Energy restriction results in a mass-adjusted decrease in energy expenditure in cats that is maintained after weight regain

Dietary energy restriction (ER) is used to treat obesity in cats but it is often unsuccessful. The purpose of this study was to determine whether ER results in a sustained decrease in mass-adjusted energy expenditure (EE) that may oppose weight loss and promote weight regain. EE and body composition were measured in 10 adult neutered cats at 3 time points: baseline (obese cats), during weight loss (40% ER), and following weight regain. The cats started with a body weight (BW) of 6.1 +/- 0.30 kg, body condition score (BCS) of 7.6 +/- 0.14 (on a 9-point scale), and fat body mass (FM) of 38 +/- 1.0% of BW. After weight loss, BW was 5.0 +/- 0.19 kg, BCS was 5.5 +/- 0.07 kg, and FM was 31 +/- 1.6% (P < 0.01). After weight regain, BW was 6.2 +/- 0.30 kg, BCS was 7.7 +/- 0.16, and FM was 42 +/- 1.8% (P < 0.01). Total EE decreased from 1258 +/- 33.7 kJ/d to 1025 +/- 39.6 kJ/d during weight loss (P < 0.001). After weight regain, EE was still lower than baseline (1103 +/- 41.5 kJ/d, P < 0.001). Energy intake (EI) at baseline (1337 +/- 50.6 kJ/d) was higher than EI after weight loss and regain (1217 +/- 61.2 kJ/d), resulting in no differences in energy balance (78 +/- 30.4 and 104 +/- 35.4 kJ/d, respectively, P = 0.581). These results support the hypothesis that ER results in a mass-adjusted decrease in EE in cats that is maintained after weight regain.     

Validation of energy intake measurements determined from observer-recorded food records and recall methods compared with the doubly labeled water method in overweight and obese individuals

BACKGROUND: Measurements of dietary intake in obese and overweight populations are often inaccurate because food intakes are underestimated. OBJECTIVE: The purpose of this study was to evaluate the validity of the combined use of observer-recorded weighed-food records and 24-h snack recalls in estimating energy intakes in overweight and obese individuals. DESIGN: Subjects were 32 healthy women and 22 healthy men with mean body mass indexes (in kg/m(2)) of 29.5 and 30.3, respectively. Energy intake (EI) was measured over 2 wk in a university cafeteria. No restrictions were made on meal frequency or EI. To document food consumed outside the cafeteria, 24-h snack recalls were conducted before meals. Energy expenditure (EE) was measured with the doubly labeled water (DLW) method (EE(DLW)). Energy balance was determined by measuring body weight at the beginning and end of the 2-wk period. RESULTS: The mean EI in the women (10.40 +/- 1.94 MJ/d) and men (14.37 +/- 3.21 MJ/d) was not significantly lower than the EE(DLW) in the women (10.86 +/- 1.76 MJ/d) and men (14.14 +/- 2.83 MJ/d). The mean EI represented 96.9 +/- 17.0% and 103 +/- 18.9% of the measured EE for women and men, respectively. There were no significant changes in weight in the group as a whole or by sex at the end of the testing period; the men lost 0.23 +/- 1.58 kg and the women lost 0.25 +/- 1.09 kg. CONCLUSION: The combination of observer-recorded food records and 24-h snack recalls is a valid method for measuring EI in overweight and obese individuals.     

Relation of body mass index and body fatness to energy expenditure: longitudinal changes from preadolescence through adolescence

BACKGROUND: Although it is widely accepted that weight gain results when energy intake exceeds energy expenditure (EE), how reduced EE contributes to the development of obesity remains unclear. OBJECTIVE: We tested the hypothesis that reduced EE in the premenarcheal period in girls constitutes a risk factor for an increase in relative weight [body mass index (BMI) z score] and percentage of body fat (%BF) during adolescence. DESIGN: We measured EE at study entry in 196 premenarcheal nonobese girls. Resting metabolic rate (RMR) was measured by indirect calorimetry. Total energy expenditure (TEE) was measured by the doubly labeled water method. Activity energy expenditure (AEE) was calculated from RMR and TEE. After the baseline study, girls were followed annually until 4 y after menarche (x+/- SD: 7.1 +/- 2.6 y). At each visit, height, weight, and %BF by bioelectrical impedance were measured. Girls also completed annual food-frequency and activity questionnaires. Linear mixed effects modeling was used to evaluate the longitudinal relation between BMI z score and %BF and measures of baseline EE. RESULTS: We found no significant relation in change in %BF with RMR, AEE, or TEE. We observed a small positive relation between BMI z score and AEE and TEE (P < 0.05) but no significant relation with RMR. When we stratified by parental overweight, the findings were unchanged for RMR. TEE and AEE were positively related to BMI z score in girls of overweight parents. CONCLUSIONS: Our findings suggest that EE in the premenarcheal period is not a risk factor for increases in %BF or BMI z score in girls during adolescence.     

Impact of acute illness on nutritional status of infants and young children with sickle cell disease

OBJECTIVE: To evaluate changes in growth, nutritional status, body composition, and energy and nutrient intakes during illness and usual state of health in infants and young children with sickle cell disease. DESIGN: Sixteen children, aged 0.4 to 5.6 years, with SS type sickle cell disease (SCD-SS) were assessed at the time of hospital admission for an acute illness episode and during an 18-hour overnight follow-up visit 2 to 6 weeks after the acute illness episode when in a state of usual health. Main outcome measures included growth in height and weight compared with reference standards, body composition determined by the skinfold thickness technique and total body electrical conductivity, and dietary intake determined by 24-hour recall during hospital admission and at follow-up. RESULTS: Height, weight, and weight-for-height z scores did not differ from national reference data; triceps skinfold thickness and arm fat area z scores were less. Mean +/- standard error body fat was 15.6 +/- 2.1% at the time of hospital admission, as measured by total body electrical conductivity, and was not significantly different from the follow-up value (16.2 +/- 2.2%). Mean energy intake was 44 +/- 9% of Recommended Dietary Allowances at the time of admission and differed significantly from the follow-up value of 90 +/- 9% (P < .05). APPLICATIONS: Infants and children with sickle cell disease appear to be at nutritional risk during an acute illness episode, as indicated by body fat measures and inadequate intakes of energy and macronutrients. Energy intake may be suboptimal for several days surrounding an admission for an acute illness in children with sickle cell disease. Physicians and other health practitioners should be alert to inadequate nutrient intakes of their patients during this time period and may consider supplemental energy to avoid a potential net negative energy balance.     

Energy metabolism in humans at a lowered ambient temperature

OBJECTIVE: Assessment of the effect of a lowered ambient temperature, ie 16 degrees C (61 degrees F), compared to 22 degrees C (72 degrees F), on energy intake (EI), energy expenditure (EE) and respiratory quotient (RQ) in men. DESIGN: Randomized within-subject design in which subjects stayed in a respiration chamber three times for 60 h each, once at 22 degrees C, and twice at 16 degrees C, wearing standardized clothing, executing a standardized daily activities protocol, and were fed in energy balance (EBI): no significant difference between EE and EI over 24 h). During the last 24 h at 22 degrees C, and once during the last 24 h at 16 degrees C, they were fed ad libitum. SUBJECTS: Nine dietary unrestrained male subjects (ages 24+/-5 y, body mass index (BMI) 22.7+/-2.1 kg/m(2), body weight 76.2+/-9.4 kg, height 1.83+/-0.06 m, 18+/-5% body fat). RESULTS: At 16 degrees C (EB), EE (total 24 h EE) was increased to 12.9+/-2.0 MJ/day as compared to 12.2+/-2.2 MJ/day at 22 degrees C (P<0.01). The increase was due to increases in sleeping metabolic rate (SMR; the lowest EE during three consecutive hours with hardly any movements as indicated by radar): 7.6+/-0.7 vs 7.2+/-0.7 MJ/day (P<0.05) and diet-induced thermogenesis (DIT; EE-SMR, when activity induced energy expenditure as indicated by radar=0): 1.7+/-0.4 vs 1.0+/-0.4 MJ/day (P<0.01). Physical activity level (PAL; EE/SMR) was 1.63-1.68. At 16 degrees C compared to at 22 degrees C, rectal, proximal and distal skin temperatures had decreased (P<0.01). RQ was not different between the two ambient temperature situations. During ad libitum feeding, subjects overate by 32+/-12% (at 22 degrees C) and by 34+/-14% (at 16 degrees C). Under these circumstances, the decrease of rectal temperature at 16 degrees C was attenuated, and inversely related to percentage overeating (r(2)=0.7; P<0.01). CONCLUSION: We conclude that at 16 degrees C, compared to 22 degrees C, energy metabolism was increased, due to increases in SMR and DIT. Overeating under ad libitum circumstances at 16 degrees C attenuated the decrease in rectal core body temperature.     

Effects of marginally negative energy balance on insulin binding to erythrocytes of normal men

Six healthy male volunteers were confined to a metabolic unit for 105 days. Energy intake (EI) and energy expenditure (EE) were varied in order to achieve either a marginally negative (-15%) or an equilibrated energy balance (EB), in different metabolic periods (MP) as follows: MP I: EE = 1, EI = 1, EB = 0; MP II: EE = 1, EI = 0.85, EB = -15%; MP III: EE = 0.85, EI = 0.85, EB = 0; MP IV: EE = 0.85, EI = 0.70, EB = -15%; MP VI: EE = 1.15, EI = 1.15, EB = 0; MP VII: EE = 1.15, EI = 1, EB = -15%. An egg protein formula diet was fed throughout the study. The amount given in MP I was sufficient to maintain body weight constant. Assigned physical activity consisted of regulated walking and cycling. During MP I, this physical activity accounted for 15% of the energy intake. Serum insulin, insulin binding to erythrocytes and body fat content were determined at the end of each MP. No significant changes were found in serum insulin level throughout the study, but specific insulin binding did change significantly. Binding increased with increased physical activity by 23% at the end of MP VI and an additional 35% at the end of MP VII. The maximum percentage of insulin binding to erythrocytes correlated inversely with the percentage of body fat in each MP. These data suggest that insulin binding to erythrocytes, in normal men, is sensitive to a small change in energy balance, and especially to physical activity.(ABSTRACT TRUNCATED AT 250 WORDS)     

Longitudinal changes in the accuracy of reported energy intake in girls 10-15 y of age

BACKGROUND: Dietary records are often used to estimate individual energy needs and population energy requirements. However, significant underreporting of total energy intake (EI) has been found when EI is compared with total energy expenditure (EE) measured by doubly labeled water. OBJECTIVE: This study aimed to determine whether the accuracy of reported EI decreases from middle childhood to adolescence. DESIGN: In this longitudinal study of 26 healthy girls, EI and EE were measured at ages 10, 12, and 15 y. Accuracy of reported EI (EI/EE x 100%) was calculated at each age. At study entry, girls had a mean (+/- SD) body mass index (in kg/m(2)) of 16.8 +/- 1.9 and percentage body fat of 24.0 +/- 4.6%. Measurements of EI were a 7-d dietary record and those of EE were by doubly labeled water. RESULTS: As they got older, girls tended to report EI less accurately: the average accuracy was 88 +/- 13% at age 10 y, 77 +/- 21% at age 12 y, and 68 +/- 17% at age 15 y. The declines in reporting accuracy from age 10 y to age 12 y and from age 10 y to age 15 y were statistically significant (P = 0.03 and P = 0.001, respectively). Reporting accuracy also declined from age 12 to age 15 y but not significantly. When percentage body fat was added to the model, results were essentially unchanged. CONCLUSION: Because of the decline in EI reporting accuracy with age, the use of EI data obtained from dietary records in adolescent girls will result in substantial underestimation of energy needs.     

Validation study of energy expenditure and intake during calorie restriction using doubly labeled water and changes in body composition

BACKGROUND: Clinical trials involving calorie restriction (CR) require an assessment of adherence to a prescribed CR with the use of an objective measure of energy intake (EI). OBJECTIVE: The objective was to validate the use of energy expenditure (EE) measured by doubly labeled water (DLW), in conjunction with precise measures of body composition, to calculate an individual's EI during 30% CR. DESIGN: Ten participants underwent 30% CR for 3 wk. During the last week (7 d), 24-h EE was measured in a respiratory chamber and simultaneously by DLW (EEDLW). EI was calculated from 7-d EE measured by DLW and from changes in energy stores (ES) (weight and body composition). Calculated EI was then compared with the actual EI measured in the chamber by using the following equations: calculated EI (kcal/d) = EEDLW + DeltaES, where DeltaESFM/FFM (kcal/d) = (9.3 x DeltaFM, g/d) + (1.1 x DeltaFFM, g/d), FM is fat mass, and FFM is fat-free mass. RESULTS: We found close agreement (R = 0.88) between EE measured in the metabolic chamber and EEDLW during CR. Using the measured respiratory quotient, we found that the mean (+/-SD) EE(DLW) was 1934 +/- 377 kcal/d and EE measured in the metabolic chamber was 1906 +/- 327 kcal/d, ie, a 1.3 +/- 8.9% overestimation. EI calculated from EEDLW and from changes in ES was 8.7 +/- 36.7% higher than the actual EI provided during the chamber stay (1596 +/- 656 kcal/d). CONCLUSIONS: DLW methods can accurately estimate 24-h EE during CR. Although the mean difference between actual and calculated EIs for the group was small, we conclude that the interindividual variability was too large to provide an assessment of CR adherence on an individual basis.     

Estimation of total daily energy expenditure and its components by monitoring the heart rate of Japanese endurance athletes

The estimation of total daily energy expenditure (TEE) or the energy needs of athletes is important for maintaining a proper energy balance during training. This study was conducted to measure the TEE of Japanese middle- and long-distance runners using a heart-rate monitoring method (the HR method), and to ascertain the impact of three key energy expenditure (EE) components occurring within the day: sleep, exercise (training) and inactivity (other daily habitual activities). Additionally, energy balance was evaluated by comparing TEE with energy intake (EI). The mean TEE of six male athletes aged 19-21 y was 4,514+/-739 kcal/d and their mean EI was 3,784+/-91 kcal/d during the training period of 11 d. This negative energy balance led to a significant decline in body weight (p<0.01), indicating that proper care should be taken to balance energy during training. The mean daily EEs during sleep, inactivity, and exercise were 536+/-46 (12.0% of TEE), 1,722+/-145 (38.7%), and 2,255+/-658 (49.3%) kcal/d, respectively. There was a significant correlation between TEE and exercise EE (p<0.01) in the athletes. The TEE of the endurance athletes was higher than expected and significantly affected by exercise EE, indicating that the TEE of athletes, in general, must be carefully evaluated before incorporating nutritional support for them.     

Ghrelin and glucagon-like peptide 1 concentrations, 24-h satiety, and energy and substrate metabolism during a high-protein diet and measured in a respiration chamber

BACKGROUND: The mechanism of protein-induced satiety remains unclear. OBJECTIVE: The objective was to investigate 24-h satiety and related hormones and energy and substrate metabolism during a high-protein (HP) diet in a respiration chamber. DESIGN: Twelve healthy women aged 18-40 y were fed in energy balance an adequate-protein (AP: 10%, 60%, and 30% of energy from protein, carbohydrate, and fat, respectively) or an HP (30%, 40%, and 30% of energy from protein, carbohydrate, and fat, respectively) diet in a randomized crossover design. Substrate oxidation, 24-h energy expenditure (EE), appetite profile, and ghrelin and glucagon-like peptide 1 (GLP-1) concentrations were measured. RESULTS: Sleeping metabolic rate (6.40 +/- 0.47 compared with 6.12 +/- 0.40 MJ/d; P < 0.05), diet-induced thermogenesis (0.91 +/- 0.25 compared with 0.69 +/- 0.24 MJ/d; P < 0.05), and satiety were significantly higher, and activity-induced EE (1.68 +/- 0.32 compared with 1.86 +/- 0.41; P < 0.05), respiratory quotient (0.84 +/- 0.02 compared with 0.88 +/- 0.03; P < 0.0005), and hunger were significantly lower during the HP diet. There was a tendency for a greater 24-h EE during the HP diet (P = 0.05). Although energy intake was not significantly different between the diet groups, the subjects were in energy balance during the HP diet and in positive energy balance during the AP diet. Satiety was related to 24-h protein intake (r2 = 0.49, P < 0.05) only during the HP diet. Ghrelin concentrations were not significantly different between diets. GLP-1 concentrations after dinner were higher during the HP than during the AP diet (P < 0.05). CONCLUSION: An HP diet, compared with an AP diet, fed at energy balance for 4 d increased 24-h satiety, thermogenesis, sleeping metabolic rate, protein balance, and fat oxidation. Satiety was related to protein intake, and incidentally to ghrelin and GLP-1 concentrations, only during the HP diet.     

Effect of the melanocortin-3 receptor C17A and G241A variants on weight loss in childhood obesity

BACKGROUND: The central melanocortin system is critical for the long-term regulation of energy homeostasis. Melanocortin-3 receptor (MC3R) knock-out mice, despite being hypophagic, have increased fat mass and higher feed efficiency than do their wild-type littermates. OBJECTIVE: The aim was to evaluate whether, in childhood obesity, MC3R variants are associated with changes in fatness reduction as a consequence of a weight-reduction program. DESIGN: Molecular screening of the MC3R coding region in 184 obese children, 77 girls and 107 boys [x (+/-SEM) body mass index (BMI; in kg/m(2)) z score: 3.3 +/- 2.3; age 9.2 +/- 2 y], was performed. BMI was evaluated at baseline and after 6 and 12 mo of the weight loss program. RESULTS: No new mutations were found. Two previously described polymorphisms, C17A (Thr6Lys) and G241A (Val81Ile), were observed in 20 patients in almost complete linkage disequilibrium. No significant differences in BMI z scores were observed at baseline of the weight-loss program between the genotypes; however, at follow-up, heterozygotes showed a significantly higher BMI z score (P = 0.03). When the patients were divided according to the amount of weight lost, a higher prevalence of heterozygotes was observed among subjects who lowered their BMI z score <1.5 (P = 0.03). CONCLUSION: These results suggest a gene-diet interaction between the MC3R C17A and G241A variants and a weight loss program for the ability to lose weight in childhood obesity.     

Energy balance during an ironman triathlon in male and female triathletes

Energy balance of 10 male and 8 female triathletes participating in an Ironman event (3.8-km swim, 180-km cycle, 42.2-km run) was investigated. Energy intake (EI) was monitored at 7 designated points by dietary recall of food and fluid consumption. Energy expenditure (EE) during cycling and running was calculated using heart rate-VO, regression equations and during swimming by the multiple regression equation: Y = 3.65v+ 0.02W- 2.545 where Yis VO,in L x min(-1), v is the velocity in m s(-1), Wis the body weight in kilograms. Total EE (10,036 +/- 931 and 8,570 +/- 1,014 kcal) was significantly greater than total EI (3,940 +/- 868 and 3,115 +/- 914 kcal, p <.001) for males and females, respectively, although energy balance was not different between genders. Finishing time was inversely related to carbohydrate (CHO) intake (g x kg(-1) x h(-1)) during the marathon run for males (r = -.75,p <.05), and not females, suggesting that increasing CHO ingestion during the run may have been a useful strategy for improving Ironman performance in male triathletes.     

Use of a triaxial accelerometer to validate reported food intakes

BACKGROUND: An easy and cheap method for validating reported energy intake (EI) is needed. OBJECTIVE: Reported EI was compared with calculated energy expenditure (EE(calc)) and with energy expenditure measured by the doubly labeled water method (EE(DLW)). DESIGN: EE was calculated on the basis of basal metabolic rate (BMR) measured with the ventilated-hood technique and physical activity (PA) measured with a triaxial accelerometer (EE(VH+PA)) and on the basis of BMR estimated by using World Health Organization equations and PA (EE(WHO+PA)): EE(calc) = -1.259 + 1.55 x BMR + 0.076 x counts/min (r(2) = 0.90, P = 0.0001). Subjects [n = 12 men and 12 women aged 60 +/- 3 y; body mass index (in kg/m(2)): 26 +/- 4] reported their food intakes for 7 d and EE(DLW), EE(VH+PA), and EE(WHO+PA) were assessed over the same 7 d. RESULTS: Reported EI (9.0 +/- 2.1 MJ/d) was lower (P: < 0.0001) than were EE(DLW) (11.3 +/- 2.3 MJ/d), EE(VH+PA) (10.8 +/- 1.7 MJ/d), and EE(WHO+PA) (10.8 +/- 1.8 MJ/d). Underreporting was 19.4 +/- 14.0%, 16.7 +/- 13.6%, and 16.4 +/- 15.5% on the basis of EE(DLW), EE(VH+PA), and EE(WHO+PA), respectively. The difference of 2.7 +/- 8.0% between EE(DLW) and EE(VH+PA) was not related to the average of both percentages and was not significantly different from zero. The percentage of underreporting calculated with EE(WHO+PA) was not significantly different from that calculated with EE(DLW). CONCLUSIONS: The use of a combination of BMR (measured or estimated) and PA is a good method for validating reported EI. There was no significant difference between the percentage of underreporting calculated with EE(VH+PA), EE(WHO+PA), or EE(DLW).     

Food and macronutrient intake of elite kenyan distance runners

The food and macronutrient intake of elite Kenyan runners was compared to recommendations for endurance athletes. Estimated energy intake (EI: 2987 +/- 293 kcal; mean +/- standard deviation) was lower than energy expenditure (EE: 3605 +/- 119 kcal; P < 0.001) and body mass (BM: 58.9 +/- 2.7 kg vs. 58.3 +/- 2.6 kg; P < 0.001) was reduced over the 7-d intense training period. Diet was high in carbohydrate (76.5%, 0.4 g/kg BM per day) and low in fat (13.4 %). Protein intake (10.1 %; 1.3 g/kg BM per day) matched recommendations for protein intake. Fluid intake was modest and mainly in the form of water (1113 +/- 269 mL; 0.34 +/- 0.16 mL/kcal) and tea (1243 +/- 348 mL). Although the diet met most recommendations for endurance athletes for macronutrient intake, it remains to be determined if modifying energy balance and fluid intake will enhance the performance of elite Kenyan runners.     

Energy metabolism after 2 y of energy restriction: the biosphere 2 experiment

BACKGROUND: An adaptive decrease in energy expenditure (EE) in response to 6 mo of severely restricted energy intake was shown in a classic semistarvation study-the Minnesota experiment. OBJECTIVE: Our objective was to examine whether such adaptation also occurs in response to less severe but sustained energy restriction. DESIGN: Body composition, 1-wk total EE (TEE), 24-h sedentary EE, and spontaneous physical activity were measured in 8 healthy subjects (4 men and 4 women) at the end of a 2-y confinement inside Biosphere 2. Unexpectedly, the food supply was markedly restricted during most of the confinement and all subjects experienced a marked, sustained weight loss (9.1 +/- 6.6 kg; P: < 0.001) from the low-energy (7000-11000 kJ/d), low-fat (9% of energy), but nutrient-dense, diet they consumed. RESULTS: The TEE inside Biosphere 2, assessed 3 wk before exit, averaged 10700 +/- 560 kJ/d (n = 8). Within 1 wk after exit, the adjusted 24-h EE and spontaneous physical activity were lower in the biospherians (n = 5) than in 152 control subjects (6% and 45%, respectively; both P: < 0.01). Six months after exit and return to an ad libitum diet, body weight had increased to preentry levels; however, adjusted 24-h EE and spontaneous physical activity were still significantly lower than in control subjects. CONCLUSIONS: In lean humans, an adaptive decrease in EE appears to occur not only in states of life-threatening undernutrition, but also in response to less severe energy restriction sustained over several years.     

An easy-to-use semiquantitative food record validated for energy intake by using doubly labelled water technique

BACKGROUND: Estimating dietary intake is important for both epidemiological and clinical studies, but often lacks accuracy. OBJECTIVE: To investigate the accuracy and validity of energy intake estimated by an easy-to-use semiquantitative food record (EI(SQFR)) compared to total energy expenditure (TEE) estimated by doubly labelled water technique (EE(DLW)). DESIGN: TEE was measured in 29 nonobese subjects using the doubly labelled water method over a period of 14 days. Within this period, subjects reported their food consumption by a newly developed semiquantitative food record for 4 consecutive days. Energy intake was calculated using the German Food Code and Nutrition Data Base BLS II.3. RESULTS: A good correlation was observed between EI(SQFR) and EE(DLW) (r = 0.685, P < 0.001). The mean difference between EI(SQFR) and EE(DLW) was -1.7+/-2.6 MJ/day (-14+/-21%, P = 0.002). An underestimation of EI(SQFR) <10% was observed in nine subjects (31%), of 10-20% in six subjects (21%), and of >20% in nine subjects (31%). In five subjects (17%), an overestimation of EI(SQFR) was observed. CONCLUSIONS: The easy-to-use semiquantitative food record provided good estimates of EI in free-living and nonobese adults without prior detailed verbal instructions. The presented food record has limitations regarding accuracy at the individual level.     

Rice-based diets in rural Bangladesh: how do different age and sex groups adapt to seasonal changes in energy intake?

BACKGROUND: Seasonality has been recognized as a key determinant of human energy balance, especially in low-income countries. OBJECTIVE: The objective was to test the hypothesis that, in rural Bangladesh, different age and sex groups adapt similarly to seasonal changes in energy intake (EI). DESIGN: A prospective study was carried out in 2 rural Bangladeshi villages in the lean and peak seasons. Data on anthropometric measures (weight, height, and midupper arm circumference) and dietary food intake (collected with the use of a 24-h food weighing method) were obtained from all subjects from 304 households. RESULTS: The average EI increased from a least-squares mean (+/- SE) of 7.87 +/- 0.10 MJ x person(-1) x d(-1) in the lean season to 9.47 +/- 0.13 MJ x person(-1) x d(-1) in the peak season. In children and adolescents aged < 18 y of age, the prevalence of underweight (weight-for-age) was not significantly different (56%) in the 2 seasons. Among adults, a significantly higher prevalence of chronic energy deficiency [body mass index (in kg/m(2)) < 18.5] was observed in the peak season (67%) than in the lean season (61%), despite a higher EI in the peak season. Other determinants of seasonal nutritional status are presented. CONCLUSIONS: Seasonal fluctuations in EI were substantial in all age and sex groups. Children and adolescents showed no significant seasonal changes in the prevalence of underweight, which indicated that they adapted to changes in EI. In adults, the season in which EI was high coincided with average weight loss, which indicated that adults did not adapt fully to seasonal fluctuations in EI and that seasonal energy expenditure is probably a major determinant of nutritional status.     

Energy expenditure in underweight free-living adults: impact of energy supplementation as determined by doubly labeled water and indirect calorimetry

The effect of energy supplementation was evaluated in six underweight adults under free-living conditions. Customary energy intake (EI) over 4 wk and estimated body composition were defined. Then for 12 wk subjects were fed their customary EI under controlled conditions to assure stable energy reserve. Finally, intake was increased by a mean of 720 kcal/d for 8 wk adjusted to increase body fat from 9 to 18%. Body weight (means +/- SD) increased from 55.2 +/- 3.4 to 57.0 +/- 4.2 kg. Body fat gain was highly variable ranging from 0.6 to 3.8 kg. Energy expenditure (EE) by the factorial and doubly labeled water methods did not change. Fat storage accounted for 66% of the supplemental energy; 237 kcal/d remained unaccounted for. EE by the factorial method, which uses indirect calorimetry or isotopic measurements, were highly correlated (r = 0.8; p less than 0.01). Under the conditions of this study EI does not affect EE. The labeled water method permits the evaluation of energy expenditure in free-living conditions.     

Adaptation of energy metabolism of overweight women to alternating and continuous low energy intake

To investigate whether a slimming diet based on alternating (low with normal) energy intakes could counteract a decrease in energy requirement, 24-h energy expenditure (24EE), sleeping energy expenditure (sleeping EE), and physical activity were determined in a respiration chamber in 27 overweight women: before weight reduction and after 4 and 8 wk of slimming. Daily alternating and continuous slimming diets were supplied. Average weight losses over 8 wk of slimming were 6.9-9.0 kg. After 8 wk at low energy intake, 24EE had declined by 12-16% (from 2328 +/- 219 to 1987 +/- 204 kcal, mean +/- SD). Sleeping EE had declined by 7-13% (from 64 +/- 6 to 57 +/- 6 kcal/h). Measurements of physical activity indicated a reduction of spontaneous physical activity during slimming. Alternating low energy intake did not prevent 24EE from declining. The reduction in 24EE was determined by a decrease of body weight, dietary induced thermogenesis (in proportion to caloric restriction), and physical activity. There seems little reason to consider other adaptive mechanisms.     

Comparing different measures of energy expenditure in human subjects resident in a metabolic facility

OBJECTIVE: To compare energy expenditure (EE) measured by doubly labeled water (DLW) with other measures, both physical and based on subjective questionnaires. DESIGN: A comparison of methods in a stratified sample of adult volunteers. SETTING: The feeding behaviour suite (FBS) at the Rowett Research Institute, Aberdeen. SUBJECTS: A total of 59 subjects, stratified for age, sex and body mass index (BMI).Interventions:EE was assessed by DLW (validated using measurements of energy balance), heart rate monitor (HRM), activity monitor (Caltrac), 24-h physical activity diary (PAD) and 7-day physical activity recall. Energy intake was assessed using covert (investigator-weighed) food intake (EI). Data were collected over a 12-day period of residence in the Rowett's FBS. RESULTS: No methods correlated highly with physical activity assessed by DLW. Physical methods correlated more closely than did subjective recording. All methods (except EI) significantly underestimated EE, estimated by DLW. There were no significant differences in association between methods and sex, age, BMI or fat-free mass. CONCLUSION: EE is difficult to measure precisely or accurately with current approaches but physical methods are slightly better than subjective accounts.