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PubMed1998

Determinants of increased energy expenditure in HIV-infected women.

BACKGROUND: Little is known about sex-specific effects of HIV infection on energy expenditure. OBJECTIVE: We investigated the determinants of energy expenditure in HIV-infected women. DESIGN: Resting energy expenditure (REE), body composition, and hormonal and nutritional indexes were compared in 33 ambulatory, premenopausal HIV-infected women and 26 weight-matched, healthy premenopausal control subjects. REE was determined by indirect calorimetry and body composition by dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis, and skinfold-thickness analysis. Hormonal indexes included leptin, testosterone, estradiol, and insulin-like growth factor I. RESULTS: HIV-infected subjects had a higher REE than control subjects [6794 +/- 1374 compared with 6011 +/- 607 kJ/d (1624 +/- 329 compared with 1437 +/- 145 kcal/d), P = 0.0096]. On average, REE was 119 +/- 23% of Harris-Benedict predictions in HIV-infected subjects compared with 102 +/- 9% for control subjects (P = 0.0007). In HIV-infected subjects, REE was highly correlated with fat-free mass (FFM) by DXA (R = 0.641, P < 0.001), but not with weight or disease status. The slope of the regression equation for REE and FFM was significantly greater (P = 0.027, analysis of covariance) for HIV-infected subjects [REE (kJ/d) = 203.5 (kg FFM) - 1237] than for control subjects [REE (kJ/d) = 77.4 (kg FFM) + 2923]. In a stepwise regression analysis, FFM was the most significant variable (P = 0.005), followed by free testosterone (P = 0.029), which together explained 49% of the variation in REE. The final equation was REE (kJ/d) = 230.8 (kg FFM) + 395.9 (free testosterone, pmol/L) - 3304. CONCLUSIONS: Energy expenditure was higher in HIV-infected women than in control women. FFM is the primary determinant of REE in HIV-infected women, but energy expenditure is greater per kg FFM in HIV-infected subjects than in control subjects, which may contribute to the wasting syndrome.

Absorptiometry, Photon↗
PubMed1999

Energy expenditure of young Polynesian and European women in New Zealand and relations to body composition.

BACKGROUND: Reduced energy expenditure and excessive energy intake have been hypothesized to cause obesity. New Zealanders of Polynesian origin have a higher prevalence of obesity than do those of European origin. OBJECTIVE: We investigated relations between components of energy expenditure and body composition. DESIGN: We measured total energy expenditure (TEE) and resting metabolic rate (RMR) in 80 young women [40 New Zealand (NZ) Polynesian and 40 NZ European] aged 18-27 y by the doubly labeled water method and indirect calorimetry, respectively. Each group was partitioned into nonobese and obese on the basis of percentage body fat. RESULTS: TEE and body weight were highly correlated in nonobese NZ Europeans (n = 23, r = 0.76, P < 0.001), obese NZ Europeans (r = 0.58, P = 0.016), and nonobese NZ Polynesians (n = 25, r = 0.59, P = 0.002) but not in obese NZ Polynesians (r = 0.11, P = 0.70). Activity energy expenditure (AEE = TEE - RMR) was similar in obese Polynesians and Europeans (mean+/-SD: 5.5+/-2.2 and 5.2+/-1.9 MJ/d, respectively), but significantly higher in nonobese Polynesians (5.7+/-2.5 MJ/d) than in their European counterparts (3.8+/-1.9 MJ/d, P = 0.005). Similar trends were seen when AEE adjusted for body weight and TEE/RMR were compared among the subgroups. Body weight and RMR together accounted for 66% of the variation in TEE for the European group but only 17% for the Polynesian group. CONCLUSION: Care should be taken in applying "Caucasian norms" relating to energy expenditure to NZ Polynesian people.

Adolescent↗
PubMed2000

Energy expenditure, energy intake, and weight loss in Alzheimer disease.

Alzheimer disease is one of the leading causes of death among older individuals. Unexplained weight loss and cachexia are frequent clinical findings in patients with Alzheimer disease. Thus, it has been postulated that Alzheimer disease may be associated with dysfunction in body weight regulation. This brief review examines the interrelations among energy intake, energy expenditure, and body composition in Alzheimer disease. We explored whether abnormally high daily energy expenditures, low energy intakes, or both contribute to unexplained weight loss and a decline in nutritional status. Specifically, we considered studies that examined energy intake, body composition, and daily energy expenditure and its components. The application of doubly labeled water and indirect calorimetry to understand the etiology of wasting has increased our knowledge regarding the relation among energy expenditure, physical activity levels, and body composition in Alzheimer disease patients. Although the number of studies are limited, results do not support the notion that a hypermetabolic state contributes to unexplained weight loss in Alzheimer disease, even in cachectic patients. Recent findings are presented suggesting an association between abnormally elevated levels of physical activity energy expenditure and elevated appendicular skeletal muscle mass and energy intake in Alzheimer disease patients. Clinical strategies aimed at developing lifestyle and dietary interventions to maintain adequate energy intake, restore energy balance, and maintain skeletal muscle mass should be a future area of investigation in Alzheimer disease research.

Aged↗
PubMed2000

Resting energy expenditure in short-term starvation is increased as a result of an increase in serum norepinephrine.

BACKGROUND: The effects of food restriction on energy metabolism have been under investigation for more than a century. Data obtained are conflicting and research has failed to provide conclusive results. OBJECTIVE: The objective of this study was to test the hypothesis that in lean subjects under normal living conditions, short-term starvation leads to an increase in serum concentrations of catecholamines and thus to an increase in resting energy expenditure. DESIGN: Resting energy expenditure, measured by indirect calorimetry, and hormone and substrate concentrations were measured in 11 healthy, lean subjects on days 1, 2, 3, and 4 of an 84-h starvation period. RESULTS: Resting energy expenditure increased significantly from 3.97 +/- 0.9 kJ/min on day 1 to 4.53 +/- 0.9 kJ/min on day 3 (P < 0.05). The increase in resting energy expenditure was associated with an increase in the norepinephrine concentration from 1716. +/- 574 pmol/L on day 1 to 3728 +/- 1636 pmol/L on day 4 (P < 0.05). Serum glucose decreased from 4.9 +/- 0.5 to 3.5 +/- 0.5 mmol/L (P < 0.05), whereas insulin did not change significantly. CONCLUSIONS: Resting energy expenditure increases in early starvation, accompanied by an increase in plasma norepinephrine. This increase in norepinephrine seems to be due to a decline in serum glucose and may be the initial signal for metabolic changes in early starvation.

3-Hydroxybutyric Acid↗
PubMed2000

Energy expenditure of stunted and nonstunted boys and girls living in the shantytowns of São Paulo, Brazil.

BACKGROUND: Stunting increases the risk of obesity in developing countries, particularly in girls and women, but the underlying reason is not known. OBJECTIVE: Our objective was to test the hypothesis that stunted children have lower energy expenditure than do nonstunted children, a factor that has predicted an increased risk of obesity in other high-risk populations. DESIGN: A cross-sectional study was conducted in shantytown children from São Paulo, Brazil. Twenty-eight stunted children aged 8-11 y were compared with 30 nonstunted children with similar weight-for-height. Free-living total energy expenditure (TEE) was measured over 7 d by using the doubly labeled water method. In addition, resting energy expenditure (REE) was measured by indirect calorimetry and body composition was measured by dual-energy X-ray absorptiometry. RESULTS: There were no significant associations between stunting and any measured energy expenditure parameter, including REE adjusted for weight (f1.gif" BORDER="0"> +/- SEM: 4575 +/- 95 compared with 4742 +/- 91 kJ/d, in stunted and nonstunted children, respectively) and TEE adjusted for weight (8424 +/- 239 compared with 8009 +/- 221 kJ/d, in stunted and nonstunted children, respectively). In multiple regression models that included fat-free mass and fat mass, girls had significantly lower TEE than did boys (P: < 0.05) but not significantly lower REE (P: = 0.17). CONCLUSIONS: There was no association between stunting and energy expenditure after differences between groups in body size and composition were accounted for. However, the girls had lower TEE than did boys, which may help to explain the particularly high risk of obesity in stunted adolescent girls and women in urban areas of developing countries.

Absorptiometry, Photon↗
PubMed2002

Effect of 3 modified fats and a conventional fat on appetite, energy intake, energy expenditure, and substrate oxidation in healthy men.

BACKGROUND: Different dietary fats are metabolized differently in humans and may influence energy expenditure, substrate oxidation, appetite regulation, and body weight regulation. OBJECTIVE: We examined the short-term effects of 4 triacylglycerols (test fats) on subjective appetite, ad libitum energy intake, meal-induced thermogenesis, and postprandial substrate oxidation. DESIGN: Eleven healthy, normal-weight men (mean age: 25.1 +/- 0.5 y) consumed 4 different test fats [conventional fat (rapeseed oil) and 3 modified fats (lipase-structured fat, chemically structured fat, and physically mixed fat)] in a randomized, double-blind, crossover design. RESULTS: No significant differences in appetite sensations or ad libitum energy intakes were observed between the 4 test fats. Overall, the 4 fats exerted different effects on energy expenditure (meal effect: P < 0.01) and substrate oxidation (interaction between meal and time: P < 0.05). In post hoc tests, the 3 modified fats resulted in significantly higher postprandial energy expenditure and fat oxidation than did the conventional fat (P < 0.008, Bonferroni adjusted); no significant differences were observed between the 3 modified fats. CONCLUSIONS: Structured fats do not change short-term postprandial appetite sensations or ad libitum energy intakes but do result in higher postprandial energy expenditure and fat oxidation than do conventional fats and hence promote negative energy and fat balance. In humans, a physically mixed fat (trioctanoate + rapeseed oil) is metabolized as quickly as are structured fats. The position of medium-chain fatty acids on the glycerol backbone of triacylglycerols does not seem to affect energy expenditure or appetite.

Adult↗
PubMed2002

Energy expenditure in preadolescent African American and white boys and girls: the Baton Rouge Children's Study.

BACKGROUND: Low energy expenditure has been identified as a potential risk factor for body fat gain. OBJECTIVE: The objective was to determine the relations between race, sex, body fat, and energy expenditure. DESIGN: As part of the Baton Rouge Children's Study, energy expenditure was examined in 131 preadolescent African American and white girls and boys, further stratified as obese or lean. Total daily energy expenditure (TDEE) was measured by the doubly labeled water method. Resting metabolic rate (RMR) and the thermic effect of food were measured by indirect calorimetry. Fat-free mass and fat mass were measured by dual-energy X-ray absorptiometry. To account for differences in body size, energy expenditure variables were adjusted with the use of fat-free mass or fat-free mass and fat mass as covariates. RESULTS: The African American children had lower TDEE and RMR than did the white children. A lower level of energy expended in physical activity by the African American girls and a lower RMR in the African American boys accounted for the racial differences in TDEE. The white boys had a higher RMR than did the white girls. The girls had a lower TDEE and expended less energy in activity than did the boys. Energy expended in activity was lower in the obese children. CONCLUSIONS: The African American children expended less energy than did the white children. The obese children spent less time engaged in activity or engaged in lower-intensity activity. Obese children may maintain their obese state by spending less time in physical activity, but they do not have a reduced RMR or thermic effect of food.

Analysis of Variance↗
PubMed2002

Predicting total energy expenditure from self-reported dietary records and physical characteristics in adult and elderly men and women.

BACKGROUND: Energy requirements and nutrient intakes are commonly estimated from self-reported dietary records, but such estimation has proven to be unreliable. When energy intakes determined from dietary records are compared with energy expenditures measured with the use of doubly labeled water, the former consistently underestimate energy requirements and have a high degree of variability. OBJECTIVE: The objective of this study was to reduce the bias and variability of self-reported dietary records through the use of stepwise multiple regression analysis to develop models that relate energy expenditure measured with the use of doubly labeled water to energy intake from dietary records, sex, and fat-free mass (or weight and height). DESIGN: Data from 54 healthy adult men and women were used to develop these models. RESULTS: Fat-free mass, energy intake, and sex accounted for 86% of the variability in energy expenditure, whereas energy intake, sex, height, and weight accounted for 83%. When the model relating fat-free mass, energy intake, and sex to energy expenditure was tested on published data, it reduced the bias and variability of self-reported dietary records from -17 +/- 27% to 3 +/- 16%. When the model relating energy intake, sex, weight, and height to energy expenditure was tested on published data, it reduced the bias and variability of self-reported dietary records from -19 +/- 25% to -0.3 +/- 19%. CONCLUSION: Results from this study indicate that a simple relation can be used to correct self-reported dietary records to estimated energy requirements.

Adult↗
PubMed1997

Projecting future drug expenditures--1997.

Use of the producer price index; data from independent sources, drug industry analyst, group purchasing organizations (GPOs), and health maintenance organizations (HMOs); pharmacoeconomics; and legal developments to project drug expenditures and prepare pharmacy budgets for 1997 is discussed. The producer price index indicates that prices for drugs and pharmaceuticals increased 2.2% during January to May 1996; the increase for prescription preparations was 3.4%. Medi-Span reports an average increase for all drug products of 1.2% for the first six months of 1996. IMS America data show the price of all drugs increasing 1.8% between the second quarters of 1995 and 1996. Drug industry analysts project the overall price increase in the next 12 months at 2.5-5.0%. GPOs predict an average increase over the next 12 months of 2.2% for contracted drugs and 4.3% for non-contracted drugs. HMO pharmacy directors predict pharmacy expenditures will increase by 4.5% per member in 1997. Caution must be applied in using pharmacoeconomics to project drug costs and their impact on health care expenditures. Today's budget must account for the greater integration of drug expenditures into the institution's objectives, possible reductions in other service costs, capitation, competition, shifting of control of the drug budget to specific patient care centers, relocation of services to the ambulatory care setting, and outsourcing. Legal actions in 1996 that may affect price increases and drug budgets included a class-action lawsuit by community and chain pharmacies alleging price discrimination by manufactures and wholesalers. Prices of pharmaceutical products are fairly stable and may remain so in 1997, but projections of future drug expenditures must account for the continuing reshaping of the health care landscape.

Budgets↗
PubMed1993

Energy expenditure, aging and body composition.

We investigated the importance of adaptive variations in energy expenditure in the regulation of energy balance in young and elderly men of normal body weight leading unrestricted lives. Changes were measured in total and resting energy expenditure and body composition in response to overeating by approximately 4.2 MJ/d or undereating by 3.3 MJ/d for 21 d in 39 young and elderly men consuming a typical diet. In the young men, an average of 85-90% of the excess energy intake during overeating was deposited. During underfeeding, mobilization of body energy compensated for an average of 65% of the energy deficit in these subjects. The resting metabolic rate, averaged for fasting and fed states, increased during overfeeding (+0.63 +/- 0.20 MJ/d, P < 0.01) and decreased during underfeeding (-0.42 +/- 0.12 MJ/d), but at least some of these changes were due to the obligatory expenditure associated with nutrient assimilation. There was no significant change in energy expenditure for physical activity or thermoregulation from overfeeding or underfeeding. Preliminary results indicate that aging had no effect on responses to overfeeding or underfeeding. These findings suggest that adaptive variations in energy expenditure are not the major determinant of energy regulation in young adults of normal body weight and that, instead, energy balance is maintained on a day-to-day basis through the control of nutrient intakes.

Adult↗
PubMed1992

Oxygen consumption, energy expenditure, and substrate utilization after cardiac surgery in children.

OBJECTIVE: To determine the oxygen consumption (VO2), resting energy expenditure, and substrate utilization after cardiac surgery in children. DESIGN: Prospective, observational, cross-sectional study with factorial design. SETTING: Pediatric ICU at a university hospital. PATIENTS: Twenty-six consecutive children during the first 3 days after open-heart surgery. INTERVENTIONS: Patients were mechanically ventilated and received routine therapeutic interventions. MEASUREMENTS AND MAIN RESULTS: VO2, resting energy expenditure, and substrate utilization were determined by indirect calorimetry. Cardiac index was calculated using the Fick equation from the measured VO2 and the arterial-mixed venous oxygen content difference, and this cardiac index value was compared with a simultaneous cardiac index value that was measured by thermodilution whenever possible. There were excellent correlation and agreement between cardiac index measurements by Fick equation and thermodilution, indicating accurate VO2 measurements. VO2 was consistent with predicted values in healthy resting children. Resting energy expenditure was consistent with the predicted basal metabolic rate. The mean caloric intake was 19% of the mean energy expenditure. The respiratory quotient was 0.74 +/- 0.05. The substrate utilization showed a shift toward fat oxidation and either gluconeogenesis or impaired carbohydrate utilization. CONCLUSIONS: Cardiovascular surgery in children does not significantly alter resting energy expenditure but influences the substrate utilization. Perioperative hormonal stress responses and therapeutically administered catecholamines may explain the shift toward fat oxidation.

Basal Metabolism↗
PubMedDate not supplied

Equations for the estimation of energy expenditures in patients with burns with special reference to ventilatory status.

There are advantages to the use of easily assessed variables for the prediction of energy expenditures of patients with burns. The purpose of this study was to determine whether height, age, sex, weight, ventilatory status, and diagnosis could be correlated with measured energy expenditures of hospitalized patients. With the use of data from 200 patients, stepwise, multivariate regression analysis derived the following equations: EEE(v) = 1925 - 10(A) + 5(W) + 281(S) + 292(T) + 851(B) (R2 = 0.43); EEE(s) = 629 - 11(A) + 25(W) - 609(O) (R2 = 0.50); where EEE = estimated energy expenditure (kcal/day), v = ventilatory dependency, s = spontaneously breathing, A = age (yr), W = body weight (kg), S = sex (male = 1, female = 0), diagnosis of T = trauma, B = burn, O = obesity present = 1, absent = 0). The equations were tested on 100 patients. Measured energy expenditures were not significantly different from calculated EEE(s) or EEE(v) (paired t test, p greater than 0.25). Energy expenditures can be accurately estimated in a variety of patients, including those with major burns with the use of easily attained information.

Adult↗
PubMed1985

Predicting energy expenditures in burned patients.

Daily caloric requirements in patients with major burns are frequently estimated using the Curreri formula (25 X body weight (kg) + 40 X % BSA burned). In nonburned patients modifications of the Harris-Benedict formulas have been used to estimate energy requirements. These equations have not been validated against measured energy expenditures in burned patients. Thirty-five patients with second- and third-degree burns covering from 10 to 75% of the body surface area underwent assessments of energy expenditures by indirect calorimetry and by the Curreri and Harris-Benedict formulas. The mean energy expenditure calculated from the Harris-Benedict formulas (BEE) underestimated the mean measured energy expenditure (MEE) by 23% (p less than 0.001), while the mean energy expenditure calculated from the Curreri formula (CEE) overestimated the mean MEE by 58% (p less than 0.001). There were significant correlations between the MEE, BEE, and CEE. In patients with burns greater than 20% of the body surface area, the correlation between MEE and BEE was higher than that found with the Curreri formula.

Adolescent↗
PubMed1997

Energy expenditure of a noncontact boxing training session compared with submaximal treadmill running.

The aim of this study was to determine the energy expenditure of a 1-h noncontact boxing training session and to compare these results with the energy expenditure of a more conventional recreational activity such as running. Eight healthy males, accustomed to noncontact boxing training, were recruited for the study. Subjects underwent three tests: (i) a boxing training session in the laboratory during which energy expenditure was measured continuously using indirect calorimetry (BOXL), (ii) a boxing training session in a boxing studio during which heart rate was measured continuously (BOXS), and (iii) an incremental running test on the treadmill during which energy expenditure was measured continuously. The energy expenditure during 60 min of BOXL ranged between 2519 and 3079 kJ (2821 +/- 190 kJ). Seven of the 8 subjects had higher heart rates during BOXL compared with those during BOXS, suggesting that the subjects exercised at a slightly higher intensity during BOXL, possibly because of the "one on one" supervision. A typical boxing training session lasting 60 min causes a person to expend 2821 +/- 190 kJ x h(-1), the same amount of energy as someone running about 9 km in 60 min on the treadmill.

Adult↗
PubMed1998

Fitness and energy expenditure after strength training in obese prepubertal girls.

PURPOSE: The purpose of this study was to determine the effects of a school-based, low-volume strength training program on energy expenditure, strength, and physical fitness in obese prepubertal girls. METHODS: A longitudinal, 5-month strength training exercise program was undertaken by healthy, obese (> 95th percentile weight-for-height, N = 11) girls age 7-10 yr. The following were measured: strength by the one-repetition maximum test; fitness (VO2peak) by a treadmill exercise test; resting metabolic rate (RMR), 24-h sedentary energy expenditure (SEE), and sleeping metabolic rate (SMR) by room respiration calorimetry; and total energy expenditure (TEE) by the doubly labeled water method. Physical activity energy expenditure (AEE) was calculated as TEE-(RMR + 0.1.TEE) and physical activity level (PAL) as TEE/RMR. An age-matched, nonoverweight control group was measured for (VO2peak) and RMR over the same time period. RESULTS: Strength increased by 19.6 and 20.0% in the upper and lower body (P < 0.01), respectively. (VO2peak) (mL.min-1) increased in both groups over time (P < 0.05), but not when covaried for fat-free mass (FFM) or weight. After adjusting for FFM or weight, RMR did not change, but SMR and 24-h SEE decreased significantly in the exercise group. There were no changes in nonprotein respiratory quotient or substrate oxidation. No changes in TEE, AEE, and PAL occurred, either unadjusted or adjusted for FFM or weight. CONCLUSION: This long-term, school-based, low-volume strength training program favorably increases strength in obese prepubertal girls but does not increase their daily energy expenditure.

Absorptiometry, Photon↗
PubMed2001

Intermodal comparison of energy expenditure at exercise intensities corresponding to the perceptual preference range.

PURPOSE: This study compared the rate of energy expenditure among six popular exercise machines at intensities corresponding to ratings of perceived exertion (RPE) for fairly light (RPE-11), somewhat hard (RPE-13), and hard (RPE-15) in 9 healthy men and 10 healthy women. METHODS: A maximal exercise test on each exercise machine was used to anchor the Borg 15-point category scale. Subjects performed three submaximal exercise tests at selected RPEs on a treadmill, stair-stepper, cycle ergometer, rowing ergometer, cross-country ski simulator, and rider. The submaximal tests on each exercise device were performed in random order and were 6 min in duration with 15-min rest between trials. Oxygen uptake, heart rate, and blood lactate concentration were measured during the final 2 min of each exercise intensity. RESULTS: Energy expenditure at each RPE was highest on the treadmill and ski simulator in men, and on the treadmill, ski simulator, and rowing ergometer in women. Energy expenditure in men and women at all RPEs was lowest on the rider and cycle ergometer. Energy expenditure at a given RPE was greater in men than women on all exercise machines, but men and women used a similar percentage of their machine specific peak oxygen uptake at each RPE on all machines. Heart rate was generally similar among the machines and between both men and women at each RPE. CONCLUSIONS: Our results indicated that there are large differences in energy expenditure between exercise machines and between men and women at intensities perceived to be fairly light, somewhat hard, and hard. Consequently, subjects can expend more calories at the same RPE during treadmill and ski simulator exercise, for example, than during exercise with other devices. This may have important implications for the health benefits of different exercises and in promoting long term exercise adherence.

Adult↗
PubMedDate not supplied

Prediction of oxygen uptake and energy expenditure during exercise in obese women.

PURPOSE: For patients concerned with weight loss, monitoring the energy balance between daily dietary intake and exercise expenditure can be useful. Formulas commonly used to estimate the energy costs of exercise were previously derived from healthy men of normal body weight. The purpose of this study was to determine the relationship between measured and predicted exercise energy expenditure for obese women. METHODS: Oxygen uptake (VO2) was measured using respiratory gas analysis in 45 obese (92 +/- 16 kg; 40 +/- 7% fat) and 10 normal weight (control) (58 +/- 5 kg; 21 +/- 6% fat) women during progressive exercise on a motorized treadmill. VO2 was also calculated at matched workrates using a regression equation published by the American College of Sports Medicine. The relationship between predicted versus measured VO2 was determined using least squares regression analysis. RESULTS: The slope of the regression line for measured versus predicted VO2 for controls (y = 0.98x +/- 0.56; P < .001) was different than that of obese women (y = 0.75x +/- 3.06; P < .001). The slope of the regression line for controls was in close approximation to the line of identity, whereas the slope for obese was below it. Using VO2 to calculate kcal, measured energy expenditure, was significantly lower than predicted energy expenditure for obese subjects, but not for controls at several matched workrates: Stage III (213 +/- 40 versus 225 +/- 38 kcal per 30 minutes, P < .001); stage 4 (292 +/- 55 versus 340 +/- 58 kcal per 30 minutes, P < .001); and stage 5 (330 +/- 55 versus 412 +/- 70 kcal per 30 minutes, P < .001) obese measured versus obese predicted, respectively. CONCLUSIONS: The authors conclude that the standard prediction equation gives a better estimation of VO2 for women who have average body weight and body fat than for obese women. This may, in part, be due to the differences in weight and/or fat mass between these subjects and those used to derive this equation. These findings should be considered when estimates of VO2 and energy expenditure are used rather than direct measures for obese women.

Adult↗
PubMed2004

Physical activity and human energy expenditure.

PURPOSE OF REVIEW: This is a review on the measurement of physical activity under daily life conditions. The focus is on the doubly labelled water method and accelerometry. Doubly labelled water is a gold standard and the reference for the validation of field methods to assess physical activity. Accelerometry is the most objective and precise technique to assess activity patterns in terms of frequency, duration and intensity. Applications of the two techniques are illustrated with the limits of physical activity and energy expenditure and with activity intensity as a determinant of the physical activity level. RECENT FINDINGS: The upper limit of the physical activity index (total energy expenditure as a multiple of basal metabolic rate) of 2.5, as derived from cross-sectional data, is confirmed by training intervention studies. Exercise training, in which total energy expenditure was measured before and at the end of the training programme, showed no increase in physical activity index when training was combined with an energy restricted diet and in elderly subjects. In children, the distribution of time spent at activities with low and high intensity determines the physical activity index while in adults moderate-intensity activities are the main determinant. SUMMARY: In adults, within the normal physical activity index range, the distribution of time spent at activities with low and moderate intensity determines the physical activity level. High-intensity activity does not have much impact on daily energy expenditure. High-intensity activity is not required to increase the activity energy expenditure.

Adult↗