Profesionales médicos

April 03, 2026

Obesity is a chronic disease characterized by excess adipose tissue impacting health. While several biological factors may play a role in predicting weight change over time, the role of macronutrient metabolism, that is, storage versus oxidation, is one that has not been as well studied.

A new study published in the American Journal of Clinical Nutrition reports the long-term weight change follow-up of volunteers who participated in studies of dietary fatty acid metabolism conducted at Mayo Clinic between 1997 and 2012. In these studies, volunteers with stable weight and without obesity were administered ¹⁴C- or ³H-triolein during a meal to determine the relative proportions of fatty acid storage in subcutaneous adipose tissue depots and fatty acids oxidized for energy provision. Annualized weight change was tracked over time using data available in the electronic health record. A total of 107 volunteers with complete data were included in the study.

Women who stored more dietary fat in subcutaneous adipose tissue — and therefore oxidized less dietary fat — gained significantly more weight over the following 19 years than those who burned more and stored less dietary fat. This association was not present in men. There was no association between the ratio of meal fatty acid storage in upper body to lower body subcutaneous adipose tissue and subsequent diagnoses of obesity-related diseases, development of abnormal fasting glucose concentrations or lipid disorders. However, the overall incidence of these conditions was low in the study follow up period.

"Our study is unique in its analysis of meal fatty acid metabolism studies with known and quantified sources of error, combined with access to longitudinal electronic health record data and a relatively stable population," says Michael D. Jensen, M.D., an endocrinologist and obesity researcher at Mayo Clinic in Rochester, Minnesota. "The mean follow-up time of 18 years is longer than most studies. The differences seen between women and men have not previously been shown in human studies and while intriguing, require further study to fully understand."

These findings suggest that innate tendencies to metabolize dietary fat can influence energy balance over many years in women. Future research efforts could focus on designing studies that simultaneously measure meal carbohydrate and fat metabolism, as well as hepatic glycogen content, perhaps combined with measures of satiation, especially in women.

For more information

JSG Lopez, et al. Meal fatty acid metabolism is associated with long-term weight gain in females — A retrospective cohort study. American Journal of Clinical Nutrition. 2026;123:101219.

Refer a patient to Mayo Clinic.