Abstract
To provide individually adapted nutritional support to patients with chronic obstructive pulmonary disease (COPD), objective and reliable methods must be used to assess patient energy requirements. The aim of this study was to validate the use of SenseWear Armband (SWA) and ActiHeart (AH) monitors for assessing total daily energy expenditure (TEE) and activity energy expenditure (AEE) and compare these techniques with the doubly labeled water (DLW) method in free-living women with COPD. TEE and AEE were measured in 19 women with COPD for 14 days using SWAs with software version 5.1 (TEESWA5, AEESWA5) or 6.1 (TEESWA6, AEESWA6) and AH monitors (TEEAH, AEEAH), using DLW (TEEDLW) as the criterion method. The three methods were compared using intraclass correlation coefficient (ICC) and Bland–Altman analyses. The mean TEE did not significantly differ between the DLW and SWA5.1 methods (−21 ± 726 kJ/day; P = 0.9), but it did significantly differ between the DLW and SWA6.1 (709 ± 667 kJ/day) (P < 0.001) and the DLW and AH methods (709 ± 786 kJ/day) (P < 0.001). Strong agreement was observed between the DLW and TEESWA5 methods (ICC = 0.76; 95% CI 0.47–0.90), with moderate agreements between the DLW and TEESWA6 (ICC = 0.66; 95% CI 0.02–0.88) and the DLW and TEEAH methods (ICC = 0.61; 95% CI 0.05–0.85). Compared with the DLW method, the SWA5.1 underestimated AEE by 12% (P = 0.03), whereas the SWA6.1 and AH monitors underestimated AEE by 35% (P < 0.001). Bland–Altman plots revealed no systematic bias for TEE or AEE. The SWA5.1 can reliably assess TEE in women with COPD. However, the SWA6.1 and AH monitors underestimate TEE. The SWA and AH monitors underestimate AEE.
Highlights
The impact of chronic obstructive pulmonary disease (COPD) is significantly understudied in women, but current evidence suggests substantial gender differences in the susceptibility to, severity of, and response to COPD management (Varkey 2004)
The use of doubly labeled water (DLW) as a criterion method has been reported in several studies measuring energy expenditure in COPD populations of both genders, but it has not been used in studies examining women with COPD (Baarends et al 1997; Slinde et al 2003)
We validated the utility of the AH monitor in assessments of total daily energy expenditure (TEE) and activity energy expenditure (AEE), which had not been previously established in patients with COPD
Summary
The impact of chronic obstructive pulmonary disease (COPD) is significantly understudied in women, but current evidence suggests substantial gender differences in the susceptibility to, severity of, and response to COPD management (Varkey 2004). Bodyweight (BW) loss and/or low fat-free mass (FFM) are common in COPD patients and have been associated with reduced performance and increased morbidity and mortality (Schols et al 2005; Slinde et al 2005; King et al 2008). Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.
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