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Effects of short-term hypercaloric nutrition on orthostatic tolerance in healthy individuals: a randomized controlled crossover study

De Gioannis, R. and Ewald, A.C. and Gerlach, D.A. and Heusser, K. and Hoffmann, F. and Frings-Meuthen, P. and Heer, M. and Tank, J. and Jordan, J. (2022) Effects of short-term hypercaloric nutrition on orthostatic tolerance in healthy individuals: a randomized controlled crossover study. Clinical Autonomic Research, 32 (6), pp. 423-430. Springer. doi: 10.1007/s10286-022-00900-2. ISSN 0959-9851.

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Official URL: https://doi.org/10.1007/s10286-022-00900-2


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/m²) 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 URL in elib:https://elib.dlr.de/190290/
Document Type:Article
Title:Effects of short-term hypercaloric nutrition on orthostatic tolerance in healthy individuals: a randomized controlled crossover study
AuthorsInstitution or Email of AuthorsAuthor's ORCID iDORCID Put Code
De Gioannis, R.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, GermanyUNSPECIFIEDUNSPECIFIED
Gerlach, D.A.Cardiovascular Aerospace Medicine Department, Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germanyhttps://orcid.org/0000-0001-7044-6065UNSPECIFIED
Heusser, K.UNSPECIFIEDhttps://orcid.org/0000-0002-2571-5585UNSPECIFIED
Hoffmann, F.Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany and Department of Cardiology, Pneumology, and Angiology, Heart Center of the University of Cologne, GermanyUNSPECIFIEDUNSPECIFIED
Frings-Meuthen, P.German Aerospace Center (DLR), Institute of Aerospace Medicine, Space Physiology, Cologne, GermanyUNSPECIFIEDUNSPECIFIED
Heer, M.IU International University of Applied Sciences, Erfurt, GermanyUNSPECIFIEDUNSPECIFIED
Tank, J.UNSPECIFIEDhttps://orcid.org/0000-0002-5672-1187UNSPECIFIED
Jordan, J.UNSPECIFIEDhttps://orcid.org/0000-0003-4518-0706UNSPECIFIED
Date:5 October 2022
Journal or Publication Title:Clinical Autonomic Research
Refereed publication:Yes
Open Access:Yes
Gold Open Access:No
In ISI Web of Science:Yes
Page Range:pp. 423-430
Keywords:Diet; Hypercaloric; Metabolism; Neurally mediated syncope; Sympathetic nervous system
HGF - Research field:Aeronautics, Space and Transport
HGF - Program:Space
HGF - Program Themes:Research under Space Conditions
DLR - Research area:Raumfahrt
DLR - Program:R FR - Research under Space Conditions
DLR - Research theme (Project):R - CardioBrain
Location: Köln-Porz
Institutes and Institutions:Institute of Aerospace Medicine
Institute of Aerospace Medicine > Cardiovascular Medicine in Aerospace
Institute of Aerospace Medicine > Leitungsbereich ME
Deposited By: Schrage, Larissa
Deposited On:22 Nov 2022 10:59
Last Modified:28 Jun 2023 11:22

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