Total Daily Energy Expenditure Research Articles

Energy expenditure, body composition and dietary habits in progressive supranuclear palsy.

IntroductionLittle is known about metabolic changes in progressive supranuclear palsy. Goals of the present study are to: (1) investigate whether early progressive supranuclear palsy is associated with changes in energy expenditure, body composition and dietary intake compared with Parkinson’s disease and healthy controls; (2) assess the accuracy of the Harris–Benedict equation to predict measured rest energy expenditure in progressive supranuclear palsy; (3) verify differences according to sex, phenotypes, disease severity and presence of dysphagia in progressive supranuclear palsy.MethodsTwenty-one progressive supranuclear palsy, 41 Parkinson’s disease and nine healthy controls were included. Rest energy expenditure was assessed with indirect calorimeter, body composition with bio-impedance analysis and physical activity and dietary intake were estimated with a validated frequency questionnaire. Parametric testing was used to analyze differences between groups.ResultsProgressive supranuclear palsy showed reduced total daily energy expenditure and physical activity compared to both other cohorts (p < 0.001) and a tendency toward lower fat-free mass compared to Parkinson’s disease (p > 0.05). Limited accuracy was shown for the Harris–Benedict equation (accurate prediction frequency < 60%). Greater disease severity was associated with lower rest energy expenditure (p = 0.030), fat-free mass (p = 0.026) and muscle mass (p = 0.029).ConclusionGreater disease severity is associated with reduction in rest energy expenditure likely due to the reduction in lean mass and muscle mass. Such data may pave the way to clinical trials evaluating the efficacy of muscle-targeted nutritional support and physical therapy in preserving muscle mass and improving motor performances in progressive supranuclear palsy at early stages.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00415-021-10846-6.

Effect of Aerobic Exercise-induced Weight Loss on the Components of Daily Energy Expenditure.

Exercise usually results in less weight loss than expected. This suggests increased energy intake and/or deceased expenditure counteract the energy deficit induced by exercise. The aim of this study was to evaluate changes in components of daily energy expenditure (doubly labeled water and room calorimetry) after 24 wk of exercise training with two doses of aerobic exercise. This was an ancillary study in 42 (29 women, 13 men) sedentary, middle-age (47.8 ± 12.5 yr) individuals with obesity (35 ± 3.7 kg·m-2) enrolled in the Examination of Mechanisms of Exercise-induced Weight Compensation study. Subjects were randomized to three groups: healthy living control group (n = 13), aerobic exercise that expended 8 kcal·kg-1 of body weight per week (8 KKW, n = 14), or aerobic exercise that expended 20 kcal per kilogram of weight per week (20 KKW, n = 15). Total daily energy expenditure (TDEE) was measured in free-living condition by doubly labeled water and in sedentary conditions in a metabolic chamber over 24 h (24EE). Energy intake was calculated over 14 d from TDEE before and after the intervention using the intake-balance method. Significant weight loss occurred with 20 KKW (-2.1 ± 0.7 kg, P = 0.04) but was only half of expected. In the 20 KKW group free-living TDEE increased by ~4% (P = 0.03), which is attributed to the increased exercise energy expenditure (P = 0.001), while 24EE in the chamber decreased by ~4% (P = 0.04). Aerobic exercise at 8 KKW did not induce weight change, and there was no significant change in any component of EE. There was no significant change in energy intake for any group (P = 0.53). Structured aerobic exercise at a dose of 20 KKW produced less weight loss than expected possibly due to behavioral adaptations leading to reduced 24EE in a metabolic chamber without any change in energy intake.

Estimating winter energy balance and actual changes in nutrition of Mongolian grazing sheep

We aimed to estimate the energy intake and expenditure of grazing Mongolian sheep during the winter months using indirect methods of bite mass, number of bites, ME content per bite, traveling distance, body condition, and blood parameters. Energy intake was calculated as the bite mass × number of bites × ME per bite. Daily energy expenditure was calculated as the sum of the expenditures incurred for maintenance, grazing, and thermoregulating, as well as during pregnancy. We also investigated the sheep nutrition indicators (body condition and blood biochemical parameters) before and after winter. Average daily bite number, bite weight, and daily feed ME of sheep were 12,094, 53 mg in March, and 1.16 Mcal, respectively, and thus, total daily ME of intake was 0.86 Mcal. The daily energy expenditure for maintenance, grazing, thermoregulation, and fetus were 1.58, 1.56, 2.27, and 0.41 Mcal, respectively, accounting for a total daily energy expenditure per sheep of 5.82 Mcal. The total protein (70.2 to 49.1 g/L), albumin (37.4 to 16.9 g/L), and leptin contents (37.1 to 10.9 ng/mL) in the blood decreased remarkably after winter. The energy intake and expenditure results showed that the estimated total negative daily energy balance was 4.96 Mcal/d during the winter season. These results indicated that Mongolian sheep did not maintain a sufficient energy balance during winter and, thereby, required compensation for the negative energy balance using their body fat and protein stores.

Dietary Intake and Energy Expenditure in Breast Cancer Survivors: A Review.

Many breast cancer survivors (BCS) gain fat mass and lose fat-free mass during treatment (chemotherapy, radiation, surgery) and estrogen suppression therapy, which increases the risk of developing comorbidities. Whether these body composition alterations are a result of changes in dietary intake, energy expenditure, or both is unclear. Thus, we reviewed studies that have measured components of energy balance in BCS who have completed treatment. Longitudinal studies suggest that BCS reduce self-reported energy intake and increase fruit and vegetable consumption. Although some evidence suggests that resting metabolic rate is higher in BCS than in age-matched controls, no study has measured total daily energy expenditure (TDEE) in this population. Whether physical activity levels are altered in BCS is unclear, but evidence suggests that light-intensity physical activity is lower in BCS compared to age-matched controls. We also discuss the mechanisms through which estrogen suppression may impact energy balance and develop a theoretical framework of dietary intake and TDEE interactions in BCS. Preclinical and human experimental studies indicate that estrogen suppression likely elicits increased energy intake and decreased TDEE, although this has not been systematically investigated in BCS specifically. Estrogen suppression may modulate energy balance via alterations in appetite, fat-free mass, resting metabolic rate, and physical activity. There are several potential areas for future mechanistic energetic research in BCS (e.g., characterizing predictors of intervention response, appetite, dynamic changes in energy balance, and differences in cancer sub-types) that would ultimately support the development of more targeted and personalized behavioral interventions.

Daily energy expenditure through the human life course.

Total daily energy expenditure ("total expenditure") reflects daily energy needs and is a critical variable in human health and physiology, but its trajectory over the life course is poorly studied. We analyzed a large, diverse database of total expenditure measured by the doubly labeled water method for males and females aged 8 days to 95 years. Total expenditure increased with fat-free mass in a power-law manner, with four distinct life stages. Fat-free mass-adjusted expenditure accelerates rapidly in neonates to ~50% above adult values at ~1 year; declines slowly to adult levels by ~20 years; remains stable in adulthood (20 to 60 years), even during pregnancy; then declines in older adults. These changes shed light on human development and aging and should help shape nutrition and health strategies across the life span.

Changes in energy balance, body composition, metabolic profile and physical performance in a 62-day Army Ranger training in a hot-humid environment

ObjectivesTo determine the physiological effects of multiple stressors including energy deficit during a 62-day Ranger course in a hot-humid environment. DesignProspective cohort design. MethodsFood intake data were collected daily and energy expenditure at each of the three phases of the course was estimated by the doubly-labeled water method. Anthropometry, hydration status, stress and metabolic hormones, handgrip strength and lower explosive power were measured at the start and at the end of each phase. ResultsSeventeen male participants (age: 24.5 ± 3.2 years, height: 173.9 ± 5.1 cm, body mass: 69.3 ± 3.2 kg, BMI: 22.9 ± 0.9 kg/m2, percent body fat: 14 ± 5%) completed the study. Mean total daily energy expenditure was 4756 kcal/day and mean daily energy intake was 3882 kcal/day. An 18% energy deficit resulted in an average body mass loss of 4.6 kg, comprising mostly fat mass. Participants with higher baseline adiposity (>15% body fat) lost more fat mass and gained (rather than lost) muscle mass compared to those with lower baseline adiposity. Handgrip strength declined only at the end of Phase I, while lower body explosive power declined progressively throughout the course. Lean mass in arms and legs was correlated with initial grip strength and lower body explosive power, but only at the start of the course. ConclusionsPhysiologically demanding Ranger training in an equatorial environment is at least as metabolically demanding and stressful as other similar high-risk training courses, as demonstrated by the stress and metabolic endocrine responses, changes in body composition, and reduction in explosive power. Moreover, the smaller body size of Asian soldiers may confer an energetic advantage over larger sized Western counterparts.

Physical Activity and Total Daily Energy Expenditure in Older US Adults: Constrained versus Additive Models.

This study aimed to examine the shape of the relationship between physical activity (PA) and total energy expenditure (TEE) and to explore the role of energy balance status (negative, stable, positive) in influencing this association. Cross-sectional. Participants were 584 older adults (50-74 yr) participating in the Interactive Diet and Activity Tracking in AARP study. TEE was assessed by doubly labeled water and PA by accelerometer. The relationship between PA and TEE was assessed visually and using nonlinear methods (restricted cubic splines). Percent weight change (>3%) over a 6-month period was used as a proxy measurement of energy balance status. TEE generally increased with increasing deciles of PA averaging 2354 (SD, 351) kcal·d-1 in the bottom decile to 2693 (SD, 480) kcal·d-1 in the top decile. Cubic spline models showed an approximate linear association between PA and TEE (linear relation, P < 0.0001; curvature, P = 0.920). Results were similar in subgroup analyses for individuals classified as stable or positive energy balance. For those in negative energy balance, TEE was generally flat with increasing deciles of PA averaging 2428 (SD, 285) kcal·d-1 in the bottom decile to 2372 (SD, 560) kcal·d-1 in the top decile. Energy balance status seems to play an important role in the relationship between PA and TEE. When in a positive energy balance, the relationship between TEE and PA was consistent with an additive model; however, when energy balance was negative, TEE seems to be consistent with a constrained model. These findings support PA for weight gain prevention by increasing TEE; however, the effect of PA on TEE during periods of weight loss may be limited. An adequately powered, prospective study is warranted to confirm these exploratory findings.

Ornstein–Uhlenbeck process in a human body weight fluctuation

Body weight fluctuation in an unrestricted free-living adult was investigated by taking daily measurements for a decade. It was found from the time series analyses that the Ornstein–Uhlenbeck process defined as the solution of the Langevin equation, is the most dominant factor affecting the body weight fluctuation. This process was shown to reasonably describe the expected weight change in nominally healthy adults in general. Our calculation reasonably expresses the relationships among specific energy, average total daily energy expenditure and the standard deviation of the energy intake and its expenditure, demonstrating the validity of the proposed stochastic model.

Underreporting of energy intake in weight loss maintainers

Individuals with overweight or obesity commonly underreport energy intake (EI), but it is unknown if the tendency to underreport persists in formerly obese individuals who lose significant weight and maintain their weight loss over long periods of time. Assess the accuracy of self-reported EI in successful weight loss maintainers (WLM) compared with controls of normal body weight (NC) and controls with overweight/obesity (OC). Participants for this case-controlled study were recruited in 3 groups: WLM [n = 26, BMI (in kg/m2) 24.1±2.3; maintaining ≥13.6 kg weight loss for ≥1 y], NC (n = 33, BMI 22.7±1.9; similar to current BMI of WLM), and OC (n = 32, BMI 34.0±4.6; similar to pre-weight loss BMI of WLM). Total daily energy expenditure (TDEE) was measured over 7 d using the doubly labeled water (DLW) method, and self-reported EI was concurrently measured from 3-d diet diaries. DLW TDEE and self-reported EI were compared to determine accuracy of self-reported EI. WLM underreported EI (median, interquartile range) (-605, -915 to -314 kcal/d) to a greater degree than NC (-308, -471 to -68 kcal/d; P < 0.01) but not more than OC (-310, -970 to 18 kcal/d; P = 0.21). WLM also showed a greater degree of relative underreporting (-25.3%, -32.9% to -12.5%) compared with NC (-14.3%, -19.6% to -3.1%; P = 0.02) but not OC (-11.2%, -34.1% to -0.7%; P = 0.16). A greater proportion of WLM was classified as underreporters (30.8%) than NC (9.1%; P = 0.05) but not OC (28.1%; P = 1.00). WLM underreported EI in both absolute and relative terms to a greater extent than NC but not OC. These findings call into question the accuracy of self-reported EI in WLM published in previous studies and align with recent data suggesting that WLM rely less on chronic EI restriction and more on high levels of physical activity to maintain weight loss. This trial was registered at clinicaltrials.gov as NCT03422380.

Dietary Macronutrient and Micronutrient Intake over a 7-Day Period in Female Varsity Ice Hockey Players.

This study examined the energy, macronutrient, and micronutrient intakes of female ice hockey players over a 7-d period including game, practice, and rest days. Twenty-three female varsity players (19.0 ± 1.1 yr, 167.1 ± 6.5 cm, 67.0 ± 8.0 kg) volunteered for the study. Average total daily energy expenditure (TDEE) was estimated over the 7-day period. Average 7-day energy intake (EI) and TDEE were 2354 ± 353 and 2304 ± 204 kcal. The majority (n = 19) of athletes had an EI ≥ 90% of their estimated TDEE. Macronutrient intake was 52% carbohydrate (CHO), 32% fat, and 16% protein of total EI, although CHO intake was slightly below recommendations (5 g/kg BM/d) on game and practice (4.8 ± 1.4 and 4.5 g/kg BM/d) days. Game day EI was greater than practice and rest days. Recommended micronutrient intakes were not met by most athletes for iron, calcium, vitamin D, and potassium, and intakes were similar between game, practice, and rest days. In summary, the average EI for female varsity ice hockey players appeared adequate to meet their energy needs over a weekly cycle of game, practice, and rest days. However, these female athletes would benefit from increasing CHO intake on game and practice days and selecting foods that are rich in vitamins and minerals.

Development of alternatives to estimate resting metabolic rate from anthropometric variables in paralympic swimmers

ABSTRACT The resting metabolic rate (RMR) is one of the most representative components of total daily energy expenditure (TDEE). Multiple equations have been developed to estimate RMR, but none have been described for Para-Athletes. This study aimed to; i) develop and validate new RMR estimation models from anthropometric variables; and ii) explore the level of agreement between the RMR determined by indirect calorimetry (IC) and the developed models, as well as a selection of existent estimation models in Para-Athletes. Fifteen young Paralympic swimmers (age, 18.7±6.5 years) underwent assessments of RMR by IC and anthropometric batteries. Four RMR estimation models (M1-M4) were developed. The anthropometric variables which explained most of the variance were biacromial breadth (M3-37%), stature (M1-45%; M2-49%), and estimated stature from half arm span (M4-24%). However, the neck girth corrected by the submandibular skinfold entered in all four models. The 95% limits of agreement between IC and M3 equation (best performance model) ranged from -142.02 to 172.39 kcal×day−1 (bias 15.19 kcal×day−1). Concerning the commonly used equations, Harris & Benedict equation was the most consistent when compared to IC. The results of this study suggest four novel RMR equations that may assist in the estimation of energy requirements in elite Para-Athletes.

Effects of Energy Deficit on Secretory IgA During a Simulated Multi-Stressor Military Operation

ObjectivesSecretory IgA (SIgA) is a critical component of mucosal immunity and a first line of defense against pathogens. Intense physical exercise, lack of sleep, and inadequate energy intake are frequently observed during military training and operations. These factors are associated with a decline in SIgA and may increase the risk of infection; however, to what degree each of these factors contributes to immune dysfunction is unclear. This study aimed to determine the effect of severe energy deficit on mucosal immunity (SIgA) during a multi-day period of intense training. MethodsThe parent study was a randomized, crossover trial in healthy males (n = 10, 22.4 ± 5.4 y, 87.3 ± 10.9 kg) to assess the effect of severe negative energy balance on inflammation, iron absorption, and other physiological and cognitive outcomes during a simulated sustained military operation (SUSOPS; high energy expenditure with repeated bouts of intense exercise). Participants completed two SUSOPS trials and were randomized to consume ± 10% of estimated total daily energy expenditure (TDEE, energy balance) or 45% of TDEE (energy deficit). At 0500 on each SUSOPS day (D1: baseline, D2:24 h, D3:48 h), participants placed polyester oral swabs under their tongue for 3-mins. A second swab was collected (i.e., placed under the tongue until saturation) to ensure adequate sample volume. SIgA secretion rate (μg/min) was calculated from SIgA concentration (μg/mL; enzyme-linked immunosorbent assay) and salivary flow rate (mL/min). Dependent variables were log10 transformed due to non-normal distribution and data were analyzed using linear mixed models. ResultsIndependent of treatment, a main effect of time (P = 0.01) was observed where SIgA secretion rate declined by 20% from D2 [1.77 ± 0.34 μg/min] to D3 [1.41 ± 0.51 μg/min], P = 0.001, with no significant treatment by time interactions. A main effect of time (P = 0.01) was also found wherein SIgA concentration declined by 13% from D2 [2.67 ± 0.32 μg/mL] to D3 [2.33 ± 0.37 μg/mL], P = 0.001. There were no main or treatment effects with regard to SIgA flow rate. ConclusionsMucosal immune response, as measured by SIgA, declined in response to SUSOPS. Severe energy deficit did not exacerbate the decline in SIgA secretion rate observed in response to the high intensity, multi-stressor training scenario. Funding SourcesUS Army Medical Research and Development Command.

Brief Report: Youth Living With Perinatally Acquired HIV Have Lower Physical Activity Levels as They Age Compared With HIV-Exposed Uninfected Youth.

Few studies have evaluated physical activity patterns or their association with vascular inflammation among youth living with perinatally acquired HIV (YPHIV). We assessed YPHIV and youth perinatally HIV-exposed but uninfected (YPHEU) in the PHACS Adolescent Master Protocol with at least one Block physical activity questionnaire (PAQ) completed between ages 7-19 years. Physical activity metrics were as follows: (1) daily total energy expenditure (TEE) and (2) physical activity duration (PAD) defined as the minutes of daily moderate and vigorous activities. In a subgroup, we measured serum biomarkers of coagulation (fibrinogen and P-selectin) and endothelial dysfunction (soluble intracellular cell adhesion molecule-1, soluble vascular cell adhesion molecule-1, and E-selectin) obtained within 3 months of a single PAQ. Repeated measures linear regression models were used to compare the trajectories of log-transformed TEE and PAD by HIV status, adjusting for confounders. Spearman correlations were calculated to assess the relationship of TEE and PAD with vascular biomarkers. Five hundred ninety-six youth (387 YPHIV and 209 YPHEU) completed 1552 PAQs (median PAQs completed = 3). The median age at enrollment (Q1, Q3) was 11 (9, 13) years. TEE and PAD increased with age in both YPHIV and YPHEU. However, even after adjusting for confounders, YPHIV had significantly less increase per year than YPHEU for TEE (5.7% [95% confidence interval (CI): -9.9% to -1.4%, P = 0.010] less) and PAD (5.2% [95% CI: -9.2% to -1.1%, P = 0.016] less). Among 302 youth with biomarker measures (187 YPHIV and 114 YPHEU), we observed little correlation with TEE or PAD. Both groups had increases in physical activity levels as they aged, but YPHIV had smaller increases throughout adolescence compared with YPHEU, which may impact long-term health.

Comparison of Energy Expenditure Observed between Scheduled Activities in Collegiate Team-Sport Female Athletes.

Energy needs of female team-sport athletes are poorly understood with no evidence highlighting differences present between scheduled activities. The purpose of this study was to examine the difference in energy expenditure between NCAA Division II female basketball (BBALL) and lacrosse (LAX) athletes during different scheduled team activities. Female BBALL (n = 13; 19.8 ± 1.3 yrs; 173.9 ± 13.6 cm; 74.6 ± 9.1kg; 27.1 ± 3.2%fat) and LAX (n = 20; 20.4 ± 1.8yrs; 168.4 ± 6.6cm; 68.8 ± 8.9kg; 27.9 ± 3.1%fat) athletes were outfitted with heart rate and activity monitors during four consecutive days on five different occasions (20 days total) across an entire academic year to assess differences in total daily activity energy expenditure (TDEE), activity energy expenditure (AEE), and physical activity level (PAL). Data were categorized by type of scheduled daily activities: Practice, Game, Conditioning, or Off. Independent of day type, TDEE, AEE, and PAL levels were greater (p < 0.05) in BBALL athletes. For each sport, TDEE, AEE, and PAL were significantly different (p < 0.05) between classified activity days. BBALL and LAX athletes experienced higher values on game days for TDEE, AEE, and PAL, with the lowest values experienced on off days. In conclusion, calculated levels of TDEE, AEE, and PAL in female collegiate BBALL and LAX athletes were determined to be different, irrespective of the scheduled activity.

A new doubly labelled water anthropometry-based equation for prediction of total daily energy expenditure in older people from low- and middle-income countries.

For community-living older people, the ability to estimate total daily energy expenditure (TDEE) with validated predictive equations based on anthropometry is limited. To our knowledge no studies exist for non-Caucasian populations OBJECTIVE: To design and validate an anthropometry-based equation to estimate TDEE using doubly-labelled water (DLW) as the criterion measure, and to assess the performance of three other published equations in community-living older people from rural and urban areas of Brazil, Chile, Guatemala, Senegal, Cuba, and Mexico METHODS: This cross-sectional study measured anthropometry and TDEE using DLW in 69 men and 43 women aged 60-89 years. TDEE was also estimated with an anthropometry-based equation derived from the sub-sample of Mexico (n = 38) and with three other published equations. Predictive accuracy of the equations was tested by an external validation procedure RESULTS: TDEE by DLW in the six country sample was 2411 ± 41 kcal/day (mean ± SE) in men and 1939 ± 51 kcal/day in women. The best new Mexican equation was TDEE, kcal/d = [223.4 + (27.9 × weight, kg) + (239.7 × sex)]; where sex: Man = 1 and Woman = 0; having high precision; R2 = 0.89, lowest RMSE = 149.2, and Cp value of 2.0. This new Mexican equation estimated TDEE accurately in the five country sample and at country level after correction for Guatemalan older men, while the published equations performed poorly CONCLUSIONS: The Mexican equation performed better that other published equations and is recommended to accurately estimate energy requirements for community-living older people in five Latin American and one African country.

Does adaptive thermogenesis occur after weight loss in adults? A systematic review.

Adaptive thermogenesis (AT) has been proposed to be a compensatory response that may resist weight loss (WL) and promote weight regain. This systematic review examined the existence of AT in adults after a period of negative energy balance (EB) with or without a weight stabilisation phase. Studies published until 15 May 2020 were identified from PubMed, Cochrane Library, EMBASE, MEDLINE, SCOPUS and Web of Science. Inclusion criteria included statistically significant WL, observational with follow-up or experimental studies, age > 18y, sample size ≥10 participants, intervention period ≥ 1week, published in English, objective measures of total daily energy expenditure (EE) (TDEE), resting EE (REE) and sleeping EE(SEE). The systematic review was registered at PROSPERO (2020 CRD42020165348). A total of thirty-three studies comprising 2528 participants were included. AT was observed in twenty-seven studies. Twenty-three studies showed significant values for AT for REE (82·8 %), four for TDEE (80·0 %) and two for SEE (100 %). A large heterogeneity in the methods used to quantify AT and between subjects and among studies regarding the magnitude of WL and/or of AT was reported. Well-designed studies reported lower or non-significant values for AT. These findings suggest that although WL may lead to AT in some of the EE components, these values may be small or non-statistically significant when higher-quality methodological designs are used. Furthermore, AT seems to be attenuated, or non-existent, after periods of weight stabilisation/neutral EB. More high-quality studies are warranted not only to disclose the existence of AT but also to understand its clinical implications on weight management outcomes.

Effect of Bronchoscopic Lung Volume Reduction in Advanced Emphysema on Energy Balance Regulation

Background: Hypermetabolism and muscle wasting frequently occur in patients with severe emphysema. Improving respiratory mechanics by bronchoscopic lung volume reduction (BLVR) might contribute to muscle maintenance by decreasing energy requirements and alleviating eating-related dyspnoea. Objective: The goal was to assess the impact of BLVR on energy balance regulation. Design: Twenty emphysematous subjects participated in a controlled clinical experiment before and 6 months after BLVR. Energy requirements were assessed: basal metabolic rate (BMR) by ventilated hood, total daily energy expenditure (TDEE) by doubly labelled water, whole body fat-free mass (FFM) by deuterium dilution, and physical activity by accelerometry. Oxygen saturation, breathing rate, and heart rate were monitored before, during, and after a standardized meal via pulse oximetry and dyspnoea was rated. Results: Sixteen patients completed follow-up, and among those, 10 patients exceeded the minimal clinically important difference of residual volume (RV) reduction. RV was reduced with median (range) 1,285 mL (−2,430, −540). Before BLVR, 90% of patients was FFM-depleted despite a normal BMI (24.3 ± 4.3 kg/m²). BMR was elevated by 130%. TDEE/BMR was 1.4 ± 0.2 despite a very low median (range) daily step count of 2,188 (739, 7,110). Following BLVR, the components of energy metabolism did not change significantly after intervention compared to before intervention, but BLVR treatment decreased meal-related dyspnoea (4.1 vs. 1.7, p = 0.019). Conclusions: Impaired respiratory mechanics in hyperinflated emphysematous patients did not explain hypermetabolism. Clinical Trial Registry Number: NCT02500004 at www.clinicaltrial.gov.

Energy deficit increases hepcidin and exacerbates declines in dietary iron absorption following strenuous physical activity: a randomized-controlled cross-over trial

Strenuous physical activity promotes inflammation and depletes muscle glycogen, which may increase the iron regulatory hormone hepcidin. Hepcidin reduces dietary iron absorption and may contribute to declines in iron status frequently observed following strenuous physical activity. To determine the effects of strenuous physical activity on hepcidin and dietary iron absorption and whether energy deficit compared with energy balance modifies those effects. This was a randomized, cross-over, controlled-feeding trial in healthy male subjects (n=10, mean±SD age: 22.4±5.4 y, weight: 87.3±10.9 kg) with sufficient iron status (serum ferritin 77.0±36.7 ng/mL). Rest measurements were collected before participants began a 72-h simulated sustained military operation (SUSOPS), designed to elicit high energy expenditure, glycogen depletion, and inflammation, followed by a 7-d recovery period. Two 72-h SUSOPS trials were performed where participants were randomly assigned to consume either energy matched (±10%) to their individual estimated total daily energy expenditure (BAL) or energy at 45% of total daily energy expenditure to induce energy deficit (DEF). On the rest day and at the completion of BAL and DEF, participants consumed a beverage containing 3.8 mg of a stable iron isotope, and plasma isotope appearance was measured over 6 h. Muscle glycogen declined during DEF and was preserved during BAL (-188±179 mmol/kg, P-adjusted<0.01). Despite similar increases in interleukin-6, plasma hepcidin increased during DEF but not BAL, such that hepcidin was 108% greater during DEF compared with BAL (7.8±12.2 ng/mL, P-adjusted<0.0001). Peak plasma isotope appearance at 120 min was 74% lower with DEF (59±38% change from 0 min) and 49% lower with BAL (117±81%) compared with rest (230±97%, P-adjusted<0.01 for all comparisons). Strenuous physical activity decreases dietary iron absorption compared with rest. Energy deficit exacerbates both the hepcidin response to physical activity and declines in dietary iron absorption compared with energy balance. This trial was registered at clinicaltrials.gov as NCT03524690.

Evaluation of the nutritional status and total daily energy expenditure of farmers, fishermen and fish farmers in the northern areas of the Republic of Congo

A descriptive cross-sectional study was carried out among farmers, fishermen and fish farmers aged from 18 to 90 living in the northern areas of the Congo. The objective of this study was to establish a link between total daily energy expenditure and nutritional status during the practice of agriculture, fishing or fish farming. Anthropometric parameters were collected. The people’s nutritional status was assessed from calculated Body Mass Index. Total daily energy expenditure was estimated by determining a basal expenditure which is multiplied by the physical activity level for famers/ fishermen. The basal metabolic rate of each subject was estimated from Henry's predictive equations. Statistical tests (chi-square test, Pearson's correlation coefficient and ANOVA test) were used for the statistical analysis of the results. The results showed that the average age of the population was 47.14±13.65 years, the average weight was about 59.96±11.67 kg and the average height was about 1.63±0.08 m. The average Body Mass Index was 23±4 kg/m2. The mean total daily energy expenditure was 2697±480 kcal/d (men: 3041±321, women: 2271±245). The prevalence of underweight was 10%. It was higher for farmers (16.7%) than fishermen (3.7%) and fish farmers (2%). The prevalence of overweight was 22%. It was higher for fish farmers (29%), fishermen (26.9%) than farmers (15.2%). In conclusion, the population studied appears to be the victim of a double nutritional and energy burden statistically influenced by the type of activity performed. The correlation was weakly positive (r=0.234) between the Body Mass Index and the total daily energy expenditure which significantly varied (p&lt;0.001) according to the performed activity.

The Seasonal Variations of Energy Expenditure and Physical Activity in Turkish Older Adults

Objective: Regular physical activities contributes to better health outcomes in all stages of life. Older adults may have altered levels of exercise at different times of the year. Methods: Community-dwelling older adults (≥65 years of age) in Ankara, is the capital city of Turkey, were recruited prospectively. Physical activity status and the resting metabolic rate were assessed every three months (May, August, November, and February). Results: Overall, 31 individuals were analyzed (mean age; women: 73.9±7.0 years, men: 75.5±5.7 years; women: 65.0%). The level of physical activity was highest in autumn (44.0±41.0 min) and summer (41.0±48.0 min) but lowest in winter (24.0±19.0 min) (p&amp;lt;0.05). The ratio of performing regular daily exercise was highest in summer (25.8%), which decreased significantly in winter (9.7%). No statistically significant changes were noted in the total daily energy expenditure and resting metabolic energy expenditure across four seasons. Conclusion: Although some increases were observed in autumn and summer, the level of physical activity in older adults was low in all seasons. However, daily energy expenditure remained constant. The study suggests that there is a need for improvement in lifestyle behaviors of Turkish older adults to increase health-related quality of life and also to prevent adverse outcomes.