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PubMed1990

Energy expenditure and subsequent nutrient intakes in overfed young men.

We investigated the mechanisms of body weight regulation in young men of normal body weight leading unrestricted lives. Changes in total and resting energy expenditure, body composition, and subsequent voluntary nutrient intakes in response to overeating by 4,230 +/- 115 (SE) kJ/day (1,011 +/- 27 kcal/day) for 21 days were measured in seven subjects consuming a typical diet. On average, 85-90% of the excess energy intake was deposited (with 87% of this amount in fat and 13% in protein on average). There was no detectable difference between individuals in susceptibility to energy deposition. The resting metabolic rate, averaged for fasting and fed states, increased during overfeeding (mean +/- SE, 628 +/- 197 kJ/day, P less than 0.01), but at least some of this amount was obligatory expenditure associated with nutrient assimilation. No significant increase in energy expenditure for physical activity or thermoregulation resulted from overfeeding. Thus energy expenditure did not substantially adapt to increased energy intake. However, significant decreases in voluntary energy intake (1,991 +/- 824 kJ/day, P less than 0.05) and fat intake (48 +/- 11 g/day, P less than 0.01) followed overeating, indicating that adaptive changes in nutrient intakes can contribute significantly to body weight regulation after overeating.

Adult↗
PubMed1996

A comparative study of different means of assessing long-term energy expenditure in humans.

We compared three independent techniques for measurement of total energy expenditure (TEE) in human subjects: 1) weight-maintaining energy intake (dietTEE), 2) 24-h chamber calorimetry (chamberTEE), and 3) differential elimination rates 2H2O and H(2)18O (isotopeTEE). Twenty-three healthy adult in-patients [19 never obese (NO), 2 obese (OB), and 2 formerly-obese (RO); 9 female, 14 malel] ingested a liquid formula diet (40% of calories as fat, 45% carbohydrate, 15% protein), the volume of which was adjusted until body weight was stable for at least 14 days. Body composition was then determined by hydrodensitometry, isotope dilution, and dual photon beam absorptiometry (DXA). The thermic effect of feeding (TEF) and resting energy expenditure [REE; measured before arising (dietREE) and after arising (chamberREE)] were determined by indirect calorimetry. Non-resting energy expenditure (NREE) was calculated as NREE = TEE - (REE + TEF). Subjects then gained or lost 10% of their body weight and were restudied as described above. All measures of TEE were significantly correlated (dietTEE vs. chamberTEE r2 = 0.75; dietTEE vs. isotopeTEE r2 = 0.88; isotopeTEE vs. chamberTEE r2 = 0.73; P < 0.0001). ChamberTEE (mean +/- SE = 2,107 +/- 64 kcal/day) was approximately 20% lower than either dietTEE (2,536 +/- 94 kcal/day, P < 0.0001) or isotopeTEE (2,564 +/- 83 kcal/day, P < 0.0001). When data were normalized to metabolic mass, weight gain of 10% was associated with significant increases in dietTEE (P < 0.005) and isotopeTEE (P < 0.05) but not chamberTEE; weight loss of 10% was associated with significant reductions in dietTEE (P < 0.005) and isotopeTEE (P < 0.05) but not chamberTEE. We conclude that measures of energy expenditure obtained in a highly controlled environment by caloric titration (dietTEE) or differential excretion rates of 2H2O and H(2)18O (isotopeTEE) are not significantly different and that measurements of TEE obtained in a respiratory chamber (chamberTEE) are significantly lower than dietTEE or isotopeTEE, probably largely due to limitations on physical activity in the chamber.

Adult↗
PubMed1999

Activation of the NPY Y5 receptor regulates both feeding and energy expenditure.

Intracerebroventricular (ICV) administration of neuropeptide Y (NPY) has been shown to decrease energy expenditure, induce hypothermia, and stimulate food intake. Recent evidence has suggested that the Y5 receptor may be a significant mediator of NPY-stimulated feeding. The present study attempts to further characterize the role of NPY Y5-receptor subtypes in feeding and energy expenditure regulation. Satiated Long-Evans rats with temperature transponders implanted in the interscapular brown adipose tissue (BAT) displayed a dose-dependent decrease in BAT temperature and an increase in food intake after ICV infusion of NPY. Similar effects were induced by ICV administration of peptide analogs of NPY that activate the Y5 receptor, but not by analogs that activate Y1, Y2, or Y4 receptors. Furthermore, ICV infusion of the Y5 selective agonist D-[Trp(32)]-NPY significantly reduced oxygen consumption and energy expenditure of rats as measured by indirect calorimetry. These data suggest that the NPY Y5-receptor subtype not only mediates the feeding response of NPY but also contributes to brown fat temperature and energy expenditure regulation.

Adipose Tissue, Brown↗
PubMed1980

Oxygen uptake and energy expenditure during horizontal treadmill running.

The purpose of this investigation was to compare linear and curvilinear regression equations relating oxygen uptake and energy expenditure to running velocity and to examine the effects of age, sex, and maximal aerobic power on these relations in well-conditioned male and female runners. One-variable linear equations that use running velocity as the independent variable for predicting oxygen uptake and energy expenditure ahd coefficients of determination (r2) of 0.86 and 0.897, respectively. Two-variable linear equations that use body mass and velocity as independent variables had r2 values of 0.895 and 0.901 for the same relation. Age sex, and maximal aerobic power did not influence the relations between oxygen uptake, energy expenditure, and running velocity. Stepwise regression indicated that the two-variable linear equations had the highest r2 values suggesting that between the running velocities of 8.8 and 16.9 km.h-1 these equations best express the relation of oxygen uptake and energy expenditure to running velocity.

Adult↗
PubMed1988

Increased resting energy expenditure in cystic fibrosis.

To explore the hypothesis that there is an increased metabolic rate in cystic fibrosis, resting energy expenditure was measured by indirect calorimetry in 23 subjects with cystic fibrosis in a stable clinical state and in 42 normal control subjects. Resting energy expenditure was found to be elevated by an average of 0.45 MJ/24 h [95% confidence interval (CI) = 0.26-0.64, t = 4.91, P less than 0.001] (108 kcal/24 h), or 9.2% above expected values derived from the regression relating resting energy expenditure to whole body weight and sex in control subjects. When related to lean body mass, values were still elevated by 0.36 MJ/24 h (95% CI = 0.18-0.53, t = 4.15, P less than 0.001) (86 kcal/24 h), or 7.2%. The increased values were found to be independent of age, sex, or body size. There were significant correlations between increased values and poor pulmonary function as measured by the ratio of the forced expiratory volume in 1 s to forced vital capacity (r = -0.44, P less than 0.05) and subclinical infection as indicated by the blood leukocyte count (r = 0.40, P less than 0.05). However, the correlations were low, suggesting that other factors may contribute to the increased resting energy expenditure, possibly including the putative metabolic defect in cystic fibrosis.

Adolescent↗
PubMed1989

Sensitivity of methods for calculating energy expenditure by use of doubly labeled water.

Attempts to estimate human energy expenditure by use of doubly labeled water have produced three methods currently used for calculating carbon dioxide production from isotope disappearance data: 1) the two-point method, 2) the regression method, and 3) the integration method. An ideal data set was used to determine the error produced in the calculated energy expenditure for each method when specific variables were perturbed. The analysis indicates that some of the calculation methods are more susceptible to perturbations in certain variables than others. Results from an experiment on one adult human subject are used to illustrate the potential for error in actual data. Samples of second void urine, 24-h urine, and breath collected every other day for 21 days are used to calculate the average daily energy expenditure by three calculation methods. The difference between calculated energy expenditure and metabolizable energy on a weight-maintenance diet is used to estimate the error associated with the doubly labeled water method.

Adult↗
PubMed1989

Field use of D2 18O to measure energy expenditure of soldiers at different energy intakes.

To test the application of doubly labeled water under adverse field conditions, energy expenditures of 16 special operations soldiers were measured during a 28-day field training exercise. Subjects were matched by fat-free mass and divided equally between an ad libitum ready-to-eat meal diet and a 2,000 kcal/day lightweight ration. Subjects recorded intakes daily, and body composition was measured before and after the exercise. At the beginning of the study, subjects moved to a new northerly location and, therefore, a new water supply. To compensate for this, a group of soldiers who did not receive heavy water was followed to measure isotopic base-line changes. Energy expenditure by doubly labeled water was in agreement with intake/balance (3,400 +/- 260 vs. 3,230 +/- 520 kcal/day). The overall coefficient of variation of energy expenditure by doubly labeled water was half that of intake/balance (7.6 vs. 16.1%). The coefficient of variation of repeat measures with doubly labeled water was 7.3%. Energy expenditure of the ready-to-eat meal group, 3,540 +/- 180 kcal/day, was not significantly different from the lightweight ration group, 3,330 +/- 301 kcal/day. Doubly labeled water was valid under field conditions.

Adult↗
PubMed1996

Energy expenditure in rhesus monkeys (Macaca mulatta) during spaceflight using doubly labeled water (2H2(18)O).

The mean daily energy expenditure rates of three rhesus monkeys (Macaca mulatta) were determined during spaceflight on the joint US-Russian Cosmos 2044 and 2229 missions by the doubly labeled water (2H2(18)O) method. In-flight values were compared with ground data obtained from seven measurements taken from six chair-adapted control monkeys. The mean energy expenditure for the ground control determinations was 94.5 +/- 6.4 kcal.kg-1.day-1 (n = 6). The mean in-flight energy expenditure, 55.1 +/- 8.0 kcal.kg-1.day-1 (n = 3), was significantly less than the mean ground control value (P < 0.05). These data suggest that energy expenditure in restrained rhesus monkeys is significantly reduced during spaceflight.

Animals↗
PubMed1990

Comparison of a face-mask and a mouthpiece for measuring resting energy expenditure with the 'Oxylog'.

Resting energy expenditure measurements were made simultaneously with an Oxylog and a ventilated hood indirect calorimeter, using (a) the Oxylog with the original oronasal face-mask and (b) the Oxylog with a mouthpiece and a noseclip, both in 15 subjects. The mean difference between Oxylog energy expenditure, when used with the mouthpiece, and ventilated hood measurements was very small: -0.4% (p less than 0.4; n = 15). When used with the face-mask, the Oxylog tended to underestimate energy expenditure relative to the ventilated hood, the mean difference being -2.4% (p = 0.054; n = 13). In 2 subjects, the Oxylog face-mask showed obvious leaks. The subjects did not find the mouthpiece less comfortable than the face-mask, and there was no evidence that the mouthpiece disturbed respiration more than the face-mask. The Oxylog is therefore suitable for measurements of resting energy expenditure, but the use of a mouthpiece and noseclip is preferable to the use of the original Oxylog face-mask.

Adult↗
PubMed1990

Metabolic adaptation to decreases in energy intake due to changes in the energy cost of low energy expenditure regimen.

(1) The energy content in food is used in the human body for three main purposes. The first is to maintain the dissipative structures. Most of the structures of the body are of this kind, i.e. they represent stationary non-equilibrium states, or (generalized) stationary potentials, and are inherently unstable. The second is to maintain a body temperature independent of and usually higher than that of the surroundings. The third is to provide energy for performance of external work. The functional structure of the system providing these results consists of a large number of coupled processes (chemical reactions and translocations), in series and in parallel, whose general nature is well understood but whose quantitative extents are mainly unknown. The coupled processes are driven by the spontaneous reaction of the main substrates with oxygen. Energy flows through the system and is converted to heat (and external work) with simultaneous creation of stationary generalized potentials. For each potential there is an associated flow of energy and the relation between the two is an expression of the efficiency with which the potential is maintained. The processes giving rise to the potentials are likely to be controlled with respect to the efficiency with which the potentials are maintained. The control is partly provided through feedback from the potentials themselves: the potentials are regulated. In this way, the system can respond in a non-linear fashion to perturbations in the energy intake (or energy expenditure): the potentials are maintained at constant, or nearly constant, values. The concept of metabolic adaptation implies that control of the efficiency by feedback from the potentials is an important element in the overall regulation of the potentials, including that of the body temperature. (2) The concept of metabolic adaptation can be framed in such a way that it becomes operational. Quantities such as maintained potentials and efficiency can be revealed in terms of their external manifestations: performance of tasks and associated costs (energy expenditure). A change in efficiency is defined as a change in cost for given tasks. Performances can be defined such that they are both reproducible and of physiological relevance and costs can be measured. There are several complications associated with this approach to operational definition, the most important being the effect on energy expenditure of changes (or differences) in body composition. (3) The FAO approach to estimation of prevalence of undernutrition is based on measurements of energy expenditure for given tasks. This approach requires knowledge of the extent of metabolic adaptation.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Physiological↗
PubMed2004

Association between blood pressure and resting energy expenditure independent of body size.

Obesity is an important risk factor for hypertension; however, the pathway through which it raises blood pressure (BP) is poorly understood. Body size is also the primary determinant of energy expenditure, and we therefore examined the joint relationship of energy expenditure and body size to blood pressure. Resting energy expenditure (REE) was measured using respiratory gas exchange in population-based samples of 997 Nigerians and 452 African Americans. In a third sample of 118 individuals, nonresting energy expenditure (ie, physical activity) was measured in addition to REE. The univariate correlation between REE and BP ranged from 0.10 to 0.22 in the 3 samples (P<0.001). In multivariate models, adiposity, whether defined by body mass, fat mass, or leptin, was no longer associated with BP, while REE remained highly significant (P<0.001). The REE-BP association also persisted after adjustment for physical activity measured with doubly labeled water. The odds ratio for hypertension among persons in the highest quartile versus the lowest quartile of REE, after adjustment for body size, was 1.7. This relationship was not the result of hypertension among the obese, because it did not vary across the range of BMI and was the same in lean Nigerians as in obese Americans. These data suggest that metabolic processes represented by REE may mediate the effect of body size on BP. The interrelationship of REE with sympathetic tone, transmembrane ion exchange, or other metabolic processes that determine energy costs at rest could provide physiological explanations for this observation.

Adult↗
PubMed1996

The daily energy expenditure in stable chronic obstructive pulmonary disease.

Resting energy expenditure is frequently increased in chronic obstructive pulmonary disease (COPD), but it is unknown if this hypermetabolism holds true over 24 h. The aim of this study was to measure the actual 24-h energy expenditure (24-h EE) in patients with stable COPD. Energy expenditure was measured by indirect calorimetry, using a metabolic chamber for 24-h EE and a canopy for basal metabolic rate (BMR). Physical activity was detected in the chamber by a radar system, and its duration was quantified. Two groups matched for age and height were studied: 16 male ambulatory patients with stable COPD and 12 male normal subjects. Body weight was 92 +/- 12% of ideal body weight in the group with COPD and 108 +/- 11% in the control group (p = 0.01). BMR was 120 +/- 7% of predicted in the group with COPD and 108 +/- 12% in the control group (p < 0.01). However, 24-h EE was similar in the two groups, amounting to 1,935 +/- 259 kcal in patients with COPD and 2,046 +/- 253 kcal in the control group (NS). This corresponded to 145% and 137% of predicted BMR, and to 121% and 126% of measured BMR in patients with COPD and the control group, respectively (NS). Patients were allowed to pursue their usual treatment within the chamber, and a positive correlation existed between 24-h EE and the daily dose of inhaled beta 2-agonists (p < 0.03). During daytime, physical activity was lower in patients with COPD. This study shows that patients with stable COPD are characterized by a normal daily energy expenditure in controlled conditions in spite of an increased basal metabolic rate. They appear to save energy by reducing their spontaneous level of physical activity.

Administration, Inhalation↗
PubMed1990

Resting energy expenditure in interstitial lung disease.

Because interstitial lung disease increases the work of breathing, the aim of this study was to determine if this condition is associated with increased energy requirements. A group of 12 clinically stable patients with interstitial lung disease was studied. Patients with a history of weight loss had significantly more severe lung volume restriction. Regression analysis showed that 42% of body weight variation was explained by vital capacity (p less than 0.025). Resting energy expenditure was measured by standard methods of indirect calorimetry. The measurements were performed with a ventilated hood during prolonged steady-state periods after an overnight fast. We found that resting energy expenditure was increased to 117.3 and 118.7% of the predicted basal metabolic rate, according to Fleisch and to Harris and Benedict reference values, respectively (p less than 0.001). Furthermore, resting energy expenditure was increased to 120.8% of the predicted value according to body fat-free mass (p less than 0.001). This extra energy expenditure in patients with interstitial lung disease is similar to that recently reported in patients with chronic obstructive pulmonary disease.

Adult↗
PubMed1995

Metabolic predictors of obesity. Contribution of resting energy expenditure, thermic effect of food, and fuel utilization to four-year weight gain of post-obese and never-obese women.

This prospective study was designed to identify abnormalities of energy expenditure and fuel utilization which distinguish post-obese women from never-obese controls. 24 moderately obese, postmenopausal, nondiabetic women with a familial predisposition to obesity underwent assessments of body composition, fasting and postprandial energy expenditure, and fuel utilization in the obese state and after weight loss (mean 12.9 kg) to a post-obese, normal-weight state. The post-obese women were compared with 24 never-obese women of comparable age and body composition. Four years later, without intervention, body weight was reassessed in both groups. Results indicated that all parameters measured in the post-obese women were similar to the never-obese controls: mean resting energy expenditure, thermic effect of food, and fasting and postprandial substrate oxidation and insulin-glucose patterns. Four years later, post-obese women regained a mean of 10.9 kg while control subjects remained lean (mean gain 1.7 kg) (P < 0.001 between groups). Neither energy expenditure nor fuel oxidation correlated with 4-yr weight changes, whereas self-reported physical inactivity was associated with greater weight regain. The data suggest that weight gain in obesity-prone women may be due to maladaptive responses to the environment, such as physical inactivity or excess energy intake, rather than to reduced energy requirements.

Aged↗
PubMed2004

The measurement of energy expenditure.

Proper nutrition support depends upon the clinician's ability to estimate the patient's energy expenditure. The accuracy of estimation is inversely proportional to the severity of the patient's illness. This fact has spurred academic and industry groups to pursue the measurement of energy expenditure. Harris and Benedict used indirect calorimetry to develop their now-famous equation nearly 100 years ago. The concept of indirect calorimetry is simple; if you know the concentration of inspired gases and expired gases, along with the flow, you can determine the amount of a gas consumed or produced. The complexity and expense of indirect calorimeters suggest that this simple concept is technically challenging. Because we desire to know the energy expenditure of the most critically ill patients, indirect calorimetry is further confounded by the presence of oxygen and mechanical ventilation. This paper will discuss the myriad of variables and obstacles that complicate the measurement of energy expenditure and will suggest methods to avoid or overcome them.

Journal Article↗
PubMedDate not supplied

Clinical use of pulse rates to determine daily energy expenditures in trauma and surgical patients.

This study was conducted to establish practical application by using pulse rates to determine resting energy expenditures in trauma and surgical patients. A continuous flow gas analyzer measured energy expenditures and a cardiotachometer/recorder determined pulse rates simultaneously. The study consisted of 18 normal subjects as controls, seven surgical patients (totaling 36 samples), a combination of the seven surgical and three trauma patients (totaling 23 samples). The group of seven surgical patients had a correlation coefficient of 0.531 when comparing pulse rate/min with kcal/m2/hr, and this was the best correlation among the group population studied. An attempt to establish a single regression line from individual patients showed no significant correlation, with the exception of two surgical patients. Of the total number of patient samples, we found no significant correlation between pulse rate and energy expenditures. Independently, Andrews (Am J Clin Nutr 24:1139-1147, 1971) and Payne (Am J Clin Nutr 24:1164-1170, 1971) suggested that there are multiple variables such as stroke volume, state of physical training, etc., that affect the outcome of such data. In this study, our variables were more extensive with respect to the severity of injuries and varying degrees of surgical procedures. The study concluded that there is no practical clinical use of pulse rates in determining daily resting energy expenditures of surgical or trauma patients.

Energy Metabolism↗
PubMedDate not supplied

Resting energy expenditure in patients with end-stage liver disease and in normal population.

Resting energy expenditure (REE) was measured in 10 patients with end-stage liver disease (ELD) and in 31 normal controls. Basal energy expenditure (BEE) was also predicted by the Harris-Benedict equation. In order to correlate REE to lean body mass, the 24-hr urinary creatinine was measured in patients with ELD and in normal controls and expressed as kcal/g urinary creatinine. Linear regression analysis showed a statistically significant (p less than 0.0001) correlation (r = 0.72) between the REE and the 24-hr urinary creatinine in normal controls, irrespective of age and sex. Mean BEE (1580 +/- 160 vs 1575 +/- 210) and REE (1755 +/- 215 vs 1800 +/- 330) were not significantly different between patients with ELD and controls. However, the mean REE was 1900 +/- 610 kcal/g creatinine in patients with ELD and 1180 +/- 260 (p less than 0.0001) in controls. When related to lean tissue, patients with ELD had increased energy expenditure, confirming the hypermetabolic state suggested on clinical grounds. The use of urine creatinine to estimate energy expenditure may be a simple clinical technique to predict dietary energy needs in malnourished, unstressed patients. When this estimated energy expenditure/g creatinine (EEE) is compared to measured energy expenditure/g creatinine in malnourished, stressed patients, the EEE provides an index of the extent of hypermetabolism.

Adolescent↗
PubMedDate not supplied

Calculation of metabolic expenditure and substrate utilization from gas exchange measurements.

At least nine different equations have been published for calculating metabolic expenditure by indirect calorimetry. This study examined the differences between equations when they are used for the nutritional assessment in an intensive care unit (ICU). Oxygen consumption and carbon dioxide production were measured in 36 ICU patients and used to calculate metabolic expenditure with the nine equations. The equations produced differences in metabolic expenditure which averaged from 0.8-96 kcal/day. The largest difference produced by any two of the nine equations was 189 kcal/day. Although differences in original stoichiometric data have resulted in numerous different equations for the calculation of metabolic expenditure, these differences are not clinically important. It makes little difference which equation is used for nutritional assessment in an ICU.

Dietary Carbohydrates↗