Comparison of estimated energy requirements using predictive equations with total energy expenditure measured by the doubly labelled water method in acute spinal cord injury

The measurement of energy expenditure has wide applications in clinical and scientific studies. Ethical and practical problems, however, have limited the acquisition of information on total energy expenditure in infancy. The doubly-labelled-water technique, recently validated for use in infants, has now been used to measure, non-invasively, total energy expenditure in a cohort of forty-one normal, full-term infants at or close to 1·5, 3 and 6 months of age. Mean total energy expenditure was 270, 280 and 330 kJ/kg per d at these ages. Centiles for total energy expenditure in early infancy are presented; it is suggested such data are most appropriately expressed as kJ/√ (kg body-weight per d). These findings will be of importance in the re-evaluation of energy requirements in infancy and in the study of lesions in energy metabolism in disease states at this age.

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Energy requirements of infants

Public Health Nutrition ◽

10.1079/phn2005790 ◽

2005 ◽

Vol 8 (7a) ◽

pp. 953-967 ◽

Cited By ~ 59

Author(s):

Nancy F Butte

Keyword(s):

Energy Expenditure ◽

Total Energy ◽

Energy Intake ◽

Energy Deposition ◽

Total Energy Expenditure ◽

Energy Requirements ◽

Term Infants ◽

Doubly Labelled Water

AbstractObjectiveTo estimate the energy requirements of infants from total energy expenditure and energy deposition during growth.DesignEnergy requirements during infancy were estimated from total energy expenditure measured by the doubly labelled water method and energy deposition based on measured protein and fat gains.SettingDatabase on the total energy expenditure and energy deposition of infants was compiled from available studies conducted in China, Chile, Gambia, Mexico, Netherlands, UK, and USA.SubjectsHealthy, term infants.ResultsTotal energy requirements (kJ day−1) increased with age and were higher in boys than girls due to differences in weight. Energy requirements decreased from 473 kJ kg−1per day for boys and 447 kJ kg−1per day for girls at 1 month of age to 337 kJ kg−1per day for boys and 341 kJ kg−1per day for girls at 6 months of age, and thereafter tended to plateau. Energy deposition as a percentage of total energy requirements decreased from 40% at 1 month to 3% at 12 months of age. These estimates are 10–32% lower than the 1985 FAO/WHO/UNU recommendations which were based on observed energy intakes of infants.ConclusionsRecommendations for the energy intake of infants should be revised based on new estimates of total energy expenditure and energy deposition.

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Energy Expenditure Assessment and Validation After Acute Spinal Cord Injury

Nutrition in Clinical Practice ◽

10.1177/0115426502017005309 ◽

2002 ◽

Vol 17 (5) ◽

pp. 309-313 ◽

Cited By ~ 8

Author(s):

Kathy T. Barco ◽

Rochelle A. Smith ◽

Joel R. Peerless ◽

Brian R. Plaisier ◽

Cinda S. Chima

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Energy Expenditure ◽

Acute Spinal Cord Injury ◽

Cord Injury

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Total energy expenditure measured using doubly labeled water compared with estimated energy requirements in older adults (≥65 y): analysis of primary data

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqz200 ◽

2019 ◽

Vol 110 (6) ◽

pp. 1353-1361 ◽

Cited By ~ 7

Author(s):

Judi Porter ◽

Kay Nguo ◽

Jorja Collins ◽

Nicole Kellow ◽

Catherine E Huggins ◽

...

Keyword(s):

Older Adults ◽

Energy Expenditure ◽

Total Energy ◽

Reference Method ◽

Total Energy Expenditure ◽

Activity Level ◽

Energy Requirements ◽

Primary Data ◽

Doubly Labeled Water ◽

Predictive Equations

ABSTRACT Background Contemporary energy expenditure data are crucial to inform and guide nutrition policy in older adults to optimize nutrition and health. Objective The aim was to determine the optimal method of estimating total energy expenditure (TEE) in adults (aged ≥65 y) through 1) establishing which published predictive equations have the closest agreement between measured resting metabolic rate (RMR) and predicted RMR and 2) utilizing the RMR equations with the best agreement to predict TEE against the reference method of doubly labeled water (DLW). Methods A database consisting of international participant-level TEE data from DLW studies was developed to enable comparison with energy requirements estimated by 17 commonly used predictive equations. This database included 31 studies comprising 988 participant-level RMR data and 1488 participant-level TEE data. Mean physical activity level (PAL) was determined for men (PAL = 1.69, n = 320) and women (PAL = 1.66, n = 668). Bland–Altman plots assessed agreement of measured RMR and TEE with predicted RMR and TEE in adults aged ≥65 y, and subgroups of 65–79 y and ≥80 y. Linear regression assessed proportional bias. Results The Ikeda, Livingston, and Mifflin equations most closely agreed with measured RMR and TEE in all adults aged ≥65 y and in the 65–79 y and ≥80 y subgroups. In adults aged ≥65 y, the Ikeda and Livingston equations overestimated TEE by a mean ± SD of 175 ± 1362 kJ/d and 86 ± 1344 kJ/d, respectively. The Mifflin equation underestimated TEE by a mean ± SD of 24 ± 1401 kJ/d. Proportional bias was present as energy expenditure increased. Conclusions The Ikeda, Livingston, or Mifflin equations are recommended for estimating energy requirements of older adults. Future research should focus on developing predictive equations to meet the requirements of the older population with consideration given to body composition and functional measures.

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Agreement between the total energy expenditure calculated with accelerometry data and the BMR yielded by predictive equations v. the total energy expenditure obtained with doubly labelled water in low-income women with excess weight

British Journal Of Nutrition ◽

10.1017/s0007114519002460 ◽

2019 ◽

Vol 122 (12) ◽

pp. 1398-1408 ◽

Cited By ~ 2

Author(s):

Mateus L. Macena ◽

Isabele R. O. M. Pureza ◽

Ingrid S. V. Melo ◽

Ana G. Clemente ◽

Haroldo S. Ferreira ◽

...

Keyword(s):

Energy Expenditure ◽

Total Energy ◽

Low Income ◽

Total Energy Expenditure ◽

Excess Weight ◽

Doubly Labelled Water ◽

Predictive Equations ◽

Technical Report Series ◽

Technical Report ◽

Food And Nutrition

AbstractLow-income women are the group with the highest levels of obesity worldwide. In low-income settings, the use of predictive equations, which yield a measure of the individuals’ BMR, is a feasible approach to estimate the individuals’ total energy expenditure (TEE), using the factorial method (calculated-TEE = BMR × physical activity level), an important step of the obesity nutritional care. The present study aimed to identify the predictive equation that, in conjunction with metabolic equivalents of tasks (MET) data from accelerometers, yields the calculated-TEE with better agreement compared with the TEE measured by doubly labelled water (TEE-DLW). Forty-five women aged 19–45 years, with excess weight and mothers of undernourished children, were included. They received DLW to determine TEE (14 d); at the same time, they used triaxial accelerometers (7 d) to estimate their MET. The Bland–Altman method, paired-sample t tests, concordance correlation coefficient and root-mean-square error were used to assess the agreement. Maximum allowed differences were defined as 24 %, based on the within-variance coefficient of the energy intake of the sample. Eleven equations were studied. The calculated-TEE obtained by five equations showed non-significant bias: Dietary Reference Intake (Institute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids), FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series), Harris & Benedict ((1919) Proc Natl Acad Sci USA4, 370–373), Henry & Rees ((1991) Eur J Clin Nutr45, 177–185) and Schofield ((1985) Hum Nutr Clin Nutr39, 5–41). The mean percentage differences were –1·5, –0·8, 2·2, –2·2 and 2·0 %, respectively. Considering all parameters, FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series) equation performed slightly better than the others; nevertheless, no equation in conjunction with the estimated-MET showed a calculated-TEE with its CI for the Bland–Altman limits of agreement inside the pre-defined acceptable range.

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Energy expenditure in disease: time to revisit?

Proceedings of The Nutrition Society ◽

10.1017/s0029665100000227 ◽

2000 ◽

Vol 59 (2) ◽

pp. 199-207 ◽

Cited By ~ 19

Author(s):

Eileen R. Gibney

Keyword(s):

Energy Expenditure ◽

Total Energy ◽

Energy Requirement ◽

Total Energy Expenditure ◽

Energy Requirements ◽

Direct Result ◽

Free Living ◽

Doubly Labelled Water ◽

Tracer Techniques ◽

Urea Method

Knowledge of energy expenditure is especially important in disease, and may in fact help in the understanding of the pathophysiology of wasting associated with disease. Energy requirements in a clinical setting are often ‘prescribed’ by health professionals, either directly through enteral or parenteral feeding, or perhaps controlled through a hospital diet. Studies initially suggested an increase in energy expenditure, and thus energy requirements, as a direct result of an increase in basal metabolic rate often seen in disease. However, many problems exist in the measurement of BMR in a disease situation, due to the effects of drugs, clinical practice, feeding or possibly anxiety either as a cause of the disease or the measurement itself. These problems could in themselves contribute to the rise in metabolism seen in disease. More recently, however, with the use of tracer techniques such as doubly-labelled water and the bicarbonate–urea method, more accurate estimates of energy expenditure, and thus energy requirements, have been made. Some such measurements have in fact shown that even with an elevated BMR, free-living total energy expenditure can in fact be reduced in many disease situations, suggesting a reduced rather than an increased energy requirement. The present review investigates measurements of total energy expenditure in disease to explore the hypothesis that energy expenditure in disease, even with an elevated BMR, can in fact be reduced due to a concurrent reduction in physical activity.

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