Abstract
Low total energy expenditure (TEE, MJ/d) has been a hypothesized risk factor for weight gain, but repeatability of TEE, a critical variable in longitudinal studies of energy balance, is understudied. We examine repeated doubly labeled water (DLW) measurements of TEE in 348 adults and 47 children from the IAEA DLW Database (mean ± SD time interval: 1.9 ± 2.9 y) to assess repeatability of TEE, and to examine if TEE adjusted for age, sex, fat-free mass, and fat mass is associated with changes in weight or body composition. Here, we report that repeatability of TEE is high for adults, but not children. Bivariate Bayesian mixed models show no among or within-individual correlation between body composition (fat mass or percentage) and unadjusted TEE in adults. For adults aged 20–60 y (N = 267; time interval: 7.4 ± 12.2 weeks), increases in adjusted TEE are associated with weight gain but not with changes in body composition; results are similar for subjects with intervals >4 weeks (N = 53; 29.1 ± 12.8 weeks). This suggests low TEE is not a risk factor for, and high TEE is not protective against, weight or body fat gain over the time intervals tested.
Highlights
Obesity is a highly prevalent health condition associated with increased morbidity and mortality[1]
We calculated repeatability of adjusted total energy expenditure (TEE), which controls for body composition variables (FFM, fat mass (FM)), sex, and age
Adjusted TEE was repeatable for adults (R = 0.64, SE = 0.033; credible intervals (CIs) = 0.578–0.703; PLRT < 0.0001, PPermutation < 0.001; Fig. 1b) but not for children (R = 0.00, SE = 0.077; CI = 0.000– 0.262; PLRT = 1.0, PPermutation = 1.0; Fig. 1c)
Summary
Obesity is a highly prevalent health condition associated with increased morbidity and mortality[1]. Low TEE has long been hypothesized to be a risk factor for obesity[3,4]. Research in this area has produced mixed results. Two studies reported that adults with a low 24-h energy expenditure (measured in a whole-room indirect calorimeter) were more likely to gain body mass over the subsequent 2.0–6.7 years than individuals with a high energy expenditure[3,8]. Several longitudinal studies have shown that TEE is not predictive of subsequent changes in body fat percentage in infants and children[9,10,11,12] or in adult women[13,14]. Average weight gain for U.S adults aged 40–69 years is
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