Strength changes induced by extreme dieting and exercise in severely obese females.

Strength changes, induced by very low-calorie diet (VLCD, 520 kcal/day) alone and in combination with exercise, were determined in 109 severely obese females (46.8 +/- 4.69% fat). Experimental treatments included VLCD alone (LC, n = 40), VLCD with endurance exercise (EE, n = 23), VLCD with endurance exercise and resistance strength training (EERST, n = 23), and VLCD with resistance strength training (RST, n = 23). All subjects participated in the study for 90 days while EE, EERST, and RST exercised four times/week according to specified schedules. Results indicated significant differences for the change scores (baseline to 90 days) for bench press, knee flexion, upper body and lower body composite strength scores between RST and all other groups. RST was the only treatment that increased upper and lower body strength. No differences between groups were found for body mass losses, decrease in percent fat and fat mass. In contrast, these variables showed significant change scores for all groups. Decreases in fat-free mass (FFM) were 5.18 +/- 3.40 kg, 4.79 +/- 4.15 kg (p = 0.001), 4.64 +/- 4.23 kg, and 3.26 +/- 2.67 kg for EE, LC, RST, and EERST, respectively. These data suggest that the combination of resistance strength training and VLCD increases strength despite a loss of FFM. However, endurance exercise and VLCD do not seem to affect body mass loss or FFM loss per se. Moreover, it seems that these increases in strength may represent a training effect which might imply improved central neuromuscular function rather than muscular hypertrophy since FFM decreased in all groups.     

The effect of a high protein-low calorie diet on the energy expenditure of obese adolescents.

Resting energy expenditure (REE), and body composition, as fat-free mass (FFM) and fat mass, were determined in seven obese adolescents before and after weight loss of a mean 13.5 kg on an approximately 800 kcal/d (3349 kJ), high protein reducing diet regimen. Ideal body weight decreased from 166% to 142% in 8 weeks. There were no significant changes in total body potassium (TBK), extracellular water (ECW), intracellular water (ICW) or total body water (TBW) with weight loss. The REE (kcal/d) fell from 2034 +/- 392 (8514 +/- 1641 kJ) to 1762 +/- 453 (7376 +/- 1896 kJ) with weight loss (P < 0.05). However, when the REE was expressed as kcal/body weight there was no difference between before and after weight loss, 21.4 +/- 2.8 (90 +/- 21 kJ) and 21.6 +/- 4.5 (90 +/- 19 kJ). Similarly, when REE was examined in relation to FFM (kcal/kg) before and after weight loss, there were also no significant differences: 34.6 +/- 5.1 (145 +/- 21 kJ) and 32.1 +/- 7.9 (134 +/- 33 kJ).     

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.     

Resting Energy Expenditure and Related Factors in 6- to 9-Year-Old Southern African Children of Diverse Population Groups

Lower resting energy expenditure (REE) may partially explain the disproportionate prevalence of overweight/obesity among black African women. As no previous studies have investigated the REE of Southern African (South. Afr.) children, we aimed to determine, by sex and population group, the REE of 6- to 9-year-old urban school children. In a cross-sectional study with quota sampling, REE was measured with indirect calorimetry (IC). Confounders considered were: body composition (BC) (fat-free mass (FFM), FFM index, fat mass (FM), FM index), assessed using multifrequency bioelectrical impedance analysis, and physical activity (PA) measured with a pedometer. Multivariate regression was used to calculate REE adjusted for phenotypes (BC, z-scores of weight-for-age, height-for-age, body mass index-for-age) and PA. Sex and population differences in REE were determined with two-way ANOVA. Ninety-four healthy children (59.6% girls; 52.1% black) with similar socioeconomic status and PA opportunities participated. Despite BC variations, sex differences in REE were not significant (41 kcal/day; P = 0.375). The REE of black participants was lower than of white (146 kcal/day; P = 0.002). When adjusted for FFM and HFA z-score, the differences in REE declined but remained clinically meaningful at 91 kcal/day (P = 0.039) and 82 kcal/day (P = 0.108), respectively. We recommend the development of population-specific REE prediction equations for South. Afr. children.     

Relationship between blood adipocytokines and resting energy expenditure in young and elderly women

It has been demonstrated in a previous study that resting energy expenditure (REE) is associated with adiponectin levels in the blood. However, body composition was not taken into consideration in that study. The purpose of the present study was to again investigate the relationship between blood adipocytokines and REE, adjusted by body composition, in both young and elderly women. REE and blood adipocytokines were measured in 115 young (age: 22.3+/-2.1 y, BMI: 21.3+/-1.9 kg/m(2)) and 71 elderly (63.4+/-6.5 y, 22.9+/- 2.3 kg/m(2)) women. Dual energy X-ray absorptiometry was used to measure percent body fat. Fat mass and fat free mass (FFM) were calculated. REE (kcal/d and kcal/kg BW/d) was lower in elderly women than in young women, but no significant difference was observed in REE, expressed as kcal/kg FFM/d, between the two groups. Although elderly women had a higher percent body fat and higher serum leptin concentrations than young women, plasma adiponectin concentrations did not differ between young and elderly women. In elderly women, REE (kcal/d) was significantly and inversely correlated with plasma adiponectin concentration (r=-0.386, p<0.001), but REE expressed per kilogram of BW or FFM was not significantly correlated. Furthermore, no significant correlation was observed between REE (kcal/d) and concentrations of plasma adiponectin or serum leptin, after adjusting for potential confounders such as body composition and hormones, in either age group. These results suggest that adipocytokines do not influence REE in adult women.     

Resting energy expenditure can be assessed by fat-free mass in female athletes regardless of body size

Energy requirements can be estimated from resting energy expenditure (REE). However, little is known about factors influencing REE in Japanese female athletes. This study was performed to evaluate the relationship between REE and body composition in Japanese female athletes with a wide range of body sizes. Ninety-three athletes (age 20.3±1.2 y, height 162.8±6.4 cm, body weight (BW) 57.0±9.2 kg, fat-free mass (FFM) 45.4±6.2 kg) were classified into three groups according to BW: small-size (S) (n=34), medium-size (M) (n=34), and large-size (L) (n=25). Systemic and regional body compositions (skeletal muscle (SM), fat mass (FM), bone mass (BM), and residual mass (RM)) were estimated by dual energy X-ray absorptiometry (DXA). Measured resting energy expenditure (REEm) was evaluated by indirect calorimetry. Marked differences were found in REEm (S: 1,111±150, M: 1,242±133, L: 1,478±138 kcal/d), and systemic and regional body compositions among the three groups. REEm was strongly correlated with FFM, and absolute values of RM and SM increased significantly according to body size. There was good agreement between REEm and estimated REE (REEe) from the specific metabolic rates of four major organ tissue level compartments. These data indicate that REE for female athletes can be attributed to changes in organ tissue mass, and not changes in organ tissue metabolic rate. That is, change in REE can be explained mainly by the change in FFM, and REE can be assessed by FFM in female athletes regardless of body size.     

Energy balance in relation to cancer cachexia

The aim of the current study was to determine the contribution of increased resting energy expenditure (REE) and/or decreased energy intake (EI) to the development of weight loss in gastric and colorectal (GCR) and lung cancer patients. REE was measured in 22 GCR cancer patients and 17 lung cancer patients and was compared with REE values in 40 apparently healthy controls. REE in lung cancer patients expressed per kg fat free mass (REE/FFM) was significantly increased when compared to healthy controls (33.5 +/- 5.4 and 29.6 +/- 2.9 kcal, respectively; p < 0.01). GCR cancer patients had no elevated REE compared to these healthy controls. No significant differences in EI were established between the three groups. Eight GCR cancer patients reported a decrease in food intake compared to pre-disease intake, in contrast to only one lung cancer patient. Semi-starving GCR cancer patients showed a significant weight loss (8.7 +/- 8.1%), a low respiratory quoteint (RQ) (0.76 +/- 0.04) and a high beta-hydroxybutyrate level (259 +/- 192 mumol/l), but they showed no difference in REE compared to patients with a normal EI. The current study suggests that weight loss in GCR cancer patients is initiated by decreased food intake, whereas weight loss in lung cancer patients represents a combination of an increased REE and a relatively low EI.     

Resting energy expenditure during mechanical ventilation and its relationship with the type of lesion

BACKGROUND: Resting energy expenditure (REE) of critically ill patients is usually calculated according to basal energy expenditure obtained from Harris-Benedict equations traditionally corrected by different stress factors, resulting in a variable accuracy for the individual patient. The objective of this study was to investigate whether or not the type of lesion affects the metabolism level of critically ill patients treated with mechanical ventilation. We performed a retrospective study measuring the REE of critically ill patients with 3 different types of lesions (trauma, medical, surgical) who were treated with mechanical ventilation and sedation. Each lesion group of patients was matched with another group, differing in the type of lesion, according to gender, age, and weight. METHODS: Eighty-seven from a database of 175 critically ill patients undergoing indirect calorimetry were necessary for matching. Twenty matched pairs of patients for each of the following different type of lesion were obtained: medical vs surgical, medical vs trauma, and surgical vs trauma. RESULTS: The mean REE difference was 52 kcal/d (95% confidence interval [CI] of -136 -241 kcal/d) for the medical vs surgical group, 5 kcal/d (95% CI -236 -247 kcal/d) for the medical vs trauma group and 43 kcal/d (95% CI of -132-219 kcal/d) for the surgical vs trauma group. No statistically significant differences between groups were found in the measured REE. We did not find statistically significant differences in the measured REE of patients with and without infection. CONCLUSIONS: Critically ill patients with different types of lesion treated with mechanical ventilation have similar measured REE.     

Dieting and the development of eating disorders in obese women: results of a randomized controlled trial

BACKGROUND: Some investigators fear that dieting may precipitate binge eating and other adverse behavioral consequences. OBJECTIVE: The objective of the study was to examine whether dieting would elicit binge eating and mood disturbance in individuals free of these complications before treatment. DESIGN: A total of 123 obese women were randomly assigned to 1) a 1000 kcal/d diet that included 4 servings/d of a liquid meal replacement (MR); 2) a 1200-1500 kcal/d balanced deficit diet (BDD) of conventional foods; or 3) a nondieting (ND) approach that discouraged energy restriction. All women attended weekly group sessions for 20 wk and biweekly sessions from week 20 to week 40. RESULTS: At week 20, participants in the MR, BDD, and ND groups lost 12.1 +/- 6.7%, 7.8 +/- 6.0%, and 0.1 +/- 2.4% of initial weight, respectively (P < 0.001). During the first 20 wk, there were no significant differences among groups in the number of persons who had objective binge episodes or in reports of hunger or dietary disinhibition. Symptoms of depression decreased significantly more (P < 0.001) in the MR and BDD groups than in ND participants. At week 28, significantly more (P < 0.003) cases of binge eating were observed in MR participants than in the 2 other groups. No differences, however, were observed between groups at weeks 40 or 65 (a follow-up visit). At no time did any participant meet criteria for binge-eating disorder. CONCLUSION: Concerns about possible adverse behavioral consequences of dieting should not dissuade primary care providers from recommending modest energy restriction to obese individuals.     

Influence of methods used in body composition analysis on the prediction of resting energy expenditure

OBJECTIVE: There are considerable differences in published prediction algorithms for resting energy expenditure (REE) based on fat-free mass (FFM). The aim of the study was to investigate the influence of the methodology of body composition analysis on the prediction of REE from FFM. DESIGN: In a cross-sectional design measurements of REE and body composition were performed. SUBJECTS: The study population consisted of 50 men (age 37.1+/-15.1 years, body mass index (BMI) 25.9+/-4.1 kg/m2) and 54 women (age 35.3+/-15.4 years, BMI 25.5+/-4.4 kg/m2). INTERVENTIONS: REE was measured by indirect calorimetry and predicted by either FFM or body weight. Measurement of FFM was performed by methods based on a 2-compartment (2C)-model: skinfold (SF)-measurement, bioelectrical impedance analysis (BIA), Dual X-ray absorptiometry (DXA), air displacement plethysmography (ADP) and deuterium oxide dilution (D2O). A 4-compartment (4C)-model was used as a reference. RESULTS: When compared with the 4C-model, REE prediction from FFM obtained from the 2C methods were not significantly different. Intercepts of the regression equations of REE prediction by FFM differed from 1231 (FFM(ADP)) to 1645 kJ/24 h (FFM(SF)) and the slopes ranged between 100.3 kJ (FFM(SF)) and 108.1 kJ/FFM (kg) (FFM(ADP)). In a normal range of FFM, REE predicted from FFM by different methods showed only small differences. The variance in REE explained by FFM varied from 69% (FFM(BIA)) to 75% (FFM(DXA)) and was only 46% for body weight. CONCLUSION: Differences in slopes and intercepts of the regression lines between REE and FFM depended on the methods used for body composition analysis. However, the differences in prediction of REE are small and do not explain the large differences in the results obtained from published FFM-based REE prediction equations and therefore imply a population- and/or investigator specificity of algorithms for REE prediction.     

Fat-free mass can be utilized to assess resting energy expenditure for male athletes of different body size

The fat-free mass (FFM) of athletes is typically large, and thus the FFM is often utilized to estimate their resting energy expenditure (REE). While the proportional contribution of organ-tissues to the total influence of FFM on REE is known for untrained individuals and female athletes, the extent to which this is valid for male athletes is unclear. The purpose of this study was to clarify the contribution of the components of FFM to REE in male athletes. Fifty-seven male athletes participated in this study. REE was assessed by indirect calorimetry and body composition by dual X-ray absorptiometry. The athletes were equally divided into three groups based on FFM: Small (S), Medium (M), and Large (L). When measured REE (REEm) was compared with REE estimated (REEe) based on the four organ-tissue compartments with set metabolic rates, REEm and REEe had a strong association (r=0.76, p<0.001). In addition, the absolute value of total REE became larger in accordance with body size (S: 1,643±144, M: 1,865±140, and L: 2,060±156 kcal/d) accompanied by increases in mass of all four organ-tissue compartments as body size increased. The consistency of REE/FFM in male athletes in spite of the difference in body size can be explained by the steadiness among the three groups of the relative contribution of each organ-tissue compartment to the FFM. Based on these results, the FFM is the major determinant of REE regardless of body size in male athletes.     

Effects of cardiac stress during a very-low-calorie diet and exercise program in obese women

To assess the safety of very-low-calorie diets (VLCDs), stress tests known to induce arrhythmias in susceptible patients were performed in 24 obese women on a VLCD (660-720 kcal/d) for 6 wk. Half of the subjects had diet only (DO) and half underwent supervised exercise (DE) four times weekly. Five control subjects ate a balanced, moderately low-calorie diet (approximately 1400 kcal/d). Stress tests included maximal and submaximal (85%) exercise, psychological stress, and isometric handgrip tests, all with constant electrocardiogram (ECG) monitoring. Twenty-four-hour Holter monitors at weeks 0 and 6 and weekly resting ECGs were obtained. DO and DE lost similar amounts of weight. There were no changes in QT intervals or in voltage or width of the QRS complex on resting ECG and no arrhythmias on Holter monitoring. These data support the safety of VLCDs containing greater than or equal to 650 kcal/d and adequate amounts of high-quality protein, vitamins, and minerals for use for periods of at least 6 wk in normal, healthy obese women.     

Resting energy expenditure in patients with chronic obstructive pulmonary disease

Resting energy expenditure (REE) was measured in 68 patients with stable chronic obstructive pulmonary disease (COPD) and in 34 weight-stable, age-matched (65 +/- 8 y; means +/- SD) healthy control subjects. Fat-free mass (FFM) determined by bioelectrical resistance explained 84% of the variation in REE in the control group but only 34% in the COPD patients. REE could not reliably be predicted from regression equations either developed in healthy subjects or in COPD patients. REE adjusted for FFM was significantly higher (P less than 0.05) in weight-losing (n = 34) than in weight-stable (n = 34) patients (6851 +/- 781 and 6495 +/- 650 kJ/d, respectively). Pulmonary function was more compromised in weight-losing patients. Adjusted REE in weight-stable patients was significantly higher (P less than 0.01) than in the healthy control group (6131 +/- 405 kJ/d). In patients with COPD, factors in addition to FFM are important determinants of REE. A disease-related increase in REE develops, which may contribute to weight loss in COPD in combination with a lack of an adaptive response to undernutrition in weight-losing patients.     

Short-term overfeeding increases resting energy expenditure in patients with HIV lipodystrophy

BACKGROUND: HIV lipodystrophy and other lipodystrophy syndromes are characterized by extensive loss of subcutaneous adipose tissue. Lipodystrophy syndromes are also associated with increased resting energy expenditure (REE). This hypermetabolism may be an adaptive response to an inability to store triacylglycerol fuel in a normal manner. OBJECTIVE: This study was done to determine whether REE increases significantly after short-term overfeeding in patients with HIV lipodystrophy. DESIGN: REE was measured in HIV-infected patients with lipodystrophy (n = 9) and in HIV-infected (n = 10) and healthy (n = 9) controls after 3 d on a eucaloric diet and again after 3 d on a diet of similar composition but increased in calories by 50%. RESULTS: After 3 d of eucaloric feeding, REE was significantly higher in patients with HIV lipodystrophy [33.2 +/- 0.27 kcal/kg lean body mass (LBM)] than for both HIV-infected and healthy controls (29.9 +/- 0.26 and 29.6 +/- 0.27 kcal/kg LBM, respectively; P < 0.01). Furthermore, after 3 d of overfeeding, REE increased significantly in patients with HIV lipodystrophy but not in the control groups (33.2 +/- 0.27 vs 34.7 +/- 0.27 kcal/kg LBM; P < 0.01). Finally, postprandial thermogenesis did not differ among the groups after a "normal" test meal but tended to be higher in patients with HIV lipodystrophy than in healthy controls after a large test meal. CONCLUSIONS: Adaptive thermogenesis in the resting component of total daily energy expenditure and in the postprandial period may be a feature of the HIV lipodystrophy syndrome and may be due to an inability to store triacylglycerol fuel in a normal manner.     

Cancer cachexia: measured and predicted resting energy expenditures for nutritional needs evaluation

OBJECTIVE: Cancer cachexia is associated with weight loss, poor nutritional status, and systemic inflammation. Accurate nutritional support for patients is calculated on resting energy expenditure (REE) measurement or prediction. The present study evaluated the agreement between measured and predicted REE (mREE and pREE, respectively) and the influence of acute phase response (APR) on REE. METHODS: Thirty-six patients with cancer were divided into weight-stable (WS; weight loss <2%) and weight-losing (WL; weight loss >5%) patients. Measured REE was measured by indirect calorimetry and adjusted for fat-free mass (FFM). The Bland-Altman approach was used to assess the agreement between mREE and pREE from the Harris-Benedict equations (HBE). Blood levels of C-reactive protein were assessed. RESULTS: There was no difference in mREE between groups (WS 1677 +/- 273, WL 1521 +/- 305) even when mREE was adjusted for FFM (WS 1609 +/- 53, WL 1589 +/- 53). In WL patients, FFM-adjusted REE correlated with blood C-reactive protein levels (r = 0.471, P = 0.048). HBEs tend to underestimate REE in both groups. CONCLUSION: WL and WS patients with cancer had similar REEs but were different in terms of APR. APR could contribute to weight loss through enhancing REE. In a clinical context, HBE was in poor agreement with mREE in both groups.     

Metabolic effects of a very low calorie diet in obese children and adolescents with special reference to nitrogen balance.

Eight obese children and adolescents, mean age (+/? SD) 12.0 +/? 2.5 years, were treated for 3 weeks with a liquid formula very low calorie diet (VLCD), containing 320 kcal/1339 kj (44 g protein, 33 g carbohydrate, 0.9 g fat). Weight loss after 3 weeks was 8.0 +/? 1.8 kg resulting in 15.3 +/? 4.6% reduction of body overweight. During the dietary period no patient complained of hunger and no serious side effects were observed. Four patients achieved positive N-balance during the second week, all but one in the third week. Mean cumulative N-balance after 3 weeks was calculated to be ?23.2 +/? 31.6 gN. Great interindividual variances were observed in the rate of N-loss during the course of the study. No significant correlation was found between cumulative N-balance and weight loss or initial body weight. Blood parameters remained unaffected, except for glucose and urea, which decreased slightly from 74.6 +/? 13.6 to 50.4 +/? 20.1 mg/dl and from 14.1 +/? 4.3 to 8.6 +/? 7.4 mg/dl, respectively. Uric acid concentrations increased slightly, three of eight patients had levels higher than 8 mg/dl and therefore were treated with allopurinol. Total serum protein decreased; serum albumin values did not change. The type of VLCD used in this study proved therapeutically useful in achieving rapid weight loss. Compared with VLCD containing 30% less protein and carbohydrate, a marked improvement of N-balance in 3 weeks could be achieved with the VLCD containing 1 g protein/kg IBW/day. This amount of protein seems to be necessary to obtain the nitrogen sparing effect in children and adolescents undergoing weight reduction with VLCDs.     

The impact of parenteral nutrition on the body composition of patients with acute pancreatitis

BACKGROUND: Nutrition support by the enteral route is now the preferred modality in patients with severe acute pancreatitis. Parenteral nutrition is now required to supplement enteral nutrition when the latter is not able to provide the full nutritional requirement. We report the changes in body composition, plasma proteins, and resting energy expenditure (REE) during 14 days of parenteral nutrition (PN) in patients with acute pancreatitis. METHODS: Total body protein (TBP), total body water (TBW), and total body fat (TBF) were measured by neutron activation analysis and tritium dilution before and after PN. Fat-free mass (FFM) was derived as the difference between body weight and TBF. REE was measured by indirect calorimetry. Protein index (PI) was the ratio of measured TBP to TBP, calculated from healthy volunteers. RESULTS: Fifteen patients with acute pancreatitis (11 men, 4 women; median age 56, range 30-80 years) were studied. Thirteen patients had severe acute pancreatitis (Atlanta criteria), and 1 patient died. The gains in body weight (1.05 +/- 0.77 kg), TBW (0.49 +/- 0.87 kg), TBP (0.20 +/- 0.22 kg), FFM (0.73 +/- 0.92 kg), TBF (0.32 +/- 0.95 kg), and REE (146 +/- 90 kcal/d) after 14 days of PN were not significant. Plasma prealbumin increased by 46.5% (p = .020). When patients (n = 6) with intercurrent sepsis and recent surgery were excluded, there were significant increases in TBP (0.65 +/- 0.17 kg, p = .005) and PI (0.060 +/- 0.011, p = .0006). CONCLUSIONS: Body composition is preserved in acute pancreatitis during 14 days of PN. In patients without sepsis or recent surgery, PN is able to significantly increase body protein stores.     

Estimation of Resting Energy Expenditure: Validation of Previous and New Predictive Equations in Obese Children and Adolescents

Objective: Accurate estimation of resting energy expenditure (REE) in childrenand adolescents is important to establish estimated energy requirements. The aim of the present study was to measure REE in obese children and adolescents by indirect calorimetry method, compare these values with REE values estimated by equations, and develop the most appropriate equation for this group.

Methods: One hundred and three obese children and adolescents (57 males, 46 females) between 7 and 17 years (10.6 ± 2.19 years) were recruited for the study. REE measurements of subjects were made with indirect calorimetry (COSMED, FitMatePro, Rome, Italy) and body compositions were analyzed.

Results: In females, the percentage of accurate prediction varied from 32.6 (World Health Organization [WHO]) to 43.5 (Molnar and Lazzer). The bias for equations was ?0.2% (Kim), 3.7% (Molnar), and 22.6% (Derumeaux-Burel). Kim's (266 kcal/d), Schmelzle's (267 kcal/d), and Henry's equations (268 kcal/d) had the lowest root mean square error (RMSE; respectively 266, 267, 268 kcal/d). The equation that has the highest RMSE values among female subjects was the Derumeaux-Burel equation (394 kcal/d). In males, when the Institute of Medicine (IOM) had the lowest accurate prediction value (12.3%), the highest values were found using Schmelzle's (42.1%), Henry's (43.9%), and Müller's equations (fat-free mass, FFM; 45.6%). When Kim and Müller had the smallest bias (?0.6%, 9.9%), Schmelzle's equation had the smallest RMSE (331 kcal/d). The new specific equation based on FFM was generated as follows: REE = 451.722 + (23.202 * FFM). According to Bland-Altman plots, it has been found out that the new equations are distributed randomly in both males and females.

Conclusion: Previously developed predictive equations mostly provided unaccurate and biased estimates of REE. However, the new predictive equations allow clinicians to estimate REE in an obese children and adolescents with sufficient and acceptable accuracy.     

Anthropometric measured fat-free mass as essential determinant of resting energy expenditure for pregnant and non-pregnant women

Objective

There is conflicting evidence as to whether anthropometric parameters are related to resting energy expenditure (REE) during pregnancy. The aim of this prospective longitudinal study was to precisely assess a major anthropometric determinant of REE for pregnant and non-pregnant women with verification of its use as a possible predictor.

Methods

One hundred fifty-two randomly recruited, healthy, pregnant Czech women were divided into groups G1 and G2. G1 (n = 31) was used for determination of the association between anthropometric parameters and REE. G2 (n = 121) and a group of non-pregnant women (G0; n = 24) were used for verification that observed relations were suitable for the prediction of REE during pregnancy. The women in the study groups were measured during four periods of pregnancy for REE by indirect calorimetry and anthropometric parameters after 12 h of fasting.

Results

Associations were found in all groups between measured REE by indirect calorimetry and anthropometric parameters such as weight, fat mass, fat-free mass (FFM), body surface area, and body mass index (P < 0.0001). The best derived predictor, REE/FFM (29.5 kcal/kg, r = 0.70, P < 0.0001), in group G1 was statistically verified in group G2 and compared with G0.

Conclusion

Anthropometrically measured FFM with its metabolically active components is an essential determinant of REE in pregnancy. REE/FFM can be used for the prediction of REE in pregnant and non-pregnant woman.