Energy expenditure/basal metabolic rate ratios in normal and marginally undernourished Colombian children 6-16 years of age

Measurements of basal (BMR) and resting (RMR) metabolic rates, maintenance (MEE) and total daily energy expenditures (TDEE) have been made in Colombian children 6-16 years of age classified as nutritionally normal (boys, n = 129; girls, n = 72) and marginally undernourished (boys, n = 171; girls, n = 74). TDEE/BMR ratios were calculated for comparison with those suggested by FAO/WHO/UNU (1985) and to provide data for children less than 10 years of age. TDEE was measured in free-living, individually calibrated subjects by the heart-rate method. TDEE/BMR increased significantly with age in boys from 1.60 to 1.84 in control subjects and 1.46 to 1.92 in undernourished boys. There was no significant increase with age in the girls. There were no statistically significant differences between nutritional groups but girls had significantly lower values than boys. There was a greater rate of increase in TDEE than BMR with age and girls spent more time in light activities and less in high level activities than boys.     

Marginal malnutrition in school-aged Colombian boys: metabolic rate and estimated daily energy expenditure

Total daily energy expenditure (TDEE) and energy expenditure in activity (EAc) were estimated in 114 free-ranging, nutritionally normal, and undernourished boys 6-16 yr of age by measuring basal and resting metabolic rates, average daily heart rate while awake, and oxygen consumption and heart rate during exercise on a treadmill. Mean daily heart rates were in the range of exercising heart rates and gave reasonable estimates of TDEE and EAc. TDEE increased with age (p less than 0.001) and was reduced in undernourished boys (p = 0.011). Results indicate that nutritional group differences in TDEE were due to differences in body size. EAc increased with age but did not show significant differences between nutritional groups, indicating that in the marginal malnutrition of school-aged children, reduced growth and associated economy of energy expenditure in locomotion is sufficient physiological adaptation. Peer pressure in school and play activities may interfere with the protective mechanism of reduced activity.     

Basal metabolic rate of normal and marginally undernourished mestizo children in Colombia

The basal metabolic rate (BMR) was measured in mestizo children 6-16 years of age living under economically deprived conditions in Colombia. Of a total of 239 boys and 126 girls, 137 boys and 72 girls were classified as marginally malnourished. Differences in BMR by age, sex and nutritional group could be accounted for by differences in lean body mass. The Schofield equations were found to overestimate BMR significantly in the boys. However, the estimates in girls were not significantly different from measured values.     

Influence of dietary intervention on artificially increased activity in marginally undernourished Colombian boys

Studies of the pattern of daily energy expenditure (EE), total daily energy expenditure (TDEE) and energy expended in activity (EAC) have been carried out in 14 nutritionally normal and 19 marginally malnourished, free-living boys 10-12 years of age using the minute-by-minute heart rate recording technique. Measurements were made during an ordinary school day and again about 6 months later under conditions of a summer day-camp where the activity levels were artificially increased by encouragement to participate in supervised sports activities and play. The morning and afternoon activities were separated by a dietary intervention in the form of a hot meal providing approximately 3.2 MJ (760 kcal). In the morning sessions of the day-camp the undernourished boys did not keep up with the control group by increasing their EE. However, for about 2 h following the noon meal, they did increase EE to levels comparable to the control group but again reduced their EE later in the afternoon and earlier than the control subjects. The data show an inability of undernourished boys to increase their activity which is positively affected for a short period by dietary intervention.     

Impacts of vigorous and non-vigorous activity on daily energy expenditure

Activity intensity is a potential determinant of activity-induced energy expenditure. Tri-axial accelerometery is the most objective measurement technique for the assessment of activity intensity, in combination with doubly-labelled water for the measurement of energy expenditure under free-living conditions. Data on the effects of subject characteristics, including body size and age, and exercise training on the relationship between activity intensity and daily energy expenditure are reviewed. Average daily metabolic rate and non-basal energy expenditure are positively related to body size. The duration and intensity of physical activities do not need to be equivalent to the energy spent on activity. Obese subjects spend more energy on physical activity but can perform fewer activities, especially high-intensity (weight-bearing) activities, because of their higher body weight. Physical activity generally declines gradually from about 60 years of age onwards. Most subjects > 80 years have an activity level well below the level defined for sedentary middle-aged adults. Spending relatively more time on low-intensity activities has a negative effect on the mean physical activity level. To obtain a higher physical activity level does not necessarily imply high-intensity activities. In an average subject 25% of the activity-induced energy expenditure may be attributed to high-intensity activities. Exercise training, as a form of high-intensity activity, affects the physical activity level more in younger subjects than in elderly subjects.     

Total daily energy expenditure and activity level in anorexia nervosa.

Clinical reports consistently comment on high physical activity for anorexia nervosa patients but provide few quantitative measurements. To assess activity, total daily energy expenditure (TDEE) by doubly labeled water, basal metabolic rate (BMR), and thermic effect of meals (TEM) were measured in six female outpatients with anorexia nervosa (67% of ideal body weight) and age-, sex-, and height-matched to six control subjects. Anorexia nervosa patients expended more energy as physical activity than did control subjects [0.084 +/- 0.012 vs 0.044 +/- 0.008 MJ/kg body wt, respectively (20.1 +/- 3.0 vs 10.5 +/- 1.9 kcal/kg body wt, respectively), P less than 0.04], although they had a lower BMR [4.17 +/- 0.37 vs 5.52 +/- 0.15 MJ/d, respectively (997 +/- 89 vs 1319 +/- 37 kcal/d, respectively), P less than 0.01]. TDEE and TEM were similar in both groups. There was a reduction in serum triiodothyronine (T3; 1.20 +/- 0.15 vs 2.04 +/- 0.13 nmol/L, respectively; P less than 0.003) and a slight reduction in serum thyroxine (T4); reverse T3, thyrotropin, free T4, serum cortisol, and adrenocorticotropin values were normal. BMR correlated with total body weight and fat-free mass. These results provide quantitative evidence for increased physical activity in anorexia nervosa despite profound underweight and hypometabolism.     

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.     

Marginal malnutrition in school-aged Colombian boys: anthropometry and maturation

Colombian reference data for weight and height were used to classify 1108 boys 6 to 16 yr old as nutritionally normal, low weight for age, and low weight for height. The normal group in upper socioeconomic urban and normal, low weight for age, low weight for height groups in lower socioeconomic urban and rural populations were studied. The achieved growth, growth velocities, skinfolds, mid-arm and head circumferences, and sexual maturation were all depressed in the nutritionally deprived groups indicating marginal malnutrition. Since normal boys exist in low socioeconomic and rural populations, normative data for economically advantaged children (national standards), on the average, may serve as desirable goals for low socioeconomic and rural populations. Different cutoff points for achieved growth might be established for marginal malnutrition using national or international reference populations. These ought to be age-related because of accumulated effect of slowed growth with age. Head circumference of school-aged children may proved a useful anthropometric tool in deciding early nutritional history.     

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.     

Increasing dietary palmitic acid decreases fat oxidation and daily energy expenditure

BACKGROUND: Oleic acid (OA) is oxidized more rapidly than is palmitic acid (PA). OBJECTIVE: We hypothesized that changing the dietary intakes of PA and OA would affect fatty acid oxidation and energy expenditure. DESIGN: A double-masked trial was conducted in 43 healthy young adults, who, after a 28-d, baseline, solid-food diet (41% of energy as fat, 8.4% as PA, and 13.1% as OA), were randomly assigned to one of two 28-d formula diets: high PA (40% of energy as fat, 16.8% as PA, and 16.4% as OA; n = 21) or high OA (40% of energy as fat, 1.7% as PA, and 31.4% as OA; n = 22). Differences in the change from baseline were evaluated by analysis of covariance. RESULTS: In the fed state, the respiratory quotient was lower (P = 0.01) with the high OA (0.86 +/- 0.01) than with the high-PA (0.89 +/- 0.01) diet, and the rate of fat oxidation was higher (P = 0.03) with the high-OA (0.0008 +/- 0.0001) than with the high-PA (0.0005 +/- 0.0001 mg . kg fat-free mass(-1) . min(-1)) diet. Resting energy expenditure in the fed and fasting states was not significantly different between groups. Change in daily energy expenditure in the high-OA group (9 +/- 60 kcal/d) was significantly different from that in the high-PA group (-214 +/- 69 kcal/d; P = 0.02 or 0.04 when expressed per fat-free mass). CONCLUSIONS: Increases in dietary PA decrease fat oxidation and daily energy expenditure, whereas decreases in PA and increases in OA had the opposite effect. Increases in dietary PA may increase the risk of obesity and insulin resistance.     

A low-budget and easy-to-operate room respirometer for measuring daily energy expenditure in man

Accurate assessment of energy requirements of humans under various physiological, pathological, and environmental conditions is hampered by the high cost of techniques for measuring daily energy expenditure. A room respirometer novel in its novel in its low cost of construction and simplicity of operation is described, together with an appreciation of errors and assumptions. It is suitable for measurements of daily energy expenditure in humans with an accuracy of +/- 1.5% and can be reproduced without difficulty in both developed and developing countries.     

Indirect calorimetry in mechanically ventilated infants and children: accuracy of total daily energy expenditure with 2 hour measurements.

OBJECTIVE: To determine how accurately total daily energy expenditure can be estimated from measurement periods of less than 24 h in mechanically ventilated infants and children. DESIGN: Prospective study to validate a method to determine energy expenditure. SETTING: Pediatric intensive care unit of an university hospital. PATIENTS: Nineteen ventilated patients (age 3 weeks - 13 years) with a FiO(2)of less than 60% and tube leakage < 10% (the difference between inspiratory and expiratory tidal volume measured by the ventilator). Separately, in five patients with varying tube leakage (2-59%) the influence of tube leakage on measured energy expenditure was determined. MEASUREMENT: Energy expenditure was measured by indirect calorimetry. Total daily energy expenditure measurements for 24 h were compared with 2 h energy expenditure measurements. The influence of body temperature on measured energy expenditure was determined. RESULTS: The mean coefficient of variation among 2 hour periods of measured energy expenditure was 6% (range 2-11%) compared with total daily energy expenditure measurements. The influence of body temperature revealed an increase of 6% of energy expenditure/ degrees C. An increased tube leakage influenced the energy expenditure measurements significantly (P< 0. 001). CONCLUSION: In a clinical situation in patients with a tube leakage < 10% total daily energy expenditure can be estimated from a 2 h measurement period.     

Predicting body composition from anthropometry and bioimpedance in marginally undernourished adolescents and young adults.

Body-composition prediction equations were developed using data from a sample of 201 female and male Guatemalan ladinos (ie, people of Amerindian-European descent) aged 11-25 y. Fat-free mass (FFM) values were estimated from body density by using the two-component model and age- and sex-specific values for the density of FFM. The root-mean-square error (RMSE) of the best model predicting FFM from a set of simple anthropometric variables was 1.59 kg for females and 1.90 kg for males. The addition of more extensive anthropometry to the set of candidate predictors reduced the RMSE to 1.42 kg for females and 1.88 kg for males. The subsequent addition of a bioelectrical impedance measure (Ht2/R) further reduced the RMSE to 1.32 kg for females and 1.82 kg for males. These results suggest that for a marginally undernourished population with relatively little body fat, simple anthropometrics are as useful as more sophisticated measures for the prediction of body composition.     

Components and variations in daily energy expenditure of athletic and non-athletic adolescents in free-living conditions

The objectives of the study were to determine: (1) daily energy expenditure (EE) of athletic and non-athletic adolescents of both sexes in free-living conditions; (2) day-to-day variations in daily EE during 1 week; (3) energy costs of the main activities; and (4) the effect of usual activity on EE during sleep, seated and miscellaneous activities. Fifty adolescents (four groups of eleven to fifteen boys or girls aged 16-19 years) participated in the study. Body composition was measured by the skinfold-thickness method, and VO2max and external mechanical power (EMP) by a direct method (respiratory gas exchanges) on a cycloergometer. Daily EE and partial EE in free-living conditions were computed from heart-rate (HR) recordings during seven consecutive days using individual prediction equations established from the data obtained during a 24 h period spent in whole-body calorimeters with similar activities. Fat-free mass (FFM), VO2max, EMP, daily EE and EE during sleep were significantly higher in athletic than in non-athletic subjects. After adjustment for FFM, VO2max, EMP, daily EE and EE during exercise were still higher in athletic than in non-athletic adolescents (P < 0.001). However, adjusted sleeping EE was not significantly different between athletic and non-athletic adolescents. Increases in exercise EE were partly compensated for by significant reductions in EE during schoolwork and miscellaneous activities. Thus, the differences in daily EE between athletic and non-athletic subjects resulted mainly from increases in FFM and EE during exercise (duration and energy cost).     

Sedentary daily expenditure: a base for estimating individual energy requirements

As a base for estimating individual energy requirements, we propose using the energy expenditure of a sedentary day with regular meals and sleep at night. Ninety-five 24-h measurements of sedentary daily expenditure (SDE) by direct calorimetry on 37 men and women were analyzed, showing that fat-free mass combined with body mass index correlated highly with SDE (r2 = 0.92) with an SE of 5%. Weight and fat mass were better predictors for women and excellent predictors for men. We found that weight and height accurately predicted fat mass if suitable exponents were used in the expression wt/htx. Testing predictive equations with our own and other sets of data showed good agreement between estimated and observed SDEs. As a base for estimating individual energy requirements. SDE is more precise than basal metabolic rate and it can be predicted with useful accuracy from simple measures of weight and height.