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Beta2‑adrenergic stimulation increases energy expenditure at rest, but not during submaximal exercise in active overweight men

journal contribution
posted on 2023-05-19, 07:36 authored by Onslev, J, Glenn JacobsonGlenn Jacobson, Christian NarkowiczChristian Narkowicz, Backer, V, Kalsen, A, Kreiberg, M, Jessen, S, Bangsbo, J, Hostrup, M

Purpose: β2-Agonists have been proposed as weight-loss treatment, because they elevate energy expenditure. However, it is unknown what effect β2-agonists have on energy expenditure in overweight individuals. Furthermore, the influence of β2-agonist R- and S-enantiomer ratio for the increased energy expenditure is insufficiently explored.

Methods: Nineteen males were included in the study of which 14 completed. Subjects were 31.6 (± 3.5) years [mean (± 95% CI)] and had a fat percentage of 22.7 (± 2.1)%. On separate days, subjects received either placebo or inhaled racemic (rac-) formoterol (2 × 27 µg). After an overnight fast, energy expenditure and substrate oxidation were estimated by indirect calorimetry at rest and during submaximal exercise. Plasma (R,R)- and (S,S)-formoterol enantiomer levels were measured by ultra-performance liquid chromatograph–mass spectrometry.

Results: At rest, energy expenditure and fat oxidation were 12% (P ≤ 0.001) and 38% (P = 0.006) higher for rac-formoterol than placebo. Systemic (R,R):(S,S) formoterol ratio was correlated with change in energy expenditure at rest in response to rac-formoterol (r = 0.63, P = 0.028), whereas no association was observed between fat percentage and rac-formoterol-induced change in energy expenditure. During exercise, energy expenditure was not different between treatments, although carbohydrate oxidation was 15% higher (P = 0.021) for rac-formoterol than placebo. Rac-formoterol-induced shift in substrate choice from rest to exercise was related to plasma ln-rac-formoterol concentrations (r = 0.75, P = 0.005).

Conclusion: Selective β2-adrenoceptor agonism effectively increases metabolic rate and fat oxidation in overweight individuals. The potential for weight loss induced by β2-agonists may be greater for R-enantiopure formulations.


Publication title

European Journal of Applied Physiology










School of Pharmacy and Pharmacology



Place of publication

United States

Rights statement

Copyright 2017 Springer-Verlag GmbH Germany

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified