Measurement of the Thermic Effect of Food in a Chinese Mixed Diet in Young People.

Objective: To determine the thermic effect of food (TEF) in a Chinese mixed diet in young people. Methods: During the study, the participants were weighed and examined for body composition every morning. The total energy expenditure (TEE) of the participants was measured by the doubly labeled water method for 7 days, and during this period, basal energy expenditure was measured by indirect calorimetry and physical activity energy expenditure was measured by an accelerometer. The value obtained by subtracting basal energy expenditure and physical activity energy expenditure from TEE was used to calculate TEF. Results: Twenty healthy young students (18-30 years; 10 male) participated in the study. The energy intake of the participants was not significantly different from the Chinese Dietary Reference Intake of energy ( P > 0.05). The percentage of energy from protein, fat and carbohydrate were all in the normal range. The intakes of fruits, milk and dietary fiber of the participants were significantly lower than those in the Chinese Dietary Guidelines ( P < 0.05). There was no significant difference in the body weight of the participants during the experiment ( P > 0.05). When adjusted for body weight, there was no significant difference in either TEE or basal energy expenditure between the male and female participants ( P > 0.05). In addition, there was no significant difference in physical activity energy expenditure and TEF between the male and female participants ( P > 0.05). The percentage of TEF in TEE was 8.73%. Conclusion: The percentage of TEF in TEE in a Chinese mixed diet in young people was significantly lower than 10% ( P < 0.001). A value of 10% is usually considered to be the TEF in mixed diets as a percentage of TEE.

Measurement of the Thermic Effect of Food in a Chinese Mixed Diet in Young People / 生物医学与环境科学（英文）

OBJECTIVE@#To determine the thermic effect of food (TEF) in a Chinese mixed diet in young people.@*METHODS@#During the study, the participants were weighed and examined for body composition every morning. The total energy expenditure (TEE) of the participants was measured by the doubly labeled water method for 7 days, and during this period, basal energy expenditure was measured by indirect calorimetry and physical activity energy expenditure was measured by an accelerometer. The value obtained by subtracting basal energy expenditure and physical activity energy expenditure from TEE was used to calculate TEF.@*RESULTS@#Twenty healthy young students (18-30 years; 10 male) participated in the study. The energy intake of the participants was not significantly different from the Chinese Dietary Reference Intake of energy ( P > 0.05). The percentage of energy from protein, fat and carbohydrate were all in the normal range. The intakes of fruits, milk and dietary fiber of the participants were significantly lower than those in the Chinese Dietary Guidelines ( P < 0.05). There was no significant difference in the body weight of the participants during the experiment ( P > 0.05). When adjusted for body weight, there was no significant difference in either TEE or basal energy expenditure between the male and female participants ( P > 0.05). In addition, there was no significant difference in physical activity energy expenditure and TEF between the male and female participants ( P > 0.05). The percentage of TEF in TEE was 8.73%.@*CONCLUSION@#The percentage of TEF in TEE in a Chinese mixed diet in young people was significantly lower than 10% ( P < 0.001). A value of 10% is usually considered to be the TEF in mixed diets as a percentage of TEE.

Estado nutricional y gasto energético basal de pacientes chilenos con síndrome de down / Nutritional status and basal energy expenditure of chilean patients with down syndrome

Introducción: se ha reportado una alta prevalencia de malnutrición por exceso en pacientes con Síndrome de Down (SD), tanto en niños, como en adolescentes y adultos. Evaluar correctamente el gasto energético basal (GEB) en estos pacientes, es un aspecto crítico del control de peso, que ha sido escasamente explorado. Objetivo: evaluar el estado nutricional y el GEB mediante calorimetría indirecta y dos ecuaciones predictivas, en pacientes con SD de Concepción, Chile. Materiales y método: estudio descriptivo y transversal en 6 pacientes con SD: 2 niños y 4 mujeres adultas. Se midieron el peso y la talla y se calcularon el índice peso/edad (niños) y el índice de masa corporal (adultos). La determinación del GEB, se realizó mediante calorimetría indirecta y utilizando dos ecuaciones predictivas: Harris & Benedict y FAO/OMS (1985). Los resultados se expresaron como medianas y rangos, y la comparación de los valores del GEB, se realizó a través de la prueba de Wilcoxon (α= 0,05). Resultados: se encontró que el 50% de los pacientes presentó sobrepeso. No se encontraron diferencias estadísticamente significativas entre el GEB calculado por las ecuaciones predictivas, y el obtenido por calorimetría indirecta. Conclusión: en el grupo de pacientes con SD evaluados, se podría estimar la GEB a través de las ecuaciones predictivas (Harris & Benedict y FAO/OMS, 1985), dada su concordancia con los valores obtenidos por calorimetría indirecta, lo que puede ser muy útil en la práctica clínica, permitiendo la elaboración de planes de alimentación adecuados para estos pacientes(AU)

Introduction: a high prevalence of malnutrition due to overweight and obesity has been reported in patients with Down Syndrome (DS), in children, adolescents and adults. A correct evaluation of the basal energy expenditure (BEE) in these patients is a critical aspect of weight control; however, this aspect has not been thoroughly studied. Objective: to evaluate the nutritional status and BEE using indirect calorimetry and two predictive equations in patients with DS from Concepción, Chile. Materials and methods: a descriptive and cross-sectional study was carried out in 6 patients with DS: 2 boys and 4 adult women. Weight and height were measured, and the weight/age index (children) and the body mass index (adults) were calculated. The determination of the BEE was carried out by indirect calorimetry and using two predictive equations: Harris & Benedict and FAO/WHO (1985). The results were expressed as means, standard deviations, medians and ranges, and the comparison of the BEE values was performed using the Wilcoxon test (α = 0.05). Results: 50% of the patients were overweight. No statistically significant differences were found between the BEE calculated by the predictive equations, and that obtained by indirect calorimetry. Conclusion: In the group of patients with DS evaluated, BEE could be estimated through the predictive equations (Harris & Benedict and FAO/ WHO, 1985), given its agreement with the values obtained by indirect calorimetry, which can be very useful in clinical practice, allowing the elaboration of adequate feeding plans for these patients(AU)

Thyroid Function and Obesity: From Mechanisms to the Benefits of Levothyroxine in Obese Patients.

BACKGROUND: Thyroid disease and obesity are widespread clinical conditions in the population. They can occur together in the same subject, but their relationship does not seem exclusively stochastic. AIM: Literature was critically reviewed to explain the association between thyroid disease and obesity and to understand the possible benefits of levothyroxine therapy in euthyroid obese patients. RESULTS: A low energy expenditure rate can lead to obesity. Maintaining Basal Metabolic Rate (BMR) is the leading cause of energy expenditure in the body, which is regulated by thermogenesis. Thyroid hormone receptors (TR) play different roles in the induction of thermogenetic mechanisms; TRα is fundamental to induce thermogenesis, and TRß triggers the expression of uncoupling protein 1(UCP1). Despite such mechanisms, there is no current evidence related to the treatment of subjects suffering from obesity with thyroid hormones. CONCLUSION: Replacement therapy should be reserved only for patients with clear signs of subclinical or clinical hypothyroidism. DEFINITIONS: Basal metabolic rate (BMR) or basal energy expenditure (BEE): measurement obtained under total inactivity and controlled research conditions; resting energy expenditure (REE): measurement obtained when an individual is sitting quietly (is mildly higher than BMR/BEE).

Basal Energy Expenditure of Chinese Healthy Adults: Comparison of Measured and Predicted Values.

OBJECTIVE: This study aimed to measure the basal energy expenditure (BEE) of Chinese healthy adults and establish an accurate predictive equation for this population. METHODS: In total, 470 Chinese healthy adults had their BEE measured using the Cosmed K4b 2 portable metabolic system. Multiple linear regression analysis was applied to develop new optimal equations for predicting BEE. The bias, accuracy rate, concordance correlation coefficient (CCC), and root mean square error (RMSE) were used to evaluate the accuracy of the predictive equations. RESULTS: There was a significant difference in BEE between males and females, with 5,954 kJ/d and 5,089 kJ/d, respectively. People living in rural areas expended significantly higher BEE (5,885 kJ/d) than those in urban areas (5,279 kJ/d). Previous equations developed by Henry, Schofield, Harris-Benedict (H-B), and Liu overestimated the BEE of Chinese healthy adults. The new equations derived from the present study displayed the smallest average bias and RMSE from the measured basal energy expenditure (mBEE). The CCC of the new equations was higher than other predictive equations, but it was lower than 0.8. There was no significant difference in the accuracy rate among all predictive equations. CONCLUSIONS: Sex and regional differences in BEE were observed in Chinese healthy adults. Neither the widely used previous predictive equations nor the one derived in the present study were accurate enough for estimating the BEE of Chinese healthy adults. Further study is required to develop more accurate equations for predicting the BEE of Chinese healthy adults aged between 20-45 years.

Basal Energy Expenditure of Chinese Healthy Adults: Comparison of Measured and Predicted Values / 生物医学与环境科学（英文）

Objective@#This study aimed to measure the basal energy expenditure (BEE) of Chinese healthy adults and establish an accurate predictive equation for this population.@*Methods@#In total, 470 Chinese healthy adults had their BEE measured using the Cosmed K4b portable metabolic system. Multiple linear regression analysis was applied to develop new optimal equations for predicting BEE. The bias, accuracy rate, concordance correlation coefficient (CCC), and root mean square error (RMSE) were used to evaluate the accuracy of the predictive equations.@*Results@#There was a significant difference in BEE between males and females, with 5,954 kJ/d and 5,089 kJ/d, respectively. People living in rural areas expended significantly higher BEE (5,885 kJ/d) than those in urban areas (5,279 kJ/d). Previous equations developed by Henry, Schofield, Harris-Benedict (H-B), and Liu overestimated the BEE of Chinese healthy adults. The new equations derived from the present study displayed the smallest average bias and RMSE from the measured basal energy expenditure (mBEE). The CCC of the new equations was higher than other predictive equations, but it was lower than 0.8. There was no significant difference in the accuracy rate among all predictive equations.@*Conclusions@#Sex and regional differences in BEE were observed in Chinese healthy adults. Neither the widely used previous predictive equations nor the one derived in the present study were accurate enough for estimating the BEE of Chinese healthy adults. Further study is required to develop more accurate equations for predicting the BEE of Chinese healthy adults aged between 20-45 years.

Correlation between basal metabolic rate, visceral fat and insulin resistance among type 2 diabetes mellitus with peripheral neuropathy.

BACKGROUND: Basal Metabolic Rate (BMR) means the amount of energy utilized by body in physical and psychological resting rate, after a night sleep, awake without any previous physical activity post meal (10 h after last meal) & neutral environment. In people with type 2 diabetes mellitus (T2DM) there is an increase in BMR which is said to be associated with the level of glycaemic control. So, the objective of the study was to find out the correlation between BMR, Insulin resistance and Visceral fat in T2DM with peripheral neuropathy. MATERIALS & METHODS: A total of 50 participants with T2DM with peripheral neuropathy were included. Age group of 30-75 years were selected for the study. Participants with a known history of neurological disease, locomotor disability, and pregnancy were excluded from the study. Demographic details of the participants like duration of diabetes mellitus, age, Fasting Blood Glucose, Fasting Insulin, HOMA-IR, Glycated Haemoglobin (HBA1c), Neuropathy and Blood pressure values were noted. We measured Basal Metabolic Rate (BMR) by using Mifflin-St Jeor predictive equation in T2DM with peripheral neuropathy. RESULTS: The mean age of the participants is 60.16 ± 10.62. The mean duration of T2DM 13.44 ± 11.92. In the present study we found a statistical significant correlation between BMR and HOMA IR (r = 0.913*; p = 0.000), BMR & Fasting blood sugar (FBS) (r = 0.281*; p = 0.048), BMR and Visceral fat (VF) (r = 0.332*; p = 0.018). CONCLUSION: Basal metabolic rate is correlated to Homa-IR, visceral fat, fasting blood sugar and musculoskeletal mass among T2DM with peripheral neuropathy.

Estimating basal energy expenditure in liver transplant recipients: the value of the harris-benedict equation / Importância da equação de harris-benedict na estimativa do metabolismo basal em pacientes transplantados de fígado

ABSTRACT Background: Reliable measurement of basal energy expenditure (BEE) in liver transplant (LT) recipients is necessary for adapting energy requirements, improving nutritional status and preventing weight gain. Indirect calorimetry (IC) is the gold standard for measuring BEE. However, BEE may be estimated through alternative methods, including electrical bioimpedance (BI), Harris-Benedict Equation (HBE), and Mifflin-St. Jeor Equation (MSJ) that carry easier applicability and lower cost. Aim: To determine which of the three alternative methods for BEE estimation (HBE, BI and MSJ) would provide most reliable BEE estimation in LT recipients. Methods: Prospective cross-sectional study including dyslipidemic LT recipients in follow-up at a 735-bed tertiary referral university hospital. Comparisons of BEE measured through IC to BEE estimated through each of the three alternative methods (HBE, BI and MSJ) were performed using Bland-Altman method and Wilcoxon Rank Sum test. Results: Forty-five patients were included, aged 58±10 years. BEE measured using IC was 1664±319 kcal for males, and 1409±221 kcal for females. Average difference between BEE measured by IC (1534±300 kcal) and BI (1584±377 kcal) was +50 kcal (p=0.0384). Average difference between the BEE measured using IC (1534±300 kcal) and MSJ (1479.6±375 kcal) was -55 kcal (p=0.16). Average difference between BEE values measured by IC (1534±300 kcal) and HBE (1521±283 kcal) was -13 kcal (p=0.326). Difference between BEE estimated through IC and HBE was less than 100 kcal for 39 of all 43patients. Conclusions: Among the three alternative methods, HBE was the most reliable for estimating BEE in LT recipients.

RESUMO Racional: Estimativa confiável do metabolismo basal em pacientes transplantados de fígado é necessária para adaptar os requerimentos energéticos, melhorar o estado nutricional e prevenir ganho de peso. Calorimetria indireta (CI) é o padrão-ouro para a medição do metabolismo basal. No entanto, ele pode ser estimado utilizando-se métodos alternativos, incluindo a bioimpedância (BI), a Equação de Harris-Benedict (EHB), e também a Equação de Mifflin-St. Jeor (MSJ). Esses métodos alternativos possuem aplicabilidade mais fácil e custo inferior quando comparados à CI. Objetivo: Determinar qual dos três métodos alternativos para a estimativa do metabolismo basal (EHB, BI e MSJ) seria o mais confiável em pacientes transplantados de fígado. Métodos: Foi realizado estudo transversal prospectivo incluindo pacientes transplantados de fígado com dislipidemia, em acompanhamento ambulatorial. Comparações dos valores calculados de metabolismo basal via CI aos valores estimados por cada um dos três métodos alternativos (EHB, BI e MSJ) foram realizadas utilizando o de Bland-Altman e o teste de Wilcoxon-Mann-Whitney. Resultados: Quarenta e cinco pacientes foram incluídos com idade 58±10 anos. O metabolismo basal medido via CI foi 1664±319 kcal para pacientes do gênero masculino, e 1409±221 kcal para o feminino. A diferença média entre a taxa de metabolismo basal aferida por CI (1534±300 kcal) e estimada por BI (1584±377 kcal) foi +50 kcal (p=0.0384). A diferença média entre a taxa de metabolismo basal aferida via CI (1534±300 kcal) e estimada por MSJ (1479.6±375 kcal) foi -55 kcal (p=0.16). A diferença média entre os valores de taxa de metabolismo basal medidos via CI (1534±300 kcal) e estimados por EHB (1521±283 kcal) foi -13 kcal (p=0.326). Além disso, a diferença entre a taxa de metabolismo basal estimada via CI e a aferida por EHB foi menor que 100 kcal para 39 de todos os 43 pacientes avaliados. Conclusões: A EHB foi o mais confiável dos três métodos de estimativa da taxa de metabolismo basal em pacientes transplantados de fígado em acompanhamento ambulatorial.

Fat-free mass and calf circumference as body composition indices to determine non-exercise activity thermogenesis in patients with diabetes.

AIMS/INTRODUCTION: To investigate the clinical and anthropometrical parameters that are associated with non-exercise activity thermogenesis that is composed of basal energy expenditure (BEE) and diet-induced thermogenesis (DIT) in patients with diabetes. MATERIALS AND METHODS: Body composition was assessed using bioelectrical impedance, and BEE and DIT were measured using indirect calorimetry in 40 Japanese patients with diabetes. RESULTS: BEE correlated positively with bodyweight, body mass index, fat mass, and fat-free mass, and correlated negatively with age in both men and women. In multivariate logistic regression analysis, BEE correlated positively with both fat mass and fat-free mass independently of sex and age. In addition, DIT correlated positively with bodyweight, body mass index, fat mass and fat-free mass, and correlated negatively with age in women, but not men. Fat-free mass contributed to DIT at least partly, and an aging-related decrease in DIT was observed. The best anthropometric parameter that reflected fat mass and fat-free mass was hip circumference (HC) and calf circumference (CC), respectively, in both men and women. Indeed, both HC (men ß = 0.600, P < 0.001; women ß = 0.752, P < 0.001) and CC (men ß = 0.810, P = 0.012; women ß = 0.821, P = 0.002) were correlated with BEE independently of age and sex. In addition, CC (ß = 0.653, P = 0.009), but not HC was correlated with DIT significantly only in females, independently of age. CONCLUSIONS: HC reflects fat mass and was positively associated with BEE, but not with DIT. In contrast, CC reflects fat-free mass, and was positively associated with BEE in both men and women, and with DIT in women.

Nutritional status evaluation in patients affected by bethlem myopathy and ullrich congenital muscular dystrophy.

Collagen VI mutations lead to disabling myopathies like Bethlem myopathy (BM) and Ullrich congenital muscular dystrophy (UCMD). We have investigated the nutritional and metabolic status of one UCMD and seven BM patients (five female, three male, mean age 31 ± 9 years) in order to find a potential metabolic target for nutritional intervention. For this study, we used standard anthropometric tools, such as BMI evaluation and body circumference measurements. All results were compared to dual-energy X-ray absorptiometry (DXA), considered the "gold standard" method. Energy intake of each patient was evaluated through longitudinal methods (7-day food diary) while resting energy expenditure (REE) was predicted using specific equations and measured by indirect calorimetry. Clinical evaluation included general and nutritional blood and urine laboratory analyses and quantitative muscle strength measurement by hand-held dynamometry. BM and UCMD patients showed an altered body composition, characterized by low free fat mass (FFM) and high fat mass (FM), allowing us to classify them as sarcopenic, and all but one as sarcopenic-obese. Another main result was the negative correlation between REE/FFM ratio (basal energy expenditure per kilograms of fat-free mass) and the severity of the disease, as defined by the muscle megascore (correlation coefficient -0.955, P-value <0.001). We postulate that the increase of the REE/FFM ratio in relation to the severity of the disease may be due to an altered and pathophysiological loss of energetic efficiency at the expense of skeletal muscle. We show that a specific metabolic disequilibrium is related to the severity of the disease, which may represent a target for a nutritional intervention in these patients.

200 practising medical students Basal Energy Expenditure / 肠外与肠内营养

Objects: To measure practicing medical students' basal energy expenditure(BEE). Methods: 200 practising medical students were chosen to measure BEE by standard method of CCM metabolism cart,and the BEE results were compared with forecast values from the calculation formula of healthy adult. Results: Actual BEE of male students was(4 920.4?1 343.1)kJ/d,female(3 393.2?824.2)kJ/d.The results were significantly lower than corresponding forecast values.Conclusion: The BEE of practising medical students is lower than forecast values from the calculation formula of healthy adult,showing that students' constitution was poorer.The possible reasons may be less exercise and diet.