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PubMed2003

Alcohol consumption and expenditures for underage drinking and adult excessive drinking.

CONTEXT: Although estimates of the amount and proportion of alcohol consumed by underage and adult drinkers have been reported, more accurate estimates are possible and the economic impact has not been explored. OBJECTIVES: To provide accurate estimates of underage and adult excessive drinking and to describe consumer expenditures linked to underage and adult excessive drinking. DESIGN AND SETTING: Information was obtained from national data sets, including 1999 versions of the National Household Survey of Drug Abuse, the Youth Risk Behavior Survey (YRBS), the Behavior Risk Factor Surveillance System (BRFSS), 2000 US Census, and national data on consumption and consumer expenditures for alcohol, published by Adams Business Research. PARTICIPANTS: A total of 217 192 persons aged 12 years or older across 3 data sources. MAIN OUTCOME MEASURES: Amount as a proportion of total alcohol consumed and proportion of consumer expenditures on alcohol among underage (12-20 years) and adult excessive (> or =21 years) drinkers. RESULTS: The proportion of 12- to 20-year-olds who drink was estimated to be 50.0% using data from the YRBS; the proportion of adults aged 21 or older who drink was estimated to be 52.8% using data from the BRFSS. The estimated total number of drinks consumed per month was 4.21 billion; underage drinkers consumed 19.7% of this total. The amount of adult drinking that was excessive (>2 drinks per day) was 30.4%. Consumer expenditure on alcohol in the United States in 1999 was $116.2 billion; of that, $22.5 billion was attributed to underage drinking and $34.4 billion was attributed to adult excessive drinking. CONCLUSION: These data suggest that underage drinkers and adult excessive drinkers are responsible for 50.1% of alcohol consumption and 48.9% of consumer expenditure.

Adolescent↗
PubMed1992

Energy expenditure and substrate oxidation in patients with cirrhosis: the impact of cause, clinical staging and nutritional state.

Many clinicians subjectively feel that cirrhotic patients frequently have clinical signs of hypermetabolism. However, it is unknown whether hypermetabolism is a constant feature of chronic liver disease, corresponds to liver destruction and repair or is of prognostic value. This article is about resting energy expenditure and substrate oxidation rates in 123 patients with biopsy-proven cirrhosis differing with respect to cause, duration of the disease, biochemical parameters of parenchymal cell damage, cholestasis, liver function, number of complications, clinical staging and nutritional state. Resting energy expenditure varied between 1,090 and 2,300 kcal/day and differed from the predicted values in 70% of the patients. Resting energy expenditure was closely related to fat-free mass, and 52% of the variability could be explained by fat-free mass, age and sex. Of all the patients, 18% were hypermetabolic and 31% were hypometabolic. Hypermetabolism showed no strict association with the cause of cirrhosis, the duration of the disease, liver function, cholestasis, cell damage, clinical staging, blood hemoglobin, plasma thyroid hormone levels or human leukocyte antigens. An increased resting energy expenditure was associated with significant losses of muscle, body cell mass and extracellular mass at unchanged body fat, whereas fat and fat-free mass were increased in hypometabolic patients when compared with normometabolic patients. Lipid oxidation was increased, but glucose oxidation was reduced in nearly all patients with cirrhosis. This was most pronounced at advanced stages of liver disease. Although similar with respect to liver function and clinical staging, 76.2% of hypermetabolic patients had transplants within the observation period, compared with only 16.7% and 8.1% in the normometabolic group and hypometabolic group, respectively. Posttransplantation mortality was independent of pretransplantation resting energy expenditure, but it increased significantly in patients with losses in body cell mass. In conclusion, hypermetabolism is not a constant feature of cirrhosis and results more from extrahepatic than from hepatic factors. It may cause malnutrition and contributes to the clinical outcome of patients with chronic liver disease.

Adult↗
PubMed1997

Relationship between circulating leptin and energy expenditure in adult men and women aged 18 years to 81 years.

Recent studies suggest that leptin may be an important metabolic signal for energy regulation in rodents, but the role of leptin in human energy regulation remains uncertain. Because adaptive variations in energy expenditure play an important role in human energy regulation, we investigated the relationship between leptin and energy expenditure parameters in 61 weight-stable men and women aged 18 years to 81 years who were not obese. Measurements were made of circulating leptin in the fasting state, body fat and fat free mass, resting metabolic rate (n = 61), free-living total energy expenditure (n = 52), and the thermic effect of feeding (n = 33). After statistically accounting for age, body fat, and fat free mass, there was no association between leptin and any measured energy expenditure parameter. In addition, there was no effect of age on the relationship between circulating leptin and body fat mass. These results indicate that physiological variations in circulating leptin are not linked with adaptive variations in energy expenditure in humans, in contrast to indications of this phenomenon in the ob/ob mouse.

Adipose Tissue↗
PubMed2000

Energy expenditure of heavy to severe exercise and recovery.

A method of indirect calorimetry is proposed that attempts to better quantify the energy expenditure associated with heavy/severe exercise and the recovery from that exertion. To accomplish this objective, the energy expenditure associated with rapid anaerobic glycolysis is separated from that of mitochondrial respiration both during and after heavy/severe exercise. This model contrasts with those hypotheses that employ oxygen uptake as the sole measure of energy expenditure (e.g. the oxygen debt) or that utilizing a measure of anaerobic energy expenditure while ignoring the recovery energy expenditure. Anaerobic metabolism and its energy promoting effect on oxidative recovery must be independently acknowledged regardless of the eventual fate of lactate.

Adenosine Triphosphate↗
PubMed1985

Effect of trunk load on the energy expenditure of treadmill walking and ergometer cycling.

Data concerning the effect of trunk loads on the energy expenditure of various activities are scanty and partly conflicting. The energy expenditure of walking (4.5 km hr-1, 1.5% inclination) and ergometer cycling (60 watt, 60 rpm) was measured in 23 apparently healthy subjects with and without a trunk load of 10% of the body weight. For walking, the increment in energy expenditure per kg of load was 2.55 +/- 0.25 watt, while the increment per kg of body weight was 4.01 +/- 0.45 watt. For ergometer cycling, the increment per kg of load was 1.12 +/- 0.64 while that per kg of body weight was 2.73 +/- 0.56 watt. Prediction of energy expenditure for trunk loads has previously been made on the basis of the relation between energy expenditure and body weight. Our data show that this may lead to considerable overestimation.

Adult↗
PubMed1992

Twenty-four-hour energy expenditure in Pima Indians with type 2 (non-insulin-dependent) diabetes mellitus.

To assess the impact of Type 2 (non-insulin-dependent) diabetes mellitus on energy metabolism, 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were measured in a respiratory chamber in 151 Pima Indians, 102 with normal glucose tolerance (67 male/35 female, (mean +/- SD) 28 +/- 7 years, 99 +/- 24 kg, 32 +/- 9% body fat) and in 49 with Type 2 diabetes (22 male/27 female, 35 +/- 11 years, 107 +/- 33 kg, 39 +/- 7% body fat), after at least 3 days on a weight maintaining diet. After adjustment for differences in fat-free mass, fat mass, age and sex, 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were significantly higher in diabetic patients than in control subjects (72 kcal/day, p less than 0.05; 99 kcal/day, p less than 0.005; 99 kcal/day, p less than 0.001 respectively). Spontaneous physical activity was similar in both groups whereas the thermic effect of food, calculated as the mean energy expenditure corrected for activity throughout the day above sleeping metabolic rate and expressed as a percentage of energy intake, was significantly lower in Type 2 diabetic patients (17.1 +/- 7.1 vs 19.8 +/- 5.6%, p less than 0.05). Adjusted values of 24-h energy expenditure, basal metabolic rate and sleeping metabolic rate were correlated with hepatic endogenous glucose production (r = 0.22, p less than 0.05; r = 0.22, p less than 0.05; r = 0.31, p less than 0.01 respectively). Therefore, increased basal and sleeping metabolic rates, resulting in increased 24-h sedentary energy expenditure may play a role in the weight loss so often observed in Type 2 diabetic subjects in addition to the energy loss from glycosuria.

Adult↗
PubMed1996

Resting energy expenditure in patients with cirrhosis of the liver measured by indirect calorimetry, anthropometry and bioelectrical impedance analysis.

Energy expenditure was investigated in 15 patients with liver cirrhosis and 20 healthy controls by three methods: indirect calorimetry, anthropometry using the Harris-Benedict equation and bioelectrical impedance analysis. The energy expenditure was expressed in kcal/day, kcal/kg BW/day (BW - body weight), kcal/kg LBM/day (LBM - lean body mass, derived by bioelectrical impedance analysis) or in kcal/m2/day. We did not find statistical differences between values of resting energy expenditure obtained in patients with cirrhosis of the liver and healthy controls whichever method we used. We also did not find statistical differences between values obtained by indirect calorimetry, anthropometry and bioelectrical impedance analysis. There was a significant correlation between indirect calorimetry and anthropometry in both groups. We found significant correlations between indirect calorimetry and anthropometry, and between indirect calorimetry and bioelectrical impedance analysis, in the control group only. We can conclude that (1) resting energy expenditure of patients with cirrhosis of the liver is not changed when compared with healthy controls, and (2) bioelectrical impedance is a useful method to calculate body composition from which energy expenditure is derived; however, it gives an appropriate result only in healthy people, and only approximate values in patients with cirrhosis.

Adult↗
PubMed2006

Validity and reliability of self-reported total energy expenditure using a novel instrument.

Improved methods for quantitative self-reports of total physical activity in epidemiological studies are needed. We evaluated randomly selected individuals' ability to integrate their perception of physical activity over time to produce an estimate of the "usual" level, using a novel instrument for self-quantification of energy expenditure. A population-based sample of 418 Swedish men and women, age 20-59, completed a questionnaire containing the new instrument. For validation, three 24 hour recalls by phone served as gold standard. Reproducibility was assessed through administering the instrument another three times. The validation involved 133 subjects and another 160 completed the reproducibility evaluation. Pearson correlation between usual daily energy expenditure measured by the instrument and the mean of the 24 hour recalls was 0.73. After subdividing the self-reported daily energy expenditure and the mean of the 24 hour recalls into quintiles, 83.5% of the participants remained in the same quintile, or one quintile apart. There was a tendency towards overestimation of usual daily physical activity. This was significantly associated with low education. Reproducibility showed an intraclass correlation of 0.55. Although integrated reports of usual daily energy expenditure over longer periods seem to be afflicted with a tendency of overestimation, total energy expenditure can be estimated with reasonable validity and reproducibility using our instrument.

Adult↗
PubMed2000

Conjugated linoleic acid supplementation in humans: effects on body composition and energy expenditure.

Recent animal studies have demonstrated that dietary conjugated linoleic acid (CLA) reduces body fat and that this decrease may be due to a change in energy expenditure. The present study examined the effect of CLA supplementation on body composition and energy expenditure in healthy, adult women. Seventeen women were fed either a CLA capsule (3 g/d) or a sunflower oil placebo for 64 d following a baseline period of 30 d. The subjects were confined to a metabolic suite for the entire 94 d study where diet and activity were controlled and held constant. Change in fat-free mass, fat mass, and percentage body fat were unaffected by CLA supplementation (0.18+/-0.43 vs. 0.09+/-0.35 kg; 0.01+/-0.64 vs. -0.19+/-0.53 kg; 0.05+/-0.62 vs. -0.67+/-0.51%, placebo vs. CLA, respectively). Likewise, body weight was not significantly different in the placebo vs. the CLA group (0.48+/-0.55 vs. -0.24+/-0.46 kg change). Energy expenditure (kcal/min), fat oxidation, and respiratory exchange ratio were measured once during the baseline period and during weeks 4 and 8 of the intervention period. At all three times, measurements were taken while resting and walking. CLA had no significant effect on energy expenditure, fat oxidation, or respiratory exchange ratio at rest or during exercise. When dietary intake was controlled, 64 d of CLA supplementation at 3 g/d had no significant effect on body composition or energy expenditure in adult women, which contrasts with previous findings in animals.

Adult↗
PubMed1990

Contribution of spontaneous activity to daily energy expenditure of adult obese and lean Zucker rats.

The contribution of somatomotor activity to daily energy expenditure was estimated in 10-month-old, weight-stable, obese (fa/fa) and lean (Fa/?) Zucker rats. Total and resting heat production were assessed by recording oxygen consumption and stabilimeter activity each minute for five consecutive days in free-feeding animals. The number of activity counts, as well as their circadian pattern of occurrence, were highly similar in lean and obese groups. Likewise, the percentage of daily energy expenditure committed by the obese rats to activity was nearly identical to that of leans (19.3 vs. 19.7%, respectively). Observing these rats for one additional day under postabsorptive conditions produced similar estimates of their daily expenditure on activity. Thus, unlike prior estimates based on wheel-running behavior, continuous measurement of stabilimeter behavior indicates that both the proportion of daily expenditure on activity by fa/fa rats and its temporal pattern of occurrence are notably normal. Accordingly, it is concluded that maintenance of obesity in weight-stable adult obese Zucker rats does not depend upon a reduced expenditure on activity.

Animals↗
PubMed1989

Insulin increases energy expenditure and respiratory quotient in the rat.

The effects of insulin on energy expenditure are a matter of dispute. Various authors have reported increases or decreases. Irrespective of their nature, it is not clear whether the effects of insulin on energy expenditure are secondary to insulin-induced hypoglycemia or changes in motor activity. The present study investigated the acute effects of insulin on energy expenditure, energy substrate utilisation, motor activity and blood glucose levels. Four U/kg of fast acting insulin had no effect on any of the metabolic or motor activity measures in spite of producing a 30% reduction in blood glucose levels. In contrast, 8 U/kg of insulin increased energy expenditure and respiratory quotient, with the latter effect indicating increased reliance on carbohydrates as a source of energy. This dose reduced blood glucose levels by 68%, yet had no significant effect on motor activity. Insulin, therefore, enhances thermogenesis and carbohydrate utilisation in a manner that can be dissociated from any effect on motor activity. These effects occur at a high dose and they are not counteracted by even massive hypoglycemia. It, therefore, appears that in terms of energy expenditure insulin may be characterised as catabolic, whereas in terms of substrate utilisation it may be characterised as anabolic.

Animals↗
PubMedDate not supplied

Physiological and pathological age-associated changes in diurnal rhythm of energy expenditure in rats.

Although the idea that energy metabolism of rats decreases with age has been widely accepted, few studies with regard to the diurnal rhythm of energy expenditure have been reported. Whether age alone altered the diurnal rhythm of energy expenditure was examined in Sprague-Dawley (SD) rats. The same determination was conducted in Otsuka Long Evans Tokushima Fatty (OLETF) rats to examine the effect of insulin resistance and diabetes. OLETF rats were developed as a model of non-insulin-dependent diabetes mellitus (NIDDM) with mild obesity. The characteristic features of OLETF rats are late onset of hyperglycemia at about 18 weeks of age, followed by insulin deficiency at about 65 weeks. Age-associated changes in diurnal rhythm of energy expenditure were not observed in SD rats. In OLETF rats, the diurnal rhythm of energy expenditure with two peaks was observed at 8 weeks of age, while these two peaks disappeared at 24 weeks of age (with NIDDM). Then, the pattern of diurnal rhythm at 44 weeks of age (with advanced NIDDM) was resembled to that of 62 weeks of age (with insulin deficiency). In conclusion, we clarified the changes in diurnal rhythm of energy expenditure associated with the progress of diabetes, while age alone did not alter the diurnal rhythm.

Age Factors↗
PubMed2005

[Technical aspects and relevance of energy expenditure and physical activity assessment in clinical research for cystic fibrosis patients].

Cystic fibrosis (CF) is characterized by deteriorating lung function and mal-digestion, which result in growth failure and/or under-nutrition. Several factors, alone or combined, contribute to malnutrition in CF: poor energy intake, elevation of energy loss as a result of malabsorption, increasing resting energy expenditure due to genetic mutation and/or pulmonary exacerbation. Several techniques have been used to assess energy expenditure and physical activity in order to better understand mechanisms of malnutrition in CF and follow therapeutic interventions. Indirect calorimetry (IC) studies have shown that resting energy expenditure (REE) was 10-22% higher than predictive values. This increase could be attributed to chronic inflammation as a result of Pseudomonas aeruginosa (PA) infection. Indeed, intravenous antibiotic therapy decreases REE. Doubly labelled water technique and heart rate monitoring calibrated against IC techniques shows that total energy expenditure (TEE) was not different than in healthy children. Physical activity level assessed by the ratio TEE-REE is also not different between CF of healthy children. Recently, new accelerometry technics, easier to use and less invasive have been successfully used in order to assess physical activity level in CF. Precise and ambulatory assessment of energy expenditure and physical activity permit to check and adapt dietary allowances in CF. These techniques could be simultaneously used and be helpful to assess efficacy of intervention studies.

Adolescent↗
PubMed2004

Cost of living in free-ranging degus (Octodon degus): seasonal dynamics of energy expenditure.

Animals process and allocate energy at different seasons at variable rates, depending on their breeding season and changes in environmental conditions and resulting physiological demands. Overall total energy expenditure, in turn, should either increase in some seasons due to special added demands (e.g. reproduction) or it could simply remain at about the same level, in which case the animals must show compensatory rebalancing of other expenditures that can be reduced. To test for the alternative hypotheses of seasonal variability or compensation, we measured total daily energy expenditure (DEE) in free-living degus (Octodon degus) at four seasons and followed this with determinations of basal metabolic rate (BMR) in the laboratory in the same individuals. DEE varied seasonally but was only significantly different (lower) in summer (non-breeding season), with a DEE:BMR ratio of only 1.6, whereas autumn, winter and spring DEE values were statistically indistinguishable from one another and showed DEE:BMR ratios ranging from 1.9 to 2.2. Our values of DEE in the field fall within the broad range of allometric expectation for herbivorous mammals in general, but the ratios of DEE:BMR are lower than expected. This, together with the lack of strong major shifts in total levels of DEE, suggests that degus are showing compensatory shifts among various categories of energy expenditure that allow them to manage their overall energy balance by minimizing total expenditure.

Animals↗
PubMed2005

Relationship between the ability to recognize energy intake and expenditure, and blood sugar control in type 2 diabetes mellitus patients.

To investigate the association between an individual's ability to recognize his/her energy intake and energy expenditure with the status of diabetes mellitus (DM) control, we conducted a cross-sectional study using data from 62 outpatients with type 2 DM (46 men and 16 women), aged 33-77 years, from two hospitals in Tokyo in 1999. A dietitian-interviewer asked the patients to estimate their probable energy intake and expenditure in recent days (self-estimated energy intake and expenditure, respectively). Subsequently, a dietary survey was conducted to estimate the patient's energy intake by a self-recorded method with a dietitian's interview for three continuous business days; the physical exercise levels were measured using a pedometer with multiple-memory accelerometers for one week. The percentage of subjects whose self-estimated energy intake was within +/-10% of the dietary survey-based energy intake became significantly lower as the control status worsened (35.6, 12.9, and 11.1% in the first, second, and third tertile groups of HbA(1c), respectively; P = 0.015). Similar but non-significant results were observed for the energy expenditure (P = 0.35). Since the control status of DM was worse among patients who could not recognize their amount of caloric intake and expenditure, a training program to improve such recognition ability may be needed.

Adult↗
PubMed2005

Dentist-time expenditure for two different adhesive all-ceramic systems.

OBJECTIVES: The purpose of this clinical investigation was to compare a chair-side adhesive all-ceramic system to a laboratory processed adhesive all-ceramic system with respect to quality and time expenditure for the dentist. METHODS: The same dentist treated 10 patients, who were each to receive two large posterior single tooth restorations of similar location and extent. One restoration was made in the laboratory by using the IPS Empress system [LAB], the other one was done chair-side by utilizing the Cerec system [CHAIR]. The time expenditure was measured for [LAB] and [CHAIR] and compared by the Wilcoxon signed rank test. The restorations were also evaluated according to the USPHS criteria. RESULTS: The mean time expenditure for the dentist with low-level assistance was 111:03 min [S.D.+/-24:09 min] for [LAB] and 115:31 min [S.D.+/-15:54 min] for [CHAIR]. Time expenditure with medium level assistance for the operator was 100:53 min [S.D.+/-23:59] for [LAB] and 105:50 [S.D.+/-15:28] for [CHAIR]. Assuming a high level of assistance, the mean time values were 53:11 min [S.D.+/-14:29] for [LAB] and 54:29 min [S.D.+/-09:21] for [CHAIR]. The baseline investigation according to the modified USPHS criteria did not reveal any differences between [CHAIR] and [LAB]. CONCLUSION: There were no statistical significant differences with respect to time expenditure or quality between [LAB] and [CHAIR] in this study.

Aluminum Silicates↗
PubMed2004

Increased resting energy expenditure in subjects with Emery-Dreifuss muscular dystrophy.

We have studied changes in energy expenditure and body composition in adult males with Emery-Dreifuss muscular dystrophy, age-matched males with hyperCKemia and age-matched healthy controls. All participants were studied twice, 2-3 years apart. Resting energy expenditure was studied by indirect calorimetry, lean body mass and body fat by dual X-ray absorptiometry, and muscle mass was estimated based on 24-h urinary creatinine excretion. At baseline and 2-3 years later, body fat was significantly higher (P < 0.011 and P < 0.003, respectively) and lean body mass significantly lower (P < 0.024 and P < 0.012, respectively) in patients with Emery-Dreifuss muscular dystrophy as compared to subjects with hyperCKemia and healthy controls. Resting energy expenditure, over the study period, increased significantly in patients with Emery-Dreifuss muscular dystrophy (P < 0.031), but not in patients with hyperCKemia nor in healthy controls. Our study suggests that patients with Emery-Dreifuss muscular dystrophy may have increased energy expenditure relative to healthy subjects. If not met by increased caloric intake, this greater energy expenditure may partially contribute to a further deterioration in their muscle performance.

Absorptiometry, Photon↗
PubMed2002

The effect of huffing and directed coughing on energy expenditure in young asymptomatic subjects.

Coughing and huffing have been shown to be effective airway clearance techniques and some authors have anecdotally reported that a huff requires less energy than a series of coughs commencing and finishing at the same lung volume. The aim of this study was to determine whether there is a difference in the energy expenditure between periods of huffing and directed voluntary coughing commencing from the same initial lung volume in young asymptomatic subjects. Energy expenditure was measured using open-circuit indirect calorimetry equipment. Twenty-four non-smoking asymptomatic subjects (12 male, 12 female, aged 18-24 years), without any form of disease and within 10% of their predicted pulmonary function, completed the study. Energy expenditure was measured over three 10min, randomly ordered sessions of huffing, directed coughing and rest. The forced expiratory sessions comprised a single huff or double-barrel cough (both starting at total lung capacity) at the end of every two minutes. Each session was separated by a 5min washout period. No significant difference in energy expenditure was found between the huffing and directed coughing periods (mean difference 0.003 mL/kg/min (95% CI -0.160 to 0.114) and both produced significantly greater energy expenditure than rest (rest and huff mean difference 0.309 mL/kg/min (95% CI 0.080 to 0.549) and rest and cough mean difference 0.306 mL/kg/min (95% CI 0.074 to 0.508)). The suggested benefits of huffing versus coughing in terms of energy conservation are yet to be shown.

Adolescent↗