Measurement Of Total Energy Expenditure Research Articles

Total Energy Expenditure and Nutritional Intake in Continuous Multiday Ultramarathon Events.

Continuous multiday ultramarathon competitions are increasingly popular and impose extreme energetic and nutritional demands on competitors. However, few data have been published on energy expenditure during these events. Here, we report doubly labeled water-derived measures of total energy expenditure (in kilocalories per day) and estimated physical activity level (PAL: total energy expenditure/basal metabolic rate) collected from five elite and subelite finishers (four males and one female, age 34.6 ± 4.9years)-and nutritional intake data from the winner-of the Cocodona 250, a ∼402-km race in Arizona, and from a fastest-known-time record (one male, age 30years) on the ∼1,315-km Arizona Trail. PAL during these events exceeded four times basal metabolic rate (Cocodona range: 4.34-6.94; Arizona Trail: 5.63). Combining the results with other doubly labeled water-derived total energy expenditure data from ultraendurance events show a strong inverse relationship between event duration and PAL (r2 = .68, p < .0001). Cocodona race duration was inversely, though not significantly, associated with PAL (r2 = .70, p = .08). Water turnover varied widely between athletes and was not explained by PAL or body mass. The Cocodona race winner met ∼53% of energy demand via dietary intake, 85.6% of which was carbohydrate, while ∼47% of energy demand was met via catabolism of body energy stores. Together, these results illustrate the energetic deficits incurred during competitive continuous multiday ultramarathon efforts and implicate macronutrient absorption and/or storage as key factors in ultramarathon performance.

Estimating Total Energy Expenditure to Determine Energy Requirements in Free-Living Children With Stage 3 Chronic Kidney Disease: Can a Structured Approach Help Improve Clinical Care?

Malnutrition and obesity are complex burdensome challenges in pediatric chronic kidney disease (CKD) management that can adversely affect growth, disease progression, wellbeing, and response to treatment. Total energy expenditure (TEE) and energy requirements in children are essential for growth outcomes but are poorly defined, leaving clinical practice varied and insecure. The aims of this study were to explore a practical approach to guide prescribed nutritional interventions, using measurements of TEE, physical activity energy expenditure (PAEE), and their relationship to kidney function. In a cross-sectional prospective age-matched and sex-matched controlled study, 18 children with CKD (6-17years, mean stage 3) and 20 healthy, age-matched, and gender-matched controls were studied. TEE and PAEE were measured using basal metabolic rate (BMR), activity diaries and doubly labeled water (healthy subjects). Results were related to estimated glomerular filtration rate (eGFR). The main outcome measure was TEE measured by different methods (factorial, doubly labeled water, and a novel device). Total energy expenditure and PAEE with or without adjustments for age, gender, weight, and height did not differ between the groups and was not related to eGFR. TEE ranged from 1927±91 to 2330±73kcal/d; 95±5 to 109±5% estimated average requirement (EAR), physical activity level (PAL) 1.52±0.01 to 1.71±0.17, and PAEE 24 to 34% EAR. Comparisons between DLW and alternative methods in healthy children did not differ significantly, except for 2 (factorial methods and a fixed PAL; and the novel device). In clinical practice, structured approaches using supportive evidence (weight, height, BMI sds), predictive BMR or TEE values and simple questions on activity, are sufficient for most children with CKD as a starting energy prescription.

Total Energy Expenditure and ad Libitum Fluid/Nutrient Intake During a 24-Hour Mountain-Bike Event: A Case Study.

This case study aimed to measure the TEE, cycling metrics, and ad libitum nutrient/fluid intake during a 24-hour cross-country mountain-bike race. A trained male cyclist (41y, 74.1kg, 172.4cm) received an oral dose of doubly labeled water prior to the 24-hour event for the calculations of TEE and water turnover. Nude body weight and urine samples were collected prerace, during the race, and postrace. Total nutrient intake and total fluid intake in addition to cycling metrics (speed, power output, cadence, and heart rate) were continuously recorded during the event. The rider completed 383km coupled with a vertical gain of 7737m during the 24-hour event. Average speed, power, and heart rate were 16.3 (2)km·h-1, 122 (29)W, and 134 (18)beats·min-1, respectively. TEE and total nutrient intake were 41 and 23.5MJ, respectively. Total carbohydrate intake was 1192g with an average hourly intake of 58 (22)g·h-1. Total body weight was 75.3 and 72.3kg prerace and postrace, respectively, with a measured ad libitum total fluid intake of 13.3L and a water turnover of 17.2L. These data provide novel insights for measures of TEE, total energy intake, and total fluid intake during an ultraendurance cross-country mountain-biking event and provide a foundation for future race/training needs.

Does regular physical activity generally reduce basal energy expenditure? Arguments against an alleged paradigm change. A short report

Careau et al. (5) recently published a paper entitled “Energy compensation and adiposity in humans“ in the journal Current Biology. They evaluated measurements of total energy expenditure (TEE), basal energy expenditure (BEE) and activity energy expenditure (AEE) saved in a large data collection. Based on an overall negative correlation between BEE and AEE in a large group of subjects varying in sex, age and body mass they suggest that intense physical activity generally reduces BEE. There was “controlling for sex, age, and body composition“. But surprisingly the authors do not present values per kg body mass despite comparing subjects with a large variation in this quantity. Data published in former publications by one of the coauthors allow calculating daily kcal/kg from means. This indicates that low BEE accompanied by high AEE was caused by a smaller body mass in physically active subjects.

Determining total energy expenditure in 3–6-year-old Japanese pre-school children using the doubly labeled water method

The doubly labeled water (DLW, 2H218O) method for calculating the total production of CO2 over several days is currently considered to be the most accurate technique for the measurement of total energy expenditure (TEE), and the results obtained using this method have been used to review energy requirements. Presently, there is limited data available on TEE in Japanese children. The objective of this study was to assess the TEE in pre-school Japanese children using the DLW method. We used a cross-sectional population of 140 children (69 boys and 71 girls) aged 3–6 years. TEE was measured using the DLW method over 8 days under free-living conditions. The average weights (kg) of the boys and girls were 15.6 ± 2.5 and 15.0 ± 2.1 for the 3–4 years old and 19.8 ± 3.8 and 19.6 ± 2.7 for the 5–6 years old, respectively. The corresponding TEE (kcal/day) was 1260.9 ± 357.8 and 1265.2 ± 408.0, and 1682.3 ± 489.0 and 1693.1 ± 473.3, respectively, showing a significant difference with respect to age. Furthermore, TEE per body weight (kcal/kg/day) was 83.2 ± 29.2 and 84.9 ± 26.6, and 85.4 ± 23.2 and 86.7 ± 22.6, respectively. However, when TEE was adjusted for body weight or fat-free mass, there were no age or sex differences. We conclude that in Japanese children, TEE in those aged 3–4 years was similar to the current Ministry of Health recommendations. However, TEE in children aged 5–6 years was slightly higher than the recommendations. Based on these findings, the present results obtained from a large number of participants will provide valuable reference data for Japanese children.

Validity and Reliability of the Smart Food Diary Keenoa Against Recovery Biomarkers: A Study Protocol

ObjectivesDietary assessment provides essential data for nutrition research, but current methods have limitations impeding the accuracy of reported intakes. Keenoa is a new mobile food diary that integrates artificial intelligence food recognition. Participants take pictures of their meals, specify foods and beverages consumed and estimate portion sizes with the help of visual pictograms. Data are analyzed from the Canadian Nutrient File v2015 and other national databases. Objectives are 1) To assess Keenoa's validity and reliability for energy, protein, potassium and sodium intakes against recovery biomarkers; 2) to determine the optimal number of tracking days for maximal validity; 3) to assess the appreciation and usability from participants.MethodsAdult participants (18–70 y, n = 120) will be recruited for this 3-month study. They will track their food intake using a weighted written food diary (WFD) and Keenoa, in a randomized order, at month 1 (4 consecutive days), 2 (7 days) and 3 (4 days). At month 2, urinary nitrogen, sodium and potassium excretion will be measured from 24-h urine collections on day 3 of each tracking tool. A subsample of n = 30 will undergo measurement of total energy expenditure using the gold-standard doubly labeled water method. Intakes in other key nutrients will be compared to those reported by WFD, as a relative comparator considered the most accurate among conventional methods. Proportions of under/over-reporters will be analyzed by gender and BMI category. Perceived usability of the Keenoa application will be assessed using the validated System Usability Scale (SUS). The validity of Keenoa will be tested by comparing reported intakes of multiple days against measured recovery biomarkers with paired t-tests and Wilcoxon Signed rank test, as applicable, and Bland Altman's test for bias. Reliability will be tested by comparing repeated measures over time with intraclass correlations. P-values < 0.05 will be considered significant.ResultsN/AConclusionsIf proven accurate, reliable, and appreciated by users, this innovative tool could be used by researchers in a cost-effective manner. It could contribute to expanding nutrition knowledge and support research on the role of nutrition in health.Funding SourcesCanadian Foundation for Dietetics Research.

Relationship between Measured Aerobic Capacity and Total Energy Expenditure Obtained by the Doubly Labeled Water Method in Community-Dwelling, Healthy Adults Aged 81-94 Years.

The doubly labeled water method is a gold-standard method for the measurement of total energy expenditure in daily life. We aimed to identify the relationship between measured aerobic capacity and total energy expenditure, activity energy expenditure, or physical activity level using the doubly labeled water method in adults of advanced old age. A total of 12 physically independent older adults (10 men and 2 women), aged 81–94 years, participated in this study. The aerobic capacity was evaluated according to the lactate threshold. Total energy expenditure under free-living conditions was assessed using the doubly labeled water method, and self-reported physical activity was obtained using the Japanese version of the International Physical Activity Questionnaire. The lactate threshold was significantly positively correlated with total energy expenditure, activity energy expenditure, and physical activity level after adjusting for age and sex. We found that the aerobic capacity of the lactate threshold was positively and independently correlated with total energy expenditure, activity energy expenditure, or physical activity level. The present results suggest that maintaining aerobic capacity is an important factor in preventing frailty, although further research is required.

Physical activity and fat-free mass during growth and in later life

ABSTRACTBackgroundPhysical activity may be a way to increase and maintain fat-free mass (FFM) in later life, similar to the prevention of fractures by increasing peak bone mass.ObjectivesA study is presented of the association between FFM and physical activity in relation to age.MethodsIn a cross-sectional study, FFM was analyzed in relation to physical activity in a large participant group as compiled in the International Atomic Energy Agency Doubly Labeled Water database. The database included 2000 participants, age 3–96 y, with measurements of total energy expenditure (TEE) and resting energy expenditure (REE) to allow calculation of physical activity level (PAL = TEE/REE), and calculation of FFM from isotope dilution.ResultsPAL was a main determinant of body composition at all ages. Models with age, fat mass (FM), and PAL explained 76% and 85% of the variation in FFM in females and males < 18 y old, and 32% and 47% of the variation in FFM in females and males ≥ 18 y old, respectively. In participants < 18 y old, mean FM-adjusted FFM was 1.7 kg (95% CI: 0.1, 3.2 kg) and 3.4 kg (95% CI: 1.0, 5.6 kg) higher in a very active participant with PAL = 2.0 than in a sedentary participant with PAL = 1.5, for females and males, respectively. At age 18 y, height and FM–adjusted FFM was 3.6 kg (95% CI: 2.8, 4.4 kg) and 4.4 kg (95% CI: 3.2, 5.7 kg) higher, and at age 80 y 0.7 kg (95% CI: −0.2, 1.7 kg) and 1.0 kg (95% CI: −0.1, 2.1 kg) higher, in a participant with PAL = 2.0 than in a participant with PAL = 1.5, for females and males, respectively.ConclusionsIf these associations are causal, they suggest physical activity is a major determinant of body composition as reflected in peak FFM, and that a physically active lifestyle can only partly protect against loss of FFM in aging adults.

Total energy expenditure of bottlenose dolphins (Tursiops truncatus) of different ages.

Marine mammals are thought to have an energetically expensive lifestyle because endothermy is costly in marine environments. However, measurements of total energy expenditure (TEE; kcalday-1) are available only for a limited number of marine mammals, because large body size and inaccessible habitats make TEE measurements expensive and difficult to obtain for many taxa. We measured TEE in 10 adult common bottlenose dolphins (Tursiops truncatus) living in natural seawater lagoons at two facilities (Dolphin Research Center and Dolphin Quest) using the doubly labeled water method. We assessed the relative effects of body mass, age and physical activity on TEE. We also examined whether TEE of bottlenose dolphins, and more generally of marine mammals, differs from that expected for their body mass compared with other eutherian mammals, using phylogenetic least squares (PGLS) regressions. There were no differences in body mass or TEE (unadjusted TEE and TEE adjusted for fat-free mass) between dolphins from the two facilities. Our results show that adjusted TEE decreased and fat mass increased with age. Different measures of activity were not related to age, body fat or adjusted TEE. Both PGLS and the non-phylogenetic linear regression indicate that marine mammals have an elevated TEE compared with that of terrestrial mammals. However, bottlenose dolphins expended 17.1% less energy than other marine mammals of similar body mass. The two oldest dolphins (>40 years) showed a lower TEE, similar to the decline in TEE seen in older humans. To our knowledge, this is the first study to show an age-related metabolic decline in a large non-human mammal.

Childhood Daily Energy Expenditure Does Not Decrease with Market Integration and Is Not Related to Adiposity in Amazonia

BackgroundChildhood overweight and obesity (OW/OB) is increasingly centered in low- and middle-income countries (LMICs) as rural populations experience market integration and lifeway change. Most explanatory studies have relied on imprecise estimates of children’s energy expenditure, restricting understanding of the relative effects of changes in diet and energy expenditure on the development of OW/OB in transitioning contexts. ObjectivesThis study used gold-standard measurements of children’s energy expenditure to investigate the changes that underlie OW/OB and the nutrition/epidemiologic transition. MethodsCross-sectional data were collected from “rural” (n = 43) Shuar forager-horticulturalist children and their “peri-urban” (n = 34) Shuar counterparts (age 4–12 y) in Amazonian Ecuador. Doubly labeled water measurements of total energy expenditure (TEE; kcal/d), respirometry measurements of resting energy expenditure (REE; kcal/d), and measures of diet, physical activity, immune activity, and market integration were analyzed primarily using regression models. ResultsPeri-urban children had higher body fat percentage (+8.1%, P < 0.001), greater consumption of market-acquired foods (multiple P < 0.001), lower concentrations of immune activity biomarkers (multiple P < 0.05), and lower REE (−108 kcal/d, P = 0.002) than rural children. Despite these differences, peri-urban children’s TEE was indistinguishable from that of rural children (P = 0.499). Moreover, although sample-wide IgG concentrations and household incomes predicted REE (both P < 0.05), no examined household, immune activity, or physical activity measures were related to children’s overall TEE (all P > 0.09). Diet and energy expenditure associations with adiposity demonstrate that only reported consumption of market-acquired “protein” and “carbohydrate” foods predicted children’s body fat levels (multiple P < 0.05). ConclusionsDespite underlying patterns in REE, Shuar children’s TEE is not reliably related to market integration and—unlike dietary measures—does not predict adiposity. These findings suggest a leading role of changing dietary intake in transitions to OW/OB in LMICs.

PRECISION OF ANTHROPOMETRIC EQUATIONS TO ESTIMATE TOTAL ENERGY EXPENDITURE OF OLDER ADULTS WITH SARCOPENIA: A CROSS SECTIONAL STUDY

Purpose: The accuracy and errors of prediction of equations that estimate energy expenditure are unknown to seniors with sarcopenia. This study assessed the precision of predictive equations to estimate energy needs of sarcopenic seniors. Methods: Ninety-four community-dwelling older adults (female: 66; mean age: 75.9[5.7]) were tested for body dimensions derived from DXA. Performance tests and diagnosis of sarcopenia were performed. The total energy expenditure (TEE) of sarcopenic seniors (n=10) was measured by accelerometry and compared with three anthropometric equations: DRIs, Escott-Stump with upper (Escott-Stumpupp) and low energy margin (Escott-Stumplow). Results: Except for height, all other variables of body dimensions of sarcopenic seniors were smaller than non-sarcopenic ones (p&lt;0.05). The slightly lower TEE values in the Escott-Stumplow equation were not different from accelerometry (-53kcal; t=0.606; p=0.560) but were overestimated by the DRIs (+358kcal; t=-3.163; p=0.011) and Escott-Stumpupp (+240kcal; t=-5.817; p&lt;0.001), confirmed due to lack of agreement (Bland-Altman) with measured TEE. Conclusion: Smaller body dimensions of sarcopenic seniors suggest that their energy needs should be estimated from specific resources. The TEE assessed by the Escott-Stumplow equation was similar to that measured by accelerometry and therefore may be a good alternative for sarcopenic seniors where direct measurement of TEE is not possible.

Comparison of predictive equations for resting metabolic rate in Portuguese women

Obesity represents a public health challenge and dietary interventions to prevent or treat obesity rely on the ability to accurately determine daily energy requirements - which are based on measures of total energy expenditure. Several prediction equations to estimate resting metabolic rate (RMR) have been developed, however the validity of these equations is uncertain. The present study aims to determine the accuracy of four commonly used RMR prediction equations in normal weight, overweight and obese Portuguese women aged 18 to 64 years. RMR was measured in 156 women (age: 40.3 ± 10.2 years; Body Mass Index (BMI): 20.6 ± 6.8 kg/m2) using indirect calorimetry. The resulting values were compared with the predictive values from the Harris-Benedict, FAO/WHO/UNU, Schofield and Mifflin-St. Jeor equations across BMI categories. At an individual level, the equations with the highest percentage of accurate predictions were the Mifflin-St. Jeor equation in normal weight women (41.9%) and the Harris-Benedict equation in overweight (55.4%) and obese (50.9%) women. The accuracy of the RMR prediction equations studied varied by weight status and due to the low levels of accuracy reported, the present equations might have limited applicability for Portuguese women at an individual level.

Isolated &amp; Combined Wearable Technology Underestimate the Total Energy Expenditure of Professional Young Rugby League Players; A Doubly Labelled Water Validation Study

Costello, N, Deighton, K, Cummins, C, Whitehead, S, Preston, T, and Jones, B. Isolated & combined wearable technology underestimate the total energy expenditure of professional young rugby league players; a doubly labelled water validation study. J Strength Cond Res 36(12): 3398-3403, 2022-Accurately determining total energy expenditure (TEE) enables the precise manipulation of energy balance within professional collision-based sports. Therefore, this study investigated the ability of isolated or combined wearable technology to determine the TEE of professional young rugby league players across a typical preseason and in-season period. Total energy expenditure was measured via doubly labelled water, the criterion method, across a fourteen-day preseason ( n = 6) and 7-day in-season ( n = 7) period. Practical measures of TEE included SenseWear Pro3 Armbands in isolation and combined with metabolic power derived from microtechnology units. SenseWear Pro3 Armbands significantly under-reported preseason (5.00 [2.52] MJ·d -1 ; p = 0.002) and in-season (2.86 [1.15] MJ·d -1 ; p < 0.001) TEE, demonstrating a large and extremely large standardized mean bias, and a very large and large typical error, respectively. Combining metabolic power with SenseWear Pro3 Armbands almost certainly improved preseason (0.95 [0.15] MJ·d -1 ; Effect size = 0.32 ± 0.04; p < 0.001) and in-season (1.01 [0.15] MJ·d -1 ; ES = 0.88 ± 1.05; p < 0.001) assessment. However, SenseWear Pro3 Armbands combined with metabolic power continued to significantly under-report preseason (4.04 [2.38] MJ·d -1 ; p = 0.004) and in-season (2.18 [0.96] MJ·d -1 ; p = 0.002) expenditure, demonstrating a large and very large standardized mean bias, and a very large and large typical error, respectively. These findings demonstrate the limitations of utilizing isolated or combined wearable technology to accurately determine the TEE of professional collision-based sport athletes across different stages of the season.

Validity of Combination Use of Activity Record and Accelerometry to Measure Free-Living Total Energy Expenditure in Female Endurance Runners.

Yoshida, A, Ishikawa-Takata, K, Tanaka, S, Suzuki, N, Nakae, S, Murata, H, Taguchi, M, and Higuchi, M. Validity of combination use of activity record and accelerometry to measure free-living total energy expenditure in female endurance runners. J Strength Cond Res 33(11): 2962-2970, 2019-Herein, we attempted to prove the validity of a new approach to assessing total energy expenditure (TEE) that combines activity recording and accelerometry in athletes. Eight female endurance runners participated in this study. We measured TEE over 8 days in the regular training season by using the doubly labeled water (DLW) method. In the combined method, an activity record of the rating of perceived exertion (RPE) was used to estimate energy expenditure (EE) during the training period, whereas a triaxial accelerometer was used to evaluate EE during the nontraining time over the TEE measurement period using the DLW method. Training EE was calculated from the subjects' individual rating of perceived exertion-EE correlations provided by the exercise tolerance test. Resting metabolic rate (RMR) was measured using indirect calorimetry. There were no significant differences in TEE, activity-induced EE (AEE), or physical activity level (PAL; TEE/RMR) between the DLW method and the combined method (TEE, 3,032 ± 344 vs. 3,033 ± 495 kcal·d; AEE, 1,585 ± 303 vs. 1,586 ± 442 kcal·d; and PAL, 2.68 ± 0.37 vs. 2.68 ± 0.48, respectively). Significant positive correlations and no systematic errors were observed in AEE and PAL. Intraclass correlation coefficients were high (TEE, 0.785; AEE, 0.841; and PAL, 0.779, respectively). These findings suggest that the combined method has high validity against the DLW method. Thus, the combined method would be able to estimate free-living TEE in the regular training season for female endurance runners.

Training-induced changes in daily energy expenditure: Methodological evaluation using wrist-worn accelerometer, heart rate monitor, and doubly labeled water technique.

IntroductionWrist-mounted motion sensors can quantify the volume and intensity of physical activities, but little is known about their long-term validity. Our aim was to validate a wrist motion sensor in estimating daily energy expenditure, including any change induced by long-term participation in endurance and strength training. Supplemental heart rate monitoring during weekly exercise was also investigated.MethodsA 13-day doubly labeled water (DLW) measurement of total energy expenditure (TEE) was performed twice in healthy male subjects: during two last weeks of a 12-week Control period (n = 15) and during two last weeks of a 12-week combined strength and aerobic Training period (n = 13). Resting energy expenditure was estimated using two equations: one with body weight and age, and another one with fat-free mass. TEE and activity induced energy expenditure (AEE) were determined from motion sensor alone, and from motions sensor combined with heart rate monitor, the latter being worn during exercise only.ResultsWhen body weight and age were used in the calculation of resting energy expenditure, the motion sensor data alone explained 78% and 62% of the variation in TEE assessed by DLW at the end of Control and Training periods, respectively, with a bias of +1.75 (p <.001) and +1.19 MJ/day (p = .002). When exercise heart rate data was added to the model, the combined wearable device approach explained 85% and 70% of the variation in TEE assessed by DLW with a bias of +1.89 and +1.75 MJ/day (p <.001 for both). While significant increases in TEE and AEE were detected by all methods as a result of participation in regular training, motion sensor approach underestimated the change measured by DLW: +1.13±0.66 by DLW, +0.59±0.69 (p = .004) by motion sensor, and +0.98±0.70 MJ/day by combination of motion sensor and heart rate. Use of fat-free mass in the estimation of resting energy expenditure removed the biases between the wearable device estimations and the golden standard reference method of TEE and demonstrated a training-induced increase in resting energy expenditure by +0.18±0.13 MJ/day (p <.001).ConclusionsWrist motion sensor combined with a heart rate monitor during exercise sessions, showed high agreement with the golden standard measurement of daily TEE and its change induced by participation in a long-term training protocol. The positive findings concerning the validity, especially the ability to follow-up the change associated with a lifestyle modification, can be considered significant because they partially determine the feasibility of wearable devices as quantifiers of health-related behavior.

Validity and reliability of an online self-report 24-h dietary recall method (Intake24): a doubly labelled water study and repeated-measures analysis.

Online self-reported 24-h dietary recall systems promise increased feasibility of dietary assessment. Comparison against interviewer-led recalls established their convergent validity; however, reliability and criterion-validity information is lacking. The validity of energy intakes (EI) reported using Intake24, an online 24-h recall system, was assessed against concurrent measurement of total energy expenditure (TEE) using doubly labelled water in ninety-eight UK adults (40-65 years). Accuracy and precision of EI were assessed using correlation and Bland-Altman analysis. Test-retest reliability of energy and nutrient intakes was assessed using data from three further UK studies where participants (11-88 years) completed Intake24 at least four times; reliability was assessed using intra-class correlations (ICC). Compared with TEE, participants under-reported EI by 25 % (95 % limits of agreement -73 % to +68 %) in the first recall, 22 % (-61 % to +41 %) for average of first two, and 25 % (-60 % to +28 %) for first three recalls. Correlations between EI and TEE were 0·31 (first), 0·47 (first two) and 0·39 (first three recalls), respectively. ICC for a single recall was 0·35 for EI and ranged from 0·31 for Fe to 0·43 for non-milk extrinsic sugars (NMES). Considering pairs of recalls (first two v. third and fourth recalls), ICC was 0·52 for EI and ranged from 0·37 for fat to 0·63 for NMES. EI reported with Intake24 was moderately correlated with objectively measured TEE and underestimated on average to the same extent as seen with interviewer-led 24-h recalls and estimated weight food diaries. Online 24-h recall systems may offer low-cost, low-burden alternatives for collecting dietary information.

Validation of dietary reference intake equations for estimating energy requirements in Korean adults by using the doubly labeled water method.

BACKGROUND/OBJECTIVESThe doubly labeled water (DLW) method is considered the gold standard for the measurement of total energy expenditure (TEE), which serves to estimate energy requirements. This study evaluated the accuracy of predictive dietary reference intake (DRI) equations for determining the estimated energy requirements (EER) of Korean adults by using the DLW as a reference method. SUBJECTS/METHODS Seventy-one participants (35 men and 36 women) aged between 20 and 49 years were included in the study. The subjects' EER, calculated by using the DRI equation (EERDRI), was compared with their TEE measured by the DLW method (TEEDLW).RESULTSThe DRI equations for EER underestimated TEE by -36.3 kcal/day (-1.3%) in men and -104.5 kcal/day (-4.9%) in women. The percentages of accurate predictions among subjects were 77.1% in men and 62.9% in women. There was a strong linear correlation between EERDRI and TEEDLW (r=0.783, P<0.001 in men and r=0.810, P<0.001 in women).CONCLUSIONS The present study supports the use of DRI prediction equations to determine EER in Korean adults. More studies are needed to confirm our results and to assess the validity of these equations in other population groups, including children, adolescents, and older adults.

Energy Expenditure in Humans and Other Primates: A New Synthesis

This review examines the proximate, ecological, and evolutionary determinants of energy expenditure in humans and primates, with an emphasis on empirical measurements of total energy expenditure (TEE). Body size is the main proximate determinant of TEE, both within and between species; physical activity, genetic variation, and endocrine regulation explain substantially less of the variation in TEE. Basal metabolism is the single largest component of TEE, far exceeding the cost of physical activity, digestion, growth and reproduction, and thermoregulation in most instances. Notably, differences in physical activity do not generally result in corresponding differences in TEE, undermining the utility of activity-based factorial estimates of TEE. Instead, empirical measurements of energy expenditure in humans and other primates suggest that the body adapts dynamically to long-term changes in physical activity, maintaining TEE within an evolved, and relatively narrow, physiological range.

A SIMPLIFIED EQUATION FOR TOTAL ENERGY EXPENDITURE IN MECHANICALLY VENTILATED CRITICALLY ILL PATIENTS.

"tight calorie control" concept arose to avoid over- and under-feeding of patients. to describe and validate a simplified predictive equation of total energy expenditure (TEE) in mechanically ventilated critically ill patients. this was a secondary analysis of measurements of TEE by indirect calorimetry in critically ill patients. Patients were allocated in a 2:1 form by a computer package to develop the new predictive equation TEE (prediction cohort) and the validation cohort. Indirect calorimetry was performed with three different calorimeters: the Douglas-bag, a metabolic computer and the CalorimetR. We developed a new TEE predictive equation using measured TEE (in kcal/kg/d) as dependent variable and as independent variables different factors known to influence energy expenditure: age, gender, body mass index (BMI) and type of injury. prediction cohort: 179 patients. Validation cohort: 91 patients. The equation was: TEEPE (kcal/Kg/d) = 33 - (3 x A) - (3 x BMI) - (1 x G). Where: A (age in years): ≤ 50 = 0; > 50 = 1. BMI (Kg/m2): 18.5 - 24.9 = 0; 25 - 29.9 = 1; 30 - 34.9 = 2; 35 - 39.9 = 3. G (gender): male = 0; female = 1. The bias (95% CI) was -0.1 (-1.0 - 0.7) kcal/kg/d and the limits of agreement (} 2SD) were -8.0 to 7.8 kcal/kg/d. Predicted TEE was accurate (within 85% to 115%) in 73.6% of patients. the new predictive equation was acceptable to predict TEE in clinical practice for most mechanically ventilated critically ill patients.

Measures of Total Energy Expenditure and Its Components Using the Doubly Labeled Water Method in Rehabilitating Burn Children

A persistent hypermetabolic state delays anabolism and growth in burned children. However, our own clinical experience has been that resting energy expenditure (REE) is not increased during the rehabilitative phase, suggesting other contributing factors. We measured total energy expenditure (TEE) and its components in rehabilitating pediatric burn patients to identify the basis for accelerated energy metabolism in this population. Children admitted with initial burns of 20% of their total body surface area (TBSA) or greater were enrolled into this prospective, descriptive study. TEE was measured using the doubly labeled water method over a 7-day period. During that period, REE was measured on 2 days by indirect calorimetry. Activity energy expenditure (AEE) was assessed using a physical activity monitoring device for a 24-hour period. TEE and REE were compared with sex-specific, age-matched, and weight-matched norms using the Dietary Reference Intakes (DRI) standards. Ten children with an average burn size of 53.7% ± 20% (range, 27%-82%) of TBSA completed this study. Their mean age and weight were 10.4 ± 5.5 years and 35.8 ± 16.4 kg, respectively. Daily TEE averaged 66 kcal/kg and was 1.08% of reference DRI. REE was 92% ± 25% of predicted basal metabolic rate, not exceeding 120% as a maximum value in any child. TEE and REE in rehabilitating burn children are comparable to reference standards. Increased REE was not typical in our population, but measures of AEE were commonly high.