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.     

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.     

Estimated energy expenditure and physical activity patterns of adolescent distance runners

The purpose of this study was to examine the estimated total energy expenditure (TEE) and physical activity patterns of adolescent distance runners. Twenty-eight (20 male, 8 female) adolescent distance runners self-reported their daily physical activity with the Bouchard 3-d diary. Mean values for TEE, 57.4 +/- 11.6 and 51.0 +/- 9.8 kcal x kg(-1) x d(-1), and activity energy expenditure (AEE), 26.7 +/- 10.4 and 21.0 +/- 8.8 kcal x kg(-1) x d(-1), when expressed per kilogram body mass were not significantly different between males and females, respectively (P = 0.18). When expressed in absolute terms, TEE, 3609 +/- 927 and 2467 +/- 426 kcal/d, and AEE, 1688 +/- 746 and 977 +/- 269 kcal/d, were significantly higher in males than in females, respectively. The results document the energy expenditure and self-reported physical activity of adolescent distance runners and might be used to address recommendations for adequate dietary energy requirements in this group, which in turn is important for energy balance in the context of normal growth, health, and physical performance.     

Comparison of energy intakes estimated by weighed dietary record and diet history questionnaire with total energy expenditure measured by accelerometer in young Japanese women

In Western countries underestimation of energy intake (EI) is considered a serious problem in dietary surveys, but information on the accuracy of EI among Japanese people is sparse. We compared estimated EI with measured total energy expenditure (TEE) in 21 Japanese women aged 20-22 y. Dietary intake was estimated by 7-d weighed dietary records (7dWR) and a self-administered diet history questionnaire (DHQ). TEE was measured for 25+/-3 d (mean+/-standard deviation, range: 16-27 d) by a uniaxial accelerometer. Both EI by 7dWR (1,498+/-305 kcal/d) and EI by DHQ (1,599+/-331 kcal/d) were significantly lower than TEE (1,865+/-179 kcal/d) (p<0.001 and p<0.01, respectively), but neither estimated EI nor the magnitude of EI underestimation (20+/-15% for 7dWR and 13+/-23% for DHQ) was significantly different between two methods (p=0.25 and p=0.22, respectively). The Spearman correlation (r) between TEE and EI was 0.51 (p=0.2) for 7dWR and 0.09 (p=0.71) for DHQ, indicating better ranking of individuals by 7dWR. The accuracy of EI (EI/TEE) was negatively associated with the percentage of EI from protein in 7dWR (r=-0.44, p=0.049) and positively associated with the percentage of EI from fat in both 7dWR (r=0.45, p=0.04) and DHQ (r=0.62, p<0.01), suggesting selective overestimation of protein and selective underestimation of fat. These results indicate not only underestimation of habitual EI but also selective under- and/or overestimation of macronutrients in both 7dWR and DHQ.     

Total daily energy expenditure in wasted chronic obstructive pulmonary disease patients

OBJECTIVES: To investigate total daily energy expenditure in chronic obstructive pulmonary disease (COPD) patients during a rehabilitation programme. DESIGN: Observational study involving a case and a control group. SUBJECTS: Ten COPD patients (six with body mass index (BMI) <18.5 kg/m(2) and four with BMI >18.5 kg/m(2)) were evaluated for their energy expenditure profile. Four additional healthy age-matched volunteers were also included for methodology evaluation. INTERVENTIONS: Measurements of total daily energy expenditure (TEE), resting energy expenditure (REE) and diet-induced thermogenesis (DIT) and energy intake were undertaken by indirect calorimetry and bicarbonate-urea methods and dietary records. RESULTS: REE in COPD patients was not significantly different from that predicted by the Harris-Benedict equation. Before the exercise day the mean TEE was 1508 kcal/day and physical activity level (PAL as calculated by TEE/REE) was 1.52. On the exercise day the TEE increased to 1568 kcal/day and PAL was 1.60, but neither of these changes were significant. The energy cost of increased physical activity during rehabilitation exercise was estimated to be 191 kcal/day. No significant change was found in DIT between the two patient groups. However, overall energy balances were found to be negative (-363 kcal/day). CONCLUSION: The rehabilitation programme did not cause a significant energy demand in COPD patients. TEE in COPD patients was not greater than in free-living healthy subjects. Patients, who were underweight, did not have a higher TEE than patients with normal weight. This suggested that malnutrition in COPD patients was not due to an increased energy expenditure. On the other hand, a significant negative energy balance due to insufficient energy intake was found in seven out of 10 patients.     

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.     

Twenty-four-hour analysis of elevated energy expenditure after physical activity in a metabolic chamber: models of daily total energy expenditure

BACKGROUND: The Institute of Medicine proposed that 15% of energy expenditure (EE) as excess post-exercise oxygen consumption should be added to additional physical activity energy expenditure (DeltaPAEE) to estimate total EE. However, the magnitude of elevated post-physical activity energy expenditure (EPEE) under normal daily living conditions has not been examined. OBJECTIVE: We examined the effects of EPEE on 24-h EE by modeling standard living conditions in a metabolic chamber. DESIGN: Eleven Japanese men completed three 24-h metabolic chamber measurements: a control day (C-day), a day with high-frequency moderate-intensity physical activity (M-day), and a day with high-frequency vigorous-intensity physical activity (V-day). RESULTS: Mean (+/- SD) 24-h EE for the C-day, the M-day, and the V-day was 2228 +/- 143 kcal, 2816 +/- 197 kcal, and 2813 +/- 163 kcal, respectively. No significant difference was observed in 24-h EE between an M-day and a V-day. Mean EPEEs on the M-day and the V-day did not significantly contribute to increasing 24-h EE. Relative EPEEs to DeltaPAEEs were 6.2 +/- 13.9% (M-day) and 5.1 +/- 9.2% (V-day). However, EPEE/24-h EE was negatively correlated with maximal oxygen uptake on the V-day (r = -0.68, P = 0.02), although no significant correlation between these variables was observed on the M-day (r = -0.41, P = 0.21). CONCLUSIONS: These results suggest that EPEE has a small effect on 24-h EE in the course of normal daily activities, findings that do not support the proposition by the Institute of Medicine for estimating TEE. However, persons with low physical fitness levels could enhance EE as EPEE by increasing vigorous-intensity daily physical activity.     

The role of exercise physical activity in varying the total energy expenditure in healthy Japanese men 30 to 69 years of age

This study was designed to examine 1) the role of exercise physical activity (EPA), and then 2) physical fitness and body composition upon variation of the total energy expenditure (TEE) in healthy Japanese men aged 30 to 69 y (n = 40). EPA and TEE were assessed over 14 d using an accelerometer and a doubly labeled water (DLW) method, respectively. Basal metabolic rate (BMR) was measured after 10 h fasting on the morning of the day of DLW dosing. Physical activity-induced energy expenditure (PAEE) was calculated by subtracting BMR and diet-induced thermogenesis (DIT = 101 TEE) from TEE. EPA was subdivided into three intensities: low, moderate and high and the accumulated duration (time expressed in minutes) of each of these was calculated. Body composition and physical fitness (VO2max) were determined using an underwater weighing method and a treadmill exercise test, respectively. BMR (mean +/- SD: 1,459 +/- 181 kcal/d) declined significantly with age (r = -0.37. p < 0.05), but PAEE (946 +/- 320 kcal/d) and TEE (2,672 +/- 369 kcal/d) did not. A multiple stepwise regression analysis was used to develop an empirical model that relates energy expenditure measured by the DLW (TEE) to age, height, body mass index, FM, FFM, percentage body fat, VO2max, and accumulated duration spent for low-, moderate-, and high-intensity EPA. The results revealed that FFM and high-intensity EPA were identified as important determinants of TEE and accounted for 51%. We may therefore conclude that 1) high-intensity EPA appears to be relevant in determining TEE, especially among active individuals, and 2) body composition was more important than physical fitness in determining TEE in this population.     

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.     

Comparison of total energy expenditure and energy intake in children aged 6-9 y.

BACKGROUND: The accurate measurement of food intake in children is important for assessing nutritional status. OBJECTIVE: We sought to both compare measurements of energy intake (EI) from diet records and of total energy expenditure (TEE) by the doubly labeled water (DLW) method and to investigate misreporting of EI. DESIGN: Forty-seven children (22 boys and 25 girls) aged 7.4 +/- 0.8 y ( +/- SD) were recruited from 25 schools in western Sydney. TEE was measured by DLW over 10 d and EI by use of 3-d food records. Misreporting was defined as [(EI - TEE)/TEE] x 100%. RESULTS: Girls had a higher (P = 0.02) percentage of body fat (28.2 +/- 7.0%) than did boys (22.9 +/- 8.0%); otherwise there were no differences among sex. Although mean (+/-SD) values for EI (7514 +/- 1260 kJ/d) and TEE (7396 +/- 1281 kJ/d) were not significantly different, there was no significant correlation between EI and TEE. EI and TEE were 9% and 11% lower, respectively, than current World Health Organization recommendations for EI. The relative bias (mean difference, EI - TEE) was low at 118 kJ/d, but the limits of agreement (bias +/- 2 SD of the difference) were wide at 118 +/- 3345 kJ/d. Although the mean percentage of misreporting was low (4 +/- 23%), the high SD indicates large intraindividual differences between EI and TEE. The most significant predictor of misreporting was dietary fat intake (r(2) = 0.45, P < 0.0001). Misreporting was not associated with sex or body composition. CONCLUSIONS: In this age group, reported EI is not representative of TEE at the individual level. However, at the population level, 3-d food records may be used for surveys of EI by 6-9-y-old children.     

24-hour indirect calorimetry in mechanically ventilated critically ill patients.

BACKGROUND: Energy imbalance in critically ill, mechanically ventilated patients may lead to medical complications. The nutrition care team needs accurate, noninvasive, rapid methods to estimate energy requirements. We investigated whether brief measurements of indirect calorimetry at any time of the day would give valid estimates of 24-hour energy expenditure (EE). METHODS: EE of 12 mechanically ventilated critically ill patients (6 men, 6 women, mean +/- SD age 67 +/- 18 years, weight 70.2 +/- 8.8 kg) was recorded every minute during 24 hours by indirect calorimetry. All patients were continuously fed enteral nutrition. RESULTS: Mean +/- SD EE was 1658 +/- 279 kcal/d (6941 +/- 1167 kJ/d). Within patients, EE during the day fluctuated by 234 kcal in the most constant patient to 1190 kcal in the least constant patient, with a mean fluctuation of 521 kcal (12 patients). No statistically significant difference (p = .53) in mean EE between morning (6-12 hours, 1676 kcal), afternoon (12-18 hours, 1642 kcal), evening (18-24 hours, 1658 kcal), and night (0-6 hours, 1655 kcal) was found. A 2-hour instead of a 24-hour measurement resulted in a maximal error of 128 kcal (536 kJ), which was <10% of the average EE. The maximal error decreased with longer time intervals. CONCLUSIONS: In mechanically ventilated critically ill patients, 24-hour indirect calorimetry measurements can be replaced by shorter (>/=2 hours) measurements. Time of day did not affect EE.     

Habitual daily energy expenditure and activity levels of lean and adult-onset and child-onset obese women

The energy expenditure (EE) of eight lean, eight adult-onset obese (AOO), and eight child-onset obese (COO) women was determined over three 24-h periods by the factorial method, modified by subject-keypunched and mechanically recorded activity diaries. Mean daily EE was significantly higher in the pooled obese women (2472 +/- 488 kcal) than in lean women (1979 +/- 302 kcal) due to higher energy costs of sedentary and light activity in the obese. EE during moderate-to-strenuous activity was similar between groups because lean women performed these activities more vigorously. AOO and COO differed significantly in neither mean EE nor habitual activity. Fat-free mass (FFM) was a better predictor than body weight of both mean daily EE and the energy cost of activity. These data indicate that EE is positively related to obesity. Obese women tend to limit possible EE by reducing the vigorousness of weight-supported activity.     

Energy expenditure measured by doubly labeled water,activity recall,and diet records in the rural elderly

OBJECTIVE: The purpose of this study was to determine whether energy expenditure estimated from physical activity and energy intake were equivalent to total daily energy expenditure in an elderly rural population. METHODS: Twenty-seven elderly male (n = 14) and female (n = 13) subjects (mean age, 74 y) were recruited from a rural Pennsylvania population. Over a 2-wk period, total daily energy expenditure was measured by doubly labeled water (TEE) and estimated from 7-d physical activity recall factors multiplied by weight (PA(WT)), estimated basal metabolic rate (PA(BMR)) and resting energy expenditure from indirect calorimetry (PA(REE)), and energy intake from 3-d self-reported diet records (EI). Analysis of variance was used to determine significant within-subject differences in physical activity, energy intake, and energy expenditure. RESULTS: PA(REE) (men: 13.69 +/- 3.23 MJ, women: 9.51 +/- 2.40 MJ) and PA(BMR) (men: 13.69 +/- 2.99 MJ, women: 10.15 +/- 2.21 MJ) were not significantly different from TEE (men: 12.43 +/- 1.63 MJ, women: 9.44 +/- 0.90 MJ). EI (men: 8.66 +/- 2.34 MJ, women: 7.12 +/- 0.93 MJ) was significantly less than TEE, and PA(WT) (men: 17.03 +/- 4.07 MJ, women: 12.86 +/- 3.41 MJ) was significantly greater than TEE. CONCLUSIONS: Whereas 7-d physical activity recall determined with an age- and gender-specific estimate of resting metabolic rate or measured using indirect calorimetry accurately estimated TEE for this group of rural elderly, self-reported diet records consistently underestimated and physical activity recall determined with weight alone consistently overestimated energy expenditure measured by doubly labeled water.     

Increased caloric intake soon after exercise in cold water

We examined the acute effect of cold-water temperature on post-exercise energy intake (EI) for 1 h. In a randomized, crossover design, 11 men (25.6 +/- 5 y) exercised for 45 min on a submersed cycle ergometer at 60 +/- 2% VO2max in 33 degrees C (neutral) and 20 degrees (cold) water temperatures, and also rested for 45 min (control). Energy expenditure (EE) was determined using indirect calorimetry before, during, and after each condition. Following exercise or rest, subjects had free access to a standard assortment of food items of known caloric value. EE was similar for the cold and neutral water conditions, averaging 505 +/- 22 (+/- standard deviation) and 517 +/- 42 kcal, respectively (P = NS). EI after the cold condition averaged 877 +/- 457 kcal, 44% and 41% higher (P < 0.05) than for the neutral and resting conditions, respectively. Cold-water temperature thus stimulated post-exercise EI. Water temperature warrants consideration in aquatic programs designed for weight loss.     

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.     

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.     

The use of a handheld calorimetry unit to estimate energy expenditure during different physiological conditions

BACKGROUND: Accurately determining rates of energy expenditure (EE) under free-living conditions is important in understanding the mechanisms involved in the development and prevention of obesity. Metabolic carts are not portable enough for most free-living situations. The purpose of this study was to compare a portable, handheld indirect calorimetry device (HealtheTech Incorporated, Golden, CO) to a metabolic cart (Physio-Dyne Instrument Corporation, Quogue, NY) during 3 different physiologic states. METHODS: EE was measured by both the handheld calorimeter (5-10 minutes) and the metabolic cart (15-20 minutes) in 20 healthy subjects (18-35 years of age). Measurements were made during 3 physiologic states: (1) postabsorptive rest (REE), (2) postprandial rest (fed energy expenditure, FEE), and (3) while walking in place (activity energy expenditure, AEE). RESULTS: There were no significant differences between the means of the cart vs the hand-held device for REE (mean +/- SE; kcal/d; 1552 +/- 64 vs 1551 +/- 63), FEE (1875 +/- 99 vs 1825 +/- 86), and AEE (3333 +/- 218 vs 3489 +/- 152). The range over which the techniques were tested was 1300-5000 kcal/d. The agreement between the 2 methods was excellent for REE (0.80, p < .0001), FEE (0.89, p < .0001), and AEE (0.75, p < .0002). CONCLUSIONS: Compared with the metabolic cart, the handheld device provided similar estimates of energy expenditure during resting, postprandial, and physically active states. This suggests that portable indirect calorimetry devices can provide reliable and valuable information in free-living research situations for which maximal energy expenditure is <5000 kcal/d.     

Comparison of Energy Intake in Toddlers Assessed by Food Frequency Questionnaire and Total Energy Expenditure Measured by the Doubly Labeled Water Method

The ability of parents to accurately report energy intake in toddlers has rarely been validated using the gold-standard doubly labeled water (DLW) method to assess total energy expenditure (TEE). The aim of the study was to evaluate the accuracy of toddler energy intake (EI), estimated using the Australian Child and Adolescent Eating Survey (ACAES) food frequency questionnaire (FFQ) by parent report compared with a weighed food record (WFR) and TEE measured by DLW. Twelve toddlers had TEE assessed over 10 days using DLW. Usual energy intake was estimated by the primary caregiver, using standard toddler portions in ACAES-FFQ and a 4-day WFR and daily EI (in kilocalories) derived using national nutrient databases. Accuracy of reporting was calculated from absolute (EI-TEE) and percentage (EI/TEE×100) differences between EI and TEE and Pearson correlations and limits of agreement from Bland-Altman plots. Toddlers (n=12, 7 boys) had a mean age of 3.2±0.5 years, body mass index 16.2±0.9 kg, body mass index z score 0.1±0.8, EI from ACAES-FFQ 1,183±281kcal/day, and WFR 1,179±278 kcal/day and DLW TEE 1,251±149 kcal/day. The mean difference and limits of agreement (±2 standard deviations) compared with DLW was ?68 (?623, 488) kcal/day for the FFQ and for the WFR ?72 (?499, 354) kcal/day. Although both a semiquantitative FFQ and WFR can adequately estimate toddler energy intake at the group level in this population, toddler-specific portion size estimates should be assigned to foods listed in the FFQ. Choice of method is likely to depend on practical issues, including cost and burden.     

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.