Underestimation of resting metabolic rate using equations compared to indirect calorimetry in normal-weight subjects: Consideration of resting metabolic rate as a function of body composition

Predictive equations in determining resting energy expenditure in patients with head and neck cancer receiving home enteral nutrition

OBJECTIVE

It is important to cover energy targets among patients with head and neck cancer (HNC) to minimize weight and skeletal muscles loss. This study aimed to assess the agreement between indirect calorimetry (IC) and predictive equations for determining resting energy expenditures (REE) in HNC patients receiving home enteral nutrition (HEN).

RESEARCH METHODS AND PROCEDURES

Patients included in the study had to be diagnosed with HNC, be adults, have artificial access to the digestive tract, and participate in HEN. All measurements were conducted in the morning after prior patient preparation. Body weight and height were measured using a scale with an integrated height meter. A phase-sensitive, single-frequency bioimpedance analyzer was utilized to conduct bioelectrical impedance analysis. REE was measured using IC with a canopy hood and calculated using 27 different equations. Differences between variables were analyzed using appropriate t-tests and their nonparametric counterparts. The Bland-Altman test was used to assess the types of differences between measured REE (mREE) and predicted REE (pREE).

RESULTS

The examined patients (n = 71, 73.2% male) had a mean age of 63.99 ± 11.42 years and a BMI of 22.84 ± 3.59 kg/m2. The most common diagnosis was malignant tongue cancer. Most patients had stage III cancer. Treatment included surgery combined with radiotherapy or only chemoradiotherapy in most cases. The median duration of treatment and HEN was 206 days and 97 days, respectively. Men had a significantly higher REE than women. The Owen, Fredrix, Ireton-Jones, Korth, Weijs-Kruizenga, and Marraw,h equations estimated REE without significant statistical differences from IC and showed the smallest percentage error between pREE and mREE. The Korth equation had the smallest average mean difference between pREE and mREE, reducing the REE value average by 7 ± 274 kcal/day. The highest percentage of individual accurate predictions for pREE was obtained with the Fredrix (48%), Weijs-Kruizenga (48%), Korth (45%), and MarraPhA (45%) equations.

CONCLUSION(S)

The predictive equations examined in this study cannot replace IC for determining REE in HNC patients at the individual level. When equations are used, special attention should be given to planning HEN to account for possible discrepancies between pREE and mREE.

Validation of predictive equations to estimate resting metabolic rate of females and males across different activity levels

OBJECTIVES

Using equations to predict resting metabolic rate (RMR) has yielded different degrees of validity, particularly when sex and different physical activity levels were considered. Therefore, the purpose of the present study was to determine the validity of several different predictive equations to estimate RMR in female and male adults with varying physical activity levels.

METHOD

We measured the RMR of 50 adults (26 females and 24 males) evenly distributed through activity levels varying from sedentary to ultra-endurance. Body composition was measured by dual X-ray absorptiometry and physical activity was monitored by accelerometry. Ten equations to predict RMR were applied (using Body Mass [BM]: Harris & Benedict, 1919; Mifflin et al., 1990 [MifflinBM]; Pontzer et al., 2021 [PontzerBM]; Schofield, 1985; FAO/WHO/UNU, 2004; and using Fat-Free Mass (FFM): Cunningham, 1991; Johnstone et al., 2006; Mifflin et al., 1990 [MifflinFFM]; Nelson et al. 1992; Pontzer et al., 2021 [PontzerFFM]). The accuracy of these equations was analyzed, and the effect of sex and physical activity was evaluated using different accuracy metrics.

RESULTS

Equations using BM were less accurate for females, and their accuracy was influenced by physical activity and body composition. FFM equations were slightly less accurate for males but there was no obvious effect of physical activity or other sample parameters. PontzerFFM provides higher accuracy than other models independent of the magnitude of RMR, sex, activity levels, and sample characteristics.

CONCLUSION

Equations using FFM were more accurate than BM equations in our sample. Future studies are needed to test the accuracy of RMR prediction equations in diverse samples.

Basal metabolic rate using indirect calorimetry among individuals living with overweight or obesity: The accuracy of predictive equations for basal metabolic rate

BACKGROUND & AIMS

Weight reduction programs in people with overweight or obesity can be informed by indirect calorimetry (IC) which is the gold standard to measure basal metabolic rate (BMR). Since IC is labor intensive and expensive, predictive equations are often used as an alternative. In this study the accuracy rate was assessed and bias statistics of predictive equations were compared to IC among subjects with overweight or obesity. Secondly, differences in clinical features between individuals with over-, accurate or underestimation of their BMR were evaluated.

METHODS

This cross sectional study included 731 subjects from the outpatient obesity clinic of the Antwerp University Hospital, Belgium. Fourteen equations were evaluated. Overestimation and underestimation was defined as >10 % and <10 % of measured BMR.

RESULTS

In the total population, mean age was 43 ± 13 years, mean BMI 35.6 ± 5.8 kg/m2 and 79.5 % were female. The highest accuracy rates were reached by the Henry (73 %), Ravussin (73 %) and Mifflin St. Jeor (73 %) equations. In the total population, the Mifflin St. Jeor and Henry equation were unbiased. The Akern, Livingston and Ravussin equations were biased to underestimation. All other equations were biased to overestimation. Subjects with an underestimation of BMR had significantly higher waist-hip ratio (1.02 ± 0.13 vs 0.91 ± 0.11; P < 0.001), higher visceral adipose tissue (239 ± 96 vs 162 ± 93; P < 0.001), lower fat free mass (kg) (67.6 (45.4-95.9) vs 54.0 (39.6-95.5); P < 0.001) and a higher prevalence of the Metabolic Syndrome (24 (77.4) vs 112 (37.5); P < 0.001). Individuals with an overestimation of BMR had significantly higher subcutaneous adipose tissue (545 ± 149 vs 612 ± 149; P < 0.05), lower fasting plasma insulin (81 (10-2019) vs 67 (27-253); P < 0.001) and lower 2-h plasma glucose (132 (30-430) vs 116 (43-193); P < 0.001) during OGTT.

CONCLUSIONS

In this study, the Henry and Mifflin St. Jeor equations have the highest accuracy and lowest bias to estimate the basal metabolic rate in a Caucasian, predominantly female, population living with overweight or obesity. Visceral and subcutaneous adipose tissue and presence of metabolic syndrome were significantly different in individuals with over- or underestimation of BMR.

Effects of pre-sleep protein supplementation on plasma markers of muscle damage and inflammatory cytokines resulting from sprint interval training in trained swimmers

BACKGROUND

Pre-sleep protein has been shown to improve muscle recovery overnight following exercise-induced muscle damage. Whether such an approach affects recovery from sprint interval training (SIT) has yet to be elucidated. This study examined the effects of protein supplementation every night before sleep on early (45 min post-SIT) and late (24 and 48 h after SIT) responses of creatine kinase (CK) and inflammatory cytokines, including interleukin-6 and 10 (IL-6 and IL-10) and tumor necrosis factor-alpha (TNFα).

METHODS

Twenty trained swimmers underwent a 2-week in-water swimming SIT (two sets of 12 × 50-m all-out swims, interspersed by 1:1 recovery between each sprint and 3 min of rest between sets) and were randomized to two intervention groups receiving either 0.5 g kg-1 day-1 protein beverage (PRO) or the same amount of carbohydrate (CHO) preceding going to bed every night. For initial and final training sessions, CK and cytokine responses were analyzed at different time points, including resting, immediately after completion, 45 min post-SIT, and 24 and 48 h after SIT.

RESULTS

CK concentrations elevated from resting point to 24 and 48 h post-SIT for both PRO and CHO groups (p < 0.05). In both training groups, the peak levels of IL-6 and 10 were observed 45 min post-SIT on both occasions. TNFα levels significantly elevated from rest to immediately after SIT (p < 0.001) and returned to values equivalent to the baseline afterward in both groups and on both occasions. In both groups, swimming SIT also switched the cytokine response 48 hours after exercise to an anti-inflammatory status by decreasing the ratio of IL-6 to IL-10 (p < 0.04) in the last training session.

CONCLUSIONS

Pre-sleep protein ingestion failed to ameliorate blood markers of muscle damage. The late anti-inflammatory profile of cytokines and exercise-induced muscle damage improved after two weeks of swimming SIT with either protein or carbohydrate ingestion before sleep.

The Bioaccumulation and Health Risk Assessment of Metals among Two Most Consumed Species of Angling Fish (Cyprinus carpio and Pseudohemiculter dispar) in Liuzhou (China): Winter Should Be Treated as a Suitable Season for Fish Angling

Wild fish caught by anglers were validated to be commonly polluted by metals, but their contamination status could be varied with changing seasons. To determine the seasonal variation in metal pollution and health risks in these fish, this study took Liuzhou City as an example to investigate the concentrations of eight metals in two dominant angling fishes (Cyprinus carpio and Pseudohemiculter dispar) collected, respectively, in winter and summer. The obtained results suggested the mean concentrations of metals in fish are overall lower in winter. Only Cr, Zn, and Cd in some fish were beyond the thresholds in summer. The significant correlations between fish length and weight and most metals suggested the biological dilution effect could exert its influence in winter. The similar distribution of metals in winter suggested that metal bioaccumulation should be manipulated by living habitats, while the inconsistent distribution of metals in summer may be related to the variation in feeding behavior. The metal pollution index (Pi) values were all below 0.2 in winter, which suggested no metal contamination in fish, but most fish were found to be mostly contaminated by Cr and Cd in summer, which was confirmed by their Pi > 0.2. The fish could be consumed freely in winter due to the total target hazard quotient (TTHQ) below 1, while the consumption of fish was not entirely safe in summer, particularly for children, due to TTHQ values that were generally beyond 1. Given the higher weekly recommended consumption of fish in winter, winter should be treated as a suitable season for fish angling.