Energy expenditure,body composition,and biochemical indicators in healthy community women

A cross-sectional study was conducted on the associations between energy expenditure (EE), body composition (lean mass, fat mass, body mass index), and biochemical indicators (leptin, glucagon, insulin, cortisol, and triglycerides) among 17 sedentary African-American and Caucasian women living in the community (age, 40.7±6.0 years; body mass index, 32.8±9.0 kg/m²). Measurements included total, resting, and sleeping EE (via whole-room indirect calorimetery), body composition (via air-displacement plethysmography), body mass index, and biochemical indicators (leptin, glucagon, cortisol, insulin, and triglycerides). Analysis of associations between EE and body composition showed that EE increased with increasing body size, with lean mass explaining 79%, 71%, and 73% of the variability in total, resting, and sleeping EE, respectively. Analysis of associations between body composition and the biochemical indicators showed that leptin, glucagon, and insulin were positively correlated with increasing body size, whereas cortisol was negatively correlated with increasing body size. Analysis of associations between EE and biochemical indicators prior to controlling for body size showed that leptin was positively correlated with EE, and that the correlation between leptin and sleeping EE was significantly greater than the correlation between leptin and resting EE. After controlling for body size, the correlations between leptin and EE were no longer significant, and the partial correlation between leptin and sleeping EE was no longer significantly different from the partial correlation between leptin and resting EE. Glucagon was positively correlated with EE, but not after controlling for body composition. Future research should incorporate the use of sleeping EE in addition to resting EE, since clearly, for some biochemicals such as leptin and glucagon, this distinction is important. Methodological improvements may provide better insight into the effects of obesity modulating hormones.     

Energy expenditure, body composition, and biochemical indicators in healthy community women

A cross-sectional study was conducted on the associations between energy expenditure (EE), body composition (lean mass, fat mass, body mass index), and biochemical indicators (leptin, glucagon, insulin, cortisol, and triglycerides) among 17 sedentary African-American and Caucasian women living in the community (age, 40.7+/-6.0 years; body mass index, 32.8+/-9.0 kg/m2). Measurements included total, resting, and sleeping EE (via whole-room indirect calorimetery), body composition (via air-displacement plethysmography), body mass index, and biochemical indicators (leptin, glucagon, cortisol, insulin, and triglycerides). Analysis of associations between EE and body composition showed that EE increased with increasing body size, with lean mass explaining 79%, 71%, and 73% of the variability in total, resting, and sleeping EE, respectively. Analysis of associations between body composition and the biochemical indicators showed that leptin, glucagon, and insulin were positively correlated with increasing body size, whereas cortisol was negatively correlated with increasing body size. Analysis of associations between EE and biochemical indicators prior to controlling for body size showed that leptin was positively correlated with EE, and that the correlation between leptin and sleeping EE was significantly greater than the correlation between leptin and resting EE. After controlling for body size, the correlations between leptin and EE were no longer significant, and the partial correlation between leptin and sleeping EE was no longer significantly different from the partial correlation between leptin and resting EE. Glucagon was positively correlated with EE, but not after controlling for body composition. Future research should incorporate the use of sleeping EE in addition to resting EE, since clearly, for some biochemicals such as leptin and glucagon, this distinction is important. Methodological improvements may provide better insight into the effects of obesity modulating hormones.     

Energy balance and rectal cancer: an evaluation of energy intake, energy expenditure, and body mass index

Lack of energy balance, or greater energy intake than expenditure as indicated by a large body mass index (BMI), has been associated with colon cancer, although less is known about its association with rectal cancer. In this study, we examined the association between BMI, energy intake, and energy expenditure and their combined effect on rectal cancer risk. A population-based case-control study was conducted in Utah and Northern California. Incident cases (n = 952) of rectal cancer and population-based controls (n = 1205) were interviewed between 1997 and 2002 to obtain detailed information on body size, dietary intake, and physical activity patterns. BMI (kg/m(2)) was not associated with rectal cancer in either men or women. Participation in vigorous leisure-time physical activity over the past 20 yr was associated with a significant 40% reduction in rectal cancer risk. Energy intake was associated significantly with increased risk of rectal cancer, especially among people whose diagnosis was prior to age 60 yr (odds ratio [OR] = 3.9; 95% confidence interval [CI] = 1.7-9.1 for men; OR = 2.8; 95% CI = 1.1-7.2 for women). There was a significant interaction between energy intake and energy expenditure, although not between BMI and either energy intake or energy expenditure. These data suggest that large BMI, an indicator of lack of energy balance, is not an important component of the etiology of rectal cancer. However, both physical activity and energy intake were significantly associated with rectal cancer risk. These data suggest that energy expenditure and energy intake alter rectal cancer risk through mechanisms other than energy balance.     

Energy intake, energy expenditure, and smoking in relation to body fatness: the Zutphen Study

In 1965 within the Zutphen Study information on several possible determinants of body fatness (eg, energy intake, energy expenditure, alcohol intake, coffee consumption, tea consumption, and smoking) was collected. Univariate analyses showed that for 525 men aged 45-64 y and free from cardiovascular diseases, indicators of body fatness were inversely related to the difference between energy intake and expenditure, physical activity per kilogram body weight, smoking, and coffee consumption. Alcohol intake was directly related to Quetelet index, and tea consumption was not related to indicators of body fatness. Inverse associations between indicators of body fatness and the difference between energy intake and expenditure, physical activity per kilogram body weight, and smoking were confirmed in multivariate analyses. The inverse association between body fatness and the difference between energy intake and expenditure may be due to the underestimation of energy intake by obese subjects. In lean people this association may be explained by a thermogenic effect of smoking.     

Characteristics of body composition and resting energy expenditure in lean young women

The number of lean young women has been increasing. Fear of being fat may induce unnecessary attempts to reduce body weight, which can cause several types of illness. Many investigations have demonstrated dysfunction of the hypothalamus and metabolic differences in patients with anorexia nervosa. However, it is unclear whether there are any differences in physical characteristics between women with lower body weight and no illness compared to those of normal body weight. In this study, we investigated the differences in body composition, biochemical parameters, and resting energy expenditure (REE) between young women with low and normal body mass index (BMI). Twenty lean women (BMI<18.5 kg/m(2)) and 20 normal women (18.5≤BMI<25 kg/m(2)) were recruited for this study. Body composition, biochemical parameters, and REE (REEm: measurement of REE) were measured, and the REE (REEe: estimation of REE) was estimated by using a prediction model. Marked differences were found in body composition. All of the values of blood analysis were in the normal ranges in both groups. REEm (kcal/d and kcal/kg BW/d) was significantly lower in lean than in normal women, but there were no significant differences in the REEm to fat free mass (FFM) ratio between the two groups. In addition, there was good agreement between REEm and REEe obtained from the specific metabolic rates of four tissue organs. These data indicate that the lean women without any illness have normal values of biochemical parameters and energy metabolism compared to women with normal BMI.     

Energy metabolism, body composition, and milk production in healthy Swedish women during lactation

Variables of relevance to energy requirements during reproduction were studied in 23 healthy lactating Swedish women. Body composition and resting metabolic rate (RMR) were studied before pregnancy and three times postpartum. Energy intake was studied before pregnancy and, together with breast-milk production, 2 mo postpartum. The women gained 5.8 +/- 4.2 kg fat during pregnancy and their average fat content was unchanged during the first 2 mo of lactation whereas a slight loss (1.7 +/- 4.2 kg) occurred during the following 4 mo. RMR increased slightly during lactation in spite of a decrease in fat-free body weight 2 and 6 mo postpartum. Energy intake increased during lactation (280 +/- 440 kcal/d). The women produced 740 +/- 150 g breast milk/d containing 0.64 +/- 0.08 kcal/g. The results indicate that current estimates of energy needs during lactation may be too high.     

Energy expenditure and body composition during weight reduction in hyperplastic obese women

The energy expenditure and body composition changes in out-patients during a long-term weight reduction with a diet recommended to provide 1100 kcal were studied in eight hyperplastic obese women. The study was focused on finding plausible explanations for the decreasing weight loss rate after several weeks of successful weight reduction. Using a heart rate monitoring method, the energy expenditure was measured four times at selected intervals during the study. Then, the energy intake was calculated on the basis of three dietary recordings lasting from 4 to 7 days. The recorded energy intake increased at the end of the weight reduction, but no changes in daily energy expenditure were found. The oxygen consumption during standardized cycling, walking, and domestic work decreased, but when the patient was at rest, no changes occurred during the weight reduction. The weight loss predicted from the energy balance and body composition changes was considerably greater than the actually determined weight loss. Large discrepancies were found after 5 weeks on the weight reducing regimen between the recorded dietary intake and what could be calculated from urinary nitrogen losses. With the available methods for determining energy intake and expenditure, it was considered impossible to fully explain the reason for the weight plateau observed after long-term weight reduction in out-patients.     

Changes in body weight, body composition, and energy intake in women fed high- and low-fat diets.

The effects of a 20%-fat diet (LF) on total body weight, lean body weight, and adiposity were studied in 18 premenopausal women with body mass index (BMI) of 18-44. Subjects were fed a 37%-fat (HF) control diet for 4 wk followed by the LF diet for 20 wk. Total body weight, lean body weight, and fat weight were measured at the end of the HF and LF dietary periods by hydrostatic weighing. Despite adjustments in energy intake to maintain weight throughout the study, subjects exhibited a 2.8% decrease in total body weight (P less than 0.0006), an 11.3% decrease in fat weight (P less than 0.0001), and a 2.2% increase in lean body weight (P less than 0.0149) by the end of the LF period. Similar changes were observed in obese (BMI greater than 30) and non-obese women (BMI less than 30). By the end of the LF period, energy intake had increased significantly in comparison with the HF diet (119% of the HF intake, P less than 0.0001). Results could not be explained by changes in daily activity levels and suggest that macronutrient composition plays a role in energy requirements for weight maintenance.     

Total energy expenditure of healthy Swedish women during pregnancy and lactation.

Total energy expenditure (TEE) was estimated in healthy Swedish women by the doubly labeled water method in a longitudinal study during pregnancy and lactation. Measurements were made before pregnancy (A); in gestational weeks 16-18 (B), 30 (C), and 36 (D); as well as 2 (F) and 6 (G) mo after delivery. When the results were interpreted, earlier published data regarding resting metabolic rate (RMR), energy intake, and energy in breast milk were also considered. TEE (MJ/d) and TEE/RMR were 10.5 +/- 2.2 (mean +/- SD) and 1.87 +/- 0.42 (n = 28), 9.6 +/- 2.8 and 1.65 +/- 0.67 (n = 22), 12.5 +/- 3.4 and 1.82 +/- 0.45 (n = 22), 12.2 +/- 4.1 and 1.66 +/- 0.52 (n = 19), 10.6 +/- 2.0 and 1.82 +/- 0.41 (n = 23), and 10.8 +/- 2.7 and 1.79 +/- 0.42 (n = 23) at A, B, C, D, F, and G, respectively. The results indicated that physical activity tended to be decreased during early pregnancy. Taking changes in body energy stores into consideration, it was estimated that subjects recorded 86% and 77% of their energy intakes at A and F respectively.     

Micronutrient status during lactation in HIV-infected and HIV-uninfected South African women during the first 6 mo after delivery

BACKGROUND: Little information on the micronutrient status of HIV-infected (HIV-positive) breastfeeding women is available. OBJECTIVE: The objective was to compare the protein and micronutrient status of South African breastfeeding women by HIV status. DESIGN: Serum albumin, prealbumin, vitamin B-12, folate, retinol, alpha-tocopherol, hemoglobin, ferritin, and zinc concentrations were compared between 92 HIV-positive and 52 HIV-uninfected (HIV-negative) mothers 6, 14, and 24 wk after delivery. C-reactive protein and alpha1-acid glycoprotein were used as proxy indicators of an inflammatory process. RESULTS: Mean albumin and prealbumin were significantly lower in HIV-positive mothers, and a higher proportion of HIV-positive mothers had low albumin concentrations (< 35 g/L). Less than 45% of the mothers were vitamin B-12 or folate sufficient. Significantly more HIV-positive (70.5%) than HIV-negative (46.2%) mothers had marginal vitamin B-12 status (P < 0.05), and mean folate concentrations were lower in HIV-positive mothers (P = 0.05). Mean serum retinol was significantly lower in HIV-positive mothers, even after control for the acute phase response. At 24 wk, 70% of both groups had an alpha-tocopherol deficiency (< 11.6 micromol/L), but no significant difference by HIV status was observed. More HIV-positive (33.3%) than HIV-negative (8.7%) mothers had anemia (P = 0.018), whereas 25% of all mothers had low serum ferritin concentrations. After the acute phase response was controlled for, zinc deficiency was more common in HIV-positive (45.0%) than in HIV-negative (25.0%) mothers (P = 0.05). CONCLUSIONS: Deficiencies in vitamins B-12, folate, alpha-tocopherol, ferritin, and zinc are common in South African breastfeeding mothers. HIV-positive mothers had lower mean serum concentrations of albumin, prealbumin, folate, retinol, and hemoglobin than did HIV-negative mothers.     

Improvements in body composition, glucose tolerance, and insulin action induced by increasing energy expenditure or decreasing energy intake

Increases in exercise energy expenditure without compensatory changes in food intake (EX) and restriction of calorie intake (CR) both decrease body weight and fat mass, which, in turn, improve glucoregulatory function. However, EX may provide greater benefits than can be provided through CR. Therefore, our study hypothesis was that weight loss through EX reduces visceral abdominal fat and improves glucoregulation to a greater extent than does similar weight loss through CR. Forty-eight sedentary 50- to 60-y-old men and women, most of whom were overweight, underwent 12 mo of EX, CR, or a healthy lifestyle control period. Body composition was assessed by dual-energy x-ray absorptiometry and by magnetic resonance imaging. Indices of glucoregulatory function were determined by oral glucose tolerance test and were measured > or =48 h after the last exercise bout in the EX group. Body weight, total fat mass, and visceral fat volume decreased similarly in the EX and CR groups but did not change in the HL group. Likewise, insulin sensitivity index and the oral glucose tolerance test glucose and insulin areas under the curve improved similarly in the EX and CR groups and remained unchanged in the HL group. In conclusion, weight losses induced by exercise and by CR are effective means for improving glucose tolerance and insulin action in nonobese, healthy, middle-aged men and women; however, it does not appear that exercise training-induced weight loss results in greater improvements than those that result from CR.     

Energy expenditure, energy intake, and weight loss in Alzheimer disease

Alzheimer disease is one of the leading causes of death among older individuals. Unexplained weight loss and cachexia are frequent clinical findings in patients with Alzheimer disease. Thus, it has been postulated that Alzheimer disease may be associated with dysfunction in body weight regulation. This brief review examines the interrelations among energy intake, energy expenditure, and body composition in Alzheimer disease. We explored whether abnormally high daily energy expenditures, low energy intakes, or both contribute to unexplained weight loss and a decline in nutritional status. Specifically, we considered studies that examined energy intake, body composition, and daily energy expenditure and its components. The application of doubly labeled water and indirect calorimetry to understand the etiology of wasting has increased our knowledge regarding the relation among energy expenditure, physical activity levels, and body composition in Alzheimer disease 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 disease, even in cachectic patients. Recent findings are presented suggesting an association between abnormally elevated levels of physical activity energy expenditure and elevated appendicular skeletal muscle mass and energy intake in Alzheimer disease patients. Clinical strategies aimed at developing lifestyle and dietary interventions to maintain adequate energy intake, restore energy balance, and maintain skeletal muscle mass should be a future area of investigation in Alzheimer disease research.     

Zinc, calcium, and magnesium concentrations in milk from American and Egyptian women throughout the first 6 months of lactation

Effects of stage of lactation, nutrient intake, and cultural differences on the composition of human milk were examined during the first 6 mo of lactation in American and Egyptian women. In both population groups zinc levels in milk decreased from 1 to 6 months of lactation. American women supplemented with Zn had higher levels of Zn in their milk than did unsupplemented American or Egyptian women. Concentrations of calcium and magnesium were not significantly different in milk of American and Egyptian women except at month 6 of lactation. Ca levels in milk of both population groups increased from 1 to 2-3 mo of lactation and then decreased at 6 mo; Mg concentrations increased from 1 to 3 mo and then reached a plateau. Similarities in the longitudinal decrease observed in Zn levels of milk in Zn supplemented and unsupplemented subjects suggested physiological regulation.     

Effects of the interaction of sex and food intake on the relation between energy expenditure and body composition

BACKGROUND: The relation between physical activity energy expenditure (PAEE) and percentage body fat (%BF) is not very strong in the general population. It is possible that variables such as sex, food intake, or both may in part explain this poor coupling. OBJECTIVE: This study was designed to show the relation between PAEE and %BF and to determine whether sex, food intake, or both influence the strength of the relation. DESIGN: We used doubly labeled water or energy intake balance, indirect calorimetry, dietary interview, and dual-energy X-ray absorptiometry to measure total energy expenditure (TEE), resting energy expenditure (REE), food intake, and %BF, respectively, in 91 healthy persons (women: aged 48 y, 38.6%BF, n = 47; men: aged 47 y, 24.1%BF, n = 44). RESULTS: TEE, PAEE, and REE were significantly lower in women than in men. TEE was related to %BF in women (r = 0.53, P < 0.0001) but not in men (r = -0.22, P > 0.05). The relation between PAEE and %BF was significant in men (r = -0.34, P < 0.03) but not in women. PAL was also significantly related to %BF in men (r = -0.36, P < 0.02) but not in women. Macronutrient intake (% of total energy) did not differ significantly between the sexes, but carbohydrate (r = -0.44, P < 0.003) and fat (r = 0.31, P < 0.04) intakes were significantly related to %BF in women. CONCLUSIONS: These results suggest that the relation between PAEE and %BF is stronger in men than in women. Macronutrient composition seems have a stronger influence on %BF in women than in men.     

The quantitative effects of maternal dietary energy intake on pregnancy and lactation in rural Gambian women

The quantitative relationships between dietary energy intake and weight gain in pregnancy, birthweight and lactation performance during the first three months of infancy have been studied in such a way as to take account of major differences in the patterns of heavy manual labour at different times of the year in a subsistence farming community. Maternal weight gain and the accumulation of subcutaneous fat were significantly lower when the last trimester of pregnancy fell during the time of heaviest farm work and lowest energy intakes. The birth-weight of babies was also significantly correlated with differences in energy intake throughout the year. During early lactation breast milk yields were significantly related to concomitant alterations in the subcutaneous fat stores. Evidence has been produced which suggests that in undernourished nursing women there could be a competition for dietary energy between the repleting maternal subcutaneous fat organs and the mammary glands at the expense of milk production.     

Energy intake and expenditure of free-living, pregnant Colombian women in an urban setting.

BACKGROUND: This study examined the components of energy balance in poor, free-living pregnant women living in an urban setting of a developing country. OBJECTIVES: We tested the following hypotheses: 1) energy intake increases in pregnancy and is greater than when nonpregnant and nonlactating (NPNL), 2) basal metabolic rate (BMR) increases in pregnancy and the increase is positively correlated with prepregnancy fatness, and 3) energy expenditure in activity decreases in pregnancy and is lower than in NPNL women. DESIGN: Pregnant women were studied at 14.8 +/- 3.4 (n = 40), 25.0 +/- 3.2 (n = 54), and 34.9 +/- 2.4 (n = 43) wk gestation, and NPNL women at baseline (n = 114) and at 3 (n = 103) and 6 (n = 93) mo. Energy intake was measured by using estimated diet records and energy expenditure by using the flex heart rate method. Time allocation in physical activity was assessed by observation. RESULTS: In pregnant women, body weight, BMR, and energy intake increased but total daily energy expenditure (TDEE) did not change significantly. There were no significant changes in time allocation to selected activities except for lying down. In comparison with NPNL control subjects, women in late pregnancy had higher energy intakes and BMRs. Values for TDEE were not significantly different, but pregnant women expended less energy in activity and allocated more time to 2 energy-saving activities and less time to 2 energy-demanding activities. CONCLUSION: A decrease in energy expenditure in activity and changes in time allocation are important ways in which pregnant women meet the energy demands of pregnancy.     

Diet composition, energy intake, and exercise in relation to body fat in men and women

This study examined the relationships among body fat, diet composition, energy intake, and exercise in adults. Male (n = 107) and female (n = 109) adults aged 18-71 y (36.6 +/- 1.0 y, means +/- SEM) were hydrostatically weighed to determine body fat (5.7-49.0% of total weight). Diet and exercise behaviors were determined by use of a questionnaire. As body fat increased, percent of energy intake derived from fat increased (p less than 0.001) whereas the percent from carbohydrate decreased (p less than 0.001). There was no relationship between energy intake and adiposity although leanness and exercise were related (p less than 0.001). When subgroups of lean and obese subjects were compared, the lean subjects derived approximately 29% of their energy from fat and 53% from carbohydrate vs 35% and 46%, respectively, for the obese subjects. No differences were found between groups for energy intake but the lean individuals exercised more often than did the obese individuals. These data suggest that diet composition may play as important a role in fat deposition as do energy intake and lack of exercise.     

Short-term effects of a progestational contraceptive drug on food intake, resting energy expenditure, and body weight in young women

BACKGROUND: Studies showed that hormonal fluctuations that occur over the human menstrual cycle affect energy intake and expenditure. However, little is known about the possible effects on body weight regulation that may arise when these cyclic changes are suppressed with hormonal contraceptives. OBJECTIVE: The aim of this study was to examine how a progestational contraceptive drug (depot medroxyprogesterone acetate) affects food intake, resting energy expenditure (REE), and body weight in young women. DESIGN: Twenty normal-weight women were tested in a single-blind, placebo-controlled experiment. Body weight, REE, and 3-d food intake (food provided) were measured in the follicular and luteal phases of 2 menstrual cycles before a single injection of depot medroxyprogesterone or saline solution was administered. Measurements were also taken 4 times after injection: in the luteal and follicular phases of 2 cycles in the placebo group and 2 wk apart (to mimic timing of the menstrual phases) in the drug group. RESULTS: Before injection, the phase of the menstrual cycle affected both energy intake and REE. The study participants consumed more energy (4.3%; P = 0.02) and expended more energy at rest (4.3%; P = 0.0002) in the luteal phase than in the follicular phase. Comparison of pre- and postinjection means showed that treatment with the contraceptive drug had no significant effects on energy intake, REE, or body weight. CONCLUSIONS: This study showed that, although phases of the menstrual cycle affected energy intake and REE, depot medroxyprogesterone acetate did not alter energy intake or expenditure or cause weight gain in young women.     

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting

OBJECTIVES: To examine the components of energy balance during lactation in a population of economically disadvantaged women in an urban developing country setting in order to better understand the metabolic response to lactation. DESIGN: Cross-sectional comparison of lactating (LACT) and non-pregnant non-lactating (NPNL) women. Body size and composition were assessed via anthropometry, energy intake was measured using estimated diet records and energy expenditure using indirect calorimetry and the Flex-Heart Rate method. SETTING: Low-income neighborhoods of Cali, Colombia. SUBJECTS: Lactating women (n=15) studied at 2.4+/-0.8, 5.5+/-0.8 and 8.9+/-1.2 months postpartum, and NPNL women (n=48) studied in three measurement rounds at 0, 3.5+/-0.6 and 7.1+/-1.0 months. RESULTS: There were no significant differences between LACT and NPNL women in anthropometric dimensions, but LACT women showed decreases in waist-hip ratio, lean body mass and increases in mid-arm circumference and percentage body fat with time. Energy intake was higher in LACT women (P=0.04), but there were no significant between-group differences in energy expenditure variables. CONCLUSION: This group of women met the cost of lactation principally via increased energy intake.