A clinical cross-sectional study of resting energy expenditure in children with cerebral palsy / 中华实用儿科临床杂志

Objective:To investigate the characteristics of resting energy expenditure (REE) in children with cerebral palsy (CP) graded with different levels of Gross Motor Function Classification System (GMFCS), and to evaluate the accuracy and association of commonly used REE prediction formulas in children with CP.Methods:It was a retrospective study involving 36 children with CP aged 24-144 months who visited the Third Affiliated Hospital of Zhengzhou University between September 2021 and August 2022.REE was measured by the indirect calorimetry.Based on the GMFCS, children with CP were divided into grade Ⅰ-Ⅱ group (20 cases), grade Ⅲ group (6 cases) and grade Ⅳ-Ⅴ group(10 cases). During the same period, 11 age-matched healthy children were included in control group.The measured REE (MREE) between children with CP and healthy controls was compared.Predicted REE (PREE) calculated by the Harris-Benedict, WHO, Schofield-W, Schofield-WH and Oxford prediction formulas were compared with MREE in children for their consistency and correlation.Independent samples were analyzed using t-test or Mann- Whitney U test, and categorical data were analyzed using Chi- square test.Using paired t-test and Pearson linear correlation analysis to analyze the correlation between MREE and PREE.The accuracy of PREE values calculated by different formulas was assessed using the root mean square error. Results:The MREE in control group and children with CP were (952.18±270.56) kcal/d and (801.81±201.89) kcal/d, respectively.There was no significant difference in the MREE between grade Ⅰ-Ⅱ group versus control group[(868.30±194.81) kcal/d vs.(952.18±270.56) kcal/d, P>0.05], and grade Ⅲ group versus control group [(813.17±192.48) kcal/d vs.(952.18±270.56) kcal/d, P>0.05]. The MREE was significantly lower in grade Ⅳ-Ⅴ group than that of control group [666.00(513.50, 775.50) kcal/d vs.(952.18±270.56) kcal/d, P=0.011]. There were no significant difference between MREE and PREEs calculated by Harris-Benedict, WHO, Schofield-W, Schofield-WH, and Oxford (all P>0.05). The correct classification fraction calculated by the 5 formulas were 33.3%, 47.2%, 41.7%, 47.2%, and 41.7%, respectively.The r values of the consistency of PREE calculated by the 5 formulas were 0.585, 0.700, 0.703, 0.712, and 0.701, respectively.The Blande-Altman Limits of Agreement were (-297.77, 359.22), (-245.60, 326.94), (-250.62, 316.05), (-242.22, 177.36) and (-241.28, 325.81), respectively.The clinically acceptable range was -80.18 to 80.18 kcal/d.The root mean square error were 168.09 kcal/d, 149.64 kcal/d, 146.24 kcal/d, 144.23 kcal/d and 148.77 kcal/d, respectively. Conclusions:The MREE values decreased significantly in children with CP classified as CMFCS grade Ⅳ and Ⅴ.When REE cannot be regularly monitored by indirect calorimetry to develop nutritional support programs, children with CP may be prioritized to estimate REE using the prediction formula of Schofield-WH.

Resting energy expenditure depends on energy intake during weight loss in people with obesity: a retrospective cohort study

Abstract Objective: Resting energy expenditure (REE) decreases if there is reduced energy intake and body weight (BW). The decrease in REE could make it difficult for patients with obesity to maintain decreased BW. This study aimed to investigate the correlation among changes in REE, energy intake, and BW during the weight loss process in patients with obesity. Materials and methods: We conducted a retrospective cohort study of patients hospitalized for the treatment of obesity in Japan. Patients received fully controlled diet during hospitalization and performed exercises if able. REE was measured once a week using a hand-held indirect calorimetry. Energy intake was determined by actual dietary intake. Results: Of 44 inpatients with obesity, 17 were included in the analysis. Their BW decreased significantly after 1 week (−4.7 ± 2.0 kg, P < 0.001) and 2 weeks (−5.7 ± 2.2 kg, P < 0.001). The change in REE after 1 and 2 weeks was positively correlated with the energy intake/energy expenditure ratio (r = 0.66, P = 0.004 at 1 week, r = 0.71, P = 0.002 at 2 weeks). Using a regression equation (y = 0.5257x - 43.579), if the energy intake/energy expenditure ratio within the second week was 82.9%, the REE after 2 weeks was similar to the baseline level. There was no significant correlation between the change in REE and BW. Conclusions: Our data suggest that changes in REE depend on energy intake/energy expenditure ratio and that the decrease in REE can be minimized by matching energy intake to energy expenditure, even during the weight loss process.

Avaliação do gasto energético de repouso em pacientes com doença hepática gordurosa não alcoólica / Evaluation of rest energy expenditure in patients with non alcoholic fatty liver disease

ABSTRACT BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is currently considered a global public health problem, with changes in lifestyle being the effective way to treat the disease. To date, there is no recommended standard of assessment to determine the resting energy expenditure (REE) of patients with NAFLD, so that dietary therapy can be properly guided. OBJECTIVE: To evaluate the REE of patients with NAFLD through indirect calorimetry and compare with different predictive formulas of REE and with REE by electrical bioimpedance analysis (BIA). Assess body composition through BIA, with NAFLD staging and the presence of comorbidities. METHODS: They were evaluated in patients with NAFLD over 18 years of age treated at the Gastroenterology outpatient clinic of a tertiary level hospital in southern Brazil. NAFLD staging was performed using liver biopsy or a non-invasive method. Weight, height and body mass index (BMI) were determined in all patients. The short version of the International Physical Activity Questionnaire was used to assess physical activity. Comorbidities as arterial hypertension, diabetes mellitus and dyslipidemia were evaluated. To estimate energy expenditure at rest, Harris-Benedict, Jeor Mifflin-St, World Health Organization and Schofield formulas were used. BIA was used to assess resting metabolic rate (RMR) and body mass, and to measure RMR, indirect calorimetry was also used. Associations between categorical variables were tested with Pearson's χ2 test and between groups with McNemar's test. The level of significance assumed was 5%. The degree of agreement between the REE measurement methods was assessed using the Blan-Altman test. RESULTS: A total of 67 patients were evaluated, 70.5% male, with a mean age of 59 years and a mean BMI of 33.08 kg/m2 ±5.13. The average RMR per CI was 1,753 kcal ±614.58. When comparing the RMR estimate by different formulas with indirect calorimetry, only the Jeor Mifflin-St formula showed a statistically significant difference (P=0.0001), with a difference of +318.49 kcal. BIA and Harris Benedict's formula presented values closer to CI, 1,658 and 1,845 kcal respectively. CONCLUSION: We suggest that the Jeor Mifflin-St formula should not be used to estimate the RMR in patients with NAFLD. In the absence of indirect calorimetry, some alternatives can be used safely in this population, such as BIA and the predictive formulas of Harris Benedict, Schofield and the World Health Organization.

RESUMO CONTEXTO: A doença hepática gordurosa não alcoólica (DHGNA) é considerada, atualmente, um problema de saúde pública global, sendo a mudança no estilo de vida a forma efetiva de tratar a doença. Até o momento não há um padrão de avaliação recomendado para determinar o gasto energético de repouso (GER) de pacientes com DHGNA, para que se possa nortear adequadamente a conduta dietoterápica. OBJETIVO: Avaliar o GER de pacientes com DHGNA através da calorimetria indireta (CI) e comparar com diferentes fórmulas preditivas do GER e com GER através da bioimpedância elétrica (BIA). Avaliar a composição corporal através da BIA, com o estadiamento da DHGNA e com a presença de comorbidades. MÉTODOS: Foram avaliados em pacientes com DHGNA maiores de 18 anos de idade atendidos no ambulatório de Gastroenterologia de um Hospital de nível terciário do Sul do Brasil. O estadiamento da DHGNA foi realizado através de biópsia hepática ou método não invasivo. Peso, altura e índice de massa corporal (IMC) foram determinados em todos os pacientes. Para avaliação da atividade física foi utilizada a versão curta do International Physical Activity Questionnaire. Foram avaliadas as comorbidades hipertensão arterial, diabetes mellitus e dislipidemia. Para a estimativa do gasto energético de repouso utilizou-se as fórmulas de Harris-Benedict, de Jeor Mifflin-St, da Organização Mundial de Saúde e de Schofield. A BIA foi utilizada para avaliação do GER e da massa corporal, e para aferição do GER também se utilizou a CI. Associações entre variáveis categóricas foram testadas com teste χ2 de Pearson e entre grupos com teste de McNemar. O nível de significância assumido foi de 5%. O grau de concordância entre os métodos de mensuração do GER foi aferido pelo teste de Blan-Altman. RESULTADOS: Foram avaliados 67 pacientes, sendo 70,5% do sexo masculino, com média de idade de 59 anos e média de IMC 33,08 kg/m2 ±5,13. O GER médio por CI foi de 1.753 kcal ±614,58. Ao comparar a estimativa do GER por diferentes fórmulas com a calorimetria indireta, apenas a fórmula de Jeor Mifflin-St apresentou diferença estatisticamente significativa (P=0,0001), com uma diferença de +318,49 kcal. A BIA e a fórmula de Harris Benedict apresentaram valores mais próximos à CI, 1.658 e 1.845 kcal respectivamente. CONCLUSÃO: Sugerimos que a fórmula de Jeor Mifflin-St não deva ser utilizada para estimativa do GER em pacientes com DHGNA. Na ausência da CI algumas alternativas podem ser utilizadas com segurança nesta população, como a BIA e as fórmulas preditivas de Harris Benedict, de Schofield e da Organização Mundial de Saúde.

A correlation of per day calorie intake with resting energy expenditure in healthy young adults

Background: The energy requirement of an individual can be defined as the level of energy intake from food that will balance the energy expenditure. Dietary intakes lower or higher than the body requirements can lead to undernutrition (deficiency diseases) or overnutrition (diseases of affluence), respectively. Per day calorie intake influences various daily energy utilizing activities. The imbalance between intake and expenditure continues over long periods, changes in body weight or body composition will occur and may adversely affect health. The resting energy expenditure (REE), the largest portion (50–75%) of total energy expenditure, is the energy required to maintain the basic metabolic activities including maintaining the body temperature and keeping the functioning of vital organs such as brain, kidneys, heart, and lungs. Hence, REE plays the most important role in body functioning. Objective: The aim and objective of the present study were to access the effect of per day calorie intake on REE. Materials and Methods: One hundred subjects (age 18–25 years) were assessed for data collection. All the data were collected in the early morning hours. The study was approved by the Institutional Ethical Committee (EC/P-47/2018) of Rajasthan University of Health Sciences College of Medical Sciences, Jaipur. Demographic data including the anthropometric measurement of the participants such as weight, height, and body mass index (BMI). Calories intake (kcal) in 24 h was measured using food frequency questionnaire. Moreover, REE was measured using the gold standard method indirect calorimetry. Pearson correlation was calculated to seen correlation between per day calorie intake and REE. Results: A total of 75 males and 25 females with mean age of males and females were 19.97 ± 1.81 years and 19.32 ± 1.75 years, respectively. The mean BMI was 21.77 ± 4 kg/m² of males and 22.68 kg/m² of females. The mean calorie intake was 2532.082 ± 830.970 kcal in males and 1991.176 ± 783.291 kcal in females. The mean REE of male subjects was 2081.470 ± 587.661 kcal and of females was 1827.895 ± 469.671 kcal. The present study results showed the positive poor correlation (r = +0.1572) between calorie intake and REE in male subjects and negative poor correlation (r = −0.1484) in female subjects. Conclusion: The present study results concluded that there was a poor association between per day calorie intake and REE. Moreover, on the basis of the present study results, we can also say that most of our energy intake was expended to maintain body functioning at rest.

Energy expenditure, growth, and nutritional therapy in appropriate and small for gestational age preterm infants / Gasto energético, crescimento e terapia nutricional em recém-nascidos pré-termo adequados e pequenos para idade gestacional

Abstract Objective: To evaluate the resting energy expenditure, growth, and quantity of energy and macronutrients intake in a group of preterm newborns. Methods: The cohort study was performed with appropriate and small for gestational age preterm infants (birth weight lower than 1500 g or gestational age < 32 weeks). Resting energy expenditure was measured using indirect calorimetry on the 7th, 14th, 21st, and 28th days of life, and at discharge. Length, head circumference and body weight were assessed weekly. Nutritional therapy was calculated during the hospital stay and the information for each type of food was recorded in software that calculates the total amount of energy and macronutrients. Results: 61 preterm infants were followed; 43 appropriate and 18 small for gestational age infants. There was no statistical difference for resting energy expenditure between the groups, and it increased from the first to the fourth week of life (appropriate: 26.3% and small: 21.8%). Energy intake in the first two weeks of life was well below the energy requirement. Conclusion: Considering that the results demonstrate high energy expenditure during the first weeks of life, there is an evident need to provide the best quality of nutrition for each child in the first weeks of life so that preterm infants with or without intrauterine growth restriction can achieve their maximum potential for growth and development.

Resumo Objetivo: Avaliar o gasto energético de repouso, o crescimento e a quantidade ofertada de energia e macronutrientes em um grupo de recém-nascidos pré-termo. Método: Foi feito estudo de coorte com recém-nascidos pré-termo adequados e pequenos para a idade gestacional (peso de nascimento inferior a 1.500 gramas ou idade gestacional < 32 semanas). O gasto energético foi avaliado com a calorimetria indireta nos dias 7°, 14°, 21°, 28° dias de vida e alta hospitalar. Medidas do comprimento, perímetro cefálico e peso corporal foram avaliadas semanalmente. A terapia nutricional foi calculada durante a internação do recém-nascido e as informações de cada tipo de alimentação foram registradas em um software que calcula a quantidade total de energia e macronutrientes. Resultados: Foram acompanhados 61 recém-nascidos, sendo 43 adequados e 18 pequenos para idade gestacional. O gasto energético de repouso não apresentou diferença estatística entre os grupos e aumentou entre a primeira e quarta semana de vida (adequados: 26,3% e pequenos: 21,8%). O aporte energético nas duas primeiras semanas de vida mostrou-se bem abaixo do requerimento energético mensurado pela calorimetria. Conclusão: Considerando os resultados que demonstram um gasto energético alto ao longo das primeiras semanas de vida, fica evidente a necessidade de fornecer ao recém-nascido pré-termo um melhor aporte energético já nas primeiras semanas de vida, para que os neonatos com ou sem restrição intrauterina possam atingir o seu potencial máximo de crescimento e desenvolvimento.

Comparison of Predicted and Measured Resting Energy Expenditure in Overweight and Obese Korean Women / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to compare predictions and measurements of the resting energy expenditure (REE) of overweight and obese adult women in Korea. METHODS: The subjects included 65 overweight or obese adult women ranging in age from 20~60 with a recorded body mass index (BMI) of 23 or higher. Their height, weight, waist-hip ratio, and blood pressure were measured. The investigator also measured their body fat, body fat percentage, and body composition of total weight without fat using Dual energy X-ray absorptiometry (DXA) and measured resting energy expenditure by indirect calorimetry. Measured resting energy expenditures were compared with predictions from six methods: Harris-Benedict, Mifflin, Owen, WHO-WH, Henry-WH, and KDRI. RESULTS: Harris-Benedict predictions showed the smallest differences from measured resting energy expenditure at an accurate prediction rate of 70%. The study analyzed regression between measured resting energy expenditure and body measurements including height, weight and age. The formula proposed by this research is as follows: Proposed REE equation for overweight and obese Korean women = 721 − (1.5 × age) + (0.4 × height) + (9.9 × weight). CONCLUSIONS: These findings suggest that age is a significant variable when predicting resting energy expenditure in overweight and obese women. Therefore, prediction of resting energy expenditure should consider age when determining energy requirements in overweight and obese women.

Nutritional status and energy metabolism characteristics in patients with nonalcoholic fatty liver disease / 中华肝脏病杂志

Objective@#To study the nutritional status and energy metabolic characteristics of patients with nonalcoholic fatty liver disease (NAFLD), and to provide evidence for clinical evaluation and intervention.@*Methods@#A total of 359 NAFLD patients diagnosed on ultrasound from June 2015 to March 2017 were selected as study subjects and divided into mild, moderate to severe fatty liver disease group and 50 healthy subjects as control group. The changes of ICW, ECW, body fat, skeletal muscle, protein and visceral fat area (VFA) of patients and controls were analyzed by using body composition analyzer. The energy metabolism index was measured by the oxidation rate of resting energy expenditure(REE), respiratory quotient (RQ), and the oxidation rates of the three nutrients (CHO %, FAT %, and PRO %). According to different types of data, non-parametric tests like Kruskal-Wallis or χ2 were used for this analysis.@*Results@#Compared with the mild fatty liver group and the control group, the moderate and severe fatty liver group the BMI, waist circumference, waist-hip ratio were significantly elevated (P-value < 0.001), and their serum alanine aminotransferase, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, FBS levels were significantly increased (P value < 0.05). The Body composition analysis showed that there was no significant difference in skeletal muscle content between the three groups (P = 0.067). The ICW, ECW, protein, body fat content of moderate and severe fatty liver group were significantly higher than those of mild fatty liver group and control group (P < 0.01), but there was no significant difference between the mild fatty liver group and the control group. There was significant difference in the VFA between the three groups, while VFA in the moderate and severe fatty liver group was significantly increased. Metabolic results showed that the RQ of patients with moderate-severe fatty liver and mild fatty liver were 0.72 ± 0.08 and 0.78 ± 0.06, respectively, which were lower than those of the control group (0.80 ± 0.02), P = 0.004. Resting energy expenditure (REE) was not significantly different between moderate and severe fatty liver group and mild fatty liver group (P = 0.207), but both were significantly higher than those of the control group (P < 0.001). The percentages of CHO, FAT and PRO in moderate and severe fatty liver group were 19.49% ± 9.71%, 66.23% ± 12.54% and 14.22% ± 6.11% respectively. Compared with the control group, CHO % decreased, and FAT % increased.@*Conclusion@#NAFLD patients have different extent of nutritional imbalance and energy metabolism disorders, the use of Body Composition analyzer and metabolic cart can comprehensively assess and monitor NAFLD patient’s nutrition and energy metabolism status, to provide a basis for clinical intervention.

Comparison of Predicted and Measured Resting Energy Expenditure in Overweight and Obese Korean Women / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to compare predictions and measurements of the resting energy expenditure (REE) of overweight and obese adult women in Korea. METHODS: The subjects included 65 overweight or obese adult women ranging in age from 20~60 with a recorded body mass index (BMI) of 23 or higher. Their height, weight, waist-hip ratio, and blood pressure were measured. The investigator also measured their body fat, body fat percentage, and body composition of total weight without fat using Dual energy X-ray absorptiometry (DXA) and measured resting energy expenditure by indirect calorimetry. Measured resting energy expenditures were compared with predictions from six methods: Harris-Benedict, Mifflin, Owen, WHO-WH, Henry-WH, and KDRI. RESULTS: Harris-Benedict predictions showed the smallest differences from measured resting energy expenditure at an accurate prediction rate of 70%. The study analyzed regression between measured resting energy expenditure and body measurements including height, weight and age. The formula proposed by this research is as follows: Proposed REE equation for overweight and obese Korean women = 721 − (1.5 × age) + (0.4 × height) + (9.9 × weight). CONCLUSIONS: These findings suggest that age is a significant variable when predicting resting energy expenditure in overweight and obese women. Therefore, prediction of resting energy expenditure should consider age when determining energy requirements in overweight and obese women.

Applicability of predictive equations for resting energy expenditure in obese patients with obstructive sleep apnea

ABSTRACT Objective To investigate the applicability of predictive equations for resting energy expenditure (REE) in obese individuals with obstructive sleep apnea (OSA) and the effects of OSA severity on REE. Materials and methods Twenty-nine obese men, 41.5 ± 7 years old, with moderate and severe OSA were recruited. All subjects were submitted to a clinical polysomnography, body composition, and indirect calorimetry measurements. REE was also predicted by three different equations: Harris and Benedict (1919), Cunningham (1990), and DRI (2002). Results No effects of OSA severity on REE were found. The measured REE (2416.0 ± 447.1 kcal/day) and the REE predicted by equations were different from each other (F = 2713.88; p < 0.05): Harris and Benedict (2128.0 ± 245.8 kcal/day), Cunningham (1789.1 ± 167.8 kcal/day) and DRI (2011.1 ± 181.4 kcal/day). Pearson correlations showed a moderate positive correlation between the REE measured and predicted by all equations. Conclusion Our findings suggest that predictive equations for REE underestimate the energy expenditure in obese patients with sleep apnea. Also, no effects of OSA severity on REE were found.

Body composition, resting energy expenditure and inflammatory markers: impact in users of depot medroxyprogesterone acetate after 12 months follow-up

ABSTRACT Objective The aim of this study was to evaluate for 12 months the changes of body weight using Depot Medroxyprogesterone Acetate (DMPA) and if these changes are related to inflammatory markers. Subjects and methods Twenty women of childbearing age who chose the DMPA, without previous use of this method, BMI < 30 kg/m2, and 17 women using IUD TCu 380A, participated in the study. At the baseline and after one year, changes in weight gain, body composition by the bioimpedance electric method, resting energy expenditure (REE) by the indirect calorimetry method, inflammatory markers and HOMA-IR were assessed. Results After 12 months of evaluation, we could observe a significant increase in the DMPA group in weight (3,01 kg) and BMI, while the IUD group’s only significant increase was observed in the BMI. Relative to REE there was an increase of basal metabolic rate (BMR) in both groups after one year. The sub-group DMPA that gained < 3 kg had increased significant weight, BMI and body surface (BS) with respiratory quotient (RQ) reduction, while the sub-group that gained ≥ 3 kg had a significant increase in weight, BMI, BS, fat-free mass, fat mass, BMR, Leptin, HOMA-IR and waist circumference, with RQ significantly reduced. Conclusion Our study found significant changes in weight, body composition and metabolic profile of the population studied in the first 12 months of contraceptive use. These changes mainly increased body weight, leptin levels and HOMA-IR which can contribute to the development of some chronic complications, including obesity, insulin resistance and diabetes mellitus.

Relationship between resting energy expenditure and metabolic disorders in Chinese obese children and adolescents / 中华实用儿科临床杂志

Objective To study the characteristics of resting energy expenditure (REE) and evaluate the association between REE and obesity-related comorbidities in obese children and adolescents.Methods Recruited obese children and adolescents were recruited from the Department of Child Health Care in Nanjing Children's Hospital from July,2015 to September,2016.Height,weight(WT),waist circumference,hip circumference,blood pressure were measured.Puberty status was determined by Tanner staging.REE was measured by indirect calorimetry.Body composition,including fat mass (FM),fat free mass (FFM) were assessed in terms of bioelectrical impedance.Serum biochemical parameters were assessed,including fasting blood glucose (FBG),fasting blood insulin (FBI),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C) and uric acid (UA).B-model ultrasonography of the liver was conducted.Results One hundred and ninety-six obese children (143 boys and 53 girls) aged 7-15 years were recruited.The measured REE was (1 497.2 ± 312.1) kcal/d.Pearson correlation analysis indicated that REE was positively related to age (r =0.386,P ＜ 0.001),WT(r =0.676,P ＜ 0.001),FM (r =0.629,P ＜0.001),FFM(r=0.635,P＜0.001) and FM％ (r =0.335,P＜0.001),but negatively related to FFM％ (r=-0.335,P ＜0.001).By studying stepwise linear regression,it was found that the factors which influenced REE were age and weight[REE(kcal/d) =899.469-32.098 × age (year) + 16.143 × weight (kg),P ＜ 0.001].REE was expressed per kg of body weight (REE/WT),and there was a significant difference in REE/WT during pubertal development (P ＜0.001) in both males and females and the pubertal males had lower REE/WT than females.Moreover,REE/WT was lower in insulin resistant group compared to the normal insulin group.Meanwhile,REE/WT in hypertension group was lower than that in the normal blood pressure group.The above differences remained after adjusted for age adjustment(P ＜0.O1).Conclusion The decrease in REE/WT level in obese children and adolescents is correlated with puberty development and obesity complicated with insulin resistance and hypertension.

Postoperative resting energy expenditure in children with congenital heart disease / 中华临床营养杂志

Objective To determine postoperative resting energy expenditure ( REE) in children with congenital heart disease ( CHD) requiring open heart surgery , to compare measured resting energy expenditure (MREE) with current predictive equations (PEE), and to investigate the possible influencing factors on the metabolic status of the postoperative CHD children .Methods From February 2015 to June 2015 , 150 ventila-ted children admitted to the cardiac intensive care unit after surgery for congenital heart disease in Shanghai Children's Medical Center were enrolled consecutively .Indirect calorimetry ( IC) measurements were performed using metabolic cart 4 hours after surgery .General clinical data were recorded .Results Totally 104 male and 46 female patients were enrolled, with a median age of 14 months (8.3-36.0 months).The non-protein re-spiratory quotient of patient was 0.79 ±0.20, MREE was (264.76 ±61.74) kJ/(kg· d), and PEE using Schofield equations was (278.51 ±93.42) kJ/(kg· d).Although there was no significant differences (P=0.096 ) between MREE and PEE , the agreement was poor between them ( R2 =0.119 ) .Multivariate stepwise regression analysis showed that MREE had significant positive correlation with risk adjustment in congenital heart surgery (RACHS-1) score (P=0.012) and negative correlation with age (P=0.010).Up to 97.33%of children (146/150) had lower energy intake compared with MREE on the 1st postoperative day .Conclu-sions MREE does not increase after surgery in CHD children;however , the substrate utilization is influenced . Factors influencing the postoperative REE include RACHS-1 score and age.The energy intake at 1st day after surgery is generally lower than REE in these children .

Change of energy metabolism and body composition before and after chemotherapy in patients with colon cancer / 肠外与肠内营养

Objective:To evaluate the nutritional status before and after chemotherapy in patients with colon cancer by measuring energy metabolism and body composition.Methods:Fifty-one patients with colon cancer were included and were investigated using self-control method (before and after chemotherapy).Resting energy expenditure (REE) was determined by bed metabolic instrument,and body composition was measured by body composition analyzer.Results:For all patients,the REE on the 2nd day after chemotherapy was decreased significantly compared with that before chemotherapy (P ＜ 0.05).After chemotherapy,body fat percentage and body moisture percentage were increased significantly (P ＜ 0.05),and lean body mass percentage was decreased significantly (P ＜ 0.05).Conclusion:After chemotherapy,the REE and lean body mass percentage of the patients with colon cancer were decreased,and body fat percentage and body moisture percentage were increased.

Activity of Autonomic Nervous System, Energy Expenditure and Assessment of Oxidative Stress in Menopause-women Using Hormone Replacement Therapy.

Aims: Menopause is a period of significant physiological change that may be associated with increased body weight and obesity-related diseases. Many studies have been carried out to determine influences of estrogen depletion, resting energy expenditure (REE) decline and aging during menopause-related obesity. Methodology: In the present experiment, REE, body composition, activity of the autonomic nervous system, oxidative stress and food intake were measured in three groups of women: pre-menopause (n=40), post-menopause with hormone-replacement therapy (HRT) (n=40) and post-menopause without HRT (n=40). Results: In post-menopause women with HRT a significant increase was found in: 1) the sympathetic activity, measured by the power spectral analysis of the heart rate variability; 2) REE, measured by indirect calorimetry; 3) oxidative stress, measured by Free Radical Analytical System 4 (Fras-4) compared to the value of the other two, while fat mass, measured by Body Impedance Analysis (BIA), was reduced in favor of a recovery of free fat mass. Conclusion: The study emphasizes the important changes due to HRT on various components influencing body weight in menopause-women.

Continuous resting energy expenditure measurement in ventilated critically ill children / 中华临床营养杂志

Objective To monitor the changes of resting energy expenditure in ventilated critically ill children,to compare the results of standard equations and indirect calorimetry (IC) in predicting energy expenditure,and to investigate the possible influence factors of the metabolic status of the critically ill children.Methods From September 2012 to September 2013,56 critically ill children on assisted ventilation and fitting the requirements of IC in pediatric intensive care unit of Shanghai Children's Medical Center were enrolled in this prospective study.IC measurements were performed using metabolic cart on day 1,4,7,10 after trachea intubation.General clinical data of these children were recorded.Results 130 IC measurements were performed in the 56 children.The measured resting energy expenditure (MREE) did not exhibit significant differences among day 1,4,7,and 10 (P =0.379).Although there were no significant differences between MREE and energy expenditure predicted with Schofield and WHO equations (P =0.917,P =0.995),the agreement was poor between the measured and predicted values (R2 =0.185,R2 =0.322).The metabolic status of the children on day 1 of ventilation was only correlated with age (P =0.000) and height (P =0.027),not with severity of underlying diseases or clinical outcomes.Conclusions MREE of IC method in ventilated critically ill children did not significantly change over time in this study.A poor agreement was observed between equationpredicted energy expenditure and MREE.IC measurement of resting energy expenditure is recommended for guiding individual nutritional support among critically ill children so as to improve clinical outcome.

Resting energy expenditure in critically ill children / 中国小儿急救医学

Resting energy expenditure is the main indicator to assess energy consu mpit on of ap tine ts. The ne eryg expenditure of critically ill children can be influenced by many factors.Different ts atse of diseases are followed by different values of resting energy expenditure.Right now,indirect calorimetry is the “golden standard” of measurement of energy metabolism.Indirect calorimetry can be used to accurately grasp energy expenditure of patients.And it is beneficial to optimization of nutrition support,also for individualized nutri-tion therapy.

The Effect of Decreased Energy Intake under Hot Summer on Physique and Energy Expenditure in High School Baseball Players / 日本温泉気候物理医学会雑誌

Background & Objectives: Generally, food intake of athletes decrease under hot summer and, therefore, it would affect on their physiques and the athletic power (competition). The present study investigated the effect of decreased energy intake on athletes’ physique, energy expenditure and/or thyroid hormones. Methods: Forty two males of high school baseball team in Hokuriku area, Japan, participated in this study. The nutrition survey and physical measurements were performed, and total energy expenditure (TEE) from activity records were estimated in April, July, and December. Energy balance was determined from energy intake and TEE. Furthermore, the resting energy metabolism (REE) was measured by the expired gas analysis. Thyroid hormones were assayed respectively T3, FT3, and FT4. Results: Seventy percent of baseball players showed reduction of energy intake in summer. We, accurately, recognized that one can see two groups, i,e., a group that energy intake was decreased in summer (LA) and another was not decreased in the same summer (HA). Many subjects showed decrease of energy intake but their TEE was rather increased in summer. The energy balance of LA group was largely negative, but that of HA group was slightly negative. In LA group, body weight, BMI, and MAC (midarm circumference) were significantly decreased by 2∼4% in summer than that in spring, while the decrease of physical measurements is 1∼2% in HA group. Thus, a large negative energy balance affected the physique negatively. From energy composition of diet, it seems that LA group had high carbohydrate energy diet and HA group had high fat diet. There was a significant positive correlation between the energy intake and each of the nutrient intakes. The REE was significantly decreased in summer and thus it seems to be related with energy intake. FT3 and T3 were not changed in summer but were in winter, and it looks to be slightly related with REE. Conclusion: Decrease of energy intake in summer indicated a large negative effect on physique such as body weight, MAC. The decrease of energy intake in summer seems to be related with reduction of REE.

The Effect of Decreased Energy Intake under Hot Summer on Physique and Energy Expenditure in High School Baseball Players / 日本温泉気候物理医学会雑誌

<b>Background & Objectives:</b> Generally, food intake of athletes decrease under hot summer and, therefore, it would affect on their physiques and the athletic power (competition). The present study investigated the effect of decreased energy intake on athletes’ physique, energy expenditure and/or thyroid hormones.<BR><b>Methods:</b> Forty two males of high school baseball team in Hokuriku area, Japan, participated in this study. The nutrition survey and physical measurements were performed, and total energy expenditure (TEE) from activity records were estimated in April, July, and December. Energy balance was determined from energy intake and TEE. Furthermore, the resting energy metabolism (REE) was measured by the expired gas analysis. Thyroid hormones were assayed respectively T3, FT3, and FT4.<BR><b>Results:</b> Seventy percent of baseball players showed reduction of energy intake in summer. We, accurately, recognized that one can see two groups, i,e., a group that energy intake was decreased in summer (L_A) and another was not decreased in the same summer (H_A). Many subjects showed decrease of energy intake but their TEE was rather increased in summer. The energy balance of L_Agroup was largely negative, but that of H_A group was slightly negative. In L_A group, body weight, BMI, and MAC (midarm circumference) were significantly decreased by 2∼4% in summer than that in spring, while the decrease of physical measurements is 1∼2% in H_A group. Thus, a large negative energy balance affected the physique negatively. From energy composition of diet, it seems that L_A group had high carbohydrate energy diet and H_A group had high fat diet. There was a significant positive correlation between the energy intake and each of the nutrient intakes. The REE was significantly decreased in summer and thus it seems to be related with energy intake. FT3 and T3 were not changed in summer but were in winter, and it looks to be slightly related with REE.<BR><b>Conclusion:</b> Decrease of energy intake in summer indicated a large negative effect on physique such as body weight, MAC. The decrease of energy intake in summer seems to be related with reduction of REE.

Resting energy expenditure is not associated with disease activity in women with rheumatoid arthritis: cross-sectional study

BACKGROUND/AIMS: Increased resting energy expenditure (REE) in rheumatoid arthritis (RA) patients is thought to be caused by hypermetabolism associated with production of proinflammatory cytokines. Our aim in the present study was to explore the possible association between REE and disease activity in females with RA. METHODS: A total of 499 female RA patients were recruited to this cross-sectional study assessing REE scores on disease activity indices (the routine assessment of patient index data 3 [RAPID3], the disease activity score 28, and the clinical/simplified disease activity index [CDAI/SDAI]) and the levels of RA-associated autoantibodies (rheumatoid factor and anticyclic citrullinated peptide [anti-CCP] antibodies). Age-matched healthy female controls (n = 131) were also enrolled. RESULTS: REE did not differ between RA patients (all patients, and those in remission or not) and controls, or between RA patients in remission or not (p > 0.05 for all comparisons). Increased REE in total RA patients was associated with younger age and a higher body mass index (BMI) (p < 0.001 and p < 0.001, respectively), but not with disease activity index scores on any of RAPID3, CDAI, or SDAI. BMI was the only clinical parameter exhibiting a significant relationship with REE quartiles (Q1 to Q4; p < 0.001); none of disease duration, functional status, or anti-CCP antibody titer in RA patients was significantly related to REE, based on analysis of covariance. CONCLUSIONS: We found no association between REE and disease activity in RA patients, implying that energy metabolism in RA patients might be independent of RA-associated systemic inflammation.

Observation of proper nutritional therapy in critically ill patients guided by indirect caloimetry / 中国基层医药

Objective To evaluate the effect of proper nutritional therapy guided by indirect caloimetry . Methods According to the digitaltable ,70 critically ill patients whose APACHE II >5 were randomly divided into oberserving ( nutritional therapy guided by indirect caloimetry ) and control groups ( nutritional therapy guided by harris-benedict formula),each group 35 cases.The results of nutrition support were analysed .Results TP,MAMC,ALB were higher than that before treatment in oberserving group (all P0.05).Conclusion The nutritional therapy guided by indirect caloimetry by harris-benedict formula have the some nutritional effect in critically ill patients .