Energy intake and expenditure in elderly patients admitted to hospital with acute illness

1995 ◽  
Vol 73 (2) ◽  
pp. 323-334 ◽  
Author(s):  
K. Klipstein-Grobusch ◽  
J. J. Reilly ◽  
J. Potter ◽  
C. A. Edwards ◽  
M. A. Roberts
Keyword(s):  
Energy Balance ◽  
Energy Expenditure ◽  
Elderly Patients ◽  
Metabolic Rate ◽  
Total Energy ◽  
Patient Group ◽  
Negative Energy ◽  
Total Energy Expenditure ◽  
Acute Illness ◽  
Negative Energy Balance

Studies on hospitalized elderly subjects have demonstrated that negative energy balance is common during hospitalization, but have concentrated primarily on long-stay and psychogeriatric patients. There is little information on energy balance in elderly patients admitted with acute illness from the community, despite the importance of this patient group and the presence of a number of factors likely to predispose such patients to negative energy balance. In the present study energy balance was quantified in twenty patients (eight males, mean age 82 (SD 05) years; twelve females, mean age 84 (SD 6) years) admitted from the community with acute illness, and predicted basal metabolic rate (BMR) was compared with measured resting metabolic rate (RMR). Most patients were in negative energy balance during hospitalization, and median measured energy intake (El):measured RMR ratio was 1·0 (range 0·7–1·8). The mean difference between measured El and estimated total energy expenditure was −1·3 MJ/d (range -3·4 to +2·5 MJ/d). Estimated total energy expenditure exceeded measured El in fifteen of the patients and there was a significant decline in mid-arm muscle circumference (paired t, P < 0·05) during hospitalization. We conclude that moderate negative energy balance is common in this patient group, and that these patients are at risk of undernutrition during their hospital stay.

Energy Balance and Energy Availability During a Selection Course for Belgian Paratroopers

2021 ◽  
Author(s):  
Patrick Mullie ◽  
Pieter Maes ◽  
Laurens van Veelen ◽  
Damien Van Tiggelen ◽  
Peter Clarys
Keyword(s):  
Physical Activity ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Metabolic Rate ◽  
Energy Intake ◽  
Rest Metabolic Rate ◽  
Negative Energy ◽  
Fat Free Mass ◽  
Negative Energy Balance ◽  
Energy Availability

ABSTRACT Introduction Adequate energy supply is a prerequisite for optimal performances and recovery. The aims of the present study were to estimate energy balance and energy availability during a selection course for Belgian paratroopers. Methods Energy expenditure by physical activity was measured with accelerometer (ActiGraph GT3X+, ActiGraph LLC, Pensacola, FL, USA) and rest metabolic rate in Cal.d−1 with Tinsley et al.’s equation based on fat-free mass = 25.9 × fat-free mass in kg + 284. Participants had only access to the French individual combat rations of 3,600 Cal.d−1, and body fat mass was measured with quadripolar impedance (Omron BF508, Omron, Osaka, Japan). Energy availability was calculated by the formula: ([energy intake in foods and beverages] − [energy expenditure physical activity])/kg FFM−1.d−1, with FFM = fat-free mass. Results Mean (SD) age of the 35 participants was 25.1 (4.18) years, and mean (SD) percentage fat mass was 12.0% (3.82). Mean (SD) total energy expenditure, i.e., the sum of rest metabolic rate, dietary-induced thermogenesis, and physical activity, was 5,262 Cal.d−1 (621.2), with percentile 25 at 4,791 Cal.d−1 and percentile 75 at 5,647 Cal.d−1, a difference of 856 Cal.d−1. Mean daily energy intake was 3,600 Cal.d−1, giving a negative energy balance of 1,662 (621.2) Cal.d−1. Mean energy availability was 9.3 Cal.kg FFM−1.d−1. Eleven of the 35 participants performed with a negative energy balance of 2,000 Cal.d−1, and only five participants out of 35 participants performed at a less than 1,000 Cal.d−1 negative energy balance level. Conclusions Energy intake is not optimal as indicated by the negative energy balance and the low energy availability, which means that the participants to this selection course had to perform in suboptimal conditions.

Energy expenditure climbing Mt. Everest

1992 ◽  
Vol 73 (5) ◽  
pp. 1815-1819 ◽  
Author(s):  
K. R. Westerterp ◽  
B. Kayser ◽  
F. Brouns ◽  
J. P. Herry ◽  
W. H. Saris
Keyword(s):  
Weight Loss ◽  
Body Composition ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Metabolic Rate ◽  
High Altitude ◽  
Energy Intake ◽  
Negative Energy ◽  
Negative Energy Balance ◽  
The Alps

Weight loss is a well-known phenomenon at high altitude. It is not clear whether the negative energy balance is due to anorexia only or an increased energy expenditure as well. The objective of this study was to gain insight into this matter by measuring simultaneously energy intake, energy expenditure, and body composition during an expedition to Mt. Everest. Subjects were two women and three men between 31 and 42 yr of age. Two subjects were observed during preparation at high altitude, including a 4-day stay in the Alps (4,260 m), and subsequently during four daytime stays in a hypobaric chamber (5,600–7,000 m). Observations at high altitude on Mt. Everest covered a 7- to 10-day interval just before the summit was reached in three subjects and included the summit (8,872 m) in a fourth. Energy intake (EI) was measured with a dietary record, average daily metabolic rate (ADMR) with doubly labeled water, and resting metabolic rate (RMR) with respiratory gas analysis. Body composition was measured before and after the interval from body mass, skinfold thickness, and total body water. Subjects were in negative energy balance (-5.7 +/- 1.9 MJ/day) in both situations, during the preparation in the Alps and on Mt. Everest. The loss of fat mass over the observation intervals was 1.4 +/- 0.7 kg, on average two-thirds of the weight loss (2.2 +/- 1.5 kg), and was significantly correlated with the energy deficit (r = 0.84, P < 0.05). EI on Mt. Everest was 9–13% lower than during the preparation in the Alps.(ABSTRACT TRUNCATED AT 250 WORDS)

Determination of total energy expenditure, resting metabolic rate and physical activity in lean and overweight people

1997 ◽  
Vol 36 (4) ◽  
pp. 310-312 ◽  
Author(s):  
F. Thielecke ◽  
J. Möseneder ◽  
A. Kroke ◽  
K. Klipstein-Grobusch ◽  
H. Boeing ◽  
...  
Keyword(s):  
Physical Activity ◽  
Energy Expenditure ◽  
Metabolic Rate ◽  
Total Energy ◽  
Resting Metabolic Rate ◽  
Total Energy Expenditure ◽  
Overweight People

scholarly journals Total energy expenditure assessed by salivary doubly labelled water analysis and its relevance for short-term energy balance in humans

2015 ◽  
Vol 30 (1) ◽  
pp. 143-150 ◽  
Author(s):  
Stefano Guidotti ◽  
Berthe M. A. A. A. Verstappen-Dumoulin ◽  
Henk G. Jansen ◽  
Anita T. Aerts-Bijma ◽  
André A. van Vliet ◽  
...  
Keyword(s):  
Energy Balance ◽  
Energy Expenditure ◽  
Total Energy ◽  
Water Analysis ◽  
Total Energy Expenditure ◽  
Short Term ◽  
Doubly Labelled Water ◽  
Term Energy

scholarly journals Indirect Calorimetry Protocol Development for Measuring Resting Metabolic Rate as a Component of Total Energy Expenditure in Free-Living Postmenopausal Women

2001 ◽  
Vol 131 (8) ◽  
pp. 2215-2218 ◽  
Author(s):  
Neilann K. Horner ◽  
Johanna W. Lampe ◽  
Ruth E. Patterson ◽  
Marian L. Neuhouser ◽  
Shirley A. Beresford ◽  
...  
Keyword(s):  
Energy Expenditure ◽  
Metabolic Rate ◽  
Total Energy ◽  
Postmenopausal Women ◽  
Indirect Calorimetry ◽  
Resting Metabolic Rate ◽  
Total Energy Expenditure ◽  
Free Living ◽  
Protocol Development

Disturbance of the reproductive axis induced by negative energy balance

1998 ◽  
Vol 10 (1) ◽  
pp. 65 ◽  
Author(s):  
Stephen J. Judd
Keyword(s):  
Energy Balance ◽  
Energy Expenditure ◽  
Tertiary Structure ◽  
Interleukin 2 ◽  
Growth Hormone Secretion ◽  
Negative Energy ◽  
Negative Energy Balance ◽  
Thyrotrophin Releasing Hormone ◽  
Releasing Hormone ◽  
Crf Neurons

Animal reproduction is impaired when intake of energy is so restricted that activities essential to life are threatened; this is seen as a homeostatic adjustment that restricts wasteful energy expenditure. Fasting or exercising to a degree requiring considerable energy expenditure has major effects on the hypothalamus, including activation of corticotrophin-releasing factor (CRF) neurons, suppression of thyrotrophin-releasing hormone synthesis, and increased growth hormone secretion; these are associated with increased concentrations of hypothalamic neuropeptide Y mRNA and are corrected by administration of leptin, an adipose-tissue protein with a tertiary structure similar to the cytokine interleukin-2. This response to fasting results from a disordered pattern of activity in the gonadotrophin-releasing hormone (GnRH) pacemaker, characterized by reduced luteinizing hormone pulsatility, particularly during daytime. Animal studies have suggested that the response depends on an intact afferent vagal system from the stomach and the presence of oestrogen. Noradrenergic neurons forming the A2 group increase the activity of CRF neurons that, in turn, inhibit GnRH pulsatility. Reproductive impairment due to fasting is reversed by leptin, and abnormalities of leptin are described in individuals who fast or who develop exercise-induced amenorrhoea. This paper discusses these changes induced by negative energy balance and speculates on the involvement of leptin as a contributor to these abnormalities.

scholarly journals ENERGY BALANCE AND VITAL SIGNS IN PEDIATRIC PATIENTS

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0020
Author(s):  
Julie A. Young ◽  
Jessica Napolitano ◽  
Mitchell J. Rauh ◽  
Jeanne Nichols ◽  
Anastasia N. Fischer
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Vital Signs ◽  
Negative Energy ◽  
Negative Energy Balance ◽  
Energy Deficit ◽  
Energy Deficiency ◽  
Males And Females

BACKGROUND: Prior studies have shown that vital signs such as heart rate, blood pressure and body temperature are depressed in patients with an eating disorder who have experienced a negative energy balance for a significant amount of time. More recently, a negative energy balance has been the focus of Relative Energy Deficiency in Sport (RED-S), which links energy availability to the health of multiple body systems in adults in as little as 5 days with a negative energy balance. High rates of disordered eating patterns have been reported in high school athletes. As adolescents grow, the consequences of a negative energy balance can be significant and potentially irreversible. Thus, vital signs may help clinicians quickly evaluate a patient’s energy status or highlight them for further evaluation. PURPOSE: The purpose of this study was to examine energy balance and vital signs in a cohort of adolescents who were seen by a sports dietitian to gain weight or optimize sports performance. METHODS: We evaluated 240 subjects, 83% female, average age 15.0±2.3 years. Heart rate and blood pressure were measured with a dynamometer in a seated position. Body temperature was measured orally. Height and weight were recorded. BMI was then calculated and evaluated by percentile. Energy intake was assessed using a 3-day food recall log. Energy expenditure was calculated using Harris Benedict Equation and combined with estimated exercise energy expenditure. Energy balance was estimated as energy intake minus energy expenditure. RESULTS: Average age was 15.03±2.71. 85% were female. 30% were below the 15th percentile for BMI. There were no differences in BMI percentiles between males and females (p=0.99). The average heart rate was 71.62±13.4 bpm and 19% were below the 10th percentile for heart rate. Average systolic blood pressure was 110±11 mm Hg and average diastolic blood pressure was 62±7 mmHg. Average temperature was 98.1±.4 degrees F. 88%were in a negative energy balance with an average energy deficit of 552±511 calories. There were no statistically significant differences in energy balance between males and females (p=0.08). CONCLUSIONS: A disproportional number of children with low BMI and heart rate percentiles was observed, which may indicate a long-standing energy deficiency. We also found a high proportion of adolescents who experienced a standalone negative energy balance itself or vital signs consistent with a negative energy balance. Additional studies are needed to study the relationships between energy deficit magnitude and duration in adolescents and children.

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.

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