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PubMed2004

The Val103Ile polymorphism of melanocortin-4 receptor regulates energy expenditure and weight gain.

OBJECTIVE: The melanocortin-4 receptor (MC4R) regulates energy intake. On the basis of animal studies, it may also regulate energy expenditure. RESEARCH METHODS AND PROCEDURES: The effect of the Val103Ile polymorphism of the MC4R gene on energy metabolism was studied in 229 middle-aged nondiabetic subjects (Group 1, age 51.2 +/- 9.8 years, BMI 26.8 +/- 4.5 kg/m2) and on weight gain in 1013 elderly subjects (Group 2, age 69.9 +/- 2.9 years, BMI 27.4 +/- 4.1 kg/m2) during a 3.5-year follow-up study. In Group 1, insulin sensitivity, energy expenditure, and substrate oxidation were measured with the hyperinsulinemic euglycemic clamp combined with indirect calorimetry. RESULTS: In Group 1, the Val103Ile genotype was associated with high rates of energy expenditure (63.42 +/- 13.40 in eight subjects with the Val103Ile genotype vs. 59.86 +/- 7.33 J/kg per minute in 221 subjects with the Val103Val genotype, p = 0.007), high rates of glucose oxidation (8.90 +/- 6.15 vs. 6.07 +/- 4.38 micromol/kg per minute, p = 0.020), and low levels of free fatty acids (0.45 +/- 0.18 vs. 0.56 +/- 0.23 mM, p = 0.029) in the fasting state, and with high rates of glucose oxidation during the clamp (18.88 +/- 4.63 vs. 17.60 +/- 3.24 micromol/kg per minute, p = 0.031). In Group 2, the 103Ile allele was associated with an increase in weight gain during the follow-up (0.78 +/- 3.98 vs. -0.82 +/- 3.98 kg, p = 0.038). DISCUSSION: The Val103Ile polymorphism of the MC4R gene is associated with energy expenditure in humans. Furthermore, it may associate with glucose oxidation, free fatty acid levels, and weight gain.

Adult↗
PubMed2006

Evaluation of a multisensor armband in estimating energy expenditure in obese individuals.

OBJECTIVE: To examine the reliability and validity of the SenseWear Pro 2 Armband (SWA; Body Media, Pittsburgh, PA) during rest and exercise compared with indirect calorimetry (IC) in obese individuals. RESEARCH METHODS AND PROCEDURES: Energy expenditure was assessed during rest with the SWA and IC in 142 obese adults (37 men and 105 women, BMI = 42.3 +/- 7.0) and in 25 lean and overweight adults (BMI = 25.3 +/- 3.2) who were used as a comparison group. Twenty-nine of the obese adults also participated in three separate short exercise sessions including cycle ergometry, stair stepping, and treadmill walking. RESULTS: The repeatability of SWA estimates in obese subjects was high (r = 0.88, p < 0.001). The SWA generally underestimated the resting energy expenditure (REE) (1811 +/- 346 vs. 1880 +/- 382 kcal/d) and highly overestimated the energy expenditure during the exercise sessions in obese individuals. REE estimations by SWA were significantly correlated with fat-free mass (r = 0.88, p < 0.001). Bland-Altman plots based statistical analysis for the estimated REE, and measured IC showed a low agreement (Total Error > 20% but Systematic Error < 5%) between the two methods in obese subjects, although they showed a high correlation and a very good agreement in lean and overweight patients. DISCUSSION: The SWA is an easy to handle, practical, new portable device for measuring energy expenditure. The accuracy of the SWA appeared to be poor in the obese subjects we examined, especially those with high REE both in rest and exercise. We believe that it is necessary to incorporate new, obesity-specific algorithms in the relative software.

Adult↗
PubMed1993

Meal-induced rise in resting energy expenditure in patients with complete cervical spinal cord lesions.

Central activation of the sympathoadrenal system is generally considered to be an essential component of the mechanisms whereby food ingestion stimulates resting energy expenditure. The functional importance of such sympathoadrenal stimulation has been demonstrated primarily in animals. To the extent that central sympathoadrenal stimulation is required for normal human nutrient-induced thermogenesis, this process should be defective in patients with complete cervical spinal cord lesion and severed connection between the central nervous system and the peripheral sympathetic nerves. Consequently, respiratory gas exchange was measured by indirect calorimetry in 9 tetraplegic patients and in 6 healthy individuals. Measurements were performed before and 2 hours after ingestion of a standardised mixed meal (40% of basal 24 h energy requirements). The basal energy expenditure was 64 +/- 4 watts in the tetraplegic patients and 79 +/- 6 watts in the controls. After the meal, energy expenditure increased on average by 17 +/- 2 watts or 26 +/- 3% of the basal values in the patients and by 14 +/- 2 watts or 19 +/- 3% in the healthy controls (NS). The thermic effect of the meal, ie the rise in energy expenditure expressed in percent of the meal's energy content, was 5.5 +/- 0.7% in the patients and 3.8 +/- 0.6% in the controls (NS). Plasma concentrations of noradrenaline were low in the tetraplegic patients (0.3-0.4 nmol/l) compared to the healthy controls (1.1-1.4 nmol/l), p < 0.02. It is concluded that nutrient-induced thermogenesis in tetraplegic patients with low sympathoadrenal activity is not diminished compared to healthy controls. The findings indicate that efferent sympathoadrenal stimulation from the brain is not a causal necessity for nutrient-induced thermogenesis in man.

Adult↗
PubMed1999

Relationship between overnight energy expenditure and BMR measured in a room-sized calorimeter.

OBJECTIVE: The purpose of this study was to determine if overnight energy expenditure, the lowest energy expenditure sustained for 60 min during the night, measured and predicted basal metabolic rate are equivalent. DESIGN: Overnight energy expenditure (ON-EE), the lowest energy expenditure sustained for 60 min during sleep (LS-EE) and basal metabolic rate (BMR) were measured two to seven times in a room-sized indirect calorimeter in 69 adult subjects. Subjects' gender, age, weight and height were also used to predict BMR (FAO/WHO/UNU, 1985) (BMR-WHO). SETTING: Beltsville Human Nutrition Research Center, Beltsville, MD, USA. RESULTS: The results from calorimetry measurements (mean +/- s.d.) included: ON-EE (6.87 +/- 0.99 MJ/d), LS-EE (6.18 +/- 0.94 MJ/d) and BMR (6.87 +/- 0.99 MJ/d). Predicted BMR mean was: BMR-WHO, 6.95 +/- 1.03. The mean within-subject difference for the calorimetry measurements were: ON-EE, 0.21 MJ/d; LS-EE, 0.16 MJ/d; and BMR, 0.34 MJ/d. Results indicate there was no significant difference between ON-EE, BMR and BMR-WHO. LS-EE was significantly lower (P < 0.0001) than ON-EE, BMR and BMR-WHO. CONCLUSION: These results indicate that while metabolic rate drops significantly below BMR during sleep, overnight metabolic rate and BMR are equivalent.

Adult↗
PubMed2000

Within- and between-subject variation in energy expenditure measured by the doubly-labelled water technique: implications for validating reported dietary energy intake.

OBJECTIVES: To estimate the total (CVt), within-subject (CVw) and between-subject (CVb) variation in free-living energy expenditure as measured by the doubly-labelled water (DLW) technique. To examine the limitation of the DLW measurement of energy expenditure for evaluating reported energy intake. To estimate the probable minimum and maximum 'habitual' energy expenditures for a sustainable lifestyle. DESIGN: Review and analysis of individual data from 25 studies with repeat DLW measurements of energy expenditure (EE). RESULTS: Pooled mean CVw derived from 21 studies was 11.8% for EE and 12.3% for physical activity level (PAL). Multiple regression analysis of CVw in 25 studies found a positive association with time span between measurements. At zero time CVw for EE was 8.2% rising to 9.6% at 13 weeks and 15.4% at 52 weeks. At the same time points CVw for PAL was 9.1%, 10.0% and 13.4% respectively. Pooled mean CVt was 13.0% for EE and 10.7% for PAL. CVb calculated from pooled mean CVt and CVw was 20.6% for EE and 7.2% for PAL. 95% confidence limits of PAL in 11 age-sex groups averaged 1.2 to 2.2. CONCLUSIONS: The analysis supported previous estimates of 8% for within-subject variation in DLW measurements including analytic plus inherent biologic variation. Variation that included changes in weight, season and activity increased with increased time between measurements to about 15% at a time span of 12 months. Confidence limits of agreement between EE and reported energy intake were estimated to range from +/-15% to +/-32%. Estimates of the range of usual EE for normally active persons ranged from 1.3 to 2.2.

Adolescent↗
PubMed2002

Relationship of high energy expenditure and variation in dietary intake with reporting accuracy on 7 day food records and diet histories in a group of healthy adult volunteers.

OBJECTIVES: To assess the accuracy of reporting from both a diet history and food record and identify some of the characteristics of more accurate reporters in a group of healthy adult volunteers for an energy balance study. DESIGN: Prospective measurements in free-living people. SETTING: Wollongong, Australia. SUBJECTS: Fifteen healthy volunteers (seven male, eight female; aged 22-59 y; body mass index (BMI) 19-33 kg/m(2)) from the local community in the city of Wollongong, Australia. INTERVENTIONS: Measurement of energy intake via diet history interview and 7 day food records, total energy expenditure by the doubly labelled water technique over 14 days, physical activity by questionnaire, and body fat by dual-energy X-ray absorptiometry. RESULTS: Increased misreporting of energy intake was associated with increased energy expenditure (r=0.90, P<0.0001, diet history; r(S)=0.79, P=0.0005, food records) but was not associated with age, sex, BMI or body fat. Range in number of recorded dinner foods correlated positively with energy expenditure (r(S)=0.63, P=0.01) and degree of misreporting (r(S)=0.71, P=0.003, diet history; r(S)=0.63, P=0.01, food records). Variation in energy intake at dinner and over the whole day identified by the food records correlated positively with energy expenditure (r=0.58, P=0.02) and misreporting on the diet history (r=0.62, P=0.01). CONCLUSIONS: Subjects who are highly active or who have variable dietary and exercise behaviour may be less accurate in reporting dietary intake. Our findings indicate that it may be necessary to screen for these characteristics in studies where accuracy of reporting at an individual level is critical.

Adult↗
PubMed2003

Body composition and energy expenditure in Duchenne muscular dystrophy.

OBJECTIVE: To investigate the relationship between resting energy expenditure (REE) and body composition in Duchenne Muscular Dystrophy (DMD). DESIGN: An observational study. SETTING: University Research Centre. SUBJECTS: Nine Duchenne children (age range 6-12 y), mean relative weight 128%, agreed to undergo the investigation and all of them completed the study; INTERVENTIONS: Assessment of body composition (total body fat and skeletal muscle mass) by magnetic resonance imaging and resting energy expenditure by indirect calorimetry. MAIN OUTCOME MEASURES: Fat mass (FM; kg and percentage weight), fat-free mass (FFM; kg and percentage weight), muscle mass (kg and percentage weight), resting energy expenditure (kJ/kg body weight and kJ/kg fat-free mass). RESULTS: : In Duchenne children fat mass averages 32% and total skeletal muscle mass 20% of body weight. Resting energy expenditure per kg of body weight falls within the normal range for children of the same age range, while when expressed per kg of FFM is significantly higher than reference values. No relationship was found between REE and total skeletal muscle mass. CONCLUSIONS: Our results do not demonstrate a low REE in DMD boys; on the contrary REE per kg of FFM is higher than normal, probably due to the altered FFM composition. We suggest that the development of obesity in DMD children is not primarily due to a low REE but to other causes such as a reduction in physical activity and or overfeeding.

Body Composition↗
PubMed1997

Physical activity related energy expenditure and fat mass in young children.

OBJECTIVE: To examine whether body fat content in pre-pubertal children is influenced by physical activity related energy expenditure (AEE) and/or more qualitative aspects of physical activity. DESIGN: Cross-sectional study. SUBJECT: 101 pre-pubertal children were examined in Study 1: (age: 5.3 +/- 0.9 y; weight: 20.2 +/- 3.6 kg). In Study 2: 68 of the original children were re-examined (age: 6.3 +/- 0.9 y; weight: 23.6 +/- 5.0 y). MEASUREMENT: Fat mass (FM) and fat free mass (FFM) were determined by bioelectrical resistance and skinfolds; AEE was estimated from the difference between total energy expenditure (TEE) by doubly labeled water and post-prandial resting energy expenditure (REE) by indirect calorimetry; qualitative information on activity was derived by questionnaire. RESULTS: AEE was significantly correlated with FFM (r = 0.32 in both Studies) and body weight (r = 0.28 in Study 1; r = 0.29 in Study 2), but not FM. There were no significant relationships between AEE and any of the variables from the activity questionnaire in children (including TV time, playing time, and an accumulated activity index in h/week). After adjusting for FFM, age, and gender, FM was inversely related to activity time in h/week (partial r = -0.24 in Study 1; partial r = -0.32 in Study 2) but not AEE (P > 0.5). CONCLUSION: After adjusting for FFM, age, and gender, a small portion of the variance in body fat mass in children (approximately 10%) is explained by time devoted to recreational activity, whereas none of the variance is explained by the combined daily energy expenditure related to physical activity.

Adipose Tissue↗
PubMed1997

Serum leptin in relation to resting energy expenditure and fuel metabolism in obese subjects.

OBJECTIVE: Leptin is the product of ob gene shown to regulate body fat in mice. It is produced by human adipose tissue as well, but its physiological functions in man are not known. We explored if there is a relationship in obese humans with serum leptin and energy and fuel metabolism. DESIGN: Cross-sectional study including 45 obese (10 men, 35 women; age and body mass index: 42 +/- 7 y and 35.1 +/- 3.6 kg/m2, respectively). MEASUREMENTS: Food intake by a four-day-food record, blood samples for serum leptin concentrations and resting energy expenditure by indirect calorimetry. RESULTS: Leptin concentrations showed an inverse association (adjusted for fat mass, age and sex) with resting energy expenditure, respiratory quotient and carbohydrate oxidation rate (r = -0.324, P < 0.05; r = -0.420, P < 0.01; r = 0.478, P = < 0.01, respectively), and interestingly, also with dietary fat intake (unadjusted r = -0.30, P < 0.05). Especially, leptin concentrations were elevated in those with low resting energy expenditure and respiratory quotient (below the median). CONCLUSION: Serum leptin concentrations in obese subjects showed an inverse association with resting energy expenditure, respiratory quotient and carbohydrate oxidation rate. The physiological significance of these associations is unclear at the moment but could indicate that obese subjects show resistance to the actions of leptin also outside the brain in terms of regulating metabolic rate and fuel metabolism.

Adult↗
PubMed1997

Replacement of dietary fat by sucrose or starch: effects on 14 d ad libitum energy intake, energy expenditure and body weight in formerly obese and never-obese subjects.

OBJECTIVE: To investigate the impact of a high-sucrose diet vs a high-starch and a high-fat diet on 14 d ad libitum energy intake, body weight, energy expenditure and sympathoadrenal activity. MEASUREMENTS: Food intake; body weight and composition (bioelectrical impedance); 24 h energy expenditure, substrate oxidation rates, spontaneous physical activity, heart rate and appetite sensations in a respiration chamber (VAS scores); plasma catecholamine concentration and blood pressure. SUBJECTS: Twenty normal-weight, healthy women, 9 post-obese (body mass index (BMI): 22.9 +/- 0.7 kg/m2) and 11 closely matched controls (BMI: 22.6 +/- 0.4 kg/m2). RESULTS: Average 14 d ad libitum energy intake was 13% and 12% lower on the starch diet compared with the sucrose and fat diets, respectively (P < 0.05). In both post-obese and normal-weight subjects, body weight and fat mass decreased significantly on the starch diet (by 0.7 +/- 0.2 kg and 0.4 +/- 0.1 kg, respectively, P < 0.05). No changes were observed on the fat or sucrose diets. After 14 d on the sucrose diet, 24 h energy expenditure as well as postprandial plasma adrenaline and noradrenaline concentrations, were significantly increased compared with the other two diets. Overall satisfy and palatability ratings were also highest on the sucrose diet. CONCLUSION: Intake of a 14-d ad libitum high-starch diet decreased energy intake and body weight compared with a high-fat or high-sucrose diet. The increased energy expenditure observed on the sucrose-rich diet can probably be explained both by the increased intake of energy and fructose (mainly from sucrose) on this diet.

Adult↗
PubMed1999

The effect of sibutramine on resting energy expenditure and adrenaline-induced thermogenesis in obese females.

BACKGROUND: Sibutramine, an inhibitor of serotonin and noradrenaline uptake, reduces appetite to cause weight loss. This study tested the hypothesis that an increase in energy expenditure also contributes to this weight loss. In addition, the effects of sibutramine on adrenaline induced changes in heart rate and cardiac output were determined METHODS: Nineteen obese females randomly received either sibutramine 15 mg daily or placebo for 12 weeks along with dietary advice. Resting energy expenditure (REE) was measured and then energy expenditure was measured during a 30 min infusion of adrenaline (25 ng/min/kg IBW). Cardiac output and heart rate, measured by Duplex Colour Doppler ultrasonography, were similarly measured in the basal state and post adrenaline. All measurements were recorded at baseline and then after 12 weeks. RESULTS: Ten patients who received sibutramine reduced their weight by 8.1+/-3.8% while 9 placebo treated subjects reduced their weight by 5.1+/-4.4%, P=0.13. In absolute terms, REE decreased in placebo subjects from 1500+/-201 kcal/24 h to 1357+/-231 kcal/24 h (9.4+/-9.9%) and in sibutramine subjects from 1540+/-184 kcal/24 h to 1444+/-128 kcal/24 h (5.3+/-12.0%), P=0.77. The increased weight loss in the sibutramine group was associated with an increase in the FFM adjusted REE (2.2+/-16.1%) unlike the expected decrease (5.8+/-9.5%) in the placebo group (P=0.11). There was some suggestion (P=0.09) that the usual positive correlation between loss of weight and decline in REE was lost in the sibutramine group (r=-0.30) compared with placebo (r=0.35). There was a negative correlation between loss of FFM and decline in REE/kg FFM and (P=0.029) which was not evident in placebo (P=0.83). Adrenaline induced energy expenditure was similar in the two groups at the end of the 12 week period and there were no significant cardiovascular changes between the two groups. CONCLUSIONS: Sibutramine limits the decline in REE associated with weight loss, equivalent to about 100 kcal/d. This could allow greater numbers of people to maintain a greater degree of weight loss.

Adult↗
PubMed1999

Do hormonal indices of maturation explain energy expenditure differences in African American and Caucasian prepubertal children?

OBJECTIVE: To examine the relationships between hormonal indices of maturation and total, resting and physical activity-related energy expenditure (TEE, REE and AEE) in African American and Caucasian prepubertal children. DESIGN: Cross-sectional study. SUBJECTS: Sixty-four African American and 48 Caucasian prepubertal children. MEASUREMENTS: TEE (by doubly labeled water), REE (by indirect calorimetry), fat mass and fat-free mass (by dual-energy X-ray absorptiometry), fasting serum dehydroepiandrosterone-sulfate (DHEAS), androstenedione, and estrone-sulfate (by radioimmunoassay). RESULTS: Serum concentrations of hormones correlated significantly with REE and TEE (r values range from 0.33 to 0.76, P<0.001). Only androstenedione correlated significantly with AEE (r = 0.23, P<0.05). However, these correlations were no longer significant after adjusting energy expenditure components for fat-free mass. In multiple regression models, ethnicity was not a significant determinant of any energy expenditure component after adjusting for body composition and hormone concentrations. CONCLUSION: Hormonal indices of maturation do not influence energy expenditure in this group of African American and Caucasian prepubertal children.

Analysis of Variance↗
PubMed2000

Daily energy expenditure in Mexican and USA Pima indians: low physical activity as a possible cause of obesity.

BACKGROUND: Obesity is caused by an imbalance between energy intake and energy expenditure. However, it is unknown whether increased physical activity protects susceptible populations against the development of obesity and type 2 diabetes. OBJECTIVE: To investigate the potential protective role of environment and physical activity against obesity by measuring total energy expenditure in Mexican and USA Pima Indians. METHODS: We compared the physical activity level of 40 (17 female and 23 male; 37+/-11 y, 66+/-13 kg) Mexican Pima Indians from a remote, mountainous area of Northwest Mexico, with 40 age-and-sex matched (17 female and 23 male; 37+/-12 y, 93+/-22 kg) Pima Indians from the Gila River Indian Community in Arizona, USA. We measured total energy expenditure (TEE) by doubly labeled water and calculated physical activity by different methods: physical activity level (PAL) as the ratio of TEE on resting metabolic rate (RMR), TEE adjusted for RMR by linear regression, activity energy expenditure adjusted for body weight (AEE), and activity questionnaire. RESULTS: Physical activity was higher in Mexican Pima Indians when compared with USA Pima Indians as assessed by PAL (1.97+/-0.34 vs 1.57+/-0.16, P<0.0001), TEE adjusted for RMR (3289+/-454 vs 2671+/-454 kcal/day, P<0.0001) and AEE adjusted for body weight (1243+/-415 vs 711+/-415 kcal/day, P<0. 0001). Questionnaires revealed more time spent on occupational activities among Mexican Pima compared with USA Pima (23.9+/-13.3 vs 12.6+/-13.9 h/week, P<0.001). CONCLUSION: These data support a significant role for physical activity in the prevention of obesity in genetically susceptible populations. International Journal of Obesity (2000)24, 55-59

Adult↗
PubMed2000

Activity related energy expenditure in children and adolescents with Prader-Willi syndrome.

OBJECTIVE: To measure activity related energy expenditure in Prader-Willi syndrome (PWS) corrected for body size. SUBJECTS: 17 PWS subjects (10 females, seven males, age 7.5-19.8 y) and 17 obese controls, matched for gender and bone age. MEAUREMENTS: Basal metabolic rate (BMR) was measured by ventilated hood and average daily metabolic rate (ADMR) was measured with doubly labelled water. Activity induced energy expenditure (AEE) was calculated as 0.9ADMR -BMR. Activity related energy expenditure was corrected for body size using the following measures: AEE per kg body weight (AEE/kg), ADMR/BMR (PAL), and the residual of the regression of ADMR on BMR (rADMR). Group differences were analyzed by analysis of covariance adjusting for bone age, fat mass (FM) and gender. RESULTS: ADMR, AEE and PAL were lower (P < 0.01) in the PWS group compared with the control group (7.14 +/- 1.72, 1.07 +/- 0.69 and 1.33 +/- 0.15 MJ/day compared with 9.94 +/- 2.64, 2.56 +/- 1.03 and 1.55 +/- 0.12 MJ/day respectively). The variance of AEE/kg and PAL was significantly explained by gender and PWS, while AEE was additionally explained by FM. The variance of rADMR was explained by PWS and not by FM or gender. CONCLUSION: Activity related energy expenditure is decreased in PWS compared with controls adjusted for bone age, FM and gender.

Adolescent↗
PubMed2001

Effects of beacon administration on energy expenditure and substrate utilisation in Psammomys obesus (Israeli sand rats).

OBJECTIVE: To investigate whether beacon administration affects substrate utilisation, physical activity levels or energy expenditure in Psammomys obesus. DESIGN: Pairs of age- and sex-matched Psammomys obesus were randomly assigned to either beacon-treated (15 microg/day for 7 days (i.c.v.)) or control (i.c.v. saline) groups. MEASUREMENTS: Indirect calorimetry on day 0 and day 7 to measure oxygen consumption and carbon dioxide production, which were used to calculate fat oxidation, carbohydrate oxidation and total energy expenditure. Physical activity in the calorimeter was measured using an infrared beam system. Food intake and body weight were measured daily. RESULTS: The administration of beacon significantly increased body weight compared to saline-treated control animals. This body weight gain was primarily due to increased body fat content. Average daily food intake tended to be higher in beacon-treated Psammomys obesus, but no effect of beacon administration on substrate oxidation, activity or energy expenditure was detected. CONCLUSION: The effects of beacon on body weight are due to increased food intake, with no detectable effect on nutrient partitioning, physical activity or energy expenditure.

Adipose Tissue↗
PubMed2003

Body weight gain in free-living Pima Indians: effect of energy intake vs expenditure.

BACKGROUND: Obesity results from a chronic imbalance between energy intake and energy expenditure. However, experimental evidence of the relative contribution of interindividual differences in energy intake and expenditure (resting or due to physical activity) to weight gain is limited. OBJECTIVE: To assess prospectively the association between baseline measurements of daily energy metabolism and weight changes by studying free-living adult Pima Indians, one of the most obese populations in the world. DESIGN: A study of the pathogenesis of obesity in the Pima Indians living in Southwestern Arizona. The participants were 92 nondiabetic Pima Indians (64M/28F, 35+/-12 y, 35+/-9% body fat; mean+/-s.d.). At baseline, free-living daily energy metabolism was assessed by doubly labeled water and resting metabolic rate (RMR) by indirect calorimetry. Data on changes in body weight (5.8+/-6.5 kg) over a follow-up period of 4+/-3 y were available in 74 (49M/25F) of the 92 subjects. RESULTS: The baseline calculated total energy intake (r=0.25, P=0.028) and RMR (r=-0.28, P=0.016) were significantly associated with changes in body weight. The baseline energy expenditure due to physical activity was not associated with changes in body weight. CONCLUSION: Using state-of-the-art methods to assess energy intake and expenditure in free-living conditions, we show for the first time that the baseline calculated total energy intake is a determinant of changes in body weight in Pima Indians. These data also confirm that a low RMR is a risk factor for weight gain in this population.

Adult↗
PubMed2000

Paraplegic adaptation to assisted-walking: energy expenditure during wheelchair versus orthosis use.

STUDY DESIGN: To study the energy cost of locomotion during ambulation with different orthoses (HIP Guidance Orthosis Orlau Parawalker (PW), n=4; Reciprocating Gait Orthosis (RGO), n=6; RGO + FNS, n=4). OBJECTIVES: Since high energy costs of locomotion have been proposed as a major reason for early rejection of orthotic use, our aims were (a) to evaluate the impact of functional neuromuscular stimulation (FNS) on energy expenditure during orthosis-assisted ambulation; (b) to study whether energy expenditure data can predict the poor long-term patients' compliance and (c) to assess selection criteria for the assignment of the different types of orthosis. SETTING: The study was completed at the Center of Sports Medicine and Center of Bioengineering, don C. Gnocchi Foundation, IRCCS, Milan, Italy. METHODS: The HR/VO2 relationship and the energy cost of locomotion (C) were studied in 14 patients (lesion level C7-T11) during wheelchair (WHCH) use at various speeds and during locomotion with different orthotic devices. Patients' short- and long-term compliance were assessed by questionnaires evaluating duration of and problems related to orthotic use. RESULTS: (a) In patients using RGO + FNS the slope difference of HR/VO2 curves (deltaslHR/VO2) between WHCH and orthosis was significantly lower than in other groups (-3 beats l(-1) in RGO + FNS vs 43 and 52 beats l(-1) in RGO and PW, respectively); (b) neither C, nor VO2 peak, or deltaslHR/VO2 correlated with orthosis duration of use; (c) in the RGO + FNS group, C was lower at maximal walking speed, which linearly correlated with maximal WHCH speed. CONCLUSION: (a) Electrical stimulation seems to improve locomotion, as a consequence of hemodynamic effects, but does not decrease energy expenditure, which remains high; (b) the poor long-term compliance to orthosis use cannot be predicted by the energy expenditure parameters; (c) the subjects who can reach high speeds by WHCH seem to be the most appropriate for RGO + FNS locomotion.

Adaptation, Physiological↗
PubMed1987

Energy expenditure in non-insulin dependent diabetic subjects on metformin or sulphonylurea therapy.

In the management of the non-insulin dependent diabetic patient, metformin often facilitates weight loss whereas sulphonylurea may predispose to weight gain. To investigate whether this is due to alterations in energy expenditure we have studied energy expenditure in seven non-insulin dependent diabetic subjects while on metformin or sulphonylurea therapy. Three components of energy expenditure were measured by indirect calorimetry, namely resting metabolic rate and the thermic responses to infused noradrenaline and to a mixed constituent meal. There was no significant difference in the resting metabolic rate on metformin (5.29 +/- 0.41 kJ/min; mean +/- SE) compared with sulphonylurea (5.34 +/- 0.34 kJ/min). The resting metabolic rate was also similar to predicted values for non-diabetic subjects (r = 0.96). The thermic response to infused noradrenaline was similar on metformin (23.14 +/- 1.87 kJ) and sulphonylurea (21.40 +/- 2.98 kJ). There was no significant difference in the thermic response to the meal on sulphonylurea (75.8 +/- 7.5 kJ) or on metformin (86.8 +/- 10.8 kJ; 95% confidence limits -17 to +39 kJ). We conclude that in non-insulin dependent diabetic subjects metformin does not enhance energy expenditure overall, compared with sulphonylurea.

Adult↗