Comparison of three different measurement methods to determine resting energy expenditure in patients with decompensated hepatitis B cirrhosis / 中华肝脏病杂志

Objective: To compare the differences to determine resting energy expenditure (REE) measured with indirect calorimetry and REE predicted by formula method and body composition analyzer in patients with decompensated hepatitis B cirrhosis, so as to provide theoretical guidance for the implementation of precision nutrition intervention. Methods: Patients with decompensated hepatitis B cirrhosis who were admitted to Henan Provincial People's Hospital from April 2020 to December 2020 were collected. REE was determined by the body composition analyzer and the H-B formula method. Results: were analyzed and compared to REE measured by the metabolic cart. Results A total of 57 cases with liver cirrhosis were included in this study. Among them, 42 were male, aged (47.93 ± 8.62) years, and 15 were female aged (57.20 ± 11.34) years. REE measured value in males was (1 808.14 ± 201.47) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.002 and 0.003, respectively). REE measured value in females was (1 496.60 ± 131.28) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.016 and 0.004, respectively). REE measured with the metabolic cart had correlation with age and area of visceral fat in men (P = 0.021) and women (P = 0.037). Conclusion: Metabolic cart use will be more accurate to obtain resting energy expenditure in patients with decompensated hepatitis B cirrhosis. Body composition analyzer and formula method may underestimate REE predictions. Simultaneously, it is suggested that the effect of age on REE in H-B formula should be fully considered for male patients, while the area of visceral fat may have a certain impact on the interpretation of REE in female patients.

Design and Verification of Human Metabolic Measurement System Based on STM32 / 中国医疗器械杂志

A high-precision human metabolic measurement system is designed. The system uses STM32F103 as the main control chip to acquire oxygen, carbon dioxide and flow signals to calculate four quantitative indicators: oxygen consumption(VO2), carbon dioxide production(VCO2), respiratory entropy(RQ) and resting energy metabolism(REE), and finally uses an upper computer to display the calculation results.In this paper, the signal acquisition circuit design was carried out for the oxygen sensor, carbon dioxide sensor and flow sensor, and the validity of the device was verified with the American machine MGCDiagnositcs using Bland-Altman analysis method, and the results showed that the four parameters of VO2,VCO2, RQ and REE of both devices fell in the agreement interval of more than 95%. The device thus provides accurate metabolic measurements and offers an effective tool for the field of general health and clinical nutrition support in China.

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.

Agreement between equations-estimated resting metabolic rate and indirect calorimetry-estimated resting metabolic rate in low-income obese women

ABSTRACT Objectives Indirect calorimetry is established as a gold standard to determine the resting metabolic rate (RMR), however, its clinical use is limited, especially in low-income settings. Thus, the use of predictive equations appear as an alternative to estimate the RMR, but its precision is debatable, especially in obese individuals and in populations without specifically developed equations. To evaluate the agreement between the RMR estimated by equations and by indirect calorimetry in low-income obese women. Subjects and methods A cross-sectional study with adult and obese women, which estimated the RMR by indirect calorimetry and compared with 13 predictive equations using the concordance correlation coefficient, root mean square error (RMSE) and Bland-Altman methods. The maximum allowed differences were predefined as 10%. Results No equation presented its confidence intervals for the Bland-Altman limits of agreement inside the predefined acceptable range. The Harris-Benedict equation achieved better agreement (bias of 2.9% and RMSE of 274.3kcal) whereas the Henry-Rees equation achieved better precision (42.3% of the sample within the 10% maximum allowed difference). Conclusion None of the studied equations satisfactorily estimated the RMR estimated by indirect calorimetry. In the absence of specific equations for this population, the use of the Harris-Benedict and Henry-Rees equations could be considered.

Validation of the Novel Basal Metabolic Rate Prediction Equation Among Adult Overweight and Obese Filipino Patients

@#BACKGROUND: Various methods and equations are available to predict the basal metabolic rate (BMR). A published study comparing the Harris-Benedict Equation, Bioelectrical Impedance Analysis, and Indirect Calorimetry (IC), was done among Filipinos, and was able to obtain a novel formula for BMR. The purpose of this study is to validate this novel formula. METHODS: This is a multi-center, cross-sectional, validation study of the novel BMR equation, done among adult overweight and obese Filipinos, who were seen at St. Luke’s Medical Center and Providence Hospital in Quezon City, Outpatient Clinics from August 2019 to March 2020. Purposive sampling was done, and upon giving consent, subjects had undergone interview, anthropometrics measurement, and IC. RESULTS: 174 samples were enrolled. Mean age is 43 years old, majority are females. 27% have no co-morbidities; of those with co-morbidities, half have diabetes mellitus (DM). Mean weight is 74.30 kg; mean BMI is 29.78 kg/m2 . The mean computed BMR is 1174.70 kcal/day, which is 145.83 significantly lower than the BMR derived with calorimetry: 1320.53 kcal/day (P-value 0.000). However, the scatterplot reveals the linearity of positive direction for both values. 31% of the computed BMR fell within the +/-10% estimate of the actual BMR. Stratification of the results between those with DM and without, lowered the difference between the calculated and actual BMR to 46 kcal/day (from 145.83) among the DM subgroup, and increased the estimated accuracy to 38% falling within the +/- 10% estimate of the actual values. CONCLUSION: The novel BMR formula is linearly reflective of the basal metabolism of adult overweight and obese Filipinos, but the numerical values are lower compared to actual calorimetry results, yielding more accuracy when applied among patients with diabetes.

Basal metabolic rate in Brazilian patients with type 2 diabetes: comparison between measured and estimated values

ABSTRACT Objectives: The aims of this study are to investigate which of the seven selected predictive equation for estimating basal metabolic rate (BMR) is the best alternative to indirect calorimetry (IC) and to evaluate the dietary energy intake in patients with type 2 diabetes. Subjects and methods: Twenty-one patients with type 2 diabetes participated in this diagnostic test study. Clinical and laboratorial variables were evaluated as well as body composition by absorptiometry dual X-ray emission (DXA) and BMR measured by IC and estimated by prediction equations. Dietary intake was evaluated by a quantitative food frequency questionnaire. Data were analyzed using Bland-Altman plots, paired t-tests, and Pearson's correlation coefficients. Results: Patients were 62 (48-70) years old, have had diabetes for 8 (2-36) yeas, and 52.4% were females. The mean body composition comprised a fat-free mass of 49.8 ± 9.4 kg and a fat mass of 28.3 ± 7.2 kg. The energy intake was 2134.3 ± 730.2 kcal/day and the BMR by IC was 1745 ± 315 kcal/day. There was a wide variation in the accuracy of BMR values predicted by equations when compared to IC BMR measurement. Harris-Benedict, Oxford, FAO/WHO/UNO equations produced the smallest differences to IC, with a general bias of < 8%. The FAO/WHO/UNO equation provided the best BMR prediction in comparison to measured BMR. Conclusion: In patients with type 2 diabetes, the equation of the FAO/WHO/UNO was the one closest to the BMR values as measured by IC.

Differences in dietary intakes, body compositions, and biochemical indices between metabolically healthy and metabolically abnormal obese Korean women

BACKGROUND/OBJECTIVES: There are various factors that affect metabolic abnormalities related to obesity. The purpose of this study is to analyze the differences in dietary intakes and body compositions of obese women according to metabolic risks and to classify them as metabolically healthy obese (MHO) or metabolically abnormal obese (MAO). SUBJECTS/METHODS: This study was conducted on 59 obese Korean women aged 19 to 60 years. NCEP-ATPIII criteria were applied and the women classified as MHO (n = 45) or MAO (n = 14). Body composition of each subject was measured by using dual-energy x-ray absorptiometry (DEXA). Three-day food records were used to analyze dietary intake. Eating habits and health-related behaviors were determined through questionnaires. Indirect calorimetry was used to measure resting metabolic rate and respiratory rate. RESULTS: The average age of the subjects was 43.7 years. The analysis of body composition according to phenotype revealed significantly higher body fat mass (P < 0.05), arm fat mass (P < 0.05), and android fat mass (P < 0.05), as measured by DEXA, in the MAO group than in the MHO group. There was no significant difference in the dietary intake of the two groups. However, eating behaviors differed. Compared to the MHO group, the MAO women had a shorter meal time (less than 10 minutes), a preference of oily foods, and a tendency to eat until full. Therefore, the eating habits of MHO women were more positive than those of MAO women. CONCLUSIONS: The results suggest that fat distribution in each body region affects various metabolic abnormalities. A high level of arm fat mass in obese Korean women may increase metabolic risk. In addition, eating habits of obese Korean women are considered to be environmental factors affecting the metabolic phenotype of obese Korean women.

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.

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.

Research progress in measurement of human basal metabolic rate / 中南大学学报(医学版)

Basal metabolic rate (BMR) is of great significance to the setting of daily energy requirements and the scientific diet guidance for the population. There are 3 kinds of measurement methods for BMR, including the direct calorimetry, the indirect calorimetry, and the equation estimation. The direct calorimetry method is difficult to implement and is only used in some special populations. The indirect calorimetry and the equation estimation are two methods that are currently used commonly. The indirect calorimetry is highly accurate and suitable for individual for basal metabolic measurement or datum collection via equation estimation. The equation estimation is simple and convenient, which is suitable for large samples.

Validity of predictive equations for resting energy expenditure in Korean non-obese adults

BACKGROUND/OBJECTIVES: Indirect calorimetry is the gold-standard method for the measurement of resting energy expenditure. However, this method is time consuming, expensive, and requires highly trained personnel. To overcome these limitations, various predictive equations have been developed. The objective of this study was to assess the validity of predictive equations for resting energy expenditure (REE) in Korean non-obese adults. SUBJECTS/METHODS: The present study involved 109 participants (54 men and 55 women) aged between 20 and 64 years. The REE was measured by indirect calorimetry. Nineteen REE equations were evaluated for validity, by comparing predicted and measured REE results. Predictive equation accuracy was assessed by determining percent bias, root mean squared prediction error (RMSE), and percentage of accurate predictions. RESULTS: The measured REE was significantly higher in men than in women (P 0.05). The equation developed in this study had an accuracy rate of 71%, a bias of 0%, and an RMSE of 155 kcal/day. Among published equations, the FAO(weight) equation gave the highest accuracy rate (70%), along with a bias of −4.4% and an RMSE of 184 kcal/day. CONCLUSIONS: The newly developed equation provided the best accuracy in predicting REE for Korean non-obese adults. Among the previously published equations, the FAO(weight) equation showed the highest overall accuracy. Regardless, at an individual level, the equations could lead to inaccuracies in a considerable number of subjects.

Comparison of 3 Nutritional Questionnaires to Determine Energy Intake Accuracy in Iranian Adults

A precision instrument is required to assess the nutritional status. This study was conducted on comparison of 3 nutritional questionnaires to determine energy intake (EI) accuracy in adults in Ravansar Non-Communicable Chronic Disease (RaNCD) cohort study. This cross-sectional study was conducted on 118 of participant's RaNCD. EI was evaluated with 3 questionnaires including food frequency questionnaire (FFQ), 24-hours recall (24HR), and food habits questionnaire (FHQ). Resting metabolic rate (RMR) was measured using indirect calorimetry. We used EI/RMR cut off to evaluate EI reporting status. The mean ± standard deviation of age in men and women were 44.1 ± 6.5 and 43.7 ± 5.25 respectively and 50.8% of participants were men. Among 3 EI estimating questionnaires, FFQ was more accurate than 2 other questionnaires (67.8%). We observed that implausible reporters of 24HR were likely overweight (p < 0.005) but we did not observe a significant difference between EI reporting of FFQ and FHQ with participants' body composition. Our finding showed that EI underreporting of 24HR and FHQ were high. Under reporters were seemed to be overweight. Therefore, these results suggested that among 3 nutritional questionnaires the FFQ was an appropriate approach to determine EI in this population due to plausible EI reporting was higher than 2 other nutritional questionnaires (24HR and FHQ).

Energy Requirements in Critically Ill Patients

During the management of critical illness, optimal nutritional support is an important key for achieving positive clinical outcomes. Compared to healthy people, critically ill patients have higher energy expenditure, thereby their energy requirements and risk of malnutrition being increased. Assessing individual nutritional requirement is essential for a successful nutritional support, including the adequate energy supply. Methods to assess energy requirements include indirect calorimetry (IC) which is considered as a reference method, and the predictive equations which are commonly used due to the difficulty of using IC in certain conditions. In this study, a literature review was conducted on the energy metabolic changes in critically ill patients, and the implications for the estimation of energy requirements in this population. In addition, the issue of optimal caloric goal during nutrition support is discussed, as well as the accuracy of selected resting energy expenditure predictive equations, commonly used in critically ill patients.

Comparison of the Harris-Benedict Equation, Bioelectrical Impedance Analysis, and Indirect Calorimetry for Measurement of Basal Metabolic Rate among adult obese Filipino patients with prediabetes or Type 2 Diabetes Mellitus / Journal of the ASEAN Federation of Endocrine Societies

Objectives@#To compare mean basal metabolic rate (BMR) estimated using Harris-Benedict equation (HB) and Bioelectrical Impedance Analysis (BIA) and the BMR measured using Indirect Calorimetry (IC) among adult obese Filipino patients with prediabetes or type 2 diabetes mellitus (T2DM).@*Methodology@#This was a multi-center, cross-sectional study based on review of outpatient medical records of adult, obese Filipino patients with pre-diabetes or type 2 diabetes mellitus who were seen prior to weight loss intervention at the Outpatient Clinic of St. Luke’s Medical Center-Quezon City and the Metabolic and Diabetes Center of Providence Hospital from August 2017 to January 2018. BMR was derived using three methods: Harris-Benedict equation, Bioelectrical Impedance Analysis and Indirect Calorimetry.@*Results@#A total of 153 subjects were included in the study. Eighty subjects (52%) have pre-diabetes while 73 subjects (48%) were diagnosed with T2DM. The mean BMR measured using IC is 1299±252 kcal/day while estimated mean BMR predicted using HB equation and BIA were 1628±251 kcal/day and 1635±260 kcal/day, respectively. Compared to measurement by IC, HBE and BIA significantly overestimated the mean BMR by 329 and 336 kcal/day, respectively (p-value=<0.0001). IC measured BMR showed strong positive correlation with weight and moderate positive correlation with height. Multiple stepwise regression analysis yielded the BMR prediction equation: BMR (kcal/day) = -780.806 + (11.108 x weight in kg) + (7.164 x height in cm).@*Conclusion@#Among obese Filipinos with T2DM or prediabetes, HB equation and BIA tend to overestimate the BMR measured using IC.

Walking economy and aerobic power in Parkinson's disease after endurance exercise training: A pilot study / Economia de caminhada e potência aeróbia na doença de parkinson após programa de treinamento de endurance: um estudo piloto

OBJECTIVE: To verify the effect of an endurance exercise program in middle stages of Parkinson's disease. METHODS: The patients were two women and seven men with Parkinson's disease, aged 56 to 74 years, classified at Hoehn and Yahr stages 2 to 2.5. The study was designed as an open long-term pilot trial over three months of supervised treadmill exercise training. Cardiopulmonary exercise test evaluations were performed before the start of the study (test 1) and after three months (test 2). The main outcome measure was walking economy (i.e., the rate of oxygen consumption during gait) measured between VT1 and VT2 speeds and Oxygen consumption (VO2). RESULTS: No changes (p=0.551) were observed for maximal oxygen uptake (VO2max, 24.6 vs 23.6 mL.kg-1.min-1) between tests. The walking economy was 20% better (p<0.001) after three months of aerobic endurance training (266.7 vs 212.6 mL.kg-1.km-1, pre- vs. post-training); the Cohen's "d" effect size (ES) was 0.99, a very large effect. CONCLUSION: Evidence from this pilot study in individuals with Parkinson's disease suggests that gains in walking economy occurs with a treadmill-training program without gain in aerobic power, but which may positively reduce the energy expenditure of activities of daily living in these patients.

OBJETIVO: Verificar o efeito de um programa de treinamento físico aeróbio em estágios intermediários da doença de Parkinson (PD). MÉTODOS: Os pacientes eram duas mulheres e sete homens com PD, com idade entre 56 e 74 anos, classificados como estágios Hoehn e Yahr 2 a 2,5. O estudo foi concebido como um ensaio piloto aberto de longo prazo durante três meses de treinamento supervisionado e realizado em esteira ergométrica. As avaliações da troca gasosa pelo teste de exercício cardiopulmonar foram realizadas antes do início do estudo (teste 1) e após três meses (teste 2). A determinação da economia de caminhada (taxa de consumo de oxigênio durante a marcha) foi medida entre as velocidades do primeiro e do segundo limiar (LV1 e LV2) e do consumo de oxigênio (VO2) entre as duas velocidades por interpolação. RESULTADOS: Não foram observadas alterações (P = 0,153) para o consumo máximo de oxigênio (VO2max: 26,7 vs. 24,2 mL.kg-1.min-1) após o período de intervenção. A economia de caminhada foi 23% maior (P <0,001) após três meses de treinamento físico aeróbio (273,4 vs. 209,4 mL.kg-1.km-1, ES = 0.99, muito alto). CONCLUSÃO: Evidências deste estudo piloto em indivíduos com DP sugerem que os ganhos na economia de caminhada podem ocorrer com um programa de treinamento de "endurance" aeróbica na esteira sem ganho na potência aeróbia, mas que positivamente pode reduzir o gasto de energia das atividades da vida diária nesses pacientes.

Comparison between resting metabolic rate and indirect calorimetry in postmenopausal women / Comparação de equações preditivas de taxa metabólica de repouso com calorimetria indireta em mulheres pós-menopáusicas

ABSTRACT Objective To compare resting metabolic rate values determined by indirect calorimetry with values estimated using different predictive equations in lean and overweight postmenopausal women. Methods Twenty-four women, who had stopped menstruating for at least two years, were subjected to anthropometric measurements and indirect calorimetry after 12-hour overnight fasting to determine, mathematically and experimentally, resting metabolic rate values. Results There was no difference in the indirect calorimetry values between the groups evaluated. Difference values of resting metabolic rate were obtained with all equations used. For the lean women, there was no difference between the values obtained by indirect calorimetry and those estimated using the equations proposed by Food and Agricultural Organization, Fredix, Lazzer, and Schofield. However, in the overweight group, the resting metabolic rate values estimated using the Institute of Medicine, Berstein and Owen equations were different from those obtained by indirect calorimetry. Conclusion This study suggests that differences in body composition in postmenopausal women influence the accuracy of predictive equations, demonstrating the need for more accurate estimation methods for resting metabolic rate in postmenopausal women with different body compositions.

RESUMO Objetivo Comparar os valores de taxa metabólica de repouso determinados por calorimetria indireta com os valores obtidos utilizando diferentes equações preditivas em mulheres pós-menopausicas eutróficas e com sobrepeso. Métodos Vinte e quatro mulheres com pelo menos dois anos de menopausa foram submetidas à avaliações antropométricas e à calorimetria indireta após 12 horas de jejum para determinar, matematicamente e experimentalmente, a taxa metabólica de repouso. Resultados Os valores para calorimetria indireta não diferiram entre os grupos e a taxa metabólica de repouso predita por equações foi diferente para todas as equações usadas. Para o grupo de eutróficas, as equações que não foram estatisticamente diferentes da calorimetria indireta foram Food and Agricultural Organization, Fredix, Lazzer e Schofield. No entanto, apenas as equações Berstein e Owen foram significativamente diferentes comparadas com calorimetria indireta para o grupo sobrepeso. Conclusão O presente estudo sugere que diferenças na composição corporal em mulheres na pós-menopausa modificam a precisão de equações que predizem a taxa metabólica de repouso, demonstrando a necessidade de aprimorar métodos de estimação de taxa metabólica de repouso em mulheres pós-menopáusicas com diferentes composições corporais.

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.

Energy expenditure of physical activity in Korean adults and assessment of accelerometer accuracy by gender / 한국영양학회지

PURPOSE: The purpose of this study was to measure energy expenditure (EE) the metabolic equivalents (METs) of 13 common physical activities by using a portable telemetry gas exchange system (K4b2) and to assess the accuracy of the accelerometer (Actigraph GT3X+) by gender in Korean adults. METHODS: A total of 109 adults (54 males, 55 females) with normal BMI (body mass index) participated in this study. EE and METs of 13 selected activities were simultaneously measured by the K4b2 portable indirect calorimeter and predicted by the GT3X+ Actigraph accelerometer. The accuracy of the accelerometer was assessed by comparing the predicted with the measured EE and METs. RESULTS: EE (kcal/kg/hr) and METs of treadmill walking (3.2 km/h, 4.8 km/h and 5.6 km/h) and running (6.4 km/h) were significantly higher in female than in male participants (p < 0.05). On the other hand, the accelerometer significantly underestimated the EE and METs for all activities except descending stairs, moderate walking, and fast walking in males as well as descending stairs in females. Low intensity activities had the highest rate of accurate classifications (88.3% in males and 91.3% females), whereas vigorous intensity activities had the lowest rate of accurate classifications (43.6% in males and 27.7% in females). Across all activities, the rate of accurate classification was significantly higher in males than in females (75.2% and 58.3% respectively, p < 0.01). Error between the accelerometer and K4b2 was smaller in males than in females, and EE and METs were more accurately estimated during treadmill activities than other activities in both males and females. CONCLUSION: The accelerometer underestimated EE and METs across various activities in Korean adults. In addition, there appears to be a gender difference in the rate of accurate accelerometer classification of activities according to intensity. Our results indicate the need to develop new accelerometer equations for this population, and gender differences should be considered.