Universität zu Köln

De Gioannis, Riccardo, Ewald, Ann C., Gerlach, Darius A., Heusser, Karsten, Hoffmann, Fabian, Frings-Meuthen, Petra, Heer, Martina, Tank, Jens and Jordan, Jens ORCID: 0000-0003-4518-0706 (2022). Effects of short-term hypercaloric nutrition on orthostatic tolerance in healthy individuals: a randomized controlled crossover study. Clin. Auton. Res., 32 (6). S. 423 - 431. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1619-1560

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Abstract

Reduced-caloric intake lowers blood pressure through sympathetic inhibition, and worsens orthostatic tolerance within days. Conversely, hypercaloric nutrition augments sympathetic activity and blood pressure. Because dietary interventions could be applied in patients with syncope, we tested the hypothesis that short-term hypercaloric dieting improves orthostatic tolerance. In a randomized crossover trial, 20 healthy individuals (7 women, 26.7 +/- 8 years, 22.6 +/- 2 kg/m(2)) followed a 4-day hypercaloric (25% increase of energy intake by fat) or normocaloric nutritional plan, with a washout period of at least 23 days between interventions. We then performed head-up tilt table testing with incremental lower body negative pressure while recording beat-by-beat blood pressure and heart rate. The primary endpoint was orthostatic tolerance defined as time to presyncope. Time to presyncope during combined head-up tilt and lower body negative pressure did not differ between hypercaloric and normocaloric dieting (median 23.19 versus 23.04 min, ratio of median 1.01, 95% CI of ratio 0.5-1.9). Heart rate, blood pressure, heart rate variability, and blood pressure variability in the supine position and during orthostatic testing did not differ between interventions. We conclude that 4 days of moderate hypercaloric nutrition does not significantly improve orthostatic tolerance in healthy individuals. Nevertheless, given the important interaction between energy balance and cardiovascular autonomic control in the brain, caloric intake deserves more attention as a potential contributor and treatment target for orthostatic intolerance.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code De Gioannis, Riccardo UNSPECIFIED UNSPECIFIED UNSPECIFIED Ewald, Ann C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerlach, Darius A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heusser, Karsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Frings-Meuthen, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Heer, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Tank, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Jordan, Jens UNSPECIFIED orcid.org/0000-0003-4518-0706 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-678306
DOI:	10.1007/s10286-022-00900-2
Journal or Publication Title:	Clin. Auton. Res.
Volume:	32
Number:	6
Page Range:	S. 423 - 431
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1619-1560
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEAD-UP TILT; BLOOD-PRESSURE VARIABILITY; FAT; DIET; SENSITIVITY Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/67830