Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Expenditures”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed1997

Oral clonidine premedication decreases energy expenditure in human volunteers.

PURPOSE: Clonidine not only stops postoperative shivering and decreases oxygen consumption, but also decreases energy expenditure with or without a reduction in shivering during recovery from anaesthesia. It is important to see if clonidine decreases energy expenditure at rest since this may contribute to a postoperative decrease in energy expenditure. The authors tested the hypothesis that oral clonidine decreases energy expenditure at rest. METHODS: Twenty healthy male volunteers were randomly assigned to one of two groups. Ten volunteers received oral clonidine approximately 5 micrograms.kg-1 (clonidine group), while the remaining 10 volunteers received placebo (control group). Blood pressure, heart rate, body temperature at the tympanic membrane, sedation score graded from 1 (alert) to 5 (sleeping and difficult to be aroused by tactile stimulation) were measured before and at 30-min intervals for three hours after administration of clonidine or placebo. Measurements of energy expenditure and respiratory quotient were made with a head canopy system at one-minute intervals and averaged over 15 min before, and at 30, 60, 90, 120, and 180 min after administration of clonidine or placebo. RESULTS: Sedation score increased from 1 to 3 (median) after clonidine administration. Energy expenditure decreased from 1452 +/- 225 kcal.24hr-1 (mean +/- SD) at baseline to 1258 +/- 175 kcal.24hr-1 at 180 min after clonidine administration (P < 0.05). CONCLUSION: This study suggests that oral clonidine at a dose of 5 micrograms.kg-1 decreases energy expenditure at rest.

Administration, Oral↗
PubMed1996

Effects of energy imbalance on energy expenditure and respiratory quotient in young and older men: a summary of data from two metabolic studies.

The roles of energy expenditure and substrate oxidation in energy regulation, and the effects of factors such as aging on these parameters, remain uncertain. A re-analysis of data from two studies involving overfeeding or underfeeding in young men (22.7 +/- 0.6 [SEM] years) and older men (68.0 +/- 1.50 years) was conducted to further evaluate the adaptive capacity of energy expenditure and respiratory quotient to an increase or a decrease in energy intake. Changes in total energy expenditure (TEE) and resting energy expenditure (REE) and respiratory quotient (RQ) in response to energy imbalance were compared between subjects undergoing overfeeding by 4.1 MJ/day for 21 days, or underfeeding by 3.2 MJ/day for 21 days. Comparing responses to overfeeding or underfeeding, there was a significant TEE response to energy imbalance averaging 1.39 MJ/day and equivalent to 19% of the alteration in energy intake (p < 0.05). There was also a significant REE response to energy imbalance averaging 0.45 MJ/day (p < 0.001), and a significant RQ response in both fasting and fed states (p < 0.01). There was no significant difference between young and older men in their TEE, energy deposition or RQ responses to energy imbalance, but older men did have significantly diminished REE response to energy imbalance (p < 0.05) and a significantly delayed thermic response to a standard meal (p < 0.05). These data indicate that energy expenditure plays a significant role in attenuating the effects of alterations in energy intake on body energy stores and that, based on some measures of energy expenditure, aging is associated with a reduction in the adaptive capacity of energy expenditure to participate in energy regulation.

Adult↗
PubMed1991

Ascites increases the resting energy expenditure in liver cirrhosis.

The purpose of this study was to investigate the effect of ascites on the energy metabolism of patients with liver cirrhosis. The resting energy expenditure was determined in 10 patients with liver cirrhosis and ascites of moderate or large volume. The resting energy expenditure measurement was performed using indirect calorimetry and the resting energy expenditure predictive value was calculated with the Harris-Benedict equation, both before and after removal of ascitic fluid by paracentesis. Metabolic stress factors were absent in all cases. After an interval of 11.2 +/- 7.7 days between measurements, a weight loss of 16.6 +/- 10.3 kg was observed with paracentesis. The resting energy expenditure measured by indirect calorimetry showed a statistically significant decrease from 1682 +/- 291 to 1523 +/- 240 kcal/day (P less than 0.005) after removal of ascites. The repeatability of our indirect calorimetry method only allowed for the analysis of the results in 4 of 10 patients in whom ascites removal produced a consistent decrease in resting energy expenditure. There were no statistically significant differences between the measurements obtained by indirect calorimetry and those provided by the Harris-Benedict equation, but the latter had a moderate reliability in predicting the real resting energy expenditure of every patient. Our results suggest that, far from being an inert volume, ascites may be associated, at least in some patients, with an increased resting energy expenditure and therefore accelerate the appearance of protein energy malnutrition with corresponding complications.

Adult↗
PubMed1985

State and Federal expenditures on Medicaid eligible chronically ill children in rural Florida.

This paper details public (State and Federal) expenditures for children's health care among Medicaid eligible chronically ill children resident in a rural setting. Of the cases, 78.5% had an expenditure in the study year with an average per capita total expenditure of +604. The mean total expenditure was considerably higher than the median total expenditure (+142), i.e. there was a relatively small proportion of high cost cases. Inpatient services accounted for 54.2% of total expenditures despite the fact that only 12% of the cases had been hospitalized. Wide variation in total expenditures, both within and among disease categories, was noted. By implication, while substantial savings might be realized from efforts directed at reducing health care costs for a small subset of the population, the identification of that subpopulation remains elusive.

Adolescent↗
PubMed1995

The effect of the alpha 2-adrenoceptor agonist, guanfacin, on energy expenditure, intake and deposition in rats.

The effect of guanfacin on the energy expenditure, food intake and body composition of female Wistar rats at maintenance was studied. Rats on a restricted food intake (about 75% of ad libitum), treated for 6 days with twice-daily injections of guanfacin.HCl (0.5 mg/kg) showed large reductions in energy expenditure (30%, p < 0.001) compared to control animals but no significant differences in liveweight gain, dry mass gain, or gains in total body energy content, protein, fat and ash. The treated group had a lower intake of metabolizable energy (9%, p = 0.01) partially due to a lower intake of food. However, this lower intake of energy did not fully account for the lowered energy expenditure in the treated animals. The unaccounted lowered energy expenditure was not due to changes in the diurnal pattern of energy expenditure since continuous indirect calorimetry with rats fed ad libitum, over 3 days, showed that twice-daily injections of guanfacin (0.5 mg/kg per injection) achieved a sustained decrease in energy expenditure. The lack of an increased growth rate of rats treated with guanfacin was attributed to behavioural changes; to a decreased food intake and to other, unknown, factors related to energy expenditure.

Adrenergic alpha-Agonists↗
PubMed2006

How accurate are predictive formulas calculating energy expenditure in adolescent patients with anorexia nervosa?

BACKGROUND & AIMS: To compare resting energy expenditure, measured by indirect calorimetry, to values estimated by different predictive formulas in adolescent patients with anorexia nervosa. METHODS: We studied 22 female in-patients with a mean age of 14.7 years (SD 1.2). Resting energy expenditure was measured by indirect calorimetry (Deltatrac II MBM-200). We compared measured resting energy expenditure to values estimated by several predictive formulas [Fleisch, Harris-Benedict, FAO, Schofield-HW, Schebendach] using the intraclass correlation coefficient and the Bland-Altman method. RESULTS: Body mass index increased significantly (P<0.001). Measured resting energy expenditure increased during hospitalization (P<0.05). All formulas overestimated resting energy expenditure with respect to indirect calorimetry except the Schebendach formula. The intraclass correlation between indirect calorimetry and the formulas were poor (0.09-0.20). We observed a poor clinical agreement (Bland-Altman). CONCLUSIONS: Body mass index and resting energy expenditure increased during hospitalization. The majority of the predictive formulas overestimate resting energy expenditure in adolescent patients with anorexia nervosa. Therefore, indirect calorimetry may be a very useful tool for calculating caloric requirements in these patients.

Adolescent↗
PubMed1994

Energy expenditure in children with Down syndrome: correcting metabolic rate for movement.

Children with Down syndrome (DS) have a high prevalence of obesity. To investigate the relation between energy expenditure and obesity, we measured body composition, resting metabolic rate (RMR), and total energy expenditure in 13 prepubescent children with DS and in 10 control subjects matched for age, weight, and percentage of fat, using indirect calorimetry and the doubly labeled water method. Measurement of RMR was complicated by excessive movement by both the DS and control subjects. We therefore developed a method of subtracting the energy expended in movement and calculated the corrected RMR. The corrected RMR was significantly lower in those with DS than in control subjects when expressed as a percentage of the basal metabolic rate, predicted by the World Health Organization: 79.5% +/- 10.4% and 96.8% +/- 7.8%, respectively (p < 0.001). No significant differences were detected in total daily energy expenditure or non-RMR expenditure between the subject groups. In the DS group, 60% of the variability in fat mass could be accounted for by non-RMR expenditure expressed per kilogram of body weight (p < 0.02). No relation was detected between fat mass and non-RMR expenditure in control subjects, nor were any measures of energy expenditure predictive of changes in fatness among the subjects with DS during a 1-year follow-up. The results of this study indicate that prepubescent children with DS have decreased RMR compared with control children.

Body Composition↗
PubMed1995

Normal energy expenditure in the infant with presymptomatic cystic fibrosis.

To investigate whether a fundamental lesion in energy metabolism is a feature of cystic fibrosis, we measured total energy expenditure using the doubly labeled water technique in 19 infants with presymptomatic cystic fibrosis (0.8 to 6.6 months of age) identified through newborn screening. Total energy expenditure data collected in a cohort of healthy infants by the same method were used for comparison. Energy balance studies were additionally performed in 10 of the infants with cystic fibrosis. Total energy expenditure levels in infants with cystic fibrosis, expressed as either kilocalories per day or kilocalories per kilogram of fat free mass per day, did not differ from control levels. When expressed on the basis of body weight (in kilocalories per kilogram per day), expenditure levels in infants with cystic fibrosis were greater (p < 0.05) than control levels. No differences in expenditure were observed between those infants who were homozygous (n = 10) for the delta F508 mutation and the heterozygous infants (n = 7), regardless of how expenditure was expressed. Assessment of energy balance indicated that infants with cystic fibrosis grow at a normal rate for metabolizable energy intakes similar to those reported for healthy infants. We conclude that there are no differences in energy expenditure between infants with presymptomatic cystic fibrosis and healthy infants, once differences in body composition are taken into account. This finding indicates that the primary cystic fibrosis defect is not an energy-requiring one.

Anthropometry↗
PubMed1997

Total energy expenditure in 9 month and 12 month infants.

OBJECTIVES: To measure the total energy expenditure of 9 and 12 month old infants and compare with current recommendations for energy intake. DESIGN: Cross-sectional study. Total energy expenditure assessed using the doubly labelled water technique over a 10 d period. Classical anthropometric measurements taken. SETTING: Community based study in and around Cambridge, UK. SUBJECTS: Twenty infants aged 9 months of age and 20 infants aged 12 months of age recruited via local hospital birth records. MAIN OUTCOME MEASURES: Total energy expenditure calculated via the doubly labelled water technique. RESULTS: Measurements of total energy expenditure was successful in 34 cases. Mean total energy expenditure was 73.5 kcal/kg, 73.2 kcal/kg, 77.1 kcal/kg and 77.6 kcal/kg in the nine month old boys, nine month old girls, twelve month old boys and twelve month old girls respectively. These measurements are approximately 17% below current recommendations (FAO/WHO/UNU, 1985) at nine months of age and 22% below at one year of age. CONCLUSION: The data are consistent with findings in younger infants and older children in that the measurements of total energy expenditure are about 20-25% below current recommendations. It is unlikely that contemporary infants are being underfed and thus more likely that changes in feeding practices and modification of infant formula composition has led to the reduction in energy intake and energy expenditure in such infants.

Anthropometry↗
PubMed2001

Prediction of energy expenditure in a whole body indirect calorimeter at both low and high levels of physical activity.

OBJECTIVES: In studies that involve the use of a room calorimeter, 24 h energy intake is often larger than 24 h energy expenditure (24 h EE) because of a decrease in activity energy expenditure due to the confined space. This positive energy balance can have large consequences for the interpretation of substrate balances. The objective of this study was to develop a method for predicting an individual's 24 h EE in a room calorimeter at both low (1.4xRMR) and high (1.8xRMR) levels of physical activity. METHODS: Two methods are presented that predict an individual's 24 h EE in a metabolic chamber. The first method was based on three components: (1) a 30 min measurement of resting metabolic rate (RMR) using a ventilated hood system; (2) measurement of exercise energy expenditure during 10 min of treadmill walking; and (3) estimation of free-living energy expenditure using a tri-axial motion sensor. Using these measurements we calculated the amount of treadmill time needed for each individual in order to obtain a total 24 h EE at either a low (1.4xRMR) or a high (1.8xRMR) level of physical activity. We also developed a method to predict total 24 h EE during the chamber stay by using the energy expenditure values for the different levels of activity as measured during the hours already spent in the chamber. This would provide us with a tool to adjust the exercise time and/or energy intake during the chamber stay. RESULTS: Method 1: there was no significant difference in expected and measured 24 h EE under either low (9.35+/-0.56 vs 9.51+/-0.47 MJ/day; measured vs predicted) or high activity conditions (13.41+/-0.74 vs 13.97+/-0.78 MJ/day; measured vs predicted). Method 2: the developed algorithm predicted 24 h EE for 97.6+/-4.0% of the final value at 3 h into the test day, and for 98.6+/-3.7% at 7 h into the test day. CONCLUSION: Both methods provide accurate prediction of energy expenditure in a room calorimeter at both high and low levels of physical activity. It equally shows that it is possible to accurately predict total 24 h EE from energy expenditure values obtained at 3 and 7 h into the study.

Adaptation, Physiological↗
PubMed1992

Raised resting energy expenditure in Parkinson's disease and its relationship to muscle rigidity.

1. Resting energy expenditure was measured, by indirect calorimetry, in 12 patients with Parkinson's disease and in eight healthy age-matched control subjects. In the patients with Parkinson's disease measurements were made in both the untreated state and after an injection of the dopamine agonist apomorphine (treated state). In each state muscle rigidity was recorded. 2. Resting energy expenditure was higher in patients with Parkinson's disease in both the treated and untreated states than in the control subjects. Of the patients with Parkinson's disease, seven showed no difference in resting energy expenditure between the two treatment states, whereas four showed markedly increased resting energy expenditure in the untreated state. The change in resting energy expenditure in the untreated state, as compared with the treated state, was significantly related to the development of muscle rigidity in the untreated state. 3. In Parkinson's disease, even in optimally treated patients, resting energy expenditure is raised and this may contribute to the weight loss seen in this disease. Severe muscle rigidity occurring during untreated periods results in a further increase in resting energy expenditure.

Apomorphine↗
PubMed1988

Reduced rate of energy expenditure as a risk factor for body-weight gain.

The contribution of reduced energy expenditure to the development of obesity has been a point of controversy. We measured 24-hour energy expenditure (adjusted for body composition, age, and sex), in a respiratory chamber, in 95 southwestern American Indians. Energy expenditure correlated with the rate of change in body weight over a two-year follow-up period (r = -0.39, P less than 0.001). The estimated risk of gaining more than 7.5 kg in body weight was increased fourfold in persons with a low adjusted 24-hour energy expenditure (200 kcal per day below predicted values) as compared with persons with a high 24-hour energy expenditure (200 kcal per day above predicted values; P less than 0.01). In another 126 subjects, the adjusted metabolic rate at rest at the initial visit was also found to predict the gain in body weight over a four-year follow-up period. When the 15 subjects who gained more than 10 kg were compared with the remaining 111 subjects, the initial mean (+/- SD) adjusted metabolic rate at rest was lower in those who gained weight (1694 +/- 103 vs. 1764 +/- 109 kcal per day; P less than 0.02) and increased to 1813 +/- 134 kcal per day (P less than 0.01) after a mean weight gain of 15.7 +/- 5.7 kg. In a group of 94 siblings from 36 families, values for adjusted 24-hour energy expenditure aggregated in families (intraclass correlation = 0.48). We conclude that a low rate of energy expenditure may contribute to the aggregation of obesity in families.

Adolescent↗
PubMed2003

Decreased energy expenditure is caused by abnormal body composition in infants with Prader-Willi Syndrome.

OBJECTIVE: Infants with Prader-Willi syndrome (PWS) are hypotonic and underweight before the onset of childhood obesity. This study evaluates body composition in the PWS infant and its relationship to energy expenditure. STUDY DESIGN: Sixteen infants and toddlers with PWS (mean age, 12.4+/-6 months; eight female subjects) underwent analysis of body composition with dual-energy x-ray absorptiometry and deuterium dilution, and energy expenditure with both doubly labeled water and indirect calorimetry. RESULTS: Percent body fat was significantly increased (male subjects, P<.001; female subjects, P<.001) and fat-free mass (FFM) was significantly decreased (male subjects, P<.001; female subjects, P=.04) in infants with PWS when compared with age-matched published data for normal infants. Meanwhile, total energy expenditure was significantly decreased (male subjects, P=.025; female subjects, P<.001) in infants with PWS when compared with published normative data. There was a normal relationship between FFM and total energy expenditure in infants with PWS. CONCLUSION: Compared with published data for infants without PWS, infants with PWS demonstrate increased percent body fat, decreased FFM, and decreased energy expenditure. Importantly, total energy expenditure per kilogram of FFM appears similar in infants with and without PWS. We conclude that lower energy expenditure in infants with PWS is caused by decreased FFM.

Absorptiometry, Photon↗
PubMed1979

Assessment of the heart-rate method for determining energy expenditure in man, using a whole-body calorimeter.

1. The heart-rate (HR) method for determining the energy expenditure of free-living subjects has been evaluated using a whole-body calorimeter in which individuals lived continuously for 27 h while carrying out normal daily activities. Eight male volunteers each occupied the calorimeter on at least two occasions when HR and energy expenditure were measured continuously. 2. After each session in the calorimeter a calibration was obtained using standard techniques by determining HR and heat production (HP) over periods of 10-15 min at several levels of activity. Energy expenditure in the calorimeter was then predicted, by each of five methods, from the mean HR in the calorimeter. Additionally, one session in the calorimeter was used to obtain a calibration and was used for predicting the subject's energy expenditure while in the calorimeter on other occasions. 3. Standard methods of prediction using one calibration point at rest and several points during activity were unreliable for predicting the energy expenditure of an individual. The 24 h HR was at the lower end of the calibration scale and there were considerable over-estimates or underestimates of energy expenditure, particularly during the night when the mean (+/- SD) difference between the actual and predicted HP was -66 +/- 38.6%. A linear regression fitted to points at the lower levels of activity improved the prediction of 24 h HP while a logistic plot reduced the error even further. The best estimate of energy expenditure was that obtained from a calibration over 24 h within the calorimeter; the mean (+/- SD) difference between the actual and predicted 24 h HP was +3 +/- 10.5% for light activity and -3 +/- 6.7% for moderate activity. Thus current procedures for calibrating subjects may lead to large errors which could be reduced by using a respiratory chamber.

Adult↗
PubMed1993

Adaptive changes in energy expenditure during mild and severe feed restriction in the rat.

Using a new-generation open-circuit calorimeter capable of monitoring the cost of activity, and thereby both the real thermic effect of feeding (TEF) and basal metabolism in free-moving freely-feeding rats, we have reassessed the proposal that when food intake is restricted an adaptative reduction in energy expenditure participates in the achievement of energy balance. Total energy expenditure, energy expenditure due to spontaneous activity, TEF, basal energy expenditure and respiratory quotient (RQ) were computed by indirect calorimetry in rats given either a mildly restricted (MR) feed intake for 20-30 d (17 g feed/d) or a severely restricted (SR) feed intake for 1-10 d (4 g feed/d). In MR rats no significant changes in any of the measured variables were observed. In contrast, SR rats exhibited an adaptative reduction in energy expenditure due to a reduced spontaneous activity and probably also due to a reduced basal energy expenditure. On the other hand none of the animals fed on a restricted feed intake showed an adaptative TEF decrease, suggesting that TEF under ad lib. feeding is rather an obligatory process that does not include an adaptative component. Taken together, these results point out that under restricted feeding most of the decrease in energy expenditure is associated with simple passive mechanisms, such as body weight loss, and with the reduced feed intake per se. Only under severe feed restriction can some additional energetic economy be obtained from a possible reduction of basal metabolism, and to some extent from reduced activity.

Adaptation, Physiological↗
PubMed1997

Feasibility of heart-rate monitoring to estimate total level and pattern of energy expenditure in a population-based epidemiological study: the Ely Young Cohort Feasibility Study 1994-5.

Increasing the precision of measurements of total energy expenditure in population-based epidemiological studies is important for accurately quantifying the relationship between this exposure and disease. Current questionnaire-based methods cannot accurately quantify total energy expenditure, although they may provide an estimate of the frequency of vigorous activities. Heart rate monitoring with individual calibration has been advocated as a method for assessing energy expenditure in field studies and has been compared with the 'gold standard' techniques of doubly-labelled water and indirect calorimetry. However the method has previously only been used on small and selected populations. This study was, therefore, established to test the feasibility of using heart rate monitoring in a population-based study of adults. A total of 167 individuals aged 30-40 years were randomly selected and underwent 4 d heart-rate monitoring. Only three individuals could not complete the protocol. The mean physical activity level (PAL) measured over 4 d was 1.89 (SD 0.40) in men and 1.76 (sd 0.31) in women. There was no difference between mean PAL on weekend days compared with weekdays (mean paired difference 0.0008, 95% CI -0.06 +0.06). The estimate of mean PAL was not correlated with BMI, percentage body fat or the waist:hip ratio. It was, however, correlated with cardio-respiratory fitness as measured by VO2(max) per kg (Spearman rank correlation coefficient 0.50 in men and 0.42 in women). The pattern of energy expenditure was assessed by calculating the percentage of daytime hours in which PAL was greater than five times basal energy expenditure. This measure was strongly correlated with the mean PAL in both men (Spearman correlation coefficient 0.77) and women (0.71). We conclude that heart-rate monitoring is a feasible method for assessing the pattern and total level of energy expenditure in medium-sized epidemiological studies. It may also prove useful as the reference technique for calibrating questionnaires to estimate energy expenditure in larger scale studies.

Adult↗
PubMed1985

[Rearing of female cattle twins using complete feed pellets in comparison to straw pellets plus concentrate mixture. 1. Weight gain performance and feed expenditure as well as rumen fermentation conditions during the 4th-12th months of life].

The investigations with young female cattle (twin cattle, n = 30) the applicability of straw as sole roughage after the end of the suckling period was tested. Completely (I) and partly (II) pelleted rations of dried feed with a straw component of 65% each in the total rations were used. Feed intake, development of body weight, feed expenditure as well as indexes of rumen fermentation and of the concentration of some metabolism parameters in the blood serum were measured. In the complete test period (between 5th and 12th months of life, 243 days) there were not any significant differences between the groups in all registrations. Average daily weight gains of 570 g were achieved with an overall high dry matter (2.6 kg/100 kg live weight) and roughage (straw) intake (1.6 kg dry matter/100 kg live weight). The standard expenditure of energy and protein given for the stage of development was differentiatedly undercut. The energy expenditure being below the standard (ca. 10%), the total energy expenditure (kEFUcattle) was by 20 (II) and 25% (I) below standard expenditure. Energy expenditure aimed at weight gain reached very satisfactory values with 3.68 (I) and 3.79 kEFUcattle/kg weight gain (II). Protein expenditure fell short of the standard for the development stage by 14 (II) and 20% (I) resp. All parameters ascertained of the rumen and intermediate metabolism were in the physiologic standard range, as is characteristic of feeding regimes with a relatively high quota of roughage.

Age Factors↗
PubMed1981

Energy expenditure and fat-free mass in men and women.

Energy expenditure was measured by direct calorimetry in 15 men and women aged 22 to 55. There were fifty-nine 24-h measurements under quiet, not basal, conditions of sedentary activity with 8 h of sleep at night, regular meals, and food intake adjusted to match individual expenditures. Fat-free mass was calculated from body density determined from underwater weight. Energy expenditure over a whole day and night varied directly with fat-free mass, with a correlation coefficient, r, of 0.95 (p less than 0.001); neither age nor sex affected the relationship. During sleep alone, energy expenditure also correlated highly with fat-free mass (r = 0.93). Energy expenditure also correlated with body surface area (r = 0.90), but men and women showed regression lines with different slopes. Metabolism from indirect calorimetry, measured simultaneously, correlated nearly as well with fat-free mass and surface area but showed more variability. The close correlation between 24-h energy expenditure and fat-free mass contrasts favorably with the imprecise prediction of basal metabolic rate according to age, sex, and surface area, and supports the idea that active tissue mass determines daily energy expenditure.

Adult↗