Assessment of total energy expenditure in a Chinese population by a physical activity questionnaire: examination of validity

A physical activity questionnaire from which total daily energy expenditure (TEE) could be estimated was developed for adult Hong Kong Chinese subjects, and its reliability and validity examined. The questionnaire was based on questionnaires used in Caucasians, and adapted for local lifestyle after focus group meetings involving subjects of all age groups. The questionnaire was administered to 94 subjects, consisting of healthy adults, the elderly, and two patient groups (those with renal disease on continuous ambulatory peritoneal dialysis and those with cancer). Seventy-one subjects were reinterviewed within 14 days to test reliability. Validity was examined in 31 normal subjects by measuring the basal metabolic rate (BMR) by indirect calorimetry and multiplying by the physical activity level (PAL) obtained from published studies using the doubly labelled water method and also from FAO/WHO/UNU to obtain the TEE. The intraclass correlation coefficient of reliability rages from 0.7 to 0.8 for all subject groups. The mean estimated TEE from the questionnaire was not significantly different from the mean value derived from measured BMR x PAL. The mean bias ranged from an underestimation of 27 kcal to overestimation of 215 kcal. However, the limits of variability were wide. Age was inversely related to the energy expended for occupational activities, but was positively associated with energy expended in leisure activities. Women spent less energy on occupational and exercise activities, and more on caretaking activities. Those with disease were also less likely to participate in caretaking activities. We conclude that this questionnaire may be a useful tool for future studies where energy expenditure needs to be estimated in various settings in the Hong Kong Chinese population.     

Activity pattern and energy expenditure due to physical activity before and during pregnancy in healthy Swedish women

Human pregnancy is associated with increased requirements for dietary energy and this increase may be partly offset by reductions in physical activity during gestation. Studies in well-nourished women have shown that the physical activity level (PAL), obtained as the total energy expenditure (TEE) divided by the BMR, decreases in late pregnancy. However, it is not known if this decrease is really caused by reductions in physical activity or if it is the result of decreases in energy expenditure/BMR (the so-called metabolic equivalent, MET) for many activities in late pregnancy. In the present study activity pattern, TEE and BMR were assessed in twenty-three healthy Swedish women before pregnancy as well as in gestational weeks 14 and 32. Activity pattern was assessed using a questionnaire and heart rate recording. TEE was assessed using the doubly labelled water method and BMR was measured by means of indirect calorimetry. When compared to the pre-pregnant value, there was little change in the PAL in gestational week 14 but it was significantly reduced in gestational week 32. Results obtained by means of the questionnaire and by heart rate recording showed that the activity pattern was largely unaffected by pregnancy. The findings support the following conclusion: in a population of well-nourished women where the activity pattern is maintained during pregnancy, the increase in BMR represents approximately the main part of the pregnancy-induced increase in TEE, at least until gestational week 32.     

A simple method of measuring total daily energy expenditure and physical activity level from the heart rate in adult men

OBJECTIVE: To evaluate a simple method that uses only a heart rate monitor to predict total energy expenditure (TEE) and physical activity level (PAL) from 24 h heart rate (HR) measurements. DESIGN: The simple method involved the determination of the physical activity ratio (PAR) from corresponding heart rate ratios (HRR) (ratio of observed to resting HR), from an individualized calibration curve relating activities with known PAR to the HRR. Several curve fits were evaluated for this curve. The PAL was calculated from minute to minute PAR. The TEE was computed as the product of the PAL and the predicted basal metabolic rate (BMR). The accuracy of the simple method was assessed by within-subject comparisons of the simple method versus the oxygen consumption - HR method and a time and motion study. SETTING: Bangalore City, India. Subjects: In all, 17 healthy male subjects between 18 and 44 years were recruited for the study. Interventions: None. RESULTS: The simple method correlated well with both the reference methods when using a calibration curve that involved the fitting of two straight lines at low and high PAR activities, respectively, to the PAR and HRR data. The mean error in TEE, as a product of BMR and PAL, was about 1%, but with limits of agreement between the methods that were about 20% of the TEE. However, the low mean error could have been due to a canceling of errors in the determination of BMR and PAL. CONCLUSIONS: The simple method is a relatively cheap, useful technique for evaluating TEE and PAL in resource-poor situations. It may particularly be of use in epidemiological investigations where population estimates of TEE and PAL are required.     

Physical Activity Pattern and Energy Expenditure of Malaysian Adults: Findings from the Malaysian Adult Nutrition Survey (MANS)

This paper aims to report the physical activity pattern and energy expenditure of adults aged 18 - 59 years in the Malaysian Adults Nutrition Survey (MANS) carried out between October 2002 and December 2003. The survey included 7349 adults representative of Peninsular Malaysia (Northern, Southern, Central and East Coast), as well as Sabah and Sarawak. A total of 6926 adults, comprising 3343 men and 3583 women, completed the physical activity section of the survey. Physical activity data was obtained using a physical activity questionnaire and 24-hour physical activity recall. Basal metabolic rate (BMR) was calculated from Ismail et al. (1998) predictive equations; total energy expenditure (TEE) was then estimated through factorial calculations based on time allocated and energy cost of various activities. Physical activity level (PAL) was calculated as the ratio of TEE to BMR. It was found that almost three-quarters of Malaysian adults traveled by passive modes of transportation. Only a third reported having ever-exercised, and an even smaller proportion of the population (14%) had adequate exercise. The population also spent the majority of their time (74% of the day) in sedentary activities, such as sleeping or lying down; doing light intensity activities (15% of the day), and doing moderate to vigorous intensity activities (10% of the day). Mean BMR and TEE was significantly higher amongst men than women, while mean PAL values were similar for men [1.6 (1.6 - 1.7)] and women [1.6 (1.6 - 1.6)]. More men (16%) were categorised as having active PAL compared to women (10%), while more women (43%) were categorised as having sedentary PAL compared to their male counterparts (37%). The present study provides the first in-depth report of the physical activity pattern, and national estimates of energy expenditure and physical activity levels of Malaysian adults, and concluded that Malaysian adults are generally sedentary. It is thus important that physical activity be further promoted and integrated into the lives of the population, preferably through various health promotion efforts as well as through the commitment of the authorities in providing a suitable environment for an active lifestyle.     

儿童体操运动员的能量消耗

用双标水方法测定了１２名６～８岁体操运动员（男女各６名）的总能量消耗（ＴＥＥ）。同时用开放式间接测热法检测了他们的基础代谢率（ＢＭＲ）。根据总能量消耗与基础代谢率的比值推算出每日体力活动水平（ＰＡＬ），用ＴＥＥ－（ＢＭＲ＋０．１ＴＥＥ）表示其在体力活动上的能量消耗（ＥＣＰＡ）。结果表明：儿童体操运动员的总能量消耗平均为８．３９±１．０８ＭＪ／ｄ（男：８．６７±１．４２ＭＪ／ｄ；女：８．１１±０．５９ＭＪ／ｄ，Ｐ＞０．０５），分别高于ＷＨＯ和我国推荐的每日能量需要量标准的３６％（Ｐ＜０．００１）和１３％（Ｐ＜０．０１）。基础代谢率平均为４．２２±０．３６ＭＪ／ｄ（男：４．４５±０．３４ＭＪ／ｄ；女：３．９９±０．２１ＭＪ／ｄ，Ｐ＜０．０５）。体力活动水平平均为１．９８±０．２９（男：１．９６±０．３５；女：２．０４±０．１５，Ｐ＞０．０５）；体力活动的能量消耗平均为３．３４±１．００ＭＪ／ｄ（男：３．３５±１．３９ＭＪ／ｄ；女：３．３２±０．５０ＭＪ／ｄ，Ｐ＞０．０５）。儿童体操运动员的总能量消耗高于ＲＤＡ，与其每日从事运动训练时消耗大量能量有关。     

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.     

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.     

Energy expenditure over 24 hours, thermal comfort and fat-free mass in Asian men

Energy expenditure while sitting or sleeping was measured over 24 h in eight young Asian immigrants to France by a suit calorimeter and also by continuous measurement of respiratory gas exchange. Fat-free mass (FFM) was estimated from skinfold measurements. The energy intake per kilogram FFM of the Asians was similar to a group of well-off North Americans of larger body size but similar body composition who had been the subjects of an earlier study. In both groups thermoneutrality was controlled by adjusting the circulating water temperature of the suit calorimeter according to the subjects' preferences. The hourly energy expenditure/kg FFM was 1.2 kcal during sleep and 1.7 kcal while sitting. The mean energy expenditure/kg FFM during a quiet day was 37 kcal/d or 1.5 kcal/h. Using published equations, the estimated BMR was 1490 kcal (6.2 MJ). This estimated value agrees quite well with the BMRs of these subjects as previously determined. In the metabolic room the daily sedentary energy expenditure averaged 1.15 BMR and the energy intake averaged 1.26 BMR for the study subjects in free-living conditions in an urban environment. This is below the 1.4 X BMR currently recommended as a 'minimum' energy intake for subjects of low activity.     

Comparison of commonly used procedures, including the doubly-labelled water technique, in the estimation of total energy expenditure of women with special reference to the significance of body fatness

According to the report of the World Health Organization (1985), total energy expenditure (TEE) in human subjects can be calculated as BMR x physical activity level (PAL). However, other reports have pointed out limitations in the suggested procedure related to the % body fat of the subjects. The purpose of the present study was to evaluate the World Health Organization (1985) procedure in thirty-four healthy women with BMI 18-39 kg/m2. BMR and TEE were measured using indirect calorimetry (BMRmeas) and the doubly-labelled water method (TEEref) respectively. When assessed using the doubly-labelled water and skinfold-thickness methods, the women had 34 (SD 8) and 33 (SD 6) % body fat respectively. On the basis of guidelines provided by the World Health Organization (1985), 1.64 was selected to represent the average PAL of the women. Furthermore, PAL was also assessed by means of an accelerometer (PALacc), heart-rate recordings (PAL(HR)) and a questionnaire (PALq). These estimates were: PALacc 1.71 (SD 0.17), PAL(HR) 1.76 (SD 0.24), PALq 1.86 (SD 0.27). These values were lower than TEEref/BMRref, which was 1.98 (SD 0.21). BMR assessed using equations recommended by the World Health Organization (1985) (BMRpredicted) overestimated BMR by 594 (SD 431) kJ/24 h. However, when TEE was calculated as BMRpredicted x PALacc, BMRpredicted x PAL(HR) and BMRpredicted x PALq respectively, average results were in agreement with TEEref. Furthermore, TEE values based on BMRpredicted and PALacc, PAL(HR), PALq as well as on PAL = 1.64, minus TEEref, were significantly correlated with body fatness. When the same PAL value (1.64) was used for all subjects, this correlation was particularly strong. Thus, the World Health Organization (1985) procedure may give TEE results that are biased with respect to the body fatness of subjects.     

Influence of urbanisation on physical activity and dietary changes in Huli-speaking population: a comparative study of village dwellers and migrants in urban settlements

The influence of urbanisation on physical activity and dietary changes was examined in a Papua New Guinea Highland population. Adult male and female subjects (n 56) were selected, including twenty-seven rural villagers and twenty-nine urban migrants. BMR was calculated from values measured in similar samples of Huli-speaking population, according to gender and body weight. Total daily energy expenditure (TEE) was assessed by 24 h heart rate (HR) monitoring (flex-HR method) and physical activity level (PAL) calculation was based on BMR. Energy, protein and fat intakes were measured by weighing food on a single day. Urban subjects were heavier and taller than their rural counterparts; significant differences were found in stature in men (P < 0.05) and body weight in women (P < 0.05). Urban subjects had longer sedentary periods (HR < or = flex-HR) and shorter active periods (HR > flex-HR) than rural subjects. Consequently, the former had lower TEE and PAL than the latter; significant differences were found in women (TEE, P < 0.05, PAL, P < 0.01) but not in men. Total daily energy intake and TEE were well balanced (<7 %) in all groups, whereas protein and fat intakes were considerably higher in urban subjects than rural subjects. Reduced PAL and increased fat intake by urban dwellers may increase the risks of obesity and chronic degenerative diseases.     

Energy requirements during pregnancy based on total energy expenditure and energy deposition

BACKGROUND: Energy requirements during pregnancy remain controversial because of uncertainties regarding maternal fat deposition and reductions in physical activity. OBJECTIVE: This study was designed to estimate the energy requirements of healthy underweight, normal-weight, and overweight pregnant women and to explore energetic adaptations to pregnancy. DESIGN: The energy requirements of 63 women [17 with a low body mass index (BMI; in kg/m(2)), 34 with a normal BMI, and 12 with a high BMI] were estimated at 0, 9, 22, and 36 wk of pregnancy and at 27 wk postpartum. Basal metabolic rate (BMR) was measured by calorimetry, total energy expenditure (TEE) by doubly labeled water, and activity energy expenditure (AEE) as TEE - BMR. Energy deposition was calculated from changes in body protein and fat. Energy requirements equaled the sum of TEE and energy deposition. RESULTS: BMR increased gradually throughout pregnancy at a mean (+/-SD) rate of 10.7 +/- 5.4 kcal/gestational week, whereas TEE increased by 5.2 +/- 12.8 kcal/gestational week, which indicated a slight decrease in AEE. Energy costs of pregnancy depended on BMI group. Although total protein deposition did not differ significantly by BMI group (mean for the 3 groups: 611 g protein), FM deposition did (5.3, 4.6, and 8.4 kg FM in the low-, normal-, and high-BMI groups; P = 0.02). Thus, energy costs differed significantly by BMI group (P = 0.02). In the normal-BMI group, energy requirements increased negligibly in the first trimester, by 350 kcal/d in the second trimester, and by 500 kcal/d in the third trimester. CONCLUSION: Extra energy intake is required by healthy pregnant women to support adequate gestational weight gain and increases in BMR, which are not totally offset by reductions in AEE.     

Measured versus predicted energy expenditure in children with inactive Crohn's disease

INTRODUCTION: The aim of the study was to assess if the estimated average requirements for energy for normal children (EAR) and the Schofield equation could reliably predict energy requirements in children with inactive Crohn's disease (CD). METHODS: Twenty-three children with inactive CD were studied, median age 14.3 years (range 7.8-16.9). Resting energy expenditure (REE) was measured by indirect calorimetry and compared with that predicted using the Schofield equation (BMR). Total energy expenditure (TEE) was measured using REE and a 3-day activity diary and compared with EAR. RESULTS: REE ranged from 79% to 136% of BMR. Mean REE was not significantly greater than mean BMR (P=0.25 2-tailed t-test). TEE ranged from 72% to 163% of estimated average requirements for energy for children of that weight (EARw). EARw tended to underestimate TEE in large children and overestimate TEE in small children (Bland-Altman plot R=0.5, P=0.002). EARw was a poor predictor of TEE (R=0.35, P=0.1). EAR underestimated energy requirements by >500 kcal/day in 40% of the children. CONCLUSIONS: The Schofield equation and EAR are unreliable methods of predicting total energy requirements in children with inactive CD with a significant potential to underestimate energy needs. When energy requirements were greater than EAR it was due to physical activity and body habitus rather than raised REE.     

Physical activity of urban adults: a general population survey in Geneva

OBJECTIVES: Describing the distribution of physical activity in populations is of major importance for developing public health campaigns to prevent sedentarism. METHODS: A population-based survey conducted during 1997-1999 in Geneva, Switzerland, included 3410 randomly selected men (n = 1707) and women (n = 1703), aged 35 to 74 years. Percentiles P10, P50, and P90 summarised the distributions of the total energy expenditure and of the percents used in moderate intensity activities (3 to 3.9 times the basal metabolism rate (BMR), e.g., normal walking, household chores), and in high and very high intensity activities (> or = 4 BMR, e.g., brisk walking, sports). RESULTS: The total energy expenditure (median 2929 kcal/day in men, 2212 kcal/day in women) decreased with age. Prevalence of sedentarism, defined as less than 10% of total energy expended in > or = 4 BMR activities, was 57% in men and 70% in women. Men expended 12% (median) of their total energy in 3 to 3.9 BMR and 8% in > or = 4 BMR activities. Corresponding percentages in women were 11% and 5%. The highest prevalence of sedentarism was in older age, women, and lower socio-economic status persons. CONCLUSION: Most of Geneva population is sedentary. Promoting physical activity should target children, adults and elderly, and physical activities which would be both attractive and financially affordable by most people.     

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.     

Energy requirements of urban Chinese adults with manual or sedentary occupations,determined using the doubly labeled water method

OBJECTIVE: To examine total energy expenditure (TEE) in relation to occupation and reported leisure time activities in free-living Chinese adults, and to determine whether measured TEE values differ from current international dietary energy recommendations. SETTING AND SUBJECTS: Seventy three weight-maintaining adults aged 35-49 y, leading unrestricted lives in urban Beijing, with a wide variety of occupations. DESIGN AND METHODS: A cross-sectional study in which TEE was determined by doubly labeled water, body composition by deuterium oxide ((2)H(2)O) dilution, resting energy expenditure (pREE) by prediction equations, and occupational and leisure time activities by questionnaire. RESULTS: For men and women respectively, TEE averaged 12.10+/-0.32 and 9.53+/-0.23 MJ/day (P<0.001), and physical activity level (PAL=TEE/pREE) was 1.77+/-0.04 and 1.66+/-0.02 (P<0.05). Fat-free mass (FFM) was the single best predictor of TEE (adjusted r(2)=0.71, P<0.001). Occupational category (light, moderate and heavy) further predicted TEE, independent of FFM (adjusted multiple r(2)=0.82, P<0.001). Both TEE adjusted for weight and PAL increased with occupational category. Measured TEE was slightly but significantly higher than the 1985 FAO/WHO/UNU estimates for women with light occupations, but did not differ from estimates for men with light occupations, or for adults with moderate or heavy occupations. CONCLUSION: Level of occupational activity, but not duration or type of leisure activity, significantly predicted TEE in free-living urban Chinese adults. Current energy requirement recommendations slightly underestimated the energy needs of women with light occupations but were accurate for men and women with moderate and heavy occupations. SPONSORSHIP: NIH grants DK53404 and F32-DK09747.     

Potential contribution of leisure activity to the energy expenditure patterns of sedentary populations

Total daily energy expenditure (TEE) by the doubly-labelled (2H218O) water method and basal metabolic rate (BMR) by indirect calorimetry were measured in thirty-two healty free-living adults in Northern Ireland. Habitual physical activity patterns in occupational and discretionary activities were assessed by interview questionnaire. Expressed as a multiple of BMR the TEE values for the sixteen males (1.88 (SD 0.28), range 1.44-2.57) and sixteen females (1.77 (SD 0.16), range 1.50-2.06) were compatible with current Department of Health and Social Security (DHSS; 1979) and Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU; 1985) estimates of energy requirements. The results suggest that discretionary physical activity is now emerging as an equally important determinant of energy expenditure in the UK as the occupational classifications currently used as the basis of DHSS (1979) and FAO/WHO/UNU (1985) recommendations for energy requirements. Therefore, realistically achievable inputs of recreational exercise can have a significant impact in counteracting low levels of energy expenditure which are associated with modern lifestyles and are implicated as a risk factor for coronary heart disease and obesity.     

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.     

Self-determined motivation towards physical activity in adolescents treated for obesity: an observational study

Background

Knowledge of adult activity patterns across domains of physical activity is essential for the planning of population-based strategies that will increase overall energy expenditure and reduce the risk of obesity and related chronic diseases. We describe domain-specific hours of activity and energy expended among participants in a prospective cohort in Alberta, Canada.

Methods

The Past Year Total Physical Activity Questionnaire was completed by 15,591 Tomorrow Project ^® participants, between 2001 and 2005 detailing physical activity type, duration, frequency and intensity. Domain-specific hours of activity and activity-related energy expenditure, expressed as a percent of total energy expenditure (TEE) (Mean (SD); Median (IQR)) are reported across inactive (<1.4), low active (1.4 to 1.59), active (1.6 to 1.89) and very active (≥ 1.9) Physical Activity Level (PAL = TEE:REE) categories.

Results

In very active women and amongst all men except those classified as inactive, activity-related energy expenditure comprised primarily occupational activity. Amongst inactive men and women in active, low active and inactive groups, activity-related energy expenditure from household activity was comparable to, or exceeded that for occupational activity. Leisure-time activity-related energy expenditure decreased with decreasing PAL categories; however, even amongst the most active men and women it accounted for less than 10 percent of TEE. When stratified by employment status, leisure-time activity-related energy expenditure was greatest for retired men [mean (SD): 10.8 (8.5) percent of TEE], compared with those who were fully employed, employed part-time or not employed. Transportation-related activity was negligible across all categories of PAL and employment status.

Conclusion

For the inactive portion of this population, active non-leisure activities, specifically in the transportation and occupational domains, need to be considered for inclusion in daily routines as a means of increasing population-wide activity levels. Environmental and policy changes to promote active transport and workplace initiatives could increase overall daily energy expenditure through reducing prolonged sitting time.     

The dietary intake of people with non-insulin-dependent diabetes (NIDDM): how valid is self-reported intake?

Background: In diabetes care, an accurate assessment of dietary intake is essential for clinical management. This study assessed the validity of dietary records from people with NIDDM by comparing reported energy and protein intakes with estimated total energy expenditure (TEE) and urinary nitrogen excretion.
Method: To assess energy and nutrient intake 185 patients kept dietary records for two 3-day periods. Basal metabolic rate (BMR^est) was estimated to calculate reported energy intake/BMR^est. Appropriate age and sex-specific physical activity levels (PAL=TEE/BMR) from published doubly-labelled water studies of TEE, were used to calculate a cut-off PAL for energy intake/BMR^est, below which intakes were statistically unlikely to be valid. A subgroup (46 patients) collected a complete 24-h urine sample to compare nitrogen excretion with protein intake.
Results: The mean value of energy intake/BMR^est (1.14±0.3) was markedly below the calculated cut-off point (1.58±0.06) suggesting widespread underreporting. Protein intake (82.5±21.3) was also lower than estimated protein losses (92.5±19.4). Obese and female NIDDS were more likely to underreport and their intakes were closer to the diabetes dietary recommendations. Conclusion: This study found that people with NIDDM were likely to underreport their food intake.     

Components of total energy expenditure in healthy young women are not affected after 14 days of feeding with medium-versus long-chain triglycerides.

OBJECTIVE: To examine the effect of consumption of medium-chain triglycerides (MCT) vs. long-chain triglycerides (LCT) on total energy expenditure (TEE) and its components in young women during the second week of a 2-week feeding period. RESEARCH METHODS AND PROCEDURES: Twelve healthy lean women (age: 22.7+/-0.7 years, body mass index [BMI]: 21.5+/-0.8 kg/m2) were fed weight maintenance diets containing 15% of energy as protein, 45% as carbohydrate, and 40% as fat, 80% of which was treatment fat, for 2 weeks in a randomized cross-over design separated by a 2-week washout period. Dietary fat was composed of triglycerides containing either 26% medium-chain fatty acids (MCFA) and 74% long-chain fatty acids (LCFA), or 2% MCFA and 98% LCFA. Free-living TEE was measured from day 7 to 14 on each dietary treatment using doubly labeled water (DLW). Basal metabolic rate (BMR) and thermic effect of food (TEF) were measured on days 7 and 14 using respiratory gas exchange analysis (RGE) for 30 minutes and 330 minutes, respectively. Activity-induced energy expenditure (AIEE) was derived as the difference between TEE and the sum of BMR and TEF. RESULTS: The average TEE while consuming the MCT diet (2246+/-98 kcal/day) did not differ from that of the LCT diet (2186+/-138 kcal/day. BMR was significantly higher on the MCT diet on day 7 (1219+/-38 kcal/day vs. 1179+/-42 kcal/day), but not on day 14; there was no effect of diet on TEF. There were no differences in BMR, TEF, or AIEE between diets when expressed as percentages of TEE. On average, BMR, TEF, and AIEE represented 54.6%, 8.2%, and 37.2%, respectively, of TEE. DISCUSSION: Results suggest that between day 7 and day 14 feeding of MCT vs. LCT at these levels, TEE is not affected and that increases seen in energy expenditure following MCT feeding may be of short duration. Thus, compensatory mechanisms may exist which blunt the effect of MCT on energy components over the longer term.