Avaliação do consumo alimentar de pacientes queimados internados em um hospital público do Distrito Federal / Evaluation of food consumption of burn patients admitted to a public hospital in the Federal District

OBJETIVO: Avaliar o consumo alimentar dos pacientes queimados hospitalizados no processo de cicatrização. MÉTODO: Estudo transversal, quantitativo, com coleta de dados prospectivos. A coleta ocorreu no Hospital Regional da Asa Norte (HRAN), no período de março de 2022 a maio de 2022, com 113 dias alimentares de 24 pacientes hospitalizados. A coleta de dados foi realizada com ficha pré-estabelecida (número de prontuário, sexo, faixa etária, percentual de área queimada e tipo de queimadura). Para calcular as necessidades nutricionais, foi utilizada a equação de Toronto. A análise dos dados coletados aconteceu a partir do software Avanutri PC, sendo uma análise quantitativa dos macronutrientes (proteína, lipídios e carboidratos) e micronutrientes (zinco, vitamina C, vitamina A, vitamina E e selênio). RESULTADOS: Os recordatórios alimentares foram calculados com e sem suplementação. Nos dias com suplementação a adequação calórica aumentou, sendo que a maioria, 39,8%, conseguiu atingir mais de100% das recomendações e 29,2% conseguiu permanecer dentro de 75-100% das necessidades energéticas diária e todas as vitaminas e minerais também aumentaram sua adequação, sendo vitamina A antes da suplementação 406,1mg e após a suplementação 531,4mg, vitamina C antes 462,2mg e 626,4mg após, vitamina E 8,3mg antes e 31,2mg após, zinco 11,8mcg antes e após 18,7mcg e selênio 54,4mg antes e 99,5mg após a suplementação. CONCLUSÕES: A nutrição desempenha um papel muito importante na recuperação de pacientes queimados, contribuindo para a cicatrização de feridas, prevenção de infecções, manutenção do peso corporal e minimização de complicações. É essencial que esses pacientes recebam suplementação adequada para auxiliar seu processo de cicatrização.

OBJECTIVE: To evaluate the food consumption of hospitalized burn patients in the healing process. METHODS: Cross-sectional, quantitative study, with prospective data collection. The collection took place at the Hospital Regional da Asa Norte (HRAN), from March 2022 to May 2022, with 113 days of eating from 24 hospitalized patients. Data collection was carried out using a pre-established form (medical record number, sex, age group, percentage of burned area and type of burn). To calculate nutritional needs, the Toronto equation was used. The analysis of the collected data took place using the Avanutri PC Software, being a quantitative analysis of macronutrients (protein, lipids and carbohydrates) and micronutrients (zinc, vitamin C, vitamin A, vitamin E and selenium). RESULTS: Dietary recalls were calculated with and without supplementation, on days with supplementation caloric adequacy increased, with the majority, 39.8%, managing to achieve more than100% of recommendations and 29.2% managing to remain within 75-100% of daily energy needs and all vitamins and minerals also increased their adequacy, with vitamin A before supplementation 406.1mg and after supplementation 531.4mg, vitamin C before 462.2mg and 626.4mg after, vitamin E 8.3mg before and 31.2mg after, zinc 11.8mcg before and after 18.7mcg and selenium 54.4mg before and 99.5mg after supplementation. CONCLUSIONS: Nutrition plays a very important role in the recovery of burn patients, contributing to wound healing, preventing infections, maintaining body weight and minimizing complications. It is essential that these patients receive adequate supplementation to aid their healing process.

Tumor cell and microvessel densities during the growth of a brain tumor: A theoretical study

Mathematical model for the tumor growth incorporating energy supply and requirement, angiogenesis efficiency and effect of elasticity of adjacent normal tissue to understand tumor biology and predict saturation status is rare to find. This study is conducted to address these issues. We propose mathematical expressions to explain alterations of tumor cell density (nT), microvessel density (MVD), and growth rate(r) during the development of brain tumors. We assume that nT increases during the growth of the tumor due to the increase of external pressure from the initial cell density (nT0); nT0 is same as the external normal tissue. The rate of increase in tumor cells (dNT/dt) depends on the rate of energy available for the creation of new cells and the energy required for a single cell division(?). Due to the increase of tumor cell density, hypoxia is developed, which up-regulates the secretion of vascular endothelial growth factor (VEGF) and new capillaries are generated. Therefore, the surface area density of capillaries (Acs) in tumors increases. Hence, we consider that Acs(t) ? nT(t). A modified logistic equation is developed. Temporal variations of nT(t), Acs(t), r(t) and tumor cell population ‘NT(t)’ are examined. The expressions of saturated cell density(nTM), saturated microvessel surface area density (AcsM) and tumor saturation time(Ts) are formulated. An important feature, tumor saturation factor ‘fTS’ is determined. When fTS<1, a tumor will saturate at Ts, and nTM depends solely on fTS.

Balance energético y estado nutricional en niños preescolares, Huanchaco, Trujillo, Perú, 2014 / Energy balance and nutritional state in preschool children, Huanchaco, Trujillo, Perú, 2014

Introducción: El balance energético equilibrado en el organismo humano permite mantener un estado nutricional y de salud adecuado, ingestas excesivas o por defecto modifican la homeostasis y producen enfermedades. Objetivo: Determinar la asociación entre balance energético y estado nutricional en niños de instituciones educativas del distrito de Huanchaco, departamento La Libertad, Perú. Métodos: Estudio cuantitativo de corte transversal en 203 niños de 3 a 5 años en el periodo abril-junio 2014. Se evaluó el estado nutricional con los índices talla/edad, peso/edad, peso/talla usando estándares de crecimiento infantil de la Organización Mundial de la Salud 2006. El balance energético se midió con la adecuación de energía ingerida respecto a su requerimiento energético estimado, expresado en porcentaje. Se aplicó la prueba estadística Chi-cuadrado con un nivel de significancia de 5 por ciento. Resultados: Los índices para evaluar el estado nutricional fueron predominante normales. El balance energético para niños y niñas de 3 años fue 123,75 ± 46,97 por ciento y 125,82 ± 13,01 por ciento de su requerimiento respectivamente; en niños y niñas de 4 años fue de 109,90 ± 23,17 por ciento y 104,69 ± 20,96 por ciento, respectivamente y finalmente en niños de 5 años fue 105,15 ± 24,97 por ciento y en las niñas un balance energético negativo de 86,39 ± 11,99 por ciento. Existe asociación altamente significativa (p < 0,01) entre estado nutricional y balance energético. Conclusiones: El balance energético con tendencia positiva predispone hacia la obesidad para los índices peso/talla y peso/edad y el equilibrado o positivo condicionan un estado nutricional normal según talla/edad(AU)

Introduction: The balanced energy state in the human body allows maintaining a nutritional and health status; excessive or small intakes of food modify the homeostasis and produce diseases. Objective: To determine the association between energy balance and nutritional state in children from educational institutions of Huanchaco District, La Libertad, Peru. Methods: A cross-sectional quantitative study was carried out in 203 children from 3 to 5 years old in the period from April to June 2014. It was assessed the nutritional state with the indexes height/age, weight/age, weight/height using child growth standards of the World Health Organization 2006. The energy balance was measured with the adequacy of energy intake in relation to their estimated energy requirement, expressed as a percentage. Chi-square statistical test was applied with a significance level of 5 percent . Results: The indexes to assess the nutritional state were predominantly normal. The energy balance for boys and girls of 3 years old was 123.75 ± 46.97 percent and 125.82 ± 13.01 percent of their requirement respectively; in children of 4 years old it was 109.90 ± 23.17 percent and 104.69 ± 20.96 percent, respectively; and finally in 5 years old boys it was 105.15 ± 24.97 percent and in girls a negative energy balance of 86.39 ± 11.99 percent. There is a highly significant association (p< 0.01) between the nutritional state and the energy balance. Conclusions: The energy balance with positive trend predisposes toward obesity for the indexes weight/height and weight/age, and the balanced or positive condition to a normal nutritional state according to height/age(AU)

Balance energético y estado nutricional en niños preescolares, Huanchaco, Trujillo, Perú, 2014 / Energy balance and nutritional state in preschool children, Huanchaco, Trujillo, Perú, 2014

RESUMEN Introducción: El balance energético equilibrado en el organismo humano permite mantener un estado nutricional y de salud adecuado, ingestas excesivas o por defecto modifican la homeostasis y producen enfermedades. Objetivo: Determinar la asociación entre balance energético y estado nutricional en niños de instituciones educativas del distrito de Huanchaco, departamento La Libertad, Perú. Métodos: Estudio cuantitativo de corte transversal en 203 niños de 3 a 5 años en el periodo abril-junio 2014. Se evaluó el estado nutricional con los índices talla/edad, peso/edad, peso/talla usando estándares de crecimiento infantil de la Organización Mundial de la Salud 2006. El balance energético se midió con la adecuación de energía ingerida respecto a su requerimiento energético estimado, expresado en porcentaje. Se aplicó la prueba estadística Chi-cuadrado con un nivel de significancia de 5 %. Resultados: Los índices para evaluar el estado nutricional fueron predominante normales. El balance energético para niños y niñas de 3 años fue 123,75 ± 46,97 % y 125,82 ± 13,01 % de su requerimiento respectivamente; en niños y niñas de 4 años fue de 109,90 ± 23,17 % y 104,69 ± 20,96 %, respectivamente y finalmente en niños de 5 años fue 105,15 ± 24,97 % y en las niñas un balance energético negativo de 86,39 ± 11,99 %. Existe asociación altamente significativa (p < 0,01) entre estado nutricional y balance energético. Conclusiones: El balance energético con tendencia positiva predispone hacia la obesidad para los índices peso/talla y peso/edad y el equilibrado o positivo condicionan un estado nutricional normal según talla/edad.

ABSTRACT Introduction: The balanced energy state in the human body allows maintaining a nutritional and health status; excessive or small intakes of food modify the homeostasis and produce diseases. Objective: To determine the association between energy balance and nutritional state in children from educational institutions of Huanchaco District, La Libertad, Peru. Methods: A cross-sectional quantitative study was carried out in 203 children from 3 to 5 years old in the period from April to June 2014. It was assessed the nutritional state with the indexes height/age, weight/age, weight/height using child growth standards of the World Health Organization 2006. The energy balance was measured with the adequacy of energy intake in relation to their estimated energy requirement, expressed as a percentage. Chi-square statistical test was applied with a significance level of 5 %. Results: The indexes to assess the nutritional state were predominantly normal. The energy balance for boys and girls of 3 years old was 123.75 ± 46.97% and 125.82 ± 13.01 % of their requirement respectively; in children of 4 years old it was 109.90 ± 23.17% and 104.69 ± 20.96 %, respectively; and finally in 5 years old boys it was 105.15 ± 24.97 % and in girls a negative energy balance of 86.39 ± 11.99 %. There is a highly significant association (p< 0.01) between the nutritional state and the energy balance. Conclusions: The energy balance with positive trend predisposes toward obesity for the indexes weight/height and weight/age, and the balanced or positive condition to a normal nutritional state according to height/age.

Sequential metabolizable energy plans for piglets from 7 to 30 kg / Planos sequenciais de energia metabolizável para leitões dos 7 aos 30 kg

ABSTRACT: The objective of this study was to evaluate sequential metabolizable energy (ME) plans, maintaining the lysine: calorie ratio for piglets from 7 to 30 kg. Forty eight female piglets with initial weight of 6.9 ± 1.2 kg and final weight of 30.5 ± 3.8 kg were randomly allocated in a randomized complete blocks design to three nutritional plans with eight replicates and two animals per experimental unit. Sequential plans provided four ME levels: plan 1: 3,300-3,250-3,200-3,150 kcal ME kg-1, plan 2: 3,400-3,350-3,300-3,250 kcal ME kg-1, and plan 3: 3,500-3,450-3,400-3,350 kcal ME kg-1 of feed, from 7 to 10 kg, 10 to 15 kg, 15 to 20 kg and 20 to 30 kg, respectively. From 7 to 10 kg, there was no effect (P>0.05) of the nutritional plans in the evaluated variables. From 7 to 15 kg, a higher (P<0.05) energy intake and weight gain and a better (P < 0.05) feed conversion was observed in animals fed with nutritional plans 2 and 3. Nutritional plans 2 and 3 resulted in higher (P<0.05) final weight, feed intake, energy intake, digestible lysine intake, weight gain, and better feed conversion in the 7 to 20 kg, 7 to 25 kg and 7 to 30 kg. It is recommended the sequential plan containing 3,400-3,350-3,300-3,250 kcal ME kg-1 of feed from 7 to 10 kg, from 10 to 15 kg, 15 to 20 kg, and from 20 to 30 kg; respectively, equivalent to levels of 2,546-2,513-2,501-2,475 kcal net energy (NE) kg-1 of feed for piglets.

RESUMO: Realizou-se este estudo com o objetivo de avaliar planos sequenciais de energia metabolizável (EM), mantendo a relação lisina: caloria, para leitões dos 7 ao 30 kg. Foram utilizados 48 leitões, fêmeas, com peso inicial de 6,9 ± 1,2 kg e final de 30,5 ± 3,8 kg, distribuídos em delineamento de blocos ao acaso em três planos nutricionais, sendo: 1- 3.300-3.250-3.200-3.150 Kcal de EM kg-1 de ração; 2- 3.400-3.350-3.300-3.250 Kcal de EM kg-1 de ração; e 3- 3.500-3.450-3.400-3.350 Kcal de EM kg-1 de ração, dos 7 aos 10 kg, dos 10 aos 15 kg, dos 15 aos 20 kg e dos 20 aos 30 kg, respectivamente, com oito repetições e dois animais por unidade experimental. Dos 7 aos 10 kg, não houve efeito (P>0,05) dos planos nutricionais nas variáveis avaliadas. Observou-se, dos 7 aos 15 kg, maiores (P<0,05) consumos de energia e ganho de peso e melhor (P < 0,05) conversão alimentar nos animais alimentados com os planos nutricionais 2 e 3. Os leitões alimentados com os planos nutricionais 2 e 3 apresentaram maior (P<0,05) peso final, consumos de ração, de energia, de lisina digestível, ganho de peso e melhor conversão alimentar nos períodos dos 7 aos 20 kg, dos 7 aos 25 kg e dos 7 aos 30 kg. Recomenda-se o plano sequencial contendo 3.400-3.350-3.300-3.250 Kcal de EM kg-1 de ração dos 7 aos 10 kg, dos 10 aos 15 kg, 15 aos 20 kg e dos 20 aos 30 kg, respectivamente, equivalentes aos níveis de 2.546-2.513-2.501-2.475 Kcal de energia líquida kg-1 de ração.

A adequação do suporte nutricional enteral na unidade de terapia intensiva não afeta o prognóstico em curto e longo prazos dos pacientes mecanicamente ventilados: um estudo piloto / Adequacy of enteral nutritional support in intensive care units does not affect the short- and long-term prognosis of mechanically ventilated patients: a pilot study

RESUMO Objetivo: Correlacionar os desfechos clínicos, em curto (tempo em ventilação mecânica e tempo de unidade de terapia intensiva) e longo prazos (capacidade funcional), dos pacientes que atingiram adequação nutricional ≥ 70% do previsto nas primeiras 72 horas de internação na unidade de terapia intensiva. Métodos: Estudo piloto prospectivo observacional, realizado em unidade de terapia intensiva de 18 leitos. Foram incluídos cem pacientes mecanicamente ventilados, recebendo suporte nutricional enteral exclusivo e submetidos à terapia intensiva por mais de 72 horas. Foram excluídos pacientes que nunca receberam nutrição enteral, gestantes, com trauma raquimedular, doadores de órgãos e casos de recusa familiar. As variáveis estudadas foram adequação nutricional ≥ 70% do previsto nas primeiras 72 horas de internação, tempo de unidade de terapia intensiva, tempo em ventilação mecânica e, após 12 meses, via contato telefônico, a capacidade de realizar Atividades da Vida Diária por meio do instrumento Lawton-Atividades de Vida Diária. Resultados: O tempo médio em ventilação mecânica foi de 18 ± 9 dias, e de internação na unidade de terapia intensiva de 19 ± 8 dias. Somente 45% dos pacientes receberem mais de 70% do alvo nutricional em 72 horas. Não houve associação entre a adequação nutricional e os desfechos em curto prazo (tempo de permanência em ventilação mecânica, tempo de internação na unidade de terapia intensiva e mortalidade), nem com os desfechos clínicos em longo prazo (capacidade funcional e mortalidade). Conclusão: Pacientes criticamente enfermos que recebem aporte calórico ≥ 70%, nas primeiras 72 horas de internação não apresentaram melhores desfechos em curto prazo ou após 1 ano.

ABSTRACT Objective: To correlate short-term (duration of mechanical ventilation and length of intensive care unit stay) and long-term (functional capacity) clinical outcomes of patients who reached nutritional adequacy ≥ 70% of predicted in the first 72 hours of hospitalization in the intensive care unit. Methods: This was a prospective observational pilot study conducted in an 18-bed intensive care unit. A total of 100 mechanically ventilated patients receiving exclusive enteral nutritional support and receiving intensive care for more than 72 hours were included. Patients who never received enteral nutrition, those with spinal cord trauma, pregnant women, organ donors and cases of family refusal were excluded. The variables studied were nutritional adequacy ≥ 70% of predicted in the first 72 hours of hospitalization, length of intensive care unit stay, duration of mechanical ventilation and the ability to perform activities of daily living after 12 months, assessed via telephone contact using the Lawton Activities of Daily Living Scale. Results: The mean duration of mechanical ventilation was 18 ± 9 days, and the mean intensive care unit length of stay was 19 ± 8 days. Only 45% of the patients received more than 70% of the target nutrition in 72 hours. There was no association between nutritional adequacy and short-term (duration of mechanical ventilation, length of stay in the intensive care unit and mortality) or long-term (functional capacity and mortality) clinical outcomes. Conclusion: Critically ill patients receiving caloric intake ≥ 70% in the first 72 hours of hospitalization did not present better outcomes in the short term or after 1 year.

Determinants and prediction methods of total energy expenditure – efforts at National Institute of Health and Nutrition in Japan – / 体力科学

The National Institute of Health and Nutrition, as a part of the National Institutes of Biomedical Innovation, Health and Nutrition at present, has put emphasis on energy metabolism research since its establishment in 1920. After 2000, the National Institute of Health and Nutrition introduced doubly labeled water method and human calorimeters and has also contributed to the establishment of energy requirements in the Dietary Reference Intakes for Japanese. Inter-individual differences in physical activity level are large and difficult to accurately evaluate. Therefore, various studies have been conducted using not only subjective methods such as questionnaire but also objective methods such as accelerometry. Moreover, determinants of total energy expenditure and physical activity have been investigated, including comparison of physical activity level between normal-weight and obese adults. New evidences on contribution of brown adipose tissue activity and diseases on energy metabolism have been obtained. In the near future, research to elucidate the mechanism of energy balance, more accurate and variety of assessment of physical activity, and examination from the viewpoints of chrono-nutrition and chrono-exercise are expected.

Inadequação calórica e proteica e fatores associados em pacientes graves / Inadequate energy and protein and associate factors in critically ill patients

RESUMO Objetivo: Investigar a adequação calórico-proteica de pacientes em terapia nutricional enteral exclusiva internados nas Unidades de Terapia Intensiva de um hospital universitário. Métodos: Estudo longitudinal realizado entre abril e novembro de 2014 nas Unidades de Terapia Intensiva de um hospital universitário. Foram avaliados no período de 14 dias: percentual de adequação calórico-proteica, calculada pelas médias dos valores prescritos e administrados; condições clínicas (unidade e diagnóstico de internação, escore prognóstico Acute Physiology and Chronic Health Evaluation II, estado nutricional, tempo de internação); complicações gastrointestinais; e motivo de interrupção da dieta. Valores inferiores a 80% de adequação calórica e proteica foram considerados inadequados. Realizou-se análise multivariada por Regressão de Poisson com nível de significância de 5%. Resultados: O estudo contou com uma amostra de 38 pacientes, sendo 52,63% desnutridos. As médias de adequação calórica e proteica foram de 76,47% e 69,11%, respectivamente. A prevalência de inadequação calórica foi de 55,26% e de proteica, 68,42%. O jejum para procedimentos foi a causa mais frequente de interrupção da dieta. O volume residual gástrico e a diarreia foram as complicações gastrointestinais mais comuns. A inadequação calórica associou-se ao tempo de permanência ≤14 dias e ao volume residual elevado. A inadequação proteica associou-se ao tempo de permanência ≤14 dias, ao volume residual gástrico elevado e à saída ou obstrução da sonda. Conclusão: A prevalência de inadequação calórica e proteica ocorreu em mais da metade dos pacientes avaliados. Estratégias como a elaboração de protocolos por equipe multiprofissional devem ser implantadas para minimizar interrupções da dieta administrada, estabelecer medidas de controle para complicações gastrointestinais e, assim, garantir um aporte nutricional adequado durante o período de internação.

ABSTRACT Objective: To investigate the energy and protein adequacies of intensive care unit of a university hospital patients in exclusive enteral nutrition. Methods: This longitudinal study was conducted between April and November 2014 in the adult intensive care unit of a university hospital. The following items were assessed during 14 days: percentage of protein energy adequacy, based on the mean prescribed and administered values; clinical conditions (unit and diagnosis on admission, Acute Physiology and Chronic Health Evaluation II, nutritional status, and length of stay); gastrointestinal complications; and reason for diet interruption. Values below 80% of the caloric and protein adequacies were considered inadequate. Multivariate analysis was performed by Poisson Regression at a significance level of 5%. Results: The sample consisted of 38 patients, and 52.63% were undernourished. The mean caloric and protein adequacies were 76.47% and 69.11%, respectively. The prevalences of caloric and protein inadequacies were 55.26% and 68.42%, respectively. Fasting for procedures was the most frequent cause for diet interruption. Residual gastric volume and diarrhea were the most common gastrointestinal complications. Caloric inadequacy was associated with length of stay ≤14 days and high residual gastric volume. Protein inadequacy was associated with length of stay ≤14 days, high residual gastric volume, and catheter displacement or obstruction. Conclusion: More than half of the patients had caloric and protein inadequacies. Strategies, such as the development of protocols for multidisciplinary teams, should be created to minimize disruption of the administered diet, establish measures to control gastrointestinal complications, and thus ensure adequate nutritional intake during intensive care unit stay.

Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications / Gasto energético de repouso em pacientes críticos: métodos de avaliação e aplicações clínicas

Summary Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE) of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis. The nutritional needs of this population are therefore complex, and determining the resting energy expenditure is essential to adjust the nutritional supply and to plan a proper diet, ensuring that energy requirements are met and avoiding complications associated with overfeeding and underfeeding. Several evaluation methods of EE in this population have been described, but all of them have limitations. Such methods include direct calorimetry, doubly labeled water, indirect calorimetry (IC), various predictive equations, and, more recently, the rule of thumb (kcal/kg of body weight). Currently, IC is considered the gold standard.

Resumo Os pacientes em cuidados intensivos apresentam alterações sistêmicas, metabólicas e hormonais, que podem afetar adversamente a condição nutricional e levar à rápida e importante depleção da massa magra e desnutrição. Vários fatores e situações clínicas podem exercer influência sobre o gasto energético (GE) de pacientes críticos, como idade, sexo, cirurgias, infecções graves, medicamentos, modalidade ventilatória e disfunção de órgãos. Dentre as condições clínicas que podem cursar com alteração do GE, encontra-se a lesão renal aguda (LRA), distúrbio complexo comumente observado em pacientes críticos, com manifestações que podem variar de mínimas elevações na creatinina sérica até insuficiência renal com necessidade dialítica. Dessa forma, essa população crítica apresenta necessidades nutricionais complexas e a determinação do gasto energético de repouso (GER) torna-se essencial para o ajuste da oferta nutricional e para o planejamento de uma nutrição adequada, assegurando que as necessidades energéticas sejam atingidas e evitando as complicações associadas à hiper ou hipoalimentação. Diversos métodos de avaliação do GE nessa população foram descritos, mas todos apresentam limitações. Dentre eles, destacam-se a calorimetria direta, a água duplamente marcada, a calorimetria indireta (CI), diversas equações preditivas e, mais atualmente, a regra de bolso (kcal/kg de peso). Atualmente, a CI é eleita o método padrão-ouro.

Net energy and ractopamine levels for barrows weighing 70 to 100kg / Níveis de energia líquida e ractopamina para suínos machos castrados dos 70 aos 100kg

ABSTRACT: The purpose of this study was to evaluate net energy and dietary ractopamine levels for barrows weighing 70 to 100kg. The 150 pigs investigated (initial weight 70.80±3.84kg) were distributed in a randomized block design with a 5×3 factorial arrangement, comprising five levels of net energy (2,300; 2,425; 2,550; 2,675; and 2,800Kcal kg-1 of diet) and three levels of ractopamine (5, 10, and 20ppm kg-1 of diet), with five replicates, and two animals per experimental unit. No interaction (P>0.05) was observed between net energy and ractopamine levels. Increasing the dietary net energy levels led to a linear reduction in feed intake, with a linear improvement in feed conversion. Net energy levels had no observable effect (P>0.05) on weight gain, final weight, or carcass characteristics. A dietary net energy level of 2,800Kcal kg-1 can be recommended for pigs weighing 70-100kg, improving feed conversion without affecting carcass characteristics, regardless of dietary ractopamine levels. Ractopamine levels above 5ppm did not affect performance or modify the quantitative characteristics of carcasses, regardless of dietary net energy levels.

RESUMO: Conduziu-se este estudo com o objetivo de avaliar níveis de energia líquida e ractopamina na dieta de suínos machos castrados em terminação dos 70 aos 100kg. Foram utilizados 150 suínos, com peso inicial de 70,80±3,84kg, distribuídos em delineamento de blocos ao acaso, em esquema fatorial 5x3, com cinco níveis de energia líquida (2.300, 2.425, 2.550, 2.675 e 2.800Kcal kg-1 de dieta) e três níveis de ractopamina (5, 10 e 20ppm kg-1 de dieta), cinco repetições e dois animais por unidade experimental. Não houve interação (P>0,05) entre os níveis de energia líquida e ractopamina. O aumento dos níveis de energia líquida das dietas proporcionou redução linear do consumo de ração e resultou em melhora linear da conversão alimentar. Não houve efeito (P>0,05) dos níveis de energia líquida no ganho de peso, peso final e nas características de carcaça. Recomenda-se o nível de 2.800Kcal de EL kg-1 de dieta para suínos de 70 a 100kg por melhorar a conversão alimentar, sem prejudicar as características de carcaça, independentemente do nível de ractopamina das dietas. A inclusão de ractopamina na dieta de suínos dos 70 aos 100kg não afeta o desempenho e não modifica as características quantitativas das carcaças, independente do nível de energia líquida das dietas.

Adequação dos balanços energético e proteico na nutrição por via enteral em terapia intensiva: quais são os fatores limitantes? / Adequacy of energy and protein balance of enteral nutrition in intensive care: what are the limiting factors?

Objetivo: Determinar os fatores que influenciam na adequação da terapia nutricional enteral em uma unidade de terapia intensiva. Métodos: Estudo prospectivo e observacional realizado em uma unidade de terapia intensiva entre 2010 e 2012. Foram incluídos pacientes >18 anos em terapia nutricional enteral exclusiva por ≥72 horas. As necessidades de energia e proteínas foram calculadas segundo protocolo da unidade. Foram coletados diariamente dados relacionados à nutrição enteral, causas de não conformidade e exames bioquímicos. Resultados: Dentre os pacientes internados na unidade, 93 foram avaliados, 82% iniciaram a terapia nutricional enteral precocemente e 80% atingiram a meta nutricional em <36 horas. Foram administrados 81,6% (±15,4) de volume de terapia nutricional enteral, com adequação de 82,2% (±16,0) de calorias, 82,2% (±15,9) de proteínas e balanço energético médio de -289,9 kcal/dia (±277,1). Houve correlação negativa da proteína C-reativa com o volume administrado e os balanços energético e proteico, e correlação positiva com o tempo para atingir a meta nutricional. A pausa para extubação foi a principal causa de interrupções (29,9% das horas de pausa) e os pacientes >60 anos apresentaram menor porcentagem de recuperação da via oral em relação aos mais jovens (p=0,014). Conclusão: O início precoce da terapia nutricional enteral, e a adequação do volume administrado, de energia e de proteínas estiveram de acordo com as diretrizes. A inadequação dos balanços energético e proteico parece estar associada à resposta inflamatória aguda (proteína C-reativa elevada). A principal causa de interrupção da oferta da terapia nutricional foi a pausa para extubação. .

Objective: To determine the factors that influence the adequacy of enteral nutritional therapy in an intensive care unit. Methods: This prospective observational study was conducted in an intensive care unit between 2010 and 2012. Patients >18 years of age underwent exclusive enteral nutritional therapy for ≥72 hours. The energy and protein requirements were calculated according to the ICU protocols. The data regarding enteral nutrition, the causes of non-compliance, and the biochemical test results were collected daily. Results: Ninety-three patients admitted to the intensive care unit were evaluated. Among these patients, 82% underwent early enteral nutritional therapy, and 80% reached the nutritional goal in <36 hours. In addition, 81.6%±15.4% of the enteral nutrition volume was infused, with an adequacy of 82.2%±16.0% for calories, 82.2%±15.9% for proteins, and a mean energy balance of -289.9±277.1kcal/day. A negative correlation of C-reactive protein with the volume infused and the energy and protein balance was observed. In contrast, a positive correlation was found between C-reactive protein and the time required to reach nutritional goals. Extubation was the main cause for interrupting the enteral nutritional therapy (29.9% of the interruption hours), and the patients >60 years of age exhibited a lower percentage of recovery of the oral route compared with the younger patients (p=0.014). Conclusion: Early enteral nutritional therapy and the adequacy for both energy and protein of the nutritional volume infused were in accordance with the established guidelines. Possible inadequacies of energy and protein balance appeared to be associated with an acute inflammatory response, which was characterized by elevated C-reactive protein levels. The main cause of interruption of the enteral nutritional therapy was the time spent in extubation. .

Requerimientos energéticos y proteicos estimados por calorimetría indirecta y nitrógeno urinario en pacientes con quemadura o pancreatitis aguda / Energy and protein requirements estimated by indirect calorimetry and urine urea nitrogen in burn and acute pancreatitis patients

The pathological states of burn injuries and acute pancreatitis are associated with hypermetabolic and hypercatabolic states. The objective of the study was to determine energy and protein requirements in these conditions. A transversal analytical study was applied to 18 patients: 10 with mild burn injuries in <5% body surface and 8 with acute pancreatitis. Anthropometric measurements were taken (weight, height, BMI, skin folds), as well as resting metabolic rate through indirect calorimetry (RMR IC), protein catabolism using 24-hour urine urea nitrogen (UUN), and trauma factor (RMR IC/BMR Harris-Benedict equation). The sample was made up of 72.2% men and27.8% women. The study of burn and acute pancreatitis patients was carried out on the average 16.1 ± 13.0 SD and 8.8 ± 2.0 SD days after the onset of the disease, respectively. There were no statistically significant differences in RMR IC since mean energy requirements were 24.4 kcal/kg/d and 23.2 kcal/kg/d in patients with burns and acute pancreatitis, respectively, for both sexes (p>0.05). Total energy expenditure (TEE) was not significant (p>0.05). Acute pancreatitis and burn patients showed mild catabolism and their protein requirement was 1,19 g/ kg/d (p>0.05). The trauma factor in acute pancreatitis patients was 0,91 (p>0.05). In conclusion, patient energy requirement was lower than reported or recommended values in both pathologies under study, whereas protein requirement was lower in burn patients.

Los estados patológicos de quemadura y pancreatitis aguda, se asocian a estados híper metabólicos e híper catabólicos. El objetivo de este estudio fue determinar los requerimientos energéticos y proteicos mediante un estudio analítico transversal en 18 pacientes: 10 con quemadura menores al 5% de la superficie corporal quemada y 8 con pancreatitis aguda. Se determinó el peso, la talla, el IMC, los pliegues cutáneos, la tasa metabólica en reposo por calorimetría indirecta (TMR CI), el catabolismo proteico mediante nitrógeno ureico (NUU) orina de 24 horas, factor trauma (TMR CI/TMB fórmula Harris Benedict). La muestra estuvo representada en 72,2 % por hombres y 27,8% por mujeres. El estudio en pacientes quemados o con pancreatitis aguda se realizó en promedio a los 16,1 ± 13,04 DS y 8,8 ± 2,0 DS días posteriores al inicio de la enfermedad, respectivamente. No mostró diferencias estadísticamente significativas en TMR CI, resultando un requerimiento energético promedio de 24,4 kcal/Kg/día y 23,2 kcal/Kg/día, en pacientes con quemadura y pancreatitis aguda, respectivamente, en ambos géneros (p>0,05); tampoco en el gasto energético total (GET) (p>0,05). Los pacientes con pancreatitis aguda o quemadura presentaron un catabolismo leve y su requerimiento proteico fue 1,19 g/Kg/día (p>0,05). En los pacientes con pancreatitis aguda el factor trauma fue 0. 91 (p>0,05). En conclusión, en ambas patologías estudiadas el requerimiento energético de los pacientes fue inferior a lo reportado, respecto al requerimiento proteico, siendo menor en el paciente quemado.

Estimating free-living human energy expenditure: Practical aspects of the doubly labeled water method and its applications

The accuracy and noninvasive nature of the doubly labeled water (DLW) method makes it ideal for the study of human energy metabolism in free-living conditions. However, the DLW method is not always practical in many developing and Asian countries because of the high costs of isotopes and equipment for isotope analysis as well as the expertise required for analysis. This review provides information about the theoretical background and practical aspects of the DLW method, including optimal dose, basic protocols of two- and multiple-point approaches, experimental procedures, and isotopic analysis. We also introduce applications of DLW data, such as determining the equations of estimated energy requirement and validation studies of energy intake.

Estimativa das necessidades energéticas em pacientes com doença renal crônica / Estimating the energy requirement of chronic kidney disease patients

Estabelecer as necessidades energéticas de pacientes com doença renal crônica é importante para que se possam tratar os distúrbios nutricionais encontrados nessa população. Segundo os guias de condutas voltados ao cuidado nutricional de pacientes com essa doença, a recomendação energética pode variar entre 30 e 40kcal/kg/dia. Contudo, trabalhos que avaliaram os componentes do gasto energético nos pacientes com doença renal crônica sugerem que as necessidades energéticas dessa população podem diferir do valor recomendado acima, a depender da condição clínica (presença de comorbidades), da modalidade de tratamento empregado e do nível de atividade física. Dessa forma, o presente trabalho tem como objetivo fazer uma revisão dos estudos sobre o gasto energético de pacientes com doença renal crônica, com o intuito de abordar as seguintes questões: (1) as atuais recomendações de energia para pacientes com doença renal crônica estão adequadas? (2) qual equação de predição poderia ser empregada para estimar as necessidades energéticas desse grupo de pacientes? Assim, esta revisão busca auxiliar o nutricionista ao estimar as necessidades energéticas de pacientes com doença renal crônica.

Estimating the energy requirement of patients with chronic kidney disease is highly important for treating the nutritional disorders often seen in this population. According to the specific guidelines for patients with chronic kidney disease, the currently recommended daily energy intake varies from 30 to 40kcal/kg/day. However, studies that investigated energy expenditure components of patients with chronic kidney disease suggested that the energy requirement may differ from the one proposed earlier, depending on overall clinical condition (i.e. presence of comorbidities), treatment modality and level of physical activity. With this perspective in mind, the present study aims to review the studies assessing energy expenditure focusing on two themes: (1) is the current energy recommendation for patients with chronic kidney disease adequate? (2) which predictive equation can be used when estimating the energy requirements of this population? Therefore, this review aims to help dietitians to estimate the energy needs of chronic kidney disease patients.

Total energy expenditure of 16 Chinese young men measured by the doubly labeled water method / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Doubly labeled water (DLW) method is the gold standard for measuring total energy expenditure (TEE). We used this method to measure TEE in Chinese young men.</p><p><b>METHODS</b>Sixteen healthy young men age 23±1 years with body mass index 22.0±1.4 kg/m2 were recruited. TEE was measured by the DLW method, and basal energy expenditure (BEE) was determined by indirect calorimetry. We also conducted 24-h activity, energy balance and factorial approach to estimate energy requirements of the subjects.</p><p><b>RESULTS</b>TEE of subjects by DLW method was 9.45±0.57 MJ/day (2258±180 kcal/day). The 24-h activity was 10.80±0.33 MJ/day (2582±136 kcal/day). The energy requirement, derived from energy balance observations, was 9.93±1.32 MJ/day (2373±315 kcal/day). The BEE of 6.65±0.28 MJ/day (1589±67 kcal/day), calculated by the adjusted Schofield equation, was significantly higher (P<0.001) than that measured by indirect calorimetry, 5.99±0.66 MJ/day (1433±158 kcal/day). The TEE derived from the factorial approach was 10.31±0.43 MJ/day (2463±104 kcal/day).</p><p><b>CONCLUSION</b>The TEE of Chinese young men measured by the DLW method was about 10% lower than the current recommended nutrient intake (RNI), suggesting that the RNI for Chinese men maybe overestimated. Further studies are warranted to determine the value of the estimated energy requirement.</p>

Terapia nutricional enteral em politraumatizados sob ventilação mecânica e oferta energética / Enteral nutritional therapy in mechanically-ventilated multiple-trauma patients and energy intake

OBJETIVO: O objetivo deste estudo foi avaliar a adequação energética dos pacientes politraumatizados em suporte ventilatório internados na unidade de terapia intensiva de um hospital público de Porto Alegre (RS), por meio da comparação entre as calorias prescritas e as efetivamente administradas, assim como entre as calorias estimadas pela equação de Harris-Benedict e a prescrição energética de cada paciente. MÉTODOS: Estudo de coorte prospectivo de pacientes politraumatizados, simultaneamente sob ventilação mecânica e terapia nutricional enteral. Verificou-se o tempo de permanência sob ventilação mecânica e a oferta energética durante o período de terapia nutricional enteral. A associação entre as variáveis quantitativas foi avaliada através do teste de correlação de Spearman devido à assimetria das variáveis. RESULTADOS: Foram acompanhados 60 pacientes, na faixa etária de 18 a 78 anos, sendo 81,7% do sexo masculino. Os tempos medianos de internação hospitalar, permanência na unidade de terapia intensiva e ventilação mecânica foram de 29, 14 e 6 dias, respectivamente. A média do percentual de dieta administrada foi de 68,6% (DP=18,3%). Da amostra total, 16 (26,7%) pacientes receberam no mínimo 80% de suas necessidades diárias. Não houve associação estatisticamente significativa entre o valor energético total administrado e os tempos de ventilação mecânica (r s=0,130; p=0,321), de unidade de terapia intensiva (r s=-0,117; p=0,372) e de internação hospitalar (r s=-0,152; p=0,246). CONCLUSÃO: Os pacientes incluídos neste estudo não receberam com precisão o aporte energético prescrito, ficando expostos aos riscos da desnutrição e seus desfechos clínicos desfavoráveis.

OBJECTIVE: The objective of this study was to asssess the adequacy of energy intake of multiple trauma patients in the intensive care unit of a public hospital in the city of Porto Alegre, Southern Brazil, who require ventilatory support, by comparing prescribed energy intake with effectively administered energy, and energy requirement estimated by the Harris-Benedict equation with the energy prescription of each patient. METHODS: This is a prospective cohort study of patients with multiple trauma simultaneously on mechanical ventilation and enteral nutrition. Duration of mechanical ventilation and energy intake during enteral nutrition were verified. The association between quantitative variables was assessed by the Spearman correlation test due to variable asymmetry. RESULTS: Sixty patients aged 18 to 78 years were studied, 81.7% of them males. Median length of hospital stay, intensive care unit stay, and duration of mechanical ventilation was 29, 14, and 6 days, respectively. The mean percentage of administered calories was 68.6% (SD=18.3%). Of the entire sample, 16 (26.7%) patients received at least 80% of their daily energy requirement. There was no significant association between total energy administered and duration of mechanical ventilation (r s=0.130; p=0.321), length of intensive care unit stay (r s=-0.117; p=0.372) and length of hospital stay (r s=-0.152; p=0.246). CONCLUSION: The study patients did not receive the prescribed energy. Therefore, they were at risk of malnutrition and its adverse clinical outcomes.

Aporte nutricional e desfechos em pacientes críticos no final da primeira semana na unidade de terapia intensiva / Nutritional support and outcomes in critically ill patients after one week in the intensive care unit

OBJETIVO: Avaliar a relação entre a oferta comparada às necessidades calóricas e proteicas no 7º dia de internação e desfechos de interesse em uma unidade de terapia intensiva. MÉTODOS: Estudo de coorte, retrospectivo, realizado na unidade de terapia intensiva, com 126 pacientes internados por >7 dias, que foram categorizados de acordo com a adequação da oferta energética e proteica administrada, em relação às necessidades. O Grupo Oferta Adequada >60% e o Grupo Suboferta <60% foram avaliados em relação ao tempo de internação, tempo livre de ventilação mecânica invasiva e mortalidade na unidade de terapia intensiva e hospitalar. RESULTADOS: Nutrição enteral foi utilizada em 95,6% dos 126 pacientes incluídos e iniciada 41 horas após a admissão na unidade de terapia intensiva. A adequação da oferta energética foi de 84% e, de proteínas, 72,5%. Não houve diferença entre os grupos oferta adequada e suboferta de energia em relação ao tempo de internação [16 (11-23) versus 15 (11-21) dias; p=0,862], tempo livre de ventilação mecânica invasiva [2 (0-7) versus 3 (0-6) dias; p=0,985], mortalidade na unidade de terapia intensiva [12 (41,4%) versus 38 (39,1%); p=0,831] e hospitalar [15 (51,7%) versus 44 (45,4%); p=0,348], respectivamente. Resultados semelhantes foram encontrados em relação à oferta proteica e ao tempo de internação [15 (12-21) versus 15 (11-21) dias; p=0,996], tempo livre de ventilação mecânica invasiva [2 (0-7) versus 3 (0-6) dias; p=0,846], mortalidade na unidade de terapia intensiva [15 (28,3%) versus 35 (47,9%); p=0,536)] e hospitalar [18 (52,9%) versus 41 (44,6%); p=0,262]. CONCLUSÃO: Não foi possível demonstrar que as ofertas energética e proteica, superior ou inferior a 60% das necessidades nutricionais, sejam divisores confiáveis, em termos de desfechos clínicos.

OBJECTIVE: This study evaluated the relationship between nutritional intake and protein and caloric requirements and observed clinical outcomes on the 7th day of intensive care unit stay. METHODS: This was a retrospective cohort study of 126 patients who were admitted to the intensive care unit for >7 days. The patients were categorized according to the adequacy of energy and protein intake in relation to requirements (a >60% Adequate Intake Group and a <60% Inadequate Intake Group). The length of stay, ventilator free time and mortality in the intensive care unit and hospital were evaluated. RESULTS: Enteral nutrition was used in 95.6% of the 126 included patients, and nutrition was initiated 41 hours after admission to the intensive care unit. The adequacy of intake was 84% for energy and 72.5% for protein. No differences in the length of stay [16 (11-23) versus 15 (11-21) days, p=0.862], ventilator free time [2 (0-7) versus 3 (0-6) days, p=0.985] or mortality in the intensive care unit [12 (41.4%) versus 38 (39.1%), p=0.831] and hospital [15 (51.7%) versus 44 (45.4%), p=0.348] were observed between the adequate and inadequate energy intake groups, respectively. Similar results in protein intake and the length of hospital stay [15 (12-21) versus 15 (11-21) days, p=0.996], ventilator free time [2 (0-7) versus 3 (0-6) days, p=0.846], and mortality in the intensive care unit [15 (28.3%) versus 35 (47.9%), p=0.536)] and hospital [18 (52.9%) versus 41 (44.6%), p=0.262] were observed between groups. CONCLUSION: The results did not establish that energy and protein intakes of greater or less than 60% of nutritional requirements were reliable dividers of clinical outcomes.

Demanda metabólica das atividades de militares da marinha: o avançar da carreira e a redução da exigência física / Metabolic demand of navy militaries activities: advancing career and the reduction of physical demand

Os objetivos deste estudo foram identificar as principais atividades comuns às rotinas ocupacional e de condicionamento físico dos militares do Centro de Educação Física da Marinha do Brasil e estimar a demanda metabólica (DM) destas atividades. Cento e sessenta e um militares (n = 149 M e 12 F) com idade entre 19 e 47 anos (30,6 ± 7,8 anos) foram divididos em três grupos diferentes: marinheiros, soldados e cabos (G1), sargentos e suboficiais (G2) e oficiais (G3). A estimativa da DM foi realizada através de uma lista de atividades adaptada do Compêndio de Atividades Físicas. O questionário foi formatado em uma plataforma na WEB (www.surveymonkey.com) para que os sujeitos respondessem digitalmente. As atividades de condicionamento foram classificadas como moderadas (5,8 e 5,9 MET), para G2 e G3, respectivamente, e vigorosas (6,1 MET), para G1. As atividades da rotina ocupacional também foram classificadas como moderadas (2,7 a 3,8 MET). Foram observadas diferenças significativas entre as médias de DM das atividades da rotina ocupacional dos três grupos. Observou-se uma relação inversa entre a DM das atividades da rotina ocupacional e o avançar da carreira militar. Nas atividades de condicionamento, a redução da DM foi relacionada à idade, mas não necessariamente aos círculos hierárquicos dos militares. Conclui-se que o avançar da carreira militar leva a uma rotina ocupacional mais sedentária, o que pode contribuir para o aumento do risco de desenvolvimento de doenças induzidas pela hipocinesia.

The purposes of this study were to identify the main usual activities of the occupational and physical fitness routines of militaries from the Physical Education Center of the Brazilian Navy and to estimate their metabolic demand (MD). One hundred and sixty one militaries (n = 149 M and 12 F) aged 19 to 47 years (30.6 ± 7.8 years) were divided into three different groups: sailors, soldiers and corporals (G1), sergeant and petty o?cers (G2) and o?cers (G3). The MD estimate was performed through a list of activities adapted from the Compendium of Physical Activities. The questionnaire was available in a web platform (www.surveymonkey.com) so that individuals respond digitally. The conditioning activities were classified as moderate (5.8 and 5.9 METs), for G2 and G3, respectively, and vigorous (6.1 METs), for G1. The activities of the occupational routines were also classified as moderate (2.7 to 3.8 METs). Significant differences were observed among the means of the MD for the occupational routines of the three different groups. There was an inverse relationship between the MD of the activities of the occupational routine and the military career advancing. In conditioning activities, the reduction of MD was related to the age but not necessarily to the military ranks. It was concluded that advancing military career leads to a more sedentary occupational routine, which may contribute to increased risk of developing hypokinesia-induced diseases.

Assessment of Energy Intake and Physical Activity Level for Korean Farmers to Establish Estimated Energy Requirements during the Off-Season for Farmers / 대한지역사회영양학회지

The purpose of this study was to assess the physical activity level of Korean farmers to establish estimated energy requirements during the off-season. Subjects were 90 healthy males (n = 25) and females (n = 65). Body weight, height and body fat and muscles of subjects were measured. The prevalence of obesity among farmers was 56.7% according to the BMI. The farmers spent about 18 hours 7 minutes (75.5%) in sleeping and resting. The farmers spent about 19 hours 56 minutes (83.1%) out of 24 hours (one day) in "sedentary activities" and spent about 3 hours 56 minutes (16.4%) in "light activities". Physical activity level (PAL, activity coefficient) of female farmers was 1.42 which was not significantly higher than that (1.37) of male farmers. Estimated energy requirements (EER) for farmers who were different in age groups and gender were calculated. For example, the EERs for male and female farmers were 2190 kcal/day and 1712 kcal/day, respectively. The daily energy intakes of male and female farmers were 1803 kcal/day and 1610 kcal/day, respectively. The EER of male farmers was 2190 kcal/day which was significantly higher than that (1803 kcal/day) of the recommended daily energy intake of male farmers. The results of this study suggest that estimated EER of farmers should be modified according to seasonal workload and energy balance of farmers should be evaluated to prevent obesity.

Physical activity level, total daily energy expenditure, and estimated energy expenditure in normal weight and overweight or obese children and adolescents

The purposes of this study were to assess the physical activity level (PAL) and the total daily energy expenditure (TEE) as well as to evaluate the validity of prediction equation for the estimated energy requirement (EER) in normal weight and overweight or obese children and adolescents. The subjects comprised of 100 healthy Korean students aged between 7-18. The anthropometric data was collected. PAL was calculated from the physical activity diary by the 24-hour recall method, and the resting metabolic rate (RMR) was measured by an open-circuit indirect calorimetry using a ventilated hood system. Daily energy expenditure was PAL multiplied by RMR. EER was calculated by using the prediction equation published in KDRIs. There was no significant difference in the means of age and height between the 46 obese subjects and 54 nonobese subjects. The weight and BMI of the obese group (60.2 kg, 25.3 kg/m2) were significantly higher than those of the nonobese group (42.4 kg, 18.4 kg/m2). However, PAL was not significantly different between the two groups (nonobese 1.45, obese 1.46). TEE of the obese group (2,212 kcal/day) was significantly higher than that of the nonobese group (1,774 kcal/day). EER (individual PA) and EER (light PA) were significantly higher than TEE (p < 0,001); however, EER (sedentary PA) was not significantly different with TEE in the two groups. These results showed that the levels of physical activity were the same as the sedentary activity both in the nonobese and obese Korean students; moreover, the predictive equation for EER published in KDRI overestimated the TEE of Korean children and adolescents. Therefore, in further research, a new predictive equation for EER should be developed for Korean children and adolescents through the doubly labeled water method.