Copyright
Copyright © Elsevier Masson SAS 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

1†

Frits-Axel Wiesel (1944–2007).

References

Allison, DB., Casey, DE.Antipsychotic-induced weight gain: a review of the literature. J Clin Psychiatry. 62 suppl. 7: 2001 22–31.Google ScholarPubMed
Astrand, PO., Ryhming, I.A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during sub-maximal work. J Appl Physiol. 1954; 7: 218–221.CrossRefGoogle ScholarPubMed
Bergh, U., Sjodin, B., Forsberg, A., Svedenhag, J.The relationship between body mass and oxygen uptake during running in humans. Med Sci Sports Exerc. 1991; 23: 205–211.CrossRefGoogle ScholarPubMed
Blaak, E.E., Saris, W.H.Substrate oxidation, obesity and exercise training. Best Pract Res Clin Endocrinol Metab. 2002; 16: 667–678.CrossRefGoogle ScholarPubMed
Bolinder, G., Noren, A., Wahren, J., De Faire, U.Long-term use of smokeless tobacco and physical performance in middle-aged men. Eur J Clin Invest. 1997; 27: 427–433.CrossRefGoogle ScholarPubMed
Borg, GA.Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982; 14: 377–381.CrossRefGoogle Scholar
Bowman, K.M., Eidson, J.P., Burladge, S.P.Biochemical studies in ten cases of dementia praecox. Boston Med Surg J. 1922; 187: 358–362.CrossRefGoogle Scholar
Braceland, FJ., Meduna, LJ., Vaichulis, JA.Delayed action of insulin in schizophrenia. Am J Psychiatry. 1945; 102: 108–110.CrossRefGoogle Scholar
Carlsson, C., Dencker, S.J., Grimby, G., Haggendal, J.Circulatory studies during physical exercise in mentally disordered patients. I. Effects of large doses of chlorpromazine. Acta Med Scand. 1968; 184: 499–509.CrossRefGoogle ScholarPubMed
Deimel, H., Lohmann, S.Physical capacity of schizophrenic patients. Rehabilitation (Stuttg). 1983; 22: 81–85.Google ScholarPubMed
Dyrstad, SM., Aandstad, A., Hallen, J.Aerobic fitness in young Norwegian men: a comparison between 1980 and 2002. Scand J Med Sci Sports. 2005; 15: 298–303.CrossRefGoogle ScholarPubMed
Ekelund, U., Franks, PW., Wareham, NJ., Aman, J.Oxygen uptakes adjusted for body composition in normal-weight and obese adolescents. Obes Res. 2004; 12: 513–520.CrossRefGoogle ScholarPubMed
Elman, I., Borsook, D., Lukas, SE.Food intake and reward mechanisms in patients with schizophrenia: implications for metabolic disturbances and treatment with second-generation antipsychotic agents. Neuropsychopharmacology. 2006; 31: 2091–2120.CrossRefGoogle ScholarPubMed
Fan, X., Anderson, E.J., Copeland, P.M., Borba, C.P., Nguyen, D.D., Freudenreich, O.et al.Higher fasting serum insulin is associated with increased resting energy expenditure in nondiabetic schizophrenia patients. Biol Psychiatry. 2006; 60: 1372–1377.CrossRefGoogle ScholarPubMed
Filozof, C., Gonzalez, C.Predictors of weight gain: the biological-behavioural debate. Obes Rev. 2000; 1: 21–26.CrossRefGoogle ScholarPubMed
Flyckt, L., Borg, J., Borg, K., Ansved, T., Edman, G., Bjerkenstedt, L.et al.Muscle biopsy, macro EMG, and clinical characteristics in patients with schizophrenia. Biol Psychiatry. 2000; 47: 991–999.CrossRefGoogle ScholarPubMed
Forslund, A.H., Johansson, A.G., Sjodin, A., Bryding, G., Ljunghall, S., Hambraeus, L.Evaluation of modified multicompartment models to calculate body composition in healthy males. Am J Clin Nutr. 1996; 63: 856–862.CrossRefGoogle ScholarPubMed
Goodpaster, B.H., Wolfe, R.R., Kelley, D.E.Effects of obesity on substrate utilization during exercise. Obes Res. 2002; 10: 575–584.CrossRefGoogle ScholarPubMed
Goran, M., Fields, D.A., Hunter, G.R., Herd, S.L., Weinsier, R.L.Total body fat does not influence maximal aerobic capacity. Int J Obes Relat Metab Disord. 2000; 24: 841–848.CrossRefGoogle Scholar
Gothelf, D., Falk, B., Singer, P., Kairi, M., Phillip, M., Zigel, L.et al.Weight gain associated with increased food intake and low habitual activity levels in male adolescent schizophrenic inpatients treated with olanzapine. Am J Psychiatry. 2002; 159: 1055–1057.CrossRefGoogle ScholarPubMed
Graham, K.A., Perkins, D.O., Edwards, L.J., Barrier, R.C., Lieberman, J.A., Harp, J.B.Effect of olanzapine on body composition and energy expenditure in adults with first-episode psychosis. Am J Psychiatry. 2005; 162: 118–123.CrossRefGoogle ScholarPubMed
Hoskins, RG., Sleeper, FH.Basal metabolism in schizophrenia. Arch Neurol Psychiatry. 1929; 21: 887–900.CrossRefGoogle Scholar
Hulens, M., Vansant, G., Lysens, R., Claessens, A.L., Muls, E.Exercise capacity in lean versus obese women. Scand J Med Sci Sports. 2001; 11: 305–309.CrossRefGoogle ScholarPubMed
Kahn, E.B., Ramsey, L.T., Brownson, R.C., Heath, G.W., Howze, E.H., Powell, K.E.et al.The effectiveness of interventions to increase physical activity. A systematic review. Am J Prev Med. 2002; 22: 73–107.CrossRefGoogle ScholarPubMed
Kay, S.R., Fiszbein, A., Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987; 13: 261–276.CrossRefGoogle Scholar
Lindamer, L.A., McKibbin, C., Norman, G.J., Jordan, L., Harrison, K., Abeyesinhe, S.et al.Assessment of physical activity in middle-aged and older adults with schizophrenia. Schizophr Res. 2008; 104: 294–301.CrossRefGoogle ScholarPubMed
Maffeis, C., Zaffanello, M., Pellegrino, M., Banzato, C., Bogoni, G., Viviani, E.et al.Nutrient oxidation during moderately intense exercise in obese prepubertal boys. J Clin Endocrinol Metab. 2005; 90: 231–236.CrossRefGoogle ScholarPubMed
Markovic, G., Vucetic, V., Nevill, A.M.Scaling behaviour of VO2 in athletes and untrained individuals. Ann Hum Biol. 2007; 34: 315–328.CrossRefGoogle ScholarPubMed
Marra, M., Scalfi, L., Contaldo, F., Pasanisi, F.Fasting respiratory quotient as a predictor of long-term weight changes in non-obese women. Ann Nutr Metab. 2004; 48: 189–192.CrossRefGoogle ScholarPubMed
Nadel, ER., Horvath, SM.Physiological responsiveness of schizoid adolescents to physical stress. Int J Neuropsychiatry. 1967; 3: 191–200.Google ScholarPubMed
Newcomer, J.W.Antipsychotic medications: metabolic and cardiovascular risk. J Clin Psychiatry. 68 suppl. 4: 2007 8–13.Google ScholarPubMed
Nilsson, B.M., Forslund, A.H., Olsson, R.M., Hambraeus, L., Wiesel, F.A.Differences in resting energy expenditure and body composition between patients with schizophrenia and healthy controls. Acta Psychiatr Scand. 2006; 114: 27–35.CrossRefGoogle ScholarPubMed
Osby, U., Correia, N., Brandt, L., Ekbom, A., Sparen, P.Mortality and causes of death in schizophrenia in Stockholm county, Sweden. Schizophr Res. 2000; 45: 21–28.CrossRefGoogle ScholarPubMed
Pajonk FG, Wobrock T, Gruber O, Scherk H, Berner D, Kaizl I, et al. Hippocampal plasticity in response to exercise in schizophrenia. Arch Gen Psychiatry 2010;67:133–43.CrossRefGoogle Scholar
Prabakaran, S., Swatton, J.E., Ryan, M.M., Huffaker, S.J., Huang, J.T., Griffin, J.L.et al.Mitochondrial dysfunction in schizophrenia: evidence for compromised brain metabolism and oxidative stress. Mol Psychiatry. 2004; 9: 684–697 [643].CrossRefGoogle ScholarPubMed
Prince, J.A., Harro, J., Blennow, K., Gottfries, C.G., Oreland, L.Putamen mitochondrial energy metabolism is highly correlated to emotional and intellectual impairment in schizophrenics. Neuropsychopharmacology. 2000; 22: 284–292.CrossRefGoogle ScholarPubMed
Procyshyn, R.M., Chau, A., Tse, G.Clozapine's effects on body weight and resting metabolic rate: a case series. Schizophr Res. 2004; 66: 159–162.CrossRefGoogle ScholarPubMed
Ravussin, E., Lillioja, S., Knowler, W.C., Christin, L., Freymond, D., Abbott, W.G.et al.Reduced rate of energy expenditure as a risk factor for body-weight gain. N Engl J Med. 1988; 318: 467–472.CrossRefGoogle ScholarPubMed
Ryan, M.C., Collins, P., Thakore, J.H.Impaired fasting glucose tolerance in first-episode, drug-naive patients with schizophrenia. Am J Psychiatry. 2003; 160: 284–289.CrossRefGoogle ScholarPubMed
Saha, S., Chant, D., McGrath, J.A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time?. Arch Gen Psychiatry. 2007; 64: 1123–1131.CrossRefGoogle ScholarPubMed
Seidell, J.C., Muller, D.C., Sorkin, J.D., Andres, R.Fasting respiratory exchange ratio and resting metabolic rate as predictors of weight gain: the Baltimore longitudinal study on aging. Int J Obes Relat Metab Disord. 1992; 16: 667–674.Google ScholarPubMed
Sharpe, J.K., Stedman, T.J., Byrne, N.M., Hills, A.P.Accelerometry is a valid measure of physical inactivity but not of energy expended on physical activity in people with schizophrenia. Schizophr Res. 2006; 85: 300–301.CrossRefGoogle Scholar
Sharpe, J.K., Stedman, T.J., Byrne, N.M., Hills, A.P.Low-fat oxidation may be a factor in obesity among men with schizophrenia. Acta Psychiatr Scand. 2009; 119: 451–456.CrossRefGoogle ScholarPubMed
Sharpe, J.K., Stedman, T.J., Byrne, N.M., Wishart, C., Hills, A.P.Energy expenditure and physical activity in clozapine use: implications for weight management. Aust N Z J Psychiatry. 2006; 40: 810–814.CrossRefGoogle ScholarPubMed
Thakore, J.H., Mann, J.N., Vlahos, I., Martin, A., Reznek, R.Increased visceral fat distribution in drug-naive and drug-free patients with schizophrenia. Int J Obes Relat Metab Disord. 2002; 26: 137–141.CrossRefGoogle ScholarPubMed
Uranova, N., Bonartsev, P., Brusov, O., Morozova, M., Rachmanova, V., Orlovskaya, D.The ultrastructure of lymphocytes in schizophrenia. World J Biol Psychiatry. 2007; 8: 30–37.CrossRefGoogle Scholar
van Aggel-Leijssen, D.P., Saris, W.H., Wagenmakers, A.J., Senden, J.M., van Baak, M.A.Effect of exercise training at different intensities on fat metabolism of obese men. J Appl Physiol. 2002; 92: 1300–1309.CrossRefGoogle ScholarPubMed
van Nimwegen, L.J., Storosum, J.G., Blumer, R.M., Allick, G., Venema, H.W., de Haan, L.et al.Hepatic insulin resistance in antipsychotic naive schizophrenic patients: stable isotope studies of glucose metabolism. J Clin Endocrinol Metab. 2008; 93: 572–577.CrossRefGoogle ScholarPubMed
Vanderburgh, P.M., Katch, F.I.Ratio scaling of VO2-max penalizes women with larger percent body fat, not lean body mass. Med Sci Sports Exerc. 1996; 28: 1204–1208.CrossRefGoogle Scholar
Ward, L., Mason, T.Aerobic capacity, weight gain and psychotropic medication. Br J Nurs. 2000; 9: 638–644.CrossRefGoogle ScholarPubMed
Weir, J.B.New methods for calculating metabolic rate with special reference to protein metabolism. 1949. Nutrition. 1990; 6: 213–221.Google ScholarPubMed
Zurlo, F., Lillioja, S., Esposito-Del Puente, A., Nyomba, B.L., Raz, I., Saad, M.F.et al.Low ratio of fat to carbohydrate oxidation as predictor of weight gain: study of 24-h RQ. Am J Physiol. 1990; 259: E650–657.Google ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.