Protein and energy metabolism in chronic bacterial infection: studies in melioidosis

2000 ◽  
Vol 100 (1) ◽  
pp. 101-110 ◽  
Author(s):  
Nicholas I. PATON ◽  
Brian ANGUS ◽  
Wipada CHAOWAGUL ◽  
Andrew J. SIMPSON ◽  
Yupin SUPUTTAMONGKOL ◽  
...  
Keyword(s):  
Energy Metabolism ◽  
Energy Expenditure ◽  
Bacterial Infection ◽  
Total Energy ◽  
Protein Turnover ◽  
Resting Energy Expenditure ◽  
Total Energy Expenditure ◽  
Whole Body ◽  
Anabolic Response ◽  
Resting Energy

Chronic infection is often accompanied by a wasting process, the metabolic basis of which is not fully understood. The aims of the present study were to measure protein and energy metabolism in patients with melioidosis (a serious and antibiotic-refractory Gram-negative bacterial infection which is endemic in South-East Asia) in order to define the metabolic abnormalities that might contribute to wasting. Whole-body protein turnover was measured using the [13C]leucine technique, both in the fasted state and while consuming a high-energy meal. Resting energy expenditure was measured by indirect calorimetry, and total energy expenditure by the bicarbonate/urea method. Results were normalized for fat-free mass, as estimated from skinfold thickness. Protein turnover was increased in melioidosis patients compared with healthy controls during fasting (170.9 compared with 124.1 µmol·kg-1·h-1; P = 0.04), but the net rate of catabolism (22.2 compared with 20.5 µmol·kg-1·h-1; P = 0.77) and the anabolic response to feeding were similar in the two groups. Resting energy expenditure was higher in melioidosis patients compared with controls (191.4 and 157.3 kJ·kg-1·day-1 respectively; P = 0.04), but total energy expenditure (measured in a separate group of eight patients with melioidosis) was low (192.1 kJ·kg-1·day-1). In conclusion, this study found no evidence of metabolic causative factors, such as accelerated net protein catabolism during fasting, a blunted anabolic response to feeding or increased daily energy expenditure, and therefore suggests that reduced energy intake is the prime cause of wasting. The observed normal response to feeding should encourage nutritional approaches to prevent wasting.

Total Energy Expenditure and Physical Activity Measured with the Bicarbonate-Urea Method in Patients with Human Immunodeficiency Virus Infection

1996 ◽  
Vol 91 (2) ◽  
pp. 241-245 ◽  
Author(s):  
N. I. J. Paton ◽  
M. Elia ◽  
S. A. Jebb ◽  
G. Jennings ◽  
D. C. MacAllan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Energy Expenditure ◽  
Total Energy ◽  
Physical Activity Level ◽  
Resting Energy Expenditure ◽  
Total Energy Expenditure ◽  
Activity Level ◽  
Hiv Positive ◽  
Urea Method ◽  
Resting Energy

1. Our objectives were to measure total energy expenditure, the daily variation in total energy expenditure and the physical activity level in a group of HIV-positive subjects using the bicarbonate-urea method. The study also aimed to assess the practicalities of using the bicarbonate-urea technique in free-living conditions. 2. Total energy expenditure was measured with the bicarbonate-urea method over 2 consecutive days (1 day in one subject) in 10 male patients with HIV infection (median CD4 count = 30). Resting energy expenditure was measured by indirect calorimetry. Physical activity level (total energy expenditure/resting energy expenditure) was calculated from these measurements and from activity diaries. 3. Resting energy expenditure was found to be 7.46 ± 0.87 MJ/day, 5% higher than predicted values. Total energy expenditure was 10.69 ± 1.95 MJ/day with an intra-individual day-to-day variation of 6 ± 6%. The measured physical activity level was 1.42 ± 0.14, higher than the diary estimate of 1.34 ± 0.16 (P = 0.029), and there were large inter-method differences in individual values. The subcutaneous infusion of bicarbonate was well tolerated and did not seem to restrict normal activities. 4. Total energy expenditure was not elevated in the group of HIV-positive subjects when compared with reference values for normal subjects. The physical activity level of the patients in this study was lower than that measured using other techniques in healthy young men, but was compatible with that expected for people leading a sedentary lifestyle. Reductions in physical activity in patients with HIV are likely to contribute to the wasting process and physical activity level may thus be a clinically useful measure. This study has also provided the first tracer estimate of the day-to-day variation in total energy expenditure. The bicarbonate-urea method represents an important new investigative tool for measuring total energy expenditure which has previously only been possible within the confines of a whole-body calorimeter or using the expensive doubly labelled water method.

scholarly journals Physical activity and energy balance

1999 ◽  
Vol 2 (3a) ◽  
pp. 335-339 ◽  
Author(s):  
Marleen A. Van Baak
Keyword(s):  
Physical Activity ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Total Energy ◽  
Energy Intake ◽  
Body Mass ◽  
Resting Energy Expenditure ◽  
Total Energy Expenditure ◽  
Activity Level ◽  
Resting Energy

AbstractEnergy expenditure rises above resting energy expenditure when physical activity is performed. The activity-induced energy expenditure varies with the muscle mass involved and the intensity at which the activity is performed: it ranges between 2 and 18 METs approximately. Differences in duration, frequency and intensity of physical activities may create considerable variations in total energy expenditure. The Physical Activity Level (= total energy expenditure divided by resting energy expenditure) varies between 1.2 and 2.2–2.5 in healthy adults. Increases in activity-induced energy expenditure have been shown to result in increases in total energy expenditure, which are usually greater than the increase in activity-induced energy expenditure itself. No evidence for increased spontaneous physical activity, measured by diary, interview or accelerometer, was found. However, this does not exclude increased physical activity that can not be measured by these methods. Part of the difference may also be explained by the post-exercise elevation of metabolic rate.If changes in the level of physical activity affect energy balance, this should result in changes in body mass or body composition. Modest decreases of body mass and fat mass are found in response to increases in physical activity, induced by exercise training, which are usually smaller than predicted from the increase in energy expenditure. This indicates that the training-induced increase in total energy expenditure is at least partly compensated for by an increase in energy intake. There is some evidence that the coupling between energy expenditure and energy intake is less at low levels of physical activity. Increasing the level of physical activity for weight loss may therefore be most effective in the most sedentary individuals.

Leucine kinetics in endurance-trained humans

1990 ◽  
Vol 69 (1) ◽  
pp. 1-6 ◽  
Author(s):  
L. S. Lamont ◽  
D. G. Patel ◽  
S. C. Kalhan
Keyword(s):  
Energy Expenditure ◽  
Protein Turnover ◽  
Resting Energy Expenditure ◽  
Whole Body ◽  
Body Protein ◽  
Energy Expenditures ◽  
Leucine Kinetics ◽  
Constant Rate ◽  
Tracer Dilution ◽  
Resting Energy

This study compared whole-body leucine kinetics in endurance-trained (TRN) and sedentary (SED) control subjects. Eleven men and women (6 TRN, 5 SED) underwent a 6-h primed, constant-rate infusion of L-[1-13C]leucine. Leucine turnover and oxidation were measured using tracer dilution and by measuring 13C enrichment of expired CO2 combined with respiratory calorimetry. Whole-body leucine turnover was greater in the TRN subjects (P less than 0.004; TRN 98.3 +/- 5.0, SED 75.3 +/- 4.2 mumol.kg-1.h-1; mean +/- SE), but there was no difference between groups in leucine oxidation (TRN 13.1 +/- 0.97, SED 11.5 +/- 0.48 mumol.kg-1.h-1). Thus more leucine turnover was available for nonoxidative utilization. In addition, the TRN subjects had higher resting energy expenditures compared with the SED group, and when all subjects were included in the analysis, there was a significant correlation between energy expenditure and protein turnover (n = 11, R = 0.61, P = 0.05). Therefore the heightened resting energy expenditure in the TRN subjects may be accounted for by an increased whole-body protein turnover. These results suggest that endurance training results in increased leucine and/or protein turnover, which may contribute to the increased resting energy expenditure observed in these subjects.

scholarly journals Whole-body protein turnover and resting energy expenditure in obese, prepubertal children

1999 ◽  
Vol 69 (5) ◽  
pp. 857-862 ◽  
Author(s):  
Yves Schutz ◽  
Clara M Rueda-Maza ◽  
Marco Zaffanello ◽  
Claudio Maffeis
Keyword(s):  
Energy Expenditure ◽  
Protein Turnover ◽  
Resting Energy Expenditure ◽  
Whole Body ◽  
Body Protein ◽  
Prepubertal Children ◽  
Resting Energy

Energy Expenditure and Body Fat Distribution in Mohawk Children

PEDIATRICS ◽  
1995 ◽  
Vol 95 (1) ◽  
pp. 89-95
Author(s):  
Michael I. Goran ◽  
Mary Kaskoun ◽  
Rachel Johnson ◽  
Charlene Martinez ◽  
Benson Kelly ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Native Americans ◽  
Energy Expenditure ◽  
Total Energy ◽  
Body Fat ◽  
Resting Energy Expenditure ◽  
Fat Distribution ◽  
Total Energy Expenditure ◽  
Fat Free Mass

Objective. Epidemiologic studies suggest that Native Americans, including the Mohawk people, have a high prevalence of obesity, diabetes, and cardiovascular risk. However, current information on alterations in related variables such as energy metabolism and body composition in Native Americans is almost exclusively limited to already obese Pima adults living in the Southwest. The aim of this study was to characterize energy metabolism and body composition in young Mohawk children (17 girls, 11 boys; aged 4 to 7 years) as compared to Caucasian children (36 girls, 34 boys; aged 4 to 7 years). Total energy expenditure was measured by doubly labeled water, postprandial resting energy expenditure by indirect calorimetry, and activity energy expenditure was derived from the difference between total and resting energy expenditure. Fat and fat free mass were estimated from bioelectrical resistance, and body fat distribution was estimated from skinfolds and circumferences. Results. There were no significant effects of ethnic background or sex on body weight, height, or body mass index. Fat free mass was significantly higher in boys and fat mass was significantly higher in girls, with no effect of ethnic background. Chest skinfold thickness, the ratio of trunk skinfolds:extremity skinfolds, and the waist:hip ratio were significantly higher in Mohawk children by 2.5 mm, 0.09 units, and 0.03 units, respectively, independent of sex and fat mass. Total energy expenditure was significantly higher in Mohawk children compared to Caucasian (100 kcal/day in girls, 150 kcal/day in boys), independent of fat free mass and sex, due to a significantly higher physical activity-related energy expenditure. Conclusion. These data suggest that: 1) body fat is more centrally distributed in Mohawk relative to Caucasian children, and this effect is independent of sex and body fat content; 2) Mohawk children have a greater total energy expenditure than Caucasian children, independent of fat free mass, due to greater physical activity-related energy expenditure.

scholarly journals Evaluation of Variability in Resting Energy Expenditure and Its Relationship with Macronutrients and Gestational Weight Gain During the Second Trimester of Pregnancy (P11-136-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kiley Vander Wyst ◽  
Matthew Buman ◽  
Gabriel Shaibi ◽  
Megan Petrov ◽  
Elizabeth Reifsnider ◽  
...  
Keyword(s):  
Weight Gain ◽  
Energy Expenditure ◽  
Total Energy ◽  
Gestational Weight Gain ◽  
Early Period ◽  
Resting Energy Expenditure ◽  
Dietary Composition ◽  
Second Trimester ◽  
Gestational Weight ◽  
Resting Energy

Abstract Objectives Resting energy expenditure (REE) comprises 60% of total energy expenditure and variations may be associated with gestational weight gain (GWG). There is a paucity of research investigating the relationship between REE and GWG. We investigated variations in REE and dietary composition throughout the second trimester and their association with GWG. Methods In this controlled trial, pregnant women (N = 16, mean age of 29.9 ± 4.3 years) with a gestational age < 17 weeks used the Breezing™ device for 13 weeks. This device is a real-time metabolism tracker that measures REE via indirect calorimetry. Height, weight, REE, and dietary intake via 24-hr recall were assessed every 2 weeks. Rate of GWG was calculated as weight gain divided by number of study weeks. Early (EC, GA wks 14–21), late (LC, GA wks 21–28), and overall (OC, GA wks 14–28) changes in macronutrient composition, REE, and GWG were used to evaluate time-specific associations. Group differences were analyzed using a General Linear Model in SPSS Version 25. Results Among the 16 participants, 25% of women were normal weight, 50% were overweight, and 25% were obese at study start. Women had a total and rate of GWG of 8.1 ± 2.9 kg and 0.6 ± 0.2 kg/wk, respectively. REE increased 72 ± 211 kcals/d during the early period, 121 ± 294 kcals/d during the late period, and 200 ± 316 kcals/d overall (from 1544 ± 237 kcal/d to 1744 ± 384 kcal/d). Early changes in REE were significantly correlated with the late changes in total (r = 0.52, P = 0.04) and rate of weight gain (r = 0.54, P = 0.03). A correlation between overall changes in REE and total weight gain was moderate and approached significance, r = 0.44, P = 0.09. Changes in total energy, fat, carbohydrate, and protein intake were not correlated with changes in REE; however, a moderate relationship between early changes in REE and overall changes in energy intake approached significance, r = 0.46, P = 0.07. Changes in GWG and REE did not differ among normal, overweight, or obese women (EC: F(2,15) = 0.36, P = 0.70; LC: F(2,15) = 2.37, P = 0.13; OC: F(2.15) = 1.27, P = 0.31). Conclusions Early changes in REE demonstrated a moderate, positive correlation with total and rate of GWG suggesting that assessment of REE early in pregnancy may help understand changes in GWG. Future research that evaluates both REE and dietary composition throughout pregnancy may provide insight into appropriate GWG. Funding Sources Project HoneyBee, Arizona State University.

scholarly journals Resting energy expenditure measured longitudinally following hip fracture compared to predictive equations: is an injury adjustment required?

2005 ◽  
Vol 94 (6) ◽  
pp. 976-982 ◽  
Author(s):  
Michelle D. Miller ◽  
Lynne A. Daniels ◽  
Elaine Bannerman ◽  
Maria Crotty
Keyword(s):  
Hip Fracture ◽  
Energy Expenditure ◽  
Total Energy ◽  
Physiological Stress ◽  
Resting Energy Expenditure ◽  
Mean Difference ◽  
Limits Of Agreement ◽  
Predictive Equations ◽  
The Mean ◽  
Resting Energy

The present study measuring resting energy expenditure (REE; kJ/d) longitudinally using indirect calorimetry in six elderly women aged ≥70 years following surgery for hip fracture, describes changes over time (days 10, 42 and 84 post-injury) and compares measured values to those calculated from routinely applied predictive equations. REE was compared to REE predicted using the Harris Benedict and Schofield equations, with and without accounting for the theoretical increase in energy expenditure of 35 % secondary to physiological stress of injury and surgery. Mean (95 % CI) measured REE (kJ/d) was 4704 (4354, 5054), 4090 (3719, 4461) and 4145 (3908, 4382) for days 10, 42 and 84, respectively. A time effect was observed for measured REE,P=0·003. Without adjusting for stress the mean difference and 95 % limits of agreement for measured and predicted REE (kJ/kg per d) for the Harris Benedict equation were 1 (−9, 12), 10 (2, 18) and 9 (1, 17) for days 10, 42 and 84, respectively. The mean difference and 95 % limits of agreement for measured and predicted REE (kJ/kg per d) for the Schofield equation without adjusting for stress were 8 (−3, 19), 16 (6, 26) and 16 (10, 22) for days 10, 42 and 84, respectively. After adjusting for stress, REE predicted from the Harris Benedict or Schofield equations overestimated measured REE by between 38 and 69 %. Energy expenditure following fracture is poorly understood. Our data suggest REE was relatively elevated early in recovery but declined during the first 6 weeks. Using the Harris Benedict or Schofield equations adjusted for stress may lead to overestimation of REE in the clinical setting. Further work is required to evaluate total energy expenditure before recommendations can be made to alter current practice for calculating theoretical total energy requirements of hip fracture patients.

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