Doubly Labeled Water Method Research Articles

Energy Intake of Swedish Overweight and Obese Children Is Underestimated Using a Diet History Interview

Estimating energy intake (EI) of a child by using a diet history interview (DHI) method may be a challenge because of difficulty for the child to remember what has been eaten as well as to report portion sizes. The aim of this research was to validate reported EI from a DHI in children classified as overweight or obese by comparing the reported EI to total energy expenditure (TEE) measured by 2 objective measures. Eighty-five 10.5- ± 1.1-y-old overweight and obese children, with help from 1 or 2 parents, reported their EI 2 wk retrospectively in a DHI. Reported EI was compared with TEE, as measured by SenseWear armband (n = 85) and the doubly-labeled water (DLW) method (n = 21), during the same period as the DHI. Reported EI was underestimated by 14% when validated against both the armband and DLW method. Underestimation did not differ between boys and girls. However, the EI of obese children was underestimated by 22%, which is twice the rate as for the overweight children (95% CI: 0.55, 3.08). Underestimated EI was negatively correlated with BMI (r = −0.38; P = <0.01) as well as age (r = −0.21; P = 0.05). EI is underestimated to a higher extent among children with higher BMI and higher age when using a DHI method. The findings show the importance of validating dietary intake of children in general and in overweight and obese children in particular.

Insights into energy balance from doubly labeled water

Obesity is defined as the excess storage of energy in the form of fat that results from imbalances between energy intake and expenditure. The study of the components of energy balance has undergone a significant advancement with the application of the doubly labeled water (DLW) method to the measurement of human energy expenditure. This manuscript includes a selective review of the studies that have utilized the doubly labeled method as it applies to the study of human obesity. Although generally now accepted, one of the major surprises from the early applications of DLW was that obese individuals have higher energy expenditures than lean controls. Moreover, weight gain, even in the already obese, is associated with an increase in energy expenditure as weight is one of the strongest predictors of total energy expenditure. Similarly, studies of weight loss treatment show a decrease in energy expenditure due to weight loss and due to adaptive changes in energetic efficiency, but these changes do not account for the common cessation of weight loss observed after 12-26 weeks of restriction. The accumulating data from the application of the DLW method suggest a need to place greater emphasis on mechanisms that lead to a mismatch between energy intake and expenditure rather than a continuing emphasis on energy intake or energy expenditure alone.

Energy and Water Flux during Terrestrial Estivation and Overland Movement in a Freshwater Turtle

The doubly labeled water (DLW) method for studying energy and water balance in field-active animals is not feasible for freshwater animals during aquatic activities, but several species of nominally aquatic reptiles leave wetlands for several critical and extended behaviors, where they face challenges to their energy and water balance. Using DLW, we studied energy and water relations during terrestrial estivation and movements in the eastern long-necked turtle (Chelodina longicollis), a species that inhabits temporary wetlands in southeastern Australia. Water efflux rates of 14.3-19.3 mL (kg d)(-1 ) during estivation were nearly offset by influx, indicating that turtles did not maintain water balance while terrestrial, though dehydration was slow. Estivation energy expenditure declined over time to 20.0-24.6 kJ (kg d)(-1) but did not indicate substantial physiological specializations. Energy reserves are predicted to limit survival in estivation to an estimated 49-261 d (depending on body fat), which is in close agreement with observed bouts of natural estivation in this population. The energy cost and water flux rates associated with overland movement behavior ranged from 46 to 99 kJ (kg d)(-1 ) and from 21.6 to 40.6 mL (kg d)(-1), respectively, for turtles moving 23-34 m d(-1). When a wetland dries, a turtle that forgoes movement to other wetlands can save sufficient energy to fuel up to 134 d in estivation. The increasing time in estivation with travel distance gained in this energy "trade-off" fits our previous observations that more turtles estivate when longer distances must be traveled to the nearest permanent lake, whereas emigration is nearly universal when only short distances must be traversed. The DLW method shows promise for addressing questions regarding the behavioral ecology and physiology of freshwater turtles in terrestrial situations, though validation studies are needed.

Validation of ActiReg® to measure physical activity and energy expenditure against doubly labelled water in obese persons

ActiReg is an instrument that uses combined recordings of body position and motion to calculate energy expenditure (EE) and physical activity (PA). The aim of the study was to compare mean total energy expenditure (TEE) measured by ActiReg and doubly labelled water (DLW) in obese subjects. TEE was measured by the DLW method during a period of 14 d in fifty obese men and women with metabolic risk factors. During the same period ActiReg recordings were obtained for 7 d. RMR was measured by indirect calorimetry and also estimated by standardized equations. Because EE may be disproportionately increased in obese subjects during weight-bearing activities, we established a new set of physical activity ratios (PAR). These ratios were based on oxygen uptake measurements during treadmill walking. The mean TEE according to the DLW was 13.94 (sd 2.47) MJ/d. Mean TEE calculated from the ActiReg data and measured RMR was 13.39 (sd 2.26) MJ/d, an underestimation of 0.55 MJ (95 % CI 0.13, 0.98; P = 0.012) or 3.9 %. RMR derived from standard equations based on weight, age and sex were overestimated while the RMR based on fat-free mass values in addition was underestimated. Despite slight underestimation ActiReg may be used to measure TEE in obese subjects on two premises: RMR should be measured, and the increased EE during weight-bearing activities in obese subjects should be considered.

Total Energy Expenditure, Substrate Use and Hydration during the Ironman World Championship: A Case Study

PURPOSE: The purpose of this study was to compare total energy expenditure (TEE) via the doubly labeled water (DLW) method to developed regression equations, determine muscle glycogen use, and hydration changes during the Ironman World Championship triathlon. METHODS: The present case study included a male athlete (39y, 182.9cm, 77.9kg). Urine samples were collected daily (AM and PM) to evaluate isotopic elimination (2H2O and H218O) for calculations of TEE and water turnover. Additional samples were also collected from researchers from the same region as the subject but not participating in the study to adjust for isotopic background shifts. Prior to race day, regression equations were developed using the relationship between expired gas and workload during steady state bike and run segments on the actual race course. Muscle biopsies were collected from the vastus lateralis approximately 2hr pre and immediately post race. Blood was analyzed and nude body weight was collected immediately prior to and following the race. RESULTS: Total energy expenditure using the DLW method for the race was 38.9 MJ (9,290 kcals) compared to the predicted 36.0 MJ (9,087 kcals) from regression analyses. Muscle glycogen concentration was decreased 68.5% (125.2 and 48.0 mmol/kg wet wt. for pre and post race, respectively). Blood Na+ remained constant at 139 mmol/L, hemoglobin and hematocrit concentration increased (Hb=15.6 g/dl to 17.3 g/dl and hematocrit=46% to 51% for pre and post race, respectively). The estimated decrease in plasma volume over the race was 18%. Body mass demonstrated a 7.5% decrease (78.6 and 72.7 kg for pre and post race, respectively). Water turnover calculated from isotopic elimination was 16.6 L. DISCUSSION: Although the DLW method for determining TEE represents the gold standard for free-living humans, accurate estimation of TEE from individual, mode specific regression analyses is possible. These results demonstrate a large flux in muscle glycogen, and total body water in response to the extreme TEE of this multi-modal ultra-endurance event. Supported by Air Force Research Laboratories, FA8650-06-1-679

Assessment of the physical activity level with two questions: validation with doubly labeled water

To validate a two-question questionnaire on physical activity with the doubly labeled water (DLW) method. Cross-sectional study. Nine volunteers, age 33-75 years, with a mean body mass index (BMI) (kg m(-2)) of 27.4. A questionnaire with one question on physical activity at work and one question on physical activity during leisure time. The answers were converted into a PAL (physical activity level=energy expenditure/basal metabolic rate) value, which was validated with the DLW method. The mean values (s.d.) of PAL for the questionnaire and DLW measurements were 1.7 (0.1) and 1.7 (0.1), respectively, with a mean difference of 0.004 (0.172). The results were promising to the extent that they could be used in large-scale epidemiological studies.

Very low levels of energy expenditure among pre-adolescent Mexican-American girls

We assessed activity energy expenditure (AEE) in Mexican-American (MA) and European-American (EA) children. Total energy expenditure (TEE) was measured using the doubly-labeled water method; AEE was calculated as the difference between TEE and resting EE (REE), and physical activity level (PAL) was calculated as TEE/REE. Groups were comparable for age, sex and body mass index (BMI). REE did not differ between groups. The boys did not differ in TEE, AEE, or PAL (MA vs. EA, respectively: TEE, 7.9+/-1.5 vs. 7.5+/-0.9 MJ x d(-1); AEE: 64.9+/-24.7 vs. 65.3+/-22.3 kJ x kg(-1) x d(-1); PAL: 1.57+/-0.18 vs. 1.58+/-0.19 kJ x kg(-1) x d(-1)). MA girls had lower TEE, AEE, and PAL than EA girls (TEE: 6.8+/-0.9 vs. 8.1+/-0.8 MJ x d(-1); AEE, 37.3+/-15.9 vs. 64.9+/-24.7 kJ x kg(-1) x d(-1); PAL, 1.40+/-0.12 vs. 1.57+/-0.18; P <0.005). Results suggest that these MA girls were expending less energy than EA children of comparable body size due to a reduced activity energy expenditure.

Validation of a 7-day physical activity diary against doubly-labelled water

Background: The assessment of physical activity intensity and duration is essential for understanding group activity patterns.Methods: The present study evaluated the validity of measurement of total energy expenditure (TEE) and physical activity level (PAL) using a categorized physical activity diary. In 29 young healthy men, aged 18–27 years, with body mass index range 21–43 kg m−2, TEE using doubly-labelled water (DLW), resting metabolic rate (RMR) by indirect calorimetry, physical activity level (PAL defined as TEE/RMR) and activity pattern, timing and level from 7-day physical activity diaries were determined.Results: TEE by DLW and estimated by activity diary were correlated (r = 0.61, p = 0.005). The mean underestimation of TEE by the activity diary compared with the DLW method was 2.50 ± 0.72 MJ day−1. Sedentary (lying, sitting and standing) time averaged 18 h day−1 and was negatively correlated with PAL (r = −0.44, p = 0.018) whilst time spent in light intensity activity (5 h day−1) was positively correlated (r = 0.51, p = 0.005).Conclusions: It is concluded that the categorized physical activity diary measured TEE with limited accuracy but presents an inexpensive, convenient method of discriminating individual and group physical activity patterns.

Total daily energy expenditure among middle-aged men and women: the OPEN Study

Background: Few large doubly labeled water (DLW) studies have provided an objective measure of total energy expenditure (TEE) in free-living men and women. The committee that developed the 2002 Dietary Reference Intake (DRI) estimated energy requirements (EER) noted that DLW studies in adults aged 40 to 60 y were limited.Objective: We aimed to describe TEE and physical activity energy expenditure in middle-aged men and women by sex, age, menopausal status, and level of obesity, and to compare TEE to the DRI EER.Design: TEE was measured by the DLW method in 450 men and women aged 40–69 y from the Observing Protein and Energy Nutrition Study. Resting metabolic rate was estimated by use of the Mifflin equation.Results: Unadjusted TEE was lower in women than in men (591 kcal/d); however, when the analysis was adjusted for fat-free mass, women had significantly higher TEE than did men (182 kcal/d). This difference appeared to be due to higher physical activity levels in women (physical activity energy expenditure adjusted for FFM was 188 kcal/d greater in women than in men). Mean TEE was lowest in the seventh decade. TEE from DLW was highly correlated (r = 0.93) with EER from the DRI equations.Conclusion: In this population, TEE was higher in women than in men when adjusted for FFM, apparently because of higher physical activity levels in women. There were no significant differences in TEE, FFM, or physical activity levels in women by menopausal status. TEE was inversely associated with age and increased linearly with body mass index. This study corroborates the use of the DRI equations for EER.

Physical activity level in healthy free-living Japanese estimated by doubly labelled water method and International Physical Activity Questionnaire

To measure total energy expenditure (TEE) for normal healthy Japanese by the doubly labelled water (DLW), and to compare the physical activity level (PAL) among categories classified by the categories used in daily reference intake (DRI), Japan and the International Physical Activity Questionnaire (IPAQ). A total of 150 healthy Japanese men and women aged 20- to 59-year-old living in four districts of Japan. TEE was measured by the DLW method, and the PAL was calculated from TEE divided by basal metabolic rate. Simultaneously with TEE measurement, the PAL was assessed employing the categories used in DRI, Japan and IPAQ. The average TEE and PAL were 10.78+/-1.67 MJ/day and 1.72+/-0.22 for males and 8.37+/-1.30 MJ/day and 1.72+/-0.27 for females, respectively. The subjects in the highly active categories assessed by both DRI and IPAQ showed significantly higher PAL compared with less active categories. However, PALs among light and moderate categories by DRI, and insufficient and sufficiently active by IPAQ were not significantly different. In developed countries, highly active subjects could be assessed by a simple questionnaire. However, the questionnaire should be improved to clarify the sedentary to moderately active subjects by assessing carefully very light to moderate physical activity.

Accuracy Of Accelerometer, Activity Record, And Questionnaire By Comparison With The Doubly-labeled Water Method

BACKGROUND: The need for developing a simple and accurate assessment method for physical activity is increasing both for the study of the relationship between physical activity and health, and for health policy making. PURPOSE: To determine the accuracy of estimates of energy expenditure using three types of commercial devices, a tri-axial accelerometer with our previously reported equation, activity record, and a simple questionnaire by comparing the energy expenditure as measured by the doubly-labeled water method. METHODS: Healthy sedentary women's college students (n=1 1, age=21.2 years, height=159.1 cm, weight 50.9 kg) and middle-aged housewives (n=12, age=40.0 years, height=156.7 cm, weight=49.6 kg) volunteered as subjects. They completed the measurement of basal metabolic rate, the 3-day activity record, and physical activity questionnaire for the Japan Arteriosclerosis Longitudinal Study (JALSPAQ). They wore a uni-axial accelerometer (Lifecorder, Suzuken Inc., Japan), an ankle-mounted accelerometer-based activity monitor (AMP331, Dynastream Innovations Inc., Canada), a tri-axial accelerometer (AC-210, GMS Inc., Japan), and a microcomuter-based portable physical activity measurement device (IDEEA, MiniSun LLC, USA). 14-day energy expenditure was measured using the doubly-labeled water method. RESULTS: Most of the subjects were at the moderate physical activity level (total energy expenditure (TEE)/basal metabolic rate=1 .60 to 1.90) according to the Dietary Reference Intakes for Japanese, 2005. All devices and the questionnaire underestimated TEE both for young and middle-aged women. The AMP331 monitor underestimated TEE the most. Accuracy of each method was similar for young women, but it varied greatly for the middle-aged women. CONCLUSION: Accuracy of the assessment method for physical activity differed with the physical activity pattern.

Isotopic Measurements of Field Metabolic Rate (FMR) in the Marsupial Honey Possum (Tarsipes rostratus)

Abstract The doubly labeled water (DLW) method for the measurement of the field metabolic rate (FMR) of free-ranging vertebrates has limitations that are most evident when dealing with very small mammals, such as the nectarivorous marsupial honey possum (Tarsipes rostratus), that exhibit high metabolic rates and elevated rates of water turnover. We tested the efficacy of the radioisotope rubidium-86 (86Rb) as an alternative method for estimating FMR in this species in winter in Scott National Park in extreme southwestern Western Australia. We carried out a trial with 58 honey possums injected with a cocktail containing 86Rb, tritium, and oxygen-18 and correlated estimates of the FMR using the DLW method with repetitive measurements of the biological elimination rate constant (kb) of 86Rb. The 2 variables were significantly correlated and a linear regression explained 86% of the variation, which increased to 91% with a power curve fit to the data. Successive measurements of kb in individuals that were repe...

Using doubly-labeled water measurements of human energy expenditure to estimate inhalation rates

Doubly-labeled water (DLW) data is recognized as an improvement over alternative methods to quantify human energy expenditure. Previously, energy expenditure has been estimated indirectly using heart-rate monitoring, calorimetry, or accelerometer measurements. Inhalation rate estimates can benefit from improved energy expenditure estimates using equations developed by Layton. DLW methods are advantageous for several reasons: the database is robust, they are direct measures, subjects are free-living, and the observation period is longer than what is possible from staged activity measures. DLW energy data is an improvement over previous inhalation estimates based on dietary recall survey data. Mean long-term inhalation rates of 16 m3/day and 13 m3/day, for physically active adult men and women, respectively, were derived based on DLW estimates of energy expended. The range of human energy expenditure is narrow with the maximum energy expenditure not likely greater than twice the minimum.

Milk intake and carbon dioxide production of piglets determined with the doubly labelled water technique

The present study was undertaken to study different methodological aspects of quantifying CO2 production and milk intake of suckling piglets using the doubly labelled water (DLW) technique. In total, 37 piglets were enriched intraperitoneally with DLW to study equilibration time of 18O (n = 3), to validate the estimation of milk intake and CO2 production (n = 10) of piglets fed milk replacer and to quantify milk intake and CO2 production of piglets nursed ordinarily by sows (n = 24). Enrichment of 18O in expired air was analysed without any sample preparation, whereas enrichment of 18O in serum was analysed after a minimum step of sample preparation, which included pipetting of the sample, blowing gaseous CO2 into the vial for 3 s and equilibrating for 24 h. The 18O enrichment of CO2 in expired air was constant within 30–40 min of intraperitoneal injection, suggesting that DLW was equilibrated within the body water by that time. For piglets fed milk replacer, the estimation of the daily CO2 production by the DLW method (64.0 ± 2.7 l CO2/day) was in agreement with that obtained by respiration trials (64.7 ± 1.8 l CO2/day). Furthermore, the intake of milk replacer (891 ± 63 g/day) determined by deuterium oxide (D2O) dilution was similar in magnitude to that found by weighing the milk disappearance (910 ± 58 g/day). The milk intake of piglets fed milk replacer was comparable with that of sucking piglets, but sucking piglets had a remarkably higher CO2 production than artificially reared piglets, which likely was caused by a higher intake of milk solids and a higher activity level. For sucking piglets, the daily CO2 production increased curvilinearly with increasing live weight (LW) in kg: piglet CO2 production (l/day) = 25.75 × LW − 1.01 × LW2. In conclusion, 18O equilibrates fast within the body water pool when administered intraperitoneally, and the accuracy of assessing milk intake and rate of CO2 production using the DLW technique is promising. Assessment of excess enrichment of 18O in serum proved to be robust. Finally, the CO2 production of piglets fed milk replacer differs considerably from that of sucking piglets.

Validation study of energy expenditure and intake during calorie restriction using doubly labeled water and changes in body composition

Background: Clinical trials involving calorie restriction (CR) require an assessment of adherence to a prescribed CR with the use of an objective measure of energy intake (EI).Objective: The objective was to validate the use of energy expenditure (EE) measured by doubly labeled water (DLW), in conjunction with precise measures of body composition, to calculate an individual’s EI during 30% CR.Design: Ten participants underwent 30% CR for 3 wk. During the last week (7 d), 24-h EE was measured in a respiratory chamber and simultaneously by DLW (EEDLW). EI was calculated from 7-d EE measured by DLW and from changes in energy stores (ES) (weight and body composition). Calculated EI was then compared with the actual EI measured in the chamber by using the following equations: calculated EI (kcal/d) = EEDLW + ΔES, where ΔESFM/FFM (kcal/d) = (9.3 × ΔFM, g/d) + (1.1 × ΔFFM, g/d), FM is fat mass, and FFM is fat-free mass.Results: We found close agreement (R = 0.88) between EE measured in the metabolic chamber and EEDLW during CR. Using the measured respiratory quotient, we found that the mean (±SD) EEDLW was 1934 ± 377 kcal/d and EE measured in the metabolic chamber was 1906 ± 327 kcal/d, ie, a 1.3 ± 8.9% overestimation. EI calculated from EEDLW and from changes in ES was 8.7 ± 36.7% higher than the actual EI provided during the chamber stay (1596 ± 656 kcal/d).Conclusions: DLW methods can accurately estimate 24-h EE during CR. Although the mean difference between actual and calculated EIs for the group was small, we conclude that the interindividual variability was too large to provide an assessment of CR adherence on an individual basis.

Gastrostomy feeding in cerebral palsy: too much of a good thing?

Gastrostomy tube (GT) feeding in children with cerebral palsy (CP) is associated with significant increases in weight gain and, potentially, with overfeeding. This study aimed to measure energy balance and body composition in children with CP who were fed either orally or by GT. Forty children (27 males, 13 females; median age 8y 6mo; range 1y 4mo‐18y 11mo) with spastic quadriplegic C P, of whom 22 were gastrostomy‐fed and 18 orally‐fed, underwent anthropometry, indirect calorimetry, and total energy expenditure determination (doubly‐labelled water method). Total body water content (estimated by the 180 dilution method) was used to determine body composition. The Gross Motor Function Classification System (GMFCS) was used to determine the degree of motor impairment. GMFCS levels ranged from I to V; in the gastrostomy group 19 out of 22 were Level V and two out of 22 were Level I V. Within the orally‐fed group, 11 out of 18 were Level V and four out of 18 were Level I V. Resting metabolic rate and total energy expenditure of the gastrostomy‐fed children were lower but they had a significantly larger triceps skin fold thickness (p=0.01) and fat mass index (p=0.02) than the orally‐fed children. Both groups had consistently higher body‐fat content and lower fat‐free (i.e. muscle and bone) content than the reference population of age‐and sex‐matched children without disabilities. This study has demonstrated the relatively low energy expenditure and high body‐fat content of children with severe CP and highlighted the potential risk of overfeeding with available enteral feeds administered via GT.

Gastrostomy feeding in cerebral palsy: too much of a good thing?

Gastrostomy tube (GT) feeding in children with cerebral palsy (CP) is associated with significant increases in weight gain and, potentially, with overfeeding. This study aimed to measure energy balance and body composition in children with CP who were fed either orally or by GT. Forty children (27 males, 13 females; median age 8y 6mo; range 1y 4mo-18y 11mo) with spastic quadriplegic CP, of whom 22 were gastrostomy-fed and 18 orally-fed, underwent anthropometry, indirect calorimetry, and total energy expenditure determination (doubly-labelled water method). Total body water content (estimated by the 18O dilution method) was used to determine body composition. The Gross Motor Function Classification System (GMFCS) was used to determine the degree of motor impairment. GMFCS levels ranged from I to V; in the gastrostomy group 19 out of 22 were Level V and two out of 22 were Level IV. Within the orally-fed group, 11 out of 18 were Level V and four out of 18 were Level IV. Resting metabolic rate and total energy expenditure of the gastrostomy-fed children were lower but they had a significantly larger triceps skinfold thickness (p=0.01) and fat mass index (p=0.02) than the orally-fed children. Both groups had consistently higher body-fat content and lower fat-free (i.e. muscle and bone) content than the reference population of age- and sex-matched children without disabilities. This study has demonstrated the relatively low energy expenditure and high body-fat content of children with severe CP and highlighted the potential risk of overfeeding with available enteral feeds administered via GT.

Field Metabolic Rates of Walrus (&lt;I&gt;Odobenus rosmarus&lt;/I&gt;) Measured by the Doubly Labeled Water Method

The energy and food requirements of free-ranging pinniped species are difficult to measure and, as a consequence, are unknown for most species. They can be inferred from measures of Field Metabolic Rate (FMR) made by the Doubly Labeled Water (DLW) method, however. In this work, we confirmed our hypothesis that the FMR of pinnipeds measured by DLW can be described by an allometric relationship as a function of body weight. Although costly and difficult to apply, the DLW method is one of the few possible methods generating estimates of energy demands for unrestrained, free-living animals. The results of its application on two adult, male, freeliving Atlantic Walruses (Odobenus rosmarus rosmarus), weighing 1,370 kg and 1,250 kg, respectively, estimated from length and girth measures, are presented here. These data extend the size range of the seven pinniped species for which the DLW method has been applied by a factor of 10. The animals were measured at a site in northeast Greenland (76° N) during the summer. FMR was dependent on the pool model for estimating metabolic rate and was approximately 13% higher when using the single-pool compared with the two-pool model. The estimates using

Comparison of energy expenditure estimates from 4 physical activity questionnaires with doubly labeled water estimates in postmenopausal women

Physical activity energy expenditure (EE) is an important determinant of health, and epidemiologists have used various methods, such as physical activity and energy intake recalls and records, to estimate energy cost. However, most epidemiologic studies have not validated these methods against the doubly labeled water (DLW) technique for measuring EE. The aim was to compare EE estimated by 4 physical activity questionnaires with that obtained with the DLW technique in free-living postmenopausal women. We measured EE in kcal/d using the DLW method, the Harvard Alumni questionnaire, the Five City Project questionnaire, the Cross-Cultural Activity Participation Study (CAPS) Four Week Activity Recall, and the CAPS Typical Week Activity Survey in 65 healthy postmenopausal women. Compared with DLW, the Harvard Alumni questionnaire, the Five City Project questionnaire, and the CAPS Four Week Activity Recall overestimated (P < 0.05) daily EE by 62%, 16%, and 11%, respectively, whereas the CAPS Typical Week Activity Recall underestimated (P < 0.05) EE by 31%. Both the Harvard Alumni and Five City Project questionnaires overestimated EE in obese and overweight women. When using 3 of the 4 questionnaire methods, postmenopausal women overestimated EEs. Of all women, obese women overestimated daily EE the most.

Total energy expenditure, resting metabolic rate and physical activity level in free-living rural elderly men and women from Cuba, Chile and México

The objective of this study was to assess total energy expenditure (TEE), resting metabolic rate (RMR) and physical activity level (PAL), and to estimate energy requirements (ERs) in free-living elderly subjects from Cuba, Chile and Mexico. Cross-sectional study designed to estimate ERs. Rural regions of Cuba, Chile and Mexico. Forty subjects >60 years old were selected to participate in this study. A dose of doubly labeled water (DLW) was administered and urine samples were collected in the following 12-14 days. From the isotopic analysis, TEE was derived. RMR was measured by indirect calorimetry. TEE in Chilean (8.8+/-1.6 MJ/day) and Cuban (8.3+/-1.3 MJ/day) elderly was not different, and was higher for the Mexican group (9.5+/-1.5 MJ/day) (P < 0.0001). RMR was not different between countries. PAL and activity energy expenditure (AEE) were only different between Chile and Mexico (P < 0.002). For the three regions, overall PALs were 1.70+/-0.16 for male and 1.62+/-0.13 for female subjects (P < 0.02), and AEE was 3.05+/-0.66 and 2.27+/-0.66 MJ/day for male and female subjects, respectively (P < 0.001). Predictive equations (MJ/day) were RMR = 1.6447 + 0.05714 x weight (kg) + 0.449 sex (male = 1; female = 0) (R2 = 0.75; SEE = 0.479) and TEE = 3.414 + 0.0795 x weight (kg) + 1.227 x sex (male = 1; female = 0) (R2 = 0.75; SEE = 0.668). There were differences in TEE and PAL owing to sex and region. The average PAL in men was higher than the PAL reported either with factorial approach or with the DLW method in elderly. Predictive ER equations based on RMR and TEE gave very similar results to calculations from the 2004 FAO/WHO/UNU report.