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PubMed1997

Normal levels of energy expenditure in patients with reported "low metabolism'.

The present study examined the hypothesis that patients with apparent diet-resistant obesity have subnormal energy expenditure. Ten biochemically euthyroid patients (eight women and two men), aged 21-76 years, with either excessive gynoid fat distribution or obesity (BMI 23.8-41.0), were referred to the department thought to be suffering from a low metabolic rate syndrome since dietary records showed very low energy intake (< 5 MJ day-1) in combination with failure to lose weight on low-energy diets. Twenty-four-hour energy expenditure (24-h EE), basal energy expenditure (BEE) and sleeping energy expenditure (SEE) were measured in a respiration chamber on a fixed activity programme. The patients consumed a diet containing 37 energy-per cent (E%) fat, 47 E% carbohydrate and 16 E% protein. The individual energy intake was estimated from a previously established algorithm between 24-h EE and fat-free mass (FFM) estimated by bioimpedance. Results were compared with equivalent values in a reference population of 76 subjects ranging from normal weight to obese. No evidence of low metabolism was found in terms of adjusted 24-h EE in the patients with diet resistance when compared with the control group (9263 +/- 819 kJ vs. 9211 +/- 558 kJ). No differences were found when comparing adjusted BEE and SEE in the two groups (7655 +/- 727 vs. 7411 +/- 770 kJ 24 h-1 and 7048 +/- 672 vs. 6911 +/- 408 kJ 24 h-1). The physical activity index (PAI) during the chamber stay was likewise within normal values (1.32 +/- 0.07 vs. 1.34 +/- 0.04; NS).

Adult↗
PubMed1993

Evaluation of mechanisms behind elevated energy expenditure in cancer patients with solid tumours.

The aim of this study was to demonstrate significant factors behind elevated resting energy expenditure in weight-losing cancer patients. Therefore, weight-losing cancer patients (n = 60), with normal liver and kidney function tests, were randomized to receive one of four drug treatments for 5 days: (a) Propranolol 80 mg x 2 (beta-adrenoceptor blockade); (b) Indomethacin 50 mg x 2 (prostaglandin synthesis inhibition); (c) Morphine 5 mg x 3 (pain relief) or (d) Placebo x 2. A reference group of healthy well-nourished individuals were examined outside the formal randomization protocol and they received Propranolol 80 mg x 2. The cancer patients were randomized by a computer based algorithm stratifying for measured resting energy expenditure (REE), body composition, biochemical tests, previous therapy, tumour type and tumour stage. Resting energy expenditure was measured by indirect calorimetry in the morning after an overnight fast before and after drug treatment. beta-blockade reduced REE significantly in cancer patients from 1416 +/- 95 kcal day-1 to 1160 +/- 63 kcal day-1 (P < 0.02) and from 1472 +/- 69 vs, 1398 +/- 63 kcal day-1 (P < 0.01) in the well-nourished reference individuals. The reduction found in cancer patients (10%) was significantly larger than that in the group of reference patients (5%), (P < 0.01). Indomethacin, morphine or placebo did not induce any significant alteration in energy expenditure in our cancer patients. Propranolol treatment was associated with a significant reduction in plasma concentrations of free fatty acids (FFA), but not in plasma glycerol.(ABSTRACT TRUNCATED AT 250 WORDS)

Basal Metabolism↗
PubMedDate not supplied

Caffeine-herbal ephedra combination increases resting energy expenditure, heart rate and blood pressure.

1. The purpose of the present study was to determine whether the consumption of an acute dose of caffeine and Ma Huang increases resting energy expenditure (REE), heart rate (HR) and blood pressure (BP) over a 3 h period. 2. A randomized, double-blind cross-over study was performed evaluating the acute effects of caffeine (150 mg)/herbal ephedra (Ma Huang; 20 mg ephedra alkaloids) versus a placebo. A total of eight healthy subjects (four males and four females) with a mean (+/-SD) age of 23.4+/-0.8 years (mean ages for males and females: 25.3+/-0.7 and 22.0+/-0.7 years, respectively) and 22.5+/-3.1% body fat (15.7+/-1.2 and 27.6+/-3.5% body fat for males and females, respectively) were recruited to the study. Participants were moderate caffeine users (approximately 150-300 mg/day). 3. Subjects reported to the laboratory following a 12 h fast and 48 h of a caffeine-free diet. Resting energy expenditure was measured prior to supplementation and for 15 min every 30 min for 3 h following supplementation. Heart rate and BP were obtained every 15 min. Blood samples were obtained every 30 min following the measurement of REE and analysed for caffeine, ephedrine, free fatty acids and glucose. 4. By 3 h, HR was 22.7+/-5.5% higher (P<0.05) than baseline for the caffeine/ephedra trial compared with 8.9+/-2.2% higher for the placebo group. At 3 h, systolic BP was 9.1+/-2.2% higher (P<0.05) than baseline for the caffeine/ephedra trial compared with only 1.9+/-2.9% different from baseline for the placebo trial. There was no effect of the caffeine/ephedra combination on diastolic BP. Resting energy expenditure during the last 30 min was 4.5+/-2.5% higher in the placebo trial and 10.7+/-2.5% higher (P<0.05) in the caffeine/ephedra trial; REE was 8.5 +/- 2.0% higher (P<0.05) in the caffeine/ephedra trial compared with the placebo trial. Free fatty acids increased over time in the placebo and caffeine/ephedra trials (from 0.5+/-0.05 to 0.63+/-0.05 mEq/L and from 0.48+/-0.06L to 0.8+/-0.05 mEq/L, respectively). 5. Caffeine and herbal ephedra, at doses of 150 mg and 20 mg (ephedrine), respectively, result in a significant elevation in REE, HR and BP. Although significant, the increase in energy expenditure is negligible in terms of weight loss.

Adult↗
PubMed1993

Energy expenditure in lean and obese diabetic patients using the doubly labelled water method.

Obesity is a common problem among Type 2 diabetic patients. To investigate the role of energy expenditure in the maintenance of obesity in diabetic subjects, total energy output was measured during weight stability in 23 diabetic patients: 8 lean, 5 overweight, and 10 obese. Free living total energy expenditure was measured over 14 days using doubly labelled water method, resting metabolic rate by indirect calorimetry, and urinary energy losses were assessed. Total energy output was higher in the obese (13.66 +/- SD 3.18 MJ 24 h-1) than normal weight patients (10.84 +/- 2.02 MJ 24 h-1; p < 0.05); 11.96 +/- 2.51 MJ 24 h-1 in the overweight. None of the lean but four of the obese had total energy output > 16 MJ 24 h-1. Urinary energy losses accounted for only 0.6% of total energy output in lean, 2.8% in overweight, and 3.1% in obese. Resting metabolic rate was significantly higher in obese (7.47 +/- 1.69 MJ 24 h-1) compared to lean (5.87 +/- 1.07; p < 0.05) and resting metabolic rate correlated with lean body mass (r = 0.8, p < 0.001). Thermogenesis plus physical activity was substantial and not lower in the obese (5.77 versus lean 4.97 MJ 24 h-1). The mean ratio of total energy expenditure to resting metabolic rate was in the moderate exercise category and similar in lean (1.87) and obese (1.80). Resting metabolic rate, total energy expenditure, and thermogenesis and physical activity were similar in all three groups when corrected for differences in lean body mass.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1999

Is there a conflict between minimizing effort and energy expenditure with increasing velocities of muscle contraction in humans?

1. The present study examined the possibility that minimizing effort conflicts with minimizing energy expenditure at different velocities of muscle contraction during cycling. 2. Six normal subjects underwent incremental exercise on an electrically stabilized cycle ergometer. Power output increased by 45 W every 3 min to exhaustion at pedalling frequencies of 40, 60, 80 and 100 r.p.m. on separate days. Energy expenditure (oxygen uptake), leg effort and dyspnoea (Borg 0-10 scale) were measured in parallel at the end of each minute. 3. All six subjects completed 10 min of exercise achieving 180 W for all four pedalling frequencies. Two-way analysis of variance indicated that oxygen uptake (P < 0.0001), leg effort (P < 0.0001) and dyspnoea (P < 0.0001) increased with duration of exercise and power output; oxygen uptake (P < 0.0001) and leg effort (P < 0.05) were significantly different between pedalling frequencies; the interactions were not significant. Oxygen uptake was minimal at 60 r.p.m., and increased at both higher and lower pedalling frequencies. Both leg effort and dyspnoea were minimal at 80 r.p.m.; leg effort intensified at higher and lower pedalling frequencies; and dyspnoea was most intense at 100 r.p.m. 4. There was a conflict between minimization of energy expenditure and leg effort at power outputs less than 180 W. Minimizing effort occurred at the expense of an increase in energy expenditure.

Adult↗
PubMed2002

Effect of steroids on energy expenditure and substrate oxidation in women with Crohn's disease.

OBJECTIVE: Patients with Crohn's disease (CD) have increased energy expenditure and fat oxidation. Steroids, commonly used to treat flare-up of CD, induce weight gain. This study was designed to evaluate the effects of prednisone and budesonide on energy expenditure and substrate oxidation in patients with CD. METHODS: Twenty-nine women with CD and 10 healthy controls were studied. Ten patients received prednisone (0.75-1.0 mg/kg/day), nine received budesonide (9 mg/ day), and 10 did not receive steroids. Resting energy expenditure and substrate oxidation were measured by indirect calorimetry in a fasting state and after a standard diet. RESULTS: In the fasting state, resting energy expenditure was higher in patients without steroids than in the controls. Lipid oxidation was lower (p < 0.01) in patients with prednisone (0.46 +/- 0.39 mg/kg/min) than in patients with budesonide (0.97 +/- 0.28 mg/kg/min) and without steroids (1.06 +/- 0.32 mg/kg/min), but was similar with control subjects (0.47 +/- 0.20 mg/kg/min). Postprandially, lipid oxidation was lower (p < 0.01) in patients with prednisone (0.32 +/- 0.23 mg/kg/min) than in patients with budesonide (0.75 +/- 0.20 mg/kg/min), without steroids (0.82 +/- 0.23 mg/kg/min), and controls (0.58 +/- 0.15 mg/kg/min). Protein oxidation was significantly higher in patients with prednisone than in the other subjects. CONCLUSIONS: In women with CD, prednisone decreases lipid oxidation and increases protein oxidation. These effects are not observed with budesonide and may contribute to the weight gain and side effects commonly observed with prednisone. A low-fat/high-protein diet could be proposed during a course of prednisone.

Adult↗
PubMed1985

Energy expenditure in the fetus and neonate: sources of variability.

The paper discusses fetal and neonatal energy expenditure. The extent of the variation in fetal energy expenditure is unknown, but calculations are presented to show that an average value may be around 18 kcal/kg X d, with the oxidative cost of growth being about 13% of the total. In the neonatal period there is apparently a large variation in total daily energy expenditure, perhaps as great as 70%. This is accounted for partly by methodological difficulties, but also by genetic variation in resting metabolism, and by variation in activity, nutritional state, growth rate and body composition. Data are presented from the literature to give some guidance as to the variability of energy expenditure at different weights and postnatal ages.

Body Composition↗
PubMed1987

States' public welfare expenditures as predictors of state suicide rates.

This exploratory multiple-regression study took its cue from social integration theory to examine the relative importance of state per capita expenditures for public welfare in predicting state suicide rates when controlling for the effects of state divorce rates, state population change rates, and the percentage of persons with annual incomes between $10,000 and $19,999. While the four variables together accounted for .73 of the explained variance in state suicide rates, the effects of state per capita expenditures for public welfare were not very important when those of the other variables were taken into account. This, however, does not mean that state per capita expenditures for public welfare are inconsequential with respect to state suicide rates, inasmuch as they were inversely related to each of the other three independent variables, each of which was positively related to state suicide rates. This means that state per capita expenditures are indirectly related to suicide--in a negative direction. The implications of the findings for policy and suicide prevention are briefly discussed.

Adolescent↗
PubMed1982

Energy expenditure of 'cafeteria'-fed rats determined from measurements of energy balance and indirect calorimetry.

1. Energy expenditure was determined in rats fed a standard laboratory diet or a varied and palatable 'cafeteria' diet, from metabolizable energy intake and body energy gain over a 15 d experiment. This was compared with measurements of oxygen consumption (Vo2) made over 24 h during the first and second weeks of the experiment. 2. Metabolizable energy intake was elevated by 50% in 'cafeteria'-fed rats and these animals gained more weight and had a higher body fat content than stock-fed controls. Energy expenditure derived from these measurements was 45% higher in the 'cafeteria' group, and the net efficiency for energy gain was significantly reduced. 3. Vo2 was increased by 45% in the 'cafeteria' group and the daily energy expenditure, estimated from Vo2, was identical to that derived from the energy balance for controls, and differed by only 3% for the 'cafeteria' group. 4. These results confirm the high levels of diet-induced thermogenesis previously seen in hyperphagic, 'cafeteria'-fed rats and reaffirm the validity of the carcass balance method for estimating energy expenditure.

Animals↗
PubMed2001

Oxygen consumption and resting energy expenditure during phototherapy in full term and preterm newborn infants.

OBJECTIVES: To determine the effect of phototherapy on the oxygen consumption and resting energy expenditure of term and preterm newborn infants. METHODS: A total of 202 infants (gestation 30-42 weeks; body weight 1270-4100 g) requiring phototherapy for the treatment of neonatal hyperbilirubinaemia were enrolled in a randomised crossover study. In random sequence, the oxygen consumption and resting energy expenditure were measured twice in each infant by indirect calorimetry, once at the end of six hours of continuous phototherapy and once after a control period of at least six hours without phototherapy. Anterior abdominal wall temperature was servocontrolled at 36.5 degrees C throughout the study. RESULTS: At the end of six hours of continuous phototherapy, oxygen consumption (mean (SD): 6.21 (1.35) v 6.26 (1.51) ml/kg, p = 0.555) and resting energy expenditure (178.11 (37.62) v 180.37 (43.14) kJ/kg/24 h, p = 0.382) did not differ significantly from those measured after the control period. There were also no significant differences in heart rate, respiratory rate, or rectal temperature. Subgroup analysis of those of gestation < 37 weeks or < 34 weeks also showed no effect of phototherapy on either oxygen consumption or resting energy expenditure. CONCLUSION: Phototherapy has no effect on the metabolic rate of thermally stable term or preterm infants.

Basal Metabolism↗
PubMed1987

Energy expenditure of agricultural workers in an area of endemic schistosomiasis in the Sudan.

Indices of physiological performance in the field under natural working conditions were measured in 46 Sudanese Gezira villagers and related to exercise performance under controlled laboratory conditions. The effect of Schistosoma mansoni infection on energy expenditure in the field was also investigated. A highly significant positive association between the maximal aerobic power output (VO2 max) measured in the laboratory with energy expenditure in the field (r = + 0.51, p less than 0.001) and with changes in body weight during work (r = 0.41, p less than 0.01) was found. The villagers' energy expenditure in field work amounted to 25-28 KJ/min, which corresponded to more than 50% of their predicted VO2 max. They maintained that relative work level for more than an hour. The differences in energy expenditure between moderately infected and non-infected villagers with schistosomiasis did not attain statistical significance but the number of non-infected subjects on which the comparison was based was small.

Adolescent↗
PubMed1997

Question 1 tobacco education expenditures in Massachusetts, USA.

BACKGROUND: In 1992, voters in Massachusetts (United States) approved Question 1, a state ballot initiative, which raised the state excise tax to provide funds for tobacco education. OBJECTIVE: To examine Question 1 expenditures for tobacco-specific programmes in the 1994, 1995, 1996, and 1997 fiscal years. DESIGN: This study examined trends in Question 1 expenditures. Data were collected from the Massachusetts Department of Public Health and the Massachusetts Department of Revenue for the 1994, 1995, 1996, and 1997 fiscal years. MAIN OUTCOME MEASURES: The amount of spending on tobacco-specific programmes. RESULTS: Excluding the 1994 fiscal year because the state allocated 18 months of new revenues, from the 1995 fiscal year to the projected 1997 fiscal year, the state will have spent 22% of Question 1 funds for tobacco-specific programmes. Question 1 expenditures for tobacco-specific programmes have declined by 15%, whereas Question 1 expenditures for the other programmes decreased only 0.4%. CONCLUSIONS: The legislature has established a trend that has produced real reductions in Question 1 funding for tobacco education, which appears contrary to the mandate of the voters when they enacted Question 1 in 1992. These reductions undermine the effectiveness of tobacco-specific programmes that are an integral part of the Massachusetts Tobacco Control Programme. These results also highlight the fact that the initial compromises made after initiatives such as Question 1 are adopted have important long-term consequences for funding of tobacco control initiatives.

Female↗
PubMed1987

Energy expenditure of longitudinal smooth muscle of rabbit urinary bladder.

Heat production, oxygen consumption, and lactate production of longitudinal smooth muscle from rabbit urinary bladder has been measured at 27 degrees C. In isometric contractions (initiated by 1-Hz electrical stimulation) ranging in duration from 2 to 300 s, total energy expenditure correlated linearly with the force-time integral. For any given force-time integral oxygen consumption could account for only approximately 60% of the total energy measured as heat production. A substantial contribution of aerobic lactate production to the total energy flux was observed. This lactate production was also linearly correlated with force-time integral and was of sufficient magnitude to account for the discrepancy between total energy expenditure determined as heat production and oxygen consumption. The suprabasal rate of energy expenditure during the maintenance of force was approximately 2.6 mW/g and remained constant throughout contractions of up to 5-min duration, suggesting that in this muscle there is no change in the energetic cost of force maintenance with increasing duration of contraction. The rate of energy expenditure during the initial period of force development was, however, about twofold greater than that during subsequent force maintenance, indicating that there is an extra energy cost associated with the activation of contraction and development of force above that required for force maintenance.

Animals↗
PubMed1990

Energy expenditure in humans: effects of dietary fat and carbohydrate.

A high-dietary fat intake may be an important environmental factor leading to obesity in some people. The mechanism could be either a decrease in energy expenditure and/or an increase in caloric intake. To determine the relative importance of these mechanisms we measured 24-h energy expenditure in a whole body calorimeter in 14 nondiabetic subjects and in six subjects with non-insulin-dependent diabetes mellitus, eating isocaloric, weight-maintenance, high-fat, and high-carbohydrate diets. All subjects were Pima Indians. In nondiabetics, the mean total 24-h energy expenditure was similar (2,436 +/- 103 vs. 2,359 +/- 82 kcal/day) on high-fat and high-carbohydrate diets, respectively. The means for sleeping and resting metabolic rates, thermic effect of food, and spontaneous physical activity were unchanged. Similar results were obtained in the diabetic subjects. In summary, using a whole body calorimeter, we found no evidence of a decrease in 24-h energy expenditure on a high-fat diet compared with a high-carbohydrate diet.

Adult↗
PubMed1991

Energy expenditure by doubly labeled water: validation in lean and obese subjects.

The doubly labeled water (2H2(18)O) method to assess energy expenditure in free-living conditions has been successfully validated against gas exchange measurements in lean healthy volunteers in both sedentary conditions and during sustained heavy exercise. However, no data are available on obese subjects. We therefore compared the 2H2(18)O method with indirect calorimetry (respiratory chamber) in 12 male subjects covering a wide range of body weight and composition (61-190 kg, 7-41% fat). Isotope pool sizes and elimination rates were calculated from 18O and 2H enrichments in baseline urine samples and in 7-h, 11.5-h, and daily postdose urine samples using the multipoint slope/intercept method. Results were corrected for isotopic fractionation. Mean 7-day energy expenditure in the respiratory chamber varied from 1,851 to 4,105 kcal/day. The doubly labeled water method tended to underestimate energy expenditure (-2.5 +/- 5.8%, not equal to 0, range -14 to +4%), with the larger underestimate observed in heavier and fatter subjects (r = -0.82 and -0.68, P less than 0.02, respectively). The underestimation in heavier subjects might be related to larger sequestration of deuterium during fat synthesis. In conclusion, the doubly labeled water method is a suitable and accurate method to measure energy expenditure in free-living conditions but might provide a slightly underestimated figure in fatter subjects.

Adipose Tissue↗
PubMed1997

Energy expenditure of adult male rhesus monkeys during the first 30 mo of dietary restriction.

Energy expenditure, activity, and body composition were measured in 30 adult male rhesus monkeys used in a study having the long-term goal of determining the effects of moderate dietary restriction (DR) on aging. All animals were fed a defined diet, with the restricted animals maintained at approximately 70% of the caloric intakes of the controls. After 12 mo of DR, body fat mass of restricted monkeys was 33% less than that of controls (P = 0.004), whereas lean body mass differences were not present until after 24 mo. At the 24- and 30-mo assessments, nighttime energy expenditure was significantly reduced (P < 0.01) in the restricted compared with control monkeys after adjustment for lean body mass differences, whereas morning, afternoon, and total energy expenditure were not significantly different (P > 0.05). No significant differences (P > 0.05) in activity were noticed between treatment groups at any time point. DR resulted in a prolonged decrease in resting energy expenditure, which could contribute to the possible life-extending action of this treatment.

Animals↗
PubMed1997

Leptin increases uncoupling protein expression and energy expenditure.

In ob/ob mice, leptin increases energy expenditure and sympathetic outflow to brown adipose tissue (BAT). To test whether the mechanism of increased energy expenditure may involve increased thermogenesis in BAT, we acclimated normal rats to thermoneutrality for 2 wk followed by leptin administration for 1 wk. Some rats were food restricted for 1 wk to the level of food consumption in the leptin-treated ad libitum-fed rats, and the same rats were both food restricted and administered leptin for a second week. We examined oxygen consumption and uncoupling protein (UCP) expression in BAT. Leptin increased oxygen consumption after the 5th and 6th days in ad libitum-fed rats and after the 4th, 5th, and 6th days in food-restricted rats. Leptin increased BAT UCP mRNA levels greater than twofold in both ad libitum-fed and food-restricted rats. These data demonstrate a leptin-induced increase in energy expenditure in nonmutant rodents and suggest that one mechanism by which leptin increases energy expenditure is through increased thermogenesis in BAT, including increased expression of UCP.

Acclimatization↗
PubMed2000

Effects of mental stress on insulin-mediated glucose metabolism and energy expenditure in lean and obese women.

The effects of the sympathetic activation elicited by a mental stress on insulin sensitivity and energy expenditure (VO(2)) were studied in 11 lean and 8 obese women during a hyperinsulinemic-euglycemic clamp. Six lean women were restudied under nonselective beta-adrenergic blockade with propranolol to determine the role of beta-adrenoceptors in the metabolic response to mental stress. In lean women, mental stress increased VO(2) by 20%, whole body glucose utilization ([6,6-(2)H(2)]glucose) by 34%, and cardiac index (thoracic bioimpedance) by 25%, whereas systemic vascular resistance decreased by 24%. In obese women, mental stress increased energy expenditure as in lean subjects, but it neither stimulated glucose uptake nor decreased systemic vascular resistance. In the six lean women who were restudied under propranolol, the rise in VO(2), glucose uptake, and cardiac output and the decrease in systemic vascular resistance during mental stress were all abolished. It is concluded that 1) in lean subjects, mental stress stimulates glucose uptake and energy expenditure and produces vasodilation; activation of beta-adrenoceptors is involved in these responses; and 2) in obese patients, the effects of mental stress on glucose uptake and systemic vascular resistance, but not on energy expenditure, are blunted.

Adrenergic beta-Antagonists↗