scholarly journals P566 Impact of induction therapy and clinical remission on resting energy expenditure in children with Crohn’s Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S526-S527
Author(s):  
G Kornitzer ◽  
J Breton ◽  
P Poinsot ◽  
D Godin ◽  
K Grzywacz ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Energy Expenditure ◽  
Nutritional Status ◽  
Metabolic Rate ◽  
Induction Therapy ◽  
Basal Metabolic Rate ◽  
Resting Energy Expenditure ◽  
Biochemical Response ◽  
Resting Energy

Abstract Background Crohn’s Disease (CD) is known to affect nutritional status and linear growth in affected children. Patients with CD often have decreased oral intake, malabsorption, and increased intestinal losses. Basal metabolic rate may be affected by chronic inflammation and states of anorexia or malnutrition in these patients. In this study, our aim was to compare the effect of different induction regimens in children with CD on resting energy expenditure (REE) and nutritional status. Methods We recruited patients under 18 years old with new-onset CD or relapse, diagnosed at our centre over a three-year period from July 2016. Patients included had one of the following induction regimens: corticosteroids, exclusive enteral nutrition (EEN), or anti-TNF therapy (Infliximab). REE was assessed at baseline and 6 to 8 weeks after induction. REE (kcal/d) was measured using an open-circuit indirect calorimeter with computerized metabolic cart (Vmax Encore, Vyaire Medical). Secondary outcomes included anthropometrics and clinical and biochemical response, defined by improved wPCDAI and negative inflammatory markers and fecal calprotectin, respectively. Results 17 patients were enrolled and 8 patients excluded (loss to follow-up (n=3), therapeutic change (n=3), revised diagnosis (n=2)). 9 patients completed REE assessments (44.4% anti-TNF (n=4), 44.4% EEN (n=4), 11.1% corticosteroid (n=1)). 3 out of 4 patients on anti-TNF had clinical and biochemical response, while only 1 of 4 patients responded to EEN. For patients in the EEN group, mean BMI change was +0.9 (SD 0.4), compared to +0.4 (SD 1.1) in the anti-TNF group. There was no difference in REE change between treatment groups. Data was then pooled based on response to treatment. 100% of non-responders had increased per cent of predicted REE (REEPP), while 75% of responders decreased their REEPP. Mean REEPP change in non-responders was +12.5% (1, 22) vs. -4.3% (-10, 6) in responders. Figure I. Relationship between REE and weight at baseline and on follow-up in non-responders. Figure II. Relationship between REE and weight at baseline and on follow-up in responders. Conclusion Our results suggest that induction regimen did not impact REE change on follow-up. In our patients, clinical response to therapy was related to a tendency to decrease REE. Patients who did not achieve remission after induction therapy increased their REE. We suspect that this increase in basal metabolic rate is related to persistent inflammation despite improved nutritional status. Further studies with larger patient populations are needed to infer significance and compare subgroups based on body composition.

Energy expenditure and substrate metabolism measured by 24 h whole-body calorimetry in patients receiving cyclic and continuous total parenteral nutrition

1991 ◽  
Vol 80 (6) ◽  
pp. 571-582 ◽  
Author(s):  
E. Pullicino ◽  
G. R. Goldberg ◽  
M. Elia
Keyword(s):  
Energy Expenditure ◽  
Parenteral Nutrition ◽  
Metabolic Rate ◽  
Total Parenteral Nutrition ◽  
Basal Metabolic Rate ◽  
Resting Energy Expenditure ◽  
Whole Body ◽  
Diet Induced Thermogenesis ◽  
Activity Energy ◽  
Resting Energy

1. Twenty-four hour energy expenditure and its components, i.e. ‘basal metabolic rate', activity energy expenditure and diet-induced thermogenesis were measured, using continuous whole-body indirect calorimetry, in patients receiving total parenteral nutrition while in remission from Crohn's disease (weight 51.9 ± 9.9 kg, body mass index 19.2 ± 2.0 kg/m2). 2. Total parenteral nutrition was infused continuously over 24 h in four subjects and cyclically, between 22.00 and 10.00 hours, in eight subjects. Twenty-four hour energy expenditure (6.83 ± 1.10 MJ/24 h) was lower than total energy intake (10.09 ± 1.63 MJ/24 h), resulting in a positive energy balance (3.26 ± 1.42 MJ) in all subjects. Repeated measurements of resting energy expenditure in the continuously fed subjects (5.82 ± 1.11 MJ/24 h) did not change significantly at different times of day (coefficient of variation 2.2–6.6%). In contrast, in cyclically fed subjects, resting energy expenditure was 24.2 ± 9.0% higher towards the end of the 12 h feeding period than the ‘basal metabolic rate', which was measured just before the start of the feeding period. 3. Diet-induced thermogenesis, calculated as the increment in resting energy expenditure above ‘basal metabolic rate’ over the 24 h period (adjusted for the reduction in energy expenditure during sleep), was found to be 0.60 ± 0.29 MJ or 6.1 ± 3.1% of the energy intake. 4. The energy cost of activity (activity energy expenditure) in the continuously fed patients, calculated as the difference between 24 h energy expenditure and the integrated 24 h measurements of resting energy expenditure, was 0.88 ± 0.53 MJ, i.e. 12.9 ± 5.9% of the 24 h energy expenditure. 5. The non-protein nonglycerol respiratory quotient exceeded 1.0 for varying periods of time (0.5–17 h) in 11 subjects, indicating net lipogenesis from carbohydrate. 6. The results demonstrate favourable rates of deposition, during intravenous feeding, of both energy and nitrogen over a 24 h period in patients recovering from an episode of Crohn's disease. The efficacy of these commonly used total parenteral nutrition regimens in these patients is related to three features that are absent in normal healthy individuals, namely a low basal metabolic rate, a low activity-related energy expenditure and prolonged periods of lipogenesis from carbohydrate.

Effects of Television on Metabolic Rate: Potential Implications For Childhood Obesity

PEDIATRICS ◽  
1993 ◽  
Vol 91 (2) ◽  
pp. 281-286
Author(s):  
Robert C. Klesges ◽  
Mary L. Shelton ◽  
Lisa M. Klesges
Keyword(s):  
Energy Expenditure ◽  
Metabolic Rate ◽  
Television Viewing ◽  
Resting Energy Expenditure ◽  
Normal Weight ◽  
Laboratory Setting ◽  
Obese Children ◽  
Two Measures ◽  
The Relationship ◽  
Resting Energy

The effects of television viewing on resting energy expenditure (metabolic rate) in obese and normal-weight children were studied in a laboratory setting. Subjects were 15 obese children and 16 normal-weight children whose ages ranged from 8 to 12 years. All subjects had two measures of resting energy expenditure obtained while at rest and one measurement of energy expenditure taken while viewing television. Results indicated that metabolic rate during television viewing was significantly lower (mean decrease of 211 kcal extrapolated to a day) than during rest. Obese children tended to have a larger decrease, although this difference was not statistically significant (262 kcal/d vs 167 kcal/d, respectively). It was concluded that television viewing has a fairly profound lowering effect of metabolic rate and may be a mechanism for the relationship between obesity and amount of television viewing.

Resting energy expenditure in girls with Turner syndrome

2017 ◽  
Vol 30 (3) ◽  
Author(s):  
Gerhard Binder ◽  
Laura Frank ◽  
Julian Ziegler ◽  
Gunnar Blumenstock ◽  
Roland Schweizer
Keyword(s):  
Energy Expenditure ◽  
Short Stature ◽  
Turner Syndrome ◽  
Resting Energy Expenditure ◽  
Bioelectrical Impedance ◽  
Fat Free Mass ◽  
Gh Treatment ◽  
Age Related ◽  
Resting Energy

AbstractBackground:Knowledge concerning energy metabolism in Turner syndrome (TS) is lacking. We compared the resting energy expenditure per fat-free mass (REE/FFM) in TS with other girls with short stature treated with growth hormone (GH) and age-related controls.Methods:We measured prospectively REE by spirometry under fasting conditions in the morning in 85 short prepubertal girls at the start of GH treatment. Diagnoses were TS (n=20), GH deficiency (GHD) (n=38) and small for gestational age (SGA) short stature (n=27). Additionally, 20 age-related controls were studied. Mean ages were 8.3 (TS), 7.1 (GHD), 6.9 (SGA) and 8.5 years (controls). Mean heights were −2.90 (TS), −3.32 (GHD), −3.69 (SGA) and −0.03 standard deviation scores (SDS) (controls). FFM was measured by bioelectrical impedance analysis (BIA).Results:At the start of GH girls with TS showed insignificantly higher REE per FFM (REE/FFM) (mean±SD; 65±9 kcal/kg×day) than did the other female patients (62±9 kcal/kg×day) (p>0.23). The healthy controls had significantly lower REE/FFM (35±4 kcal/kg×day) (p<0.001). Follow-up examination of the patients after 6 or 12 months revealed decreasing REE/FFM in TS (62±9 kcal/kg×day) resulting in comparable REE/FFM in all three patient groups.Conclusions:At baseline short girls with TS had insignificantly higher REE/FFM than short children with SGA or GHD, but in follow-up this difference was not detectable any more. Future studies are necessary to understand this observation.

scholarly journals Larger mass of high-metabolic-rate organs does not explain higher resting energy expenditure in children

2003 ◽  
Vol 77 (6) ◽  
pp. 1506-1511 ◽  
Author(s):  
Amy Hsu ◽  
Stanley Heshka ◽  
Isaac Janumala ◽  
Mi-Yeon Song ◽  
Mary Horlick ◽  
...  
Keyword(s):  
Energy Expenditure ◽  
Metabolic Rate ◽  
Resting Energy Expenditure ◽  
High Metabolic Rate ◽  
Resting Energy
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