Changes in appetite, energy intake, body composition, and circulating ghrelin constituents during an incremental trekking ascent to high altitudeReportar como inadecuado

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European Journal of Applied Physiology

pp 1–12

First Online: 24 July 2017Received: 10 April 2017Accepted: 16 July 2017


PurposeCirculating acylated ghrelin concentrations are associated with altitude-induced anorexia in laboratory environments, but have never been measured at terrestrial altitude. This study examined time course changes in appetite, energy intake, body composition, and ghrelin constituents during a high-altitude trek.

MethodsTwelve participants age: 284 years, BMI 23.02.1 kg m completed a 14-day trek in the Himalayas. Energy intake, appetite perceptions, body composition, and circulating acylated, des-acylated, and total ghrelin concentrations were assessed at baseline 113 m, 12 days prior to departure and at three fixed research camps during the trek 3619 m, day 7; 4600 m, day 10; 5140 m, day 12.

ResultsRelative to baseline, energy intake was lower at 3619 m P = 0.038 and 5140 m P = 0.016 and tended to be lower at 4600 m P = 0.056. Appetite perceptions were lower at 5140 m P = 0.027 compared with baseline. Acylated ghrelin concentrations were lower at 3619 m P = 0.046 and 4600 m P = 0.038, and tended to be lower at 5140 m P = 0.070, compared with baseline. Des-acylated ghrelin concentrations did not significantly change during the trek P = 0.177. Total ghrelin concentrations decreased from baseline to 4600 m P = 0.045. Skinfold thickness was lower at all points during the trek compared with baseline P ≤ 0.001 and calf girth decreased incrementally during the trek P = 0.010.

ConclusionsChanges in plasma acylated and total ghrelin concentrations may contribute to the suppression of appetite and energy intake at altitude, but differences in the time course of these responses suggest that additional factors are also involved. Interventions are required to maintain appetite and energy balance during trekking at terrestrial altitudes.

KeywordsGhrelin Hypoxia Altitude-induced anorexia Terrestrial altitude AbbreviationsAG:DGAcylated ghrelin to des-acylated ghrelin ratio

AMSAcute mountain sickness

ANOVAAnalysis of variance

BMIBody mass index

CASComposite appetite score


ISAKInternational Society for the Advancement of Kinanthropometry

LLSLake Louise Score

MoDRECMinistry of Defence Research Ethics Committee

RPERating of perceived exertion

SDStandard deviation

SEStandard error

SpO2Arterial oxygen saturations

VASVisual analogue scales

Communicated by Fabio Fischetti.

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