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PubMed1998

Energy expenditure in Alzheimer's disease.

Alzheimer's disease type dementia is a growing health problem and is one of the leading causes of death among elderly people. Unexplained weight loss and cachexia is a frequent clinical finding in patients with Alzheimer's disease. It has been postulated that Alzheimer's disease may by characterized by dysfunction in body weight regulation. This brief review examines energy intake, energy expenditure and body composition in Alzheimer's disease. We consider whether inappropriately high levels of energy expenditure may contribute to unexplained weight loss and decline in nutritional status. Specifically, we will consider studies that have examined body composition, daily energy expenditure and its components. The application of doubly labeled water and indirect calorimetry to problems of "wasting" has increased our knowledge regarding energy expenditure and physical activity levels in Alzheimer's 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's disease, even in cachectic patients. Clinical strategies aimed at developing feeding strategies to maintain adequate caloric intake and the restoration of energy balance should be a future area of investigation in Alzheimer's research.

Alzheimer Disease↗
PubMed2002

[Determinants and control of energy expenditure].

Obesity is a risk factor for many diseases including cardio-vascular disease, type 2 diabetes, and certain forms of cancer, among others. Obesity results from a chronic imbalance between calorie intake and energy expenditure. Genetic factors obviously play an important role in weight gain, but only in certain environments. The principal cause of the obesity epidemic is not clear: is obesity due to excessive food intake, a dynamic reduction in energy expenditure, or an association of these two factors? However, most obese subjects gain weight because of an inaptitude to adjust energy expenditure in response to excessive food intake. In this article, we review briefly the respective role of genes and environment in the development of obesity, then describe metabolic risk factors involved. Longitudinal studies conducted in Pima Indians have demonstrated that a relative decrease in basal metabolism, weak lipid oxidation in the fasting state, reduced spontaneous physical activity, and lower sympathetic nervous system activity are risk factors for obesity. Unlike our growing knowledge of food intake regulation, little is known about the control of energy expenditure. New discoveries should provide information on obesity susceptibility genes and increase the chances of developing new anti-obesity treatments.

Animals↗
PubMed1996

Household composition and expenditures on human capital formation in Kenya.

"Expenditures on human capital determinants in Kenya are analyzed using microdata. Specific expenditures on food, schooling, and medical care provide evidence of human capital formation activities of households. The analysis is focused on expenditure and distributional effects of household composition dimensions. To determine empirical magnitudes of the effects, a flexible form of a household expenditure function is estimated. The results of the analysis show that gender and age composition are important determinants of the level and distribution of human capital investments in a household. In addition, household budget allocation favors boys over girls for secondary school education. The policies implied by the findings are discussed."

Africa↗
PubMed2002

Energy intake and expenditure of obese and non-obese urban Bangladeshi children.

A case control study was conducted in Dhaka city to measure the energy intake and expenditure among 220 obese children of 4-10 years age group and 220 randomly selected age and sex matched controls. A 24 hour dietary recall was used to assess the energy intake. Data on energy expenditure was obtained by 24 hour physical activity recall. The mean energy intake of obese children (2056 +/- 751 kcal/d) was found to be significantly higher (P<0.001) compared to the non obese (1508 +/- 529 kcal/d). No sex difference was found in both obese and non obese groups. Mean energy expenditure of the obese children (1868 +/- 313 kcal/d vs 1495 +/- 200 kcal/d) was significantly higher than the non-obese (P<0.001). Of the obese, boys expended more energy than the girls (P=0.01). Furthermore, physical activity level (1.40 +/- 0.09 vs 1.35 +/- 0.14) was significantly higher among the non obese than their obese counterpart (P<0.001). However, energy balance was significantly higher among the obese (P<0.001). Dose response of energy balance shows the estimated relative risk of obesity increases with higher level of energy balance (P<0.001). The findings of this study revealed that energy balance as a result of higher energy intake and lower energy expenditure was one of the important risk factors for the development of obesity among the children of Dhaka city. Thus, appropriate interventions like behavioural change regarding food habits and physical activities are recommended.

Bangladesh↗
PubMed1992

No differences in rates of energy expenditure between post-obese women and their matched, lean controls.

Rates of energy expenditure at rest, during different daily activities and following a standardized liquid meal were compared in eight post-obese women, with a mean weight loss of 21.5 kg (range 14.1 to 33.3 kg) and eight controls who had never been overweight. Age, height, body mass index, fat-free mass and average daily energy intake were similar for both experimental groups. Resting metabolic rate averaged 23.04 cal/min/kg FFM (s.e.m. 1.14) in the post-obese and 22.70 cal/min/kg FFM (s.e.m. 0.64) in the controls on their first visit to the laboratory. Metabolic rates in the two groups rose in parallel as energy expenditure was increased by sitting, standing and walking at three different speeds (2.4, 3.9 and 5.4 km/h). At the highest walking speed energy expenditure averaged 95.30 cal/min/kg FFM (s.e.m. 4.18) in the post-obese and 93.42 cal/min/kg FFM (s.e.m. 2.97) in the control women. Comparisons of postprandial thermogenesis revealed no significant differences between the two groups. The results of the present study do not support the thesis that rates of energy expenditure, whether at rest, during different activities, or after eating, are reduced in post-obese women.

Adult↗
PubMed1992

[Estimation of energy expenditure in clinical practice: applicability to individual multiple injury cases].

In 37 multiple trauma patients the estimated and measured energy expenditures were compared. Predicted energy expenditure overestimated it in 89% of patients. The correction factor for the different pathologies was the principal source of error, since the measured/predicted basal energy expenditure ratio was 1.19 +/- 0.17. This ratio had a wide range of values (0.84-1.61) which renders the prediction of individual energy expenditure highly unreliable. Since the overestimation of energy requirements in the critically ill patients may convey important complications, the direct measurement of such requirements is recommended.

Adult↗
PubMed1992

Energy expenditure during walking in subjects with tibial rotationplasty, above-knee amputation, or hip disarticulation.

The surgical treatment of osteosarcoma with a tibial rotationplasty seems to offer functional advantages in comparison with an above-knee amputation. It has not been established whether the functional advantages are accompanied by a lower rate of energy expenditure during walking. In children with a tibial rotationplasty (n = 15), an above-knee amputation (n = 6), or a hip disarticulation (n = 5), energy expenditure was measured during treadmill walking at various walking velocities. The subjects with a tibial rotationplasty were able to walk faster, but there were no differences between the groups in energy expenditure per unit time or per unit distance. Correction for confounding variables including age, sex, height, time since operation, level of activity, and support during walking in a multiple linear regression model did not reveal any significant differences in energy expenditure during walking between groups. 1992 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

Adolescent↗
PubMed2003

[Study on the energy expenditure in college students in Guangdong Province].

UNLABELLED: To investigate the energy expenditure of college students, 61 college students (30 male and 31 female) in Guangdong were selected as the participants. Basal metabolism was measured by indirect calorimetry. The activities of college students were systematically recorded using 24 hours recall method. Total energy expenditure was evaluated by the factorial calculation method of WHO. RESULTS: Basal metabolism rates of male and female college students were (158.03 +/- 7.85) kJ/(m2.h) and (145.05 +/- 10.14) kJ/(m2.h) respectively. Total energy expenditure of 24 hours were (10389.23 +/- 1519.90) kJ/d and (7921.15 +/- 961.41) kJ/d respectively. CONCLUSION: The energy expenditure of college students in South-China accorded with the criteria of "Chinese adults at light physical activity level".

Adult↗
PubMed2004

Evaluating average expenditures per case in Kaunas University of Medicine Hospital.

The aim of the study was to evaluate average expenditures per case in Kaunas University of Medicine Hospital (KUMH). Case is defined as one treatment episode in particular inpatient department. Five cost groups have been used and defined in monetary terms in each clinical category (profile): labor costs; medication costs; laboratory, radiology and anesthesiology (for surgical clinics) services costs; running costs of medical equipment supply; other costs (including costs of patients' meal, laundry, transportation, communication, auxiliary services, heating, electricity, water, buildings maintenance and repair, etc.). Cases were analyzed using case mix dimensions: gender, age, absence or presence of surgical operation, patient separation status and inpatient service groups. During the study average expenditures per case were estimated: surgery--1161.10 Litas, therapy--1312.15 Litas, obstetrics and gynecology--685.82 Litas, newborn and child care--893.54 Litas and intensive care--1292.92 Litas. Relation between expenditures and case mix variables was measured using correlation analysis method. Using multiple regression analysis method, expenditures per case in each clinical category (profile), according case mix dimensions were predicted. Predicted expenses did not differ much from estimated cost per case.

Adolescent↗
PubMed2005

Energy expenditure during walking in amputees after disarticulation of the hip. A microprocessor-controlled swing-phase control knee versus a mechanical-controlled stance-phase control knee.

We have compared the energy expenditure during walking in three patients, aged between 51 and 55 years, with unilateral disarticulation of the hip when using the mechanical-controlled stance-phase control knee (Otto Bock 3R15) and the microprocessor-controlled pneumatic swing-phase control knee (Intelligent Prosthesis, IP). All had an endoskeletal hip disarticulation prosthesis with an Otto Bock 7E7 hip and a single-axis foot. The energy expenditure was measured when walking at speeds of 30, 50, and 70 m/min. Two patients showed a decreased uptake of oxygen (energy expenditure per unit time, ml/kg/min) of between 10.3% and 39.6% when using the IP compared with the Otto Bock 3R15 at the same speeds. One did not show any significant difference in the uptake of oxygen at 30 m/min, but at 50 and 70 m/min, a decrease in uptake of between 10.5% and 11.6% was found when using the IP. The use of the IP decreased the energy expenditure of walking in these patients.

Artificial Limbs↗
PubMedDate not supplied

Analysis of drug expenditure in medical departments from tertiary hospitals.

The aim of the study was to assess drug expenditure per hospital day in 37 departments of medical specialties from 12 tertiary hospitals of Iaşi city in 2001 year. The upper limit for drug expenditure per hospital day was considered the average total cost per hospital day recommended by the Ministry of Health for each specialty. Departments with drug expenditure that exceeded the recommended total cost per hospital day have been separately analyzed from the point of view of performance indicators (average hospital stay, utilization and bed turnover rate). In conditions of an appropriate AHS (meaning less than the recommended value by Ministry of Health for each specialty) and utilization rate (with values within interval 300-365), drug expenditure depend exclusively on the modes of prescribing pharmaceuticals.

Drug Costs↗
PubMed2005

Occupational energy expenditure and leisure-time physical activity.

OBJECTIVES: In the majority of countries around the world, a decrease in the leisure-time physical activity is observed. The aim of the study was to evaluate the correlation between occupational energy expenditure and leisure-time physical activity. Moreover, the correlation between other factors and leisure-time physical activity was assessed. MATERIALS AND METHODS: The study was performed in a randomly selected group of full-time employees (272 men and 236 women) living in the city of Lódź. Logistic regression was used to estimate odds ratios and 95% confidence intervals as well as to control the effects of occupational workload and leisure-time physical activity limitations. Physical activity was determined by the Seven Day Physical Activity Recall (SDPAR). RESULTS: Leisure-time physical activity was strongly associated with energy expenditure on occupational physical activity in men and women. Among men who expended 4000 kcal/week or more on occupational physical activity, the risk of inactivity at leisure was 1.5 times higher than in men whose weekly energy expenditure on occupational activity did not exceed 4000 kcal (adjusted OR = 1.33, 95% CI: 1.06-2.34). Among women who expended 3500 kcal/week or more on occupational physical activity, the risk of not taking up leisure-time physical activity was also higher as compared to those whose weekly energy expenditure on occupational activity was lower than 3500 kcal (adjusted OR = 1.41, 95% CI: 1.09-3.40). CONCLUSIONS: Prophylactic schedules associated with the improvement of leisure-time physical activity should be addressed to all adults, particularly to blue-collar workers. Future programs aimed at increasing physical activity in adults should consider work-related factors.

Adult↗
PubMed2006

Quantification of energy expenditure during gait in children affected by cerebral palsy.

AIM: Children affected by cerebral palsy (CP) are generally characterised by some movement limitations and abnormalities that compromised gait pattern. These disabilities during deambulation may lead to excessive energy cost and so to a compromised energy efficiency. METHODS: In this study oxygen expenditure was evaluated during walking in 20 children affected by CP and in 20 healthy children, using Cosmed K4b2 (Cosmed, Italy). From obtained data about energy consumption, some parameters (heart rate, energy expenditure index, oxygen consumption, oxygen cost) were extracted, first in order to quantify energy cost during gait in pathological and healthy subjects and then to underline differences between the 2 groups of children. RESULTS: In particular, the results obtained revealed that heart rate (bpm) and oxygen consumption (mL/kg/min) mean values didn't differ significantly between normal subjects and those with CP; instead, energy expenditure index (b/m) and oxygen cost (mL/kg/m) presented higher mean values rather than control group at a statistically level and so they revealed to be significant parameters, in order characterized energy expenditure in children affected by CP. CONCLUSIONS: This inefficiency characteristic of CP deambulation is probably directly connected to the presence of simultaneous contraction of agonist and antagonist muscle in these patients.

Adolescent↗
PubMed1991

Peak running velocity, submaximal energy expenditure, VO2max, and 8 km distance running performance.

The purposes of this study were to examine (1) if the peak running velocity achieved during maximal treadmill testing is related to 8 km distance running performance (DRP) and (2) if the relationship between selected physiological determinants are consistant for two 8 km races within a competitive season. Seven members of a University cross-country team (mean +/- SE) (age, 19.4 +/- 0.5 years, VO2max 67.0 +/- 1.0 ml/kg/min were tested 2-3 days following a mid-season race (Race M) and the season-ending conference championship (Race C). Despite similar weather and terrain, Race C (29:22 +/- 1:22 min:sec) was significantly (p less than 0.05) slower than Race M (28:31 +/- 0:58 min:sec). However, no significant differences (p greater than 0.05) were observed between testing sessions for calculated energy expenditure heart rate oxygen consumption and RER during submaximal running (248 and 268 m/min), postsubmaximal run lactate, peak running velocity, and VO2max. A significant correlation (p less than 0.05) was observed for Race M with with calculated energy expenditure during submaximal running at both speeds (r = 0.85) and with peak running velocity (r = -0.76). Regression analysis revealed that 92% of the total variance for Race M was accounted for by calculated energy expenditure during submaximal running and VO2max. No significant correlation or regression relationship was observed for any variables with Race C. These results suggest that peak running velocity, calculated energy expenditure during submaximal running, and VO2max can be associated with 8 km running performance. However, the relationship between 8 km DRP and the variables measured can differ for two races over a competitive season.

Adult↗
PubMed1990

Indirect calorimetry methods for determination of energy expenditure.

Brief history and development of calorimetric methods for the determination of energy expenditure are discussed. The author demonstrates the measuring principles of direct and indirect calorimetry. In two clinical studies the practical use of closed and open technique of indirect calorimetric measurements are presented. In 10 operated patients under isoflurane-nitrous oxide anaesthesia in closed breathing circuit dose related decrease of oxygen consumption and carbon dioxide production was found. The indirect calorimetry showed higher mean energy expenditure (+14%) than was calculated by the Brody-Kleiber formula. These values indicate that the metabolic response due to surgical stress exceeds the metabolism decreasing effect of anaesthesia. The modalities of exact determination of energy expenditure of septic patients under respiratory treatment are discussed. Data of modified Harris-Benedict equation adapted to clinical conditions and of continuous indirect calorimetric measurement of energy expenditure were compared in 25 septic patients. The measured and the calculated mean values showed good correlation (r = 0.82). The modified Harris-Benedict equation may be properly used in clinical practice, when indirect calorimetric measuring instrument is unavailable.

Calorimetry, Indirect↗
PubMedDate not supplied

[The usefulness of measuring caloric expenditure in ICU patients].

Traditionally, the energetic needs of patients subjected to parenteral nutrition have been calculated by means of formulae or nomograms. We are currently aware of the lack of correlation between the estimated needs and those calculated, especially in critical patients. For this reason, we have posed the question of the calculation of the Basal Energy Expenditure in a group of 43 patients from our Unit, divided into four subgroups: Septic, Neurological, Digestive and Postoperative following Cardiac Surgery. The Septic patients had the greatest energy expenditure, followed by the Neurological, Digestive and Post Cardiac Surgery. In all the patients studied, we found good correlations between temperature and energy expenditure and between temperature and oxygen consumption. The correlation between oxygen consumption and energy expenditure was linear.

Adult↗
PubMed1990

Changes in energy expenditure of light physical activity during a 10 day period at 34 degrees C environmental temperature.

The energy expenditure of a 2 h programme of light activity was observed daily in 8 young men after a change in habitual environmental indoor temperature of 20-24 degrees C to 34 degrees C and an absolute humidity of 6-10 g/m3 during a 10 day period. No changes were observed with respect to the daily energy intake, body weight, rectal temperature and average skin temperature, but the energy expenditure showed a decrease of between 3 and 8 per cent. The observations support results of previous studies on acclimatization with respect to energy expenditure, and indicate that differences in energy expenditure due to habitual differences in environmental temperature are small, presumably less than 5 per cent.

Adolescent↗
PubMed1989

Energy expenditure of young Swazi women as measured by the doubly-labelled water method.

The energy expenditure of a group of young (age 18-28 years) Swazi women resident at an agricultural college was measured using the doubly-labelled water (DLW) method. This was a baseline study to evaluate feasibility of the protocol under field conditions in Swaziland and to determine energy needs of sedentary women under well controlled conditions. Measurements were based on saliva samples collected over a 10-d period using the two-pair method. Two pairs of data points (days 2-9 and 3-10) were used to calculate expenditure. The two sets of data points were within 2.5 per cent of each other. Dietary intake was measured by self-report diaries for 5 study days and was not significantly different from the DLW measurements. Energy expenditure averaged 1735 kcal (7252 kJ)/d and 44 kcal (185 kJ)/kg fat-free mass, lower than other groups similarly measured. Intake averaged 1738 kcal (7265 kJ)/d. Low levels of expenditure observed probably reflect inactivity.

Adolescent↗