Repeatability of 24-h energy expenditure measurements in humans by indirect calorimetry

To estimate sources and extent of variation in energy expenditure (EE), as measured by indirect calorimetry in a room-sized human calorimeter, a number of 24-h measurements were compiled. Measured oxygen consumption and carbon dioxide production from alcohol combustion experiments averaged 101.5% of the theoretical value with a coefficient of variation (CV) of 1.4%. Experiment 1 consisted of four men who had the following averages: age, 41 y; height, 179 cm; weight, 84.6 kg; and fat, 23.5%. Five measurements, separated by 1 d, were made on each subject. Daily and basal EE averaged 2852 and 1691 kcal/d, respectively, with a within-subject CV of 2.7% and 2.4%, respectively. Experiment 2 consisted of five men who had the following averages: age, 48 y; height, 181.6 cm; weight, 87 kg; and fat, 23%. Five measurements made on each subject were separated by 1-3 wk. Daily and basal EE averaged 2619 and 1837 kcal/d, respectively, with a within-subject CV of 4.6% and 2.9%, respectively.     

Activity diary method for predicting energy expenditure as evaluated by a whole-body indirect human calorimeter

In comparison with the energy expenditure determined by a whole-body indirect human calorimeter, which provides 24-h energy expenditure (TEE) with high precision and accuracy, the accuracy of predicting energy expenditure (EE) using an activity diary (AD) method was evaluated. Observed and predicted basal metabolic rate (BMR) as well as literature values for typical physical activities were used for TEE prediction. The effect of the number of recorded items in the activity diary on the accuracy of TEE was also examined. Additionally, predicted EE was divided into sleeping, exercise, and sedentary EE to evaluate the estimation errors in the AD method. Subjects were 20- to 69-y-old Japanese women (n = 20) and men (n= 21). Predicted TEE based on the AD was derived by applying the observed or predicted BMR to literature values for physical activities; i.e., relative metabolic rate (R.M.R.), physical activity ratio (PAR), and metabolic equivalent (MET). The BMR value observed for each subject was obtained by indirect calorimetry using a Douglas bag. The BMR for the subject was also estimated from the predictive equations in the 6th revision of the Recommended Dietary Allowances for the Japanese (1999). The correlations between observed and predicted TEE appeared stronger when using observed BMR than those using predicted BMR. Although the difference of mean values between the predicted and observed TEE was small, the limits of agreement between the predicted and observed TEE were around +/- 400 kcal. Predicted EE, excluding the time periods for exercise and rest laying down when determining BMR, showed similar results to those of TEE. Furthermore, the number of recorded items in the AD was not significantly correlated to the accuracy of the predicted TEE (r = -0.03). These findings indicate that the predicted TEE of the AD using observed or predicted BMR and literature values is favorably comparable to observed TEE using a whole-body human calorimeter on a group basis; however, its use as a proxy measure of TEE or EE on an individual basis may be limited.     

A whole body transportable indirect calorimeter for human use in the tropics

A transportable, whole body indirect calorimeter, designed for use in the tropics, is described. The calorimeter was built to study energy expenditure of people having chronically or acutely low levels of food intake, and it will help to determine energy adaptations made by individuals with restricted food intake. The calorimeter comprises two units: a 27 m3 ventilated chamber connected to an office housing control and monitoring equipment. The system also allows the experimenter to assess the rate of energy expenditure by means of a ventilated hood or a baby respiration chamber. The incoming air flow rate is variable and is typically set at approximately 30 l/min. Carbon dioxide production (VCO2) and oxygen consumption (VO2) are continuously monitored by means of differential gas analysers via a computerized data acquisition unit. Gas production/consumption rates are measured with a delay of 80 s, the complete response to step changes in VCO2 or VO2 consumption being calculated over 15 min using the rate of change terms in the gas exchange equations. The total electrical power required for the whole system is 12 kW. The calorimeter has been functioning for nearly 4 years in a rural village of The Gambia during which ambient temperatures have ranged from 16 to 44 degrees C and dewpoints from -8 to 24 degrees C. The performance and accuracy of the calorimeter were tested using 20 per cent CO2 in N2 infusion and butane burning. Agreement between the theoretical and the measured values was found to be 99 per cent for VO2 and 100 per cent for VCO2 with a precision for both gases of +/- 10 ml/min over a 1-h period.     

A new hand-held indirect calorimeter to measure postprandial energy expenditure

OBJECTIVE: To verify the accuracy of a new hand-held metabolic rate measuring device (MedGem) in quantifying postprandial energy expenditure (PP EE). MedGem measurements were compared to measurements obtained with a conventional indirect calorimeter (Delta-Trac). RESEARCH METHODS AND PROCEDURES: The resting metabolic rate of 15 healthy subjects was measured for 20 minutes using Delta-Trac followed by a 10-minute measurement period using MedGem. EE was again measured for 7 hours after consumption of a 2510-kJ breakfast. Measurements were read from the Delta-Trac for the initial 50 minutes of each hour followed by a single reading from the MedGem after 5 to 10 minutes of measurement. Measured EE was calculated as the average of the total measurement period for Delta-Trac and for eight readings using MedGem; PP EE was calculated as the average of all measurements obtained after breakfast consumption. RESULTS: There was no difference in resting metabolic rate between the two methods (6455.1 +/- 417.6 vs. 6468.5 +/- 337.2 kJ/d for Delta-Trac and MedGem, respectively). Measured EE and PP EE values with Delta-Trac (7019.1 +/- 400.8 and 7099.8 +/- 399.2 kJ/d, respectively) and MedGem (6775.6 +/- 372.0 and 6819.5 +/- 379.9 kJ/d, respectively) were not significantly different. There was no bias detected in any of the measurements made with MedGem compared with those of Delta-Trac. DISCUSSION: The new hand-held EE measuring device can accurately track PP EE relative to a conventional indirect calorimetry system and, therefore, provides a new opportunity to assess PP EE in research settings and large-scale trials.     

Intra-individual variability and measurement noise in estimates of energy expenditure by whole body indirect calorimetry

1. Four men were each studied continuously over 12 d in a whole-body calorimeter. Dietary intake and daily activities were kept constant throughout the study. 2. Day-to-day coefficients of variation in energy expenditure within subjects were found to be 1.97% over 24 h, 5.93% during basal metabolic rate measurement, 2.40% overnight and 3.22% in exercise. 3. The contribution of measurement system noise to the observed variability was analysed and shown to be generally small. The source of this noise was considered. 4. The results reinforce and extend other comparable reports and show that within-subject variability forms a small part of reported observations of between-subject variability.     

Comparison of methods for achieving 24-hour energy balance in a whole-room indirect calorimeter

OBJECTIVE: To evaluate and compare methods for achieving 24-hour energy balance in a whole-room indirect calorimeter. RESEARCH METHODS AND PROCEDURES: Twenty-four-hour energy expenditure (EE) for 34 healthy adults (16 women, 18 men) was measured in a calorimeter during a prestudy day and on a subsequent nonconsecutive assessment day (AD). Several methods for estimating EE on the AD using activity factors or regression equations with data available before the AD [anthropometrics, body composition, resting metabolic rate (RMR), sleeping metabolic rate (SMR) on prestudy day, 24-hour EE on prestudy day] were compared for predictive accuracy. RESULTS: Use of a 24-hour calorimeter stay gave the smallest mean absolute error (119 +/- 16 kcal/d) and smallest single maximum error (361 kcal/d). However, several other methods were only slightly, and not significantly, less accurate (e.g., mean absolute error = 131 +/- 17, 140 +/- 20, and 141 +/- 22 kcal/d and greatest error = 384, 370, and 593 kcal/d for anthropometric, RMR, and SMR regression equations, respectively). Fat-free mass alone and SMR with a simple activity factor were seen to be less accurate. DISCUSSION: Our results indicate that there may be some improvement in achieving 24-hour energy balance in a metabolic chamber by using a preceding 24-hour calorimeter stay; that only slightly less accurate predictions can be obtained using a combination of anthropometric, body composition, and/or RMR measurements; and that there is little or no advantage in using SMR from a previous overnight calorimeter stay.     

Twenty-four-hour energy expenditure and basal metabolic rate measured in a whole-body indirect calorimeter in Gambian men

By use of a respiration chamber, 24-hour energy expenditure (EE), diet-induced thermogenesis (DIT), and basal and sleeping EE were measured in 20 young rural Gambian men during the "hungry" season (weight, 60.8 +/- 1.4 kg) and in a group of 16 European men matched for body composition (weight, 66.9 +/- 1.9 kg). The 24-h EE was lower in Gambian than in European men (2047 +/- 46 vs 2635 +/- 74 kcal/d, p less than 0.001, respectively). Basal EE and sleeping EE were also lower in Gambian than in European men (1.05 +/- 0.02 vs 1.25 +/- 0.02 kcal/min and 1.0 +/- 0.02 vs 1.18 +/- 0.02 kcal/min, p less than 0.01, respectively). DIT was blunted in Gambian compared with European men (6.3 +/- 0.6% vs 12.1 +/- 0.5%, p less than 0.001 respectively). The net efficiency of walking was greater in Gambian than in European men (23.2 +/- 0.3% vs 20.1 +/- 0.4%, p less than 0.001, respectively). A low basal and sleeping EE, a reduced DIT, and a high work efficiency are important energy-sparing mechanisms in Gambian men, which allow them to cope with a marginal level of dietary intake during the hungry season.     

Clinical accuracy of the MedGem indirect calorimeter for measuring resting energy expenditure in cancer patients

OBJECTIVE: To compare, in patients with cancer and in healthy subjects, measured resting energy expenditure (REE) from traditional indirect calorimetry to a new portable device (MedGem) and predicted REE. DESIGN: Cross-sectional clinical validation study. SETTING: Private radiation oncology centre, Brisbane, Australia. SUBJECTS: Cancer patients (n = 18) and healthy subjects (n = 17) aged 37-86 y, with body mass indices ranging from 18 to 42 kg/m(2). INTERVENTIONS: Oxygen consumption (VO(2)) and REE were measured by VMax229 (VM) and MedGem (MG) indirect calorimeters in random order after a 12-h fast and 30-min rest. REE was also calculated from the MG without adjustment for nitrogen excretion (MGN) and estimated from Harris-Benedict prediction equations. Data were analysed using the Bland and Altman approach, based on a clinically acceptable difference between methods of 5%. RESULTS: The mean bias (MGN-VM) was 10% and limits of agreement were -42 to 21% for cancer patients; mean bias -5% with limits of -45 to 35% for healthy subjects. Less than half of the cancer patients (n = 7, 46.7%) and only a third (n = 5, 33.3%) of healthy subjects had measured REE by MGN within clinically acceptable limits of VM. Predicted REE showed a mean bias (HB-VM) of -5% for cancer patients and 4% for healthy subjects, with limits of agreement of -30 to 20% and -27 to 34%, respectively. CONCLUSIONS: Limits of agreement for the MG and Harris Benedict equations compared to traditional indirect calorimetry were similar but wide, indicating poor clinical accuracy for determining the REE of individual cancer patients and healthy subjects.     

Twenty-four-hour energy expenditure in pregnant and nonpregnant Gambian women, measured in a whole-body indirect calorimeter.

Twenty-four-hour energy expenditure (EE), daily and sleeping EE, and the energy cost of a standardized treadmill exercise were assessed in a respiration chamber in 41 young pregnant Gambian women at 12 (n = 11), 24 (n = 15), and 36 (n = 15) wk of gestation and compared with 13 nonpregnant nonlactating (NPNL) control women. The rate of 24-h EE was significantly higher (P less than 0.001) at 36 wk gestation (8443 +/- 243 kJ/d) than in the NPNL group (6971 +/- 172 kJ/d) or at 12 and 24 wk (7088 +/- 222 and 7188 +/- 192 kJ/d, respectively). Per unit body weight, no more differences in 24-h EE, daily and sleeping EE, or energy cost of walking were observed between pregnant and NPNL women. There was no statistical difference in the 24-h respiratory quotient among the groups. We conclude that the state of pregnancy in Gambian women induces a progressive rise in 24-h EE, which becomes significant in the third trimester and is proportional to body weight.     

Validation of the BIOPAC indirect calorimeter for determining resting energy expenditure in healthy free-living older people

The BIOPAC indirect calorimeter for measuring resting energy expenditure (REE) is less cumbersome than many other calorimeters. We tested the hypothesis that the BIOPAC calorimeter is as well suited for determining REE in older people as traditional calorimeters. In 50 healthy persons (24 men and 26 women; age range, 61-83 years), REE by BIOPAC was validated against Vmax Spectra indirect calorimeter as a criterion method. Resting energy expenditure by BIOPAC was recorded at 2 different time intervals to find optimal conditions for older persons. Also, REE by 7 published equations was validated. The Bland-Altman procedure was used to test agreement between methods. Multiple regression analysis was applied to develop a new equation for predicting REE from BIOPAC. The BIOPAC calorimeter and most empirical equations significantly overpredicted mean REE in both sexes. Mifflin's equation best-predicted mean REE. Limits of agreement were wide for BIOPAC and narrow for most empirical equations. The Lührmann and Müller equations had smallest limits of agreement in men (±950 kJ/24 h) and the Harris-Benedict and Müller equations in women (±672 kJ/24 h). A new equation was developed for the BIOPAC device improving both predictions of mean and individual REE (R² = 0.671, standard error of the estimate = 136 kJ/24 h). Using this equation, 72.9% of subjects were lying within 10% of measured REE, compared with only 12.5% when using the manufacturer's algorithm. In conclusion, the BIOPAC calorimeter is suitable for measuring REE in healthy older adults when the new prediction equation is applied. This calorimeter is not applicable to frail older persons.     

Influence of mild cold on 24 h energy expenditure in 'normally' clothed adults

Ten subjects aged 19-35 years (four men and six women) underwent two measurements of 24 h energy expenditure (EE) in a whole-body respiration calorimeter, one at a temperature of 28 degrees and one at 20 degrees. Choice of clothing was allowed. Dietary intake was standardized and subjects were asked to follow the same pattern of activity during both measurements. Mean 24 h EE was significantly greater at the cooler temperature by 5.0 (SD 5.5)%, with individual differences ranging from 4.6% lower to 12.6% higher. The difference in EE at the two temperatures was similar during the day and the night and occurred even though subjects wore more clothes and used more bedding at 20 degrees. No relationship was observed between response to 20 degrees and body-weight status. In conclusion, the assumption that mild cold is unlikely to affect EE in subjects wearing normal clothing may be incorrect.     

Intraduodenal infusion of alpha-ketoglutarate decreases whole body energy expenditure in growing pigs

BACKGROUND AND AIMS: alpha-Ketoglutarate (AKG) has been suggested to play a particular role as an oxidative fuel for the gut, and thus may have a sparing function for fuels such as glutamate and aspartate. Using the pig model we aimed to quantify how the route of administration (intravenous, i.v.; intragastric, i.g.; intraduodenal, i.d.) affects AKG utilization, whole body energy expenditure (EE) and nutrient oxidation. METHODS: Pigs (15 kg) were supplied with a complete nutrient solution (NS) via catheters. To explore the metabolic effects of AKG, 1.0 g AKG kgBW(-1)d(-1) was infused simultaneously with the NS using either the i.d., i.v. or i.g. route. [1-(13)C]AKG (15 mg kgBW(-1)) was infused i.d., i.v. or i.g., respectively, for 3h. AKG utilization (AKG UTIL) was estimated as AKG UTIL=100-(13)C recovery (% of (13)C dose). (13)C recovery was calculated from the (13)C enrichment in breath CO(2) and the whole-body CO(2) production. RESULTS: AKG infusion and NS via the i.d. route resulted in a reduced AKG UTIL (40.1+/-6.7) as compared to the i.v. route (62.9+/-2.4, P<0.001) and i.g. route (62.3+/-1.6, P<0.001). The total EE was lower with the i.d. route of AKG and NS (745+/-68 kJkgBW(-0.62)d(-1)) as compared to the i.v. route (965+/-54 kJkgBW(-0.62)d(-1), P<0.005) and i.g. route (918+/-43 kJkgBW(-0.62)d(-1), P<0.005). Carbohydrate oxidation was increased with the i.d. route (38.2g+/-3.4 kgBW(-0.62)d(-1)) as compared to the i.v. route (27.8+/-2.9 gkgBW(-0.62)d(-1), P<0.08) and i.g. route (23.9+/-8.5 gkgBW(-0.62)d(-1), P<0.05). Fat oxidation was decreased (2.1+/-1.9 gkgBW(-0.62)d(-1); P<0.001) with the i.d. route as compared to the i.v. route (11.5+/-1.4 gkgBW(-0.62)d(-1), P<0.001) and i.g. route (11.9+/-3.1 gkgBW(-0.62)d(-1), P<0.001). CONCLUSIONS: The i.d. infusion of AKG in combination with the NS affected the whole body EE and nutrient oxidation, in comparison to that obtained with the i.v. and i.g. routes. It was concluded that the i.d. administration of AKG markedly controlled the nutrient partitioning in the oxidation processes. Finally, in contrary to the observations with glutamine or glutamate, a considerable percentage of the AKG infusion was retained in the body irrespective of the route of administration.     

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

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

The effect of environmental temperature and humidity on 24 h energy expenditure in men.

The effects of environmental temperature and humidity and their interaction on 24 h energy expenditure were measured using whole-body indirect calorimetry in eight normal-weight young men who wore standardized light clothing and followed a controlled activity regimen. A randomized-block experimental design was used, with temperature effects assessed by measurements at 20, 23, 26 and 30 degrees, while humidity was altered from ambient (50-65% relative humidity) to high (80-93% relative humidity) at 20 and 30 degrees only. There was no significant effect of humidity on 24 h energy expenditure at the two extreme temperatures in this range, though when periods of sleep and exercise were excluded the energy expenditure at high humidity was significantly higher than that ambient humidity (P < 0.02). The effect of temperature at ambient humidity levels showed lower values at 23 and 26 degrees than at 20 and 30 degrees (P < 0.02). The effect of temperature was not equally apparent in all components of the 24 h energy expenditure, as sleeping metabolic rate and the energy cost of walking and cycling showed no significant effect of temperature over this range. This raises the possibility that the effects of temperature are attributable to behavioural changes during the waking portion of the day rather than any non-shivering thermogenic mechanisms at tissue level.     

Prediction of daily energy expenditure during a feeding trial using measurements of resting energy expenditure, fat-free mass, or Harris-Benedict equations

BACKGROUND: During feeding trials, it is useful to predict daily energy expenditure (DEE) to estimate energy requirements and to assess subject compliance. OBJECTIVE: We examined predictors of DEE during a feeding trial conducted in a clinical research center. DESIGN: During a 28-d period, all food consumed by 26 healthy, nonobese, young adults was provided by the investigators. Energy intake was adjusted to maintain constant body weight. Before and after this period, fat-free mass (FFM) and fat mass were assessed by using dual-energy X-ray absorptiometry, and DEE was estimated from the change (after - before) in body energy (DeltaBE) and in observed energy intake (EI): DEE = EI - DeltaBE. We examined the relation of DEE to pretrial resting energy expenditure (REE), FFM, REE derived from the average of REE and calculated from FFM [REE = (21.2 x FFM) + 415], and an estimate of DEE based on the Harris-Benedict equation (HB estimate) (DEE = 1.6 REE). RESULTS: DEE correlated (P < 0.001) with FFM (r = 0.78), REE (r = 0.73), average REE (r = 0.82), and the HB estimate (r = 0.81). In a multiple regression model containing all these variables, R(2) was 0.70. The mean (+/-SEM) ratios of DEE to REE, to average REE, and to the HB estimate were 1.86 +/- 0.06, 1.79 +/- 0.04, and 1.02 +/- 0.02, respectively. CONCLUSIONS: Although a slightly improved prediction of DEE is possible with multiple measurements, each of these measurements suggests that DEE equals 1.60-1.86 x REE. The findings are similar to those of previous studies that describe the relation of REE to DEE measured directly.     

Comparison of indirect calorimetric measurements of resting energy expenditure with a ventilated hood, face mask, and mouthpiece

This study compared three techniques for indirect calorimetric measurement of resting energy expenditure: ventilated canopy, face mask, mouthpiece plus noseclips. A total of 18 healthy men and women underwent all three measurement techniques in three consecutive 20-min measurement periods in a Latin square design. No significant effects were found for either period or method with respect to oxygen consumption, respiratory exchange ratio, and caloric expenditure. Oxygen consumption was (mean +/- SD) 250 +/- 45, 251 +/- 47, and 254 +/- 49 mL/min for hood, mask, and mouthpiece, respectively (ns). The respiratory exchange ratio was lower for the hood (0.809 +/- 0.051) than mask (0.837 +/- 0.043) and mouthpiece (0.847 +/- 0.045) but this difference was not statistically significant (p = 0.07). Calculated caloric expenditure was 1.20 +/- 0.22, 1.21 +/- 0.22, and 1.23 +/- 0.23 kcal/min for hood, mask, and mouthpiece, respectively (ns). Thus, in healthy individuals similar results are obtained by the three methods and the face mask and mouthpiece are acceptable alternatives to the ventilated hood for estimation of resting energy expenditure.     

人体24小时使用手册

月有阴晴圆缺,人体的机能状态在一天24小时里同样有规律可循。日前,在接受记者采访时,中国中医科学院西苑医院杨力教授介绍了人体器官24小时工作表。