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Muacevic A, Adler JR, Santos Silva M, Rego R, Torrao C, Amaral IM, Pereira R, Pinho JP, Sousa Marinho RC, Sousa Marinho AD. The Caloric Necessities of Critical Care Patients During the First Week of Admission. Cureus 2023; 15:e33999. [PMID: 36824564 PMCID: PMC9941035 DOI: 10.7759/cureus.33999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION The nutritional needs of critically ill patients have been the subject of intense controversy. In accordance with international guidelines, it is advocated to optimize a nutritional intake based on the following recommendation: 25-30 kcal/kg body weight per day. However, there still are authors who recommend permissive underfeeding in the first week of hospitalization. Nevertheless, energy expenditure (EE) and necessity are influenced by the catabolic phase of critical illness, which may vary over time on a patient and from patient to patient. OBJECTIVE The objective of this study is to assess if the energy needs of critically ill patients admitted in our intensive care unit (ICU) in the first week of hospitalization are in line with those recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN) international guidelines. METHODS A prospective cross-sectional study was carried out from September to December 2019. The energy needs were evaluated by indirect calorimetry and by the Harris-Benedict equation. Stress variables were evaluated, namely, the type of pathology, hemodynamic support, sedation, temperature, sequential organ failure assessment (SOFA) score, and state at discharge. RESULTS Forty-six patients were included in this study, with an average energy expenditure by indirect calorimetry of 19.22 ± 4.67 kcal/kg/day. The energy expenditure was less than 20 kcal/kg/day in 63% of the measurements. The concordance rate did not show the relationship between the Harris-Benedict equation and the values of indirect calorimetry. Stress variables were analyzed, with the SOFA score as the only variable with values close to statistical significance. CONCLUSION In our ICU, the energy needs of critically ill patients in the first week of hospitalization are lower than the intake recommended by the guidelines.
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Pretorius A, Piderit M, Becker P, Wenhold F. Resting energy expenditure of a diverse group of South African men and women. J Hum Nutr Diet 2022; 35:1164-1177. [PMID: 35475561 PMCID: PMC9790416 DOI: 10.1111/jhn.13022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/15/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND In South Africa, overweight/obesity is a public health concern, disproportionally affecting Black females. A contributory role of a lower resting energy expenditure (REE) is suggested for African Americans. The present study assessed the REE of Black and White South African adults aiming to better understand the underlying predictors to overweight/obesity and transform this into locally appropriate recommendations. METHODS In 328 (63% female; 39% Black) healthy South African adults, REE was measured with indirect calorimetry and body composition with multifrequency bioelectrical impedance analysis. The REE was estimated with 30 sets of published equations. Black-White differences in REE, as measured and adjusted (analysis of covariance), were determined with quantile regression. Reliability/agreement of estimated (against measured) REE was determined with intra-class correlations (ICCs) and Bland-Altman analysis. A new equation was developed by median regression followed by preliminary validation. RESULTS Measured REE (adjusted for age along with fat-free mass [FFM], FFM index, FFM plus fat mass, FFM index plus fat mass index) in White subjects was significantly higher (p < 0.001) than in Black subjects for men and women alike, regardless of obesity class. None of the sets of estimation equations had good agreement with measured REE for Black, White, male and female subjects simultaneously. A new estimation equation, based on whole-body variables, had good reliability (ICC = 0.79) and agreement (mean difference: 27 kJ) and presents practical opportunities for groups at the local grass-roots level. CONCLUSIONS The REE in Black South African adults is lower than in White adults. Tailored REE equations may improve REE estimation of racially/ethnically diverse South African groups and contribute to improved obesity management.
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Affiliation(s)
- Adeline Pretorius
- Department Human Nutrition, Faculty of Health SciencesUniversity of PretoriaPretoriaSouth Africa
| | - Monique Piderit
- Department Human Nutrition, Faculty of Health SciencesUniversity of PretoriaPretoriaSouth Africa
| | - Piet Becker
- Research Office, Faculty of Health SciencesUniversity of PretoriaPretoriaSouth Africa
| | - Friede Wenhold
- Department Human Nutrition, Faculty of Health SciencesUniversity of PretoriaPretoriaSouth Africa
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Monitoring energy balance through clinical and serum biomarkers in patients with hematologic malignancies undergoing chemotherapy. Ann Hematol 2022; 101:2759-2769. [PMID: 36136099 DOI: 10.1007/s00277-022-04984-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/14/2022] [Indexed: 11/12/2022]
Abstract
Despite widespread concern about energy imbalance due to tumor and chemotherapy-related side effects, little is known about detailed variations in energy input, metabolic rate, and physical activity. This study explored changes in energy balance components and serum biomarkers of patients with hematologic malignancies undergoing chemotherapy. Our prospective study included 40 patients with hematologic malignancies hospitalized for chemotherapy. We measured energy balance components, physical function, and serum biomarkers at baseline and weekly after chemotherapy for 3 weeks. Significant weight loss, representing negative energy balance, occurred at 2 (p = 0.002) and 3 weeks (p < 0.001) post-chemotherapy. Statistically reduced oral intake was observed at 3 weeks post-chemotherapy (p = 0.040), and resting energy expenditure statistically decreased according to Harris-Benedict equation, but not to Penn State University equation. Physical function according to DEMMI score decreased significantly at 3 weeks post-chemotherapy (p = 0.002). Serum biomarker analysis demonstrated significant changes in albumin, total protein, CXCL13, and GDF15, with exception of leptin. Although conventional serum biomarkers (total protein and albumin) did not reach pathological states despite their statistical differences, subgroup analysis showed CXCL13 in weight loss group and GDF15 in reduced oral intake group were significantly changed. Over half of patients (65.0%, n = 26) suffered from energy imbalance associated with weight loss and reduced oral intake during chemotherapy. Serial laboratory results suggested that novel biomarkers (CXCL13, GDF15) could be correlated with cachexic state and reduced food intake. Monitoring clinical and serum biomarkers associated with energy balance together can help identify needs for nutritional support in patients with hematologic malignancies undergoing chemotherapy.
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Kontou TG, Sargent C, Roach GD. A Week of Sleep Restriction Does Not Affect Nighttime Glucose Concentration in Healthy Adult Males When Slow-Wave Sleep Is Maintained. SENSORS (BASEL, SWITZERLAND) 2022; 22:6962. [PMID: 36146310 PMCID: PMC9500600 DOI: 10.3390/s22186962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/10/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
The aim of this laboratory-based study was to examine the effect of sleep restriction on glucose regulation during nighttime sleep. Healthy males were randomly assigned to one of two conditions: 9 h in bed (n = 23, age = 24.0 year) or 5 h in bed (n = 18, age = 21.9 year). Participants had a baseline night with 9 h in bed (23:00-08:00 h), then seven nights of 9 h (23:00-08:00 h) or 5 h (03:00-08:00 h) in bed. Participants were mostly seated during the daytime but had three bouts of treadmill walking (4 km·h-1 for 10 min) at ~14:40 h, ~17:40 h, and ~20:40 h each day. On the baseline night and night seven, glucose concentration in interstitial fluid was assessed by using continuous glucose monitors, and sleep was assessed by using polysomnography. On night seven, compared to the 9 h group, the 5 h group obtained less total sleep (292 min vs. 465 min) and less REM sleep (81 min vs. 118 min), but their slow-wave sleep did not differ (119 min vs. 120 min), and their glucose concentration during sleep did not differ (5.1 mmol·L-1 vs. 5.1 mmol·L-1). These data indicate that sleep restriction does not cause elevated levels of circulating glucose during nighttime sleep when slow-wave sleep is maintained. In the future, it will be important to determine whether increased insulin is required to maintain circulating glucose at a normal level when sleep is restricted.
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Limon-Miro AT, Jackson CD, Eslamparast T, Yamanaka-Okumura H, Plank LD, Henry CJ, Madden AM, Ferreira LG, Kalaitzakis E, Prieto de Frías C, Knudsen AW, Gramlich L, Raman M, Alberda C, Belland D, Den Heyer V, Tandon P, Morgan MY. Predicted estimates of resting energy expenditure have limited clinical utility in patients with cirrhosis. J Hepatol 2022; 77:98-107. [PMID: 35090958 DOI: 10.1016/j.jhep.2022.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Malnutrition is associated with adverse clinical outcomes in patients with cirrhosis. Accurate assessment of energy requirements is needed to optimize dietary intake. Resting energy expenditure (REE), the major component of total energy expenditure, can be measured using indirect calorimetry (mREE) or estimated using prediction equations (pREE). This study assessed the usefulness of predicted estimates of REE in this patient population. METHODS Individual mREE data were available for 900 patients with cirrhosis (mean [±1 SD] age 55.7±11.6 years-old; 70% men; 52% south-east Asian) and 282 healthy controls (mean age 36.0±12.8 years-old; 52% men; 18% south-east Asian). Metabolic status was classified using thresholds based on the mean ± 1 SD of the mREE in the healthy controls. Comparisons were made between mREE and pREE estimates obtained using the Harris-Benedict, Mifflin, Schofield and Henry equations. Stepwise regression was used to build 3 new prediction models which included sex, ethnicity, body composition measures, and model for end-stage liver disease scores. RESULTS The mean mREE was significantly higher in patients than controls when referenced to dry body weight (22.4±3.8 cf. 20.8±2.6 kcal/kg/24 hr; p <0.001); there were no significant sex differences. The mean mREE was significantly higher in Caucasian than Asian patients (23.1±4.4 cf. 21.7±2.9 kcal/kg/24 hr; p <0.001). Overall, 37.1% of Caucasian and 25.3% of Asian patients were classified as hypermetabolic. The differences between mREE and pREE were both statistically and clinically relevant; in the total patient population, pREE estimates ranged from 501 kcal/24 hr less to 548 kcal/24 hr more than the mREE. Newly derived prediction equations provided better estimates of mREE but still had limited clinical utility. CONCLUSIONS Prediction equations do not provide useful estimates of REE in patients with cirrhosis. REE should be directly measured. LAY SUMMARY People with cirrhosis are often malnourished and this has a detrimental effect on outcome. Provision of an adequate diet is very important and is best achieved by measuring daily energy requirements and adjusting dietary intake accordingly. Prediction equations, which use information on age, sex, weight, and height can be used to estimate energy requirements; however, the results they provide are not accurate enough for clinical use, particularly as they vary according to sex and ethnicity.
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Affiliation(s)
| | - Clive Douglas Jackson
- Department of Clinical Neurophysiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | | | - Hisami Yamanaka-Okumura
- Department of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto-cho, Tokushima, Japan
| | | | | | - Angela Mary Madden
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Livia Garcia Ferreira
- Graduate Program in Nutrition and Health, Department of Nutrition, Universidade Federal de Lavras, Brazil
| | - Evangelos Kalaitzakis
- Gastro Unit, Division of Endoscopy, Copenhagen University Hospital Herlev, Denmark; Department of Gastroenterology, University Hospital of Heraklion, University of Crete, Heraklion, Greece
| | | | - Anne Wilkens Knudsen
- Gastrounit, Medical Division, Copenhagen University Hospital - Hvidovre, Denmark
| | - Leah Gramlich
- Department of Medicine, University of Alberta, Edmonton, Canada
| | - Maitreyi Raman
- Department of Medicine, Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | - Cathy Alberda
- Royal Alexandra Hospital, Alberta Health Services, Edmonton, Alberta, Canada
| | - Dawn Belland
- University of Alberta Hospital, Alberta Health Services Nutrition Services, Edmonton, Canada
| | - Vanessa Den Heyer
- University of Alberta Hospital, Alberta Health Services Nutrition Services, Edmonton, Canada
| | - Puneeta Tandon
- Department of Medicine, University of Alberta, Edmonton, Canada.
| | - Marsha Yvonne Morgan
- UCL Institute for Liver & Digestive Health, Division of Medicine, Royal Free Campus, University College London, UK.
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The Effect of Dietary Intake and Nutritional Status on Anthropometric Development and Systemic Inflammation: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115635. [PMID: 34070364 PMCID: PMC8197533 DOI: 10.3390/ijerph18115635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 11/21/2022]
Abstract
(1) Background: Daily caloric intake should aim to reduce the risk of obesity or poor anthropometric development. Our study objective was to analyze the association between food consumption, inflammatory status and anthropometric development; (2) Methods: We performed a prospective observational analytical research during September 2020 and April 2021 on a group of 160 healthy subjects, aged between 6 and 12 years old, by analyzing food ingestion, the basal metabolic rate, anthropometric development and the inflammatory status; (3) Results: IL-6 was significantly correlated to the sum of skinfolds, along with both serum proteins and triglycerides. The skin folds were significantly correlated with the caloric intake and with total fat intake, next to saturated and trans fats. Unlike the skin folds, the body weight was significantly correlated with the caloric intake along with some vitamins, such as Vitamin A and Vitamin B12. Inactive mass increased with excessive folic acid, Vitamin E, Vitamin K and saturated fat intake; (4) Conclusions: The inflammatory status was influenced by the ingestion of micronutrients, total serum lipids and proteins. The anthropometric development was associated with the ingestion of carbohydrates, energy balance and energy intake. We can conclude that daily menu and nutrition imbalances can influence both the risk of obesity and the inflammatory status.
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Del Razo-Olvera FM, Martin-Vences AJ, Brito-Córdova GX, Elías-López D, Landa-Anell MV, Melgarejo-Hernández MA, Cruz-Bautista I, Manjarrez-Martínez I, Gómez-Velasco DV, Aguilar-Salinas CA. Primary Barriers of Adherence to a Structured Nutritional Intervention in Patients with Dyslipidemia. Nutrients 2021; 13:nu13061744. [PMID: 34063795 PMCID: PMC8223790 DOI: 10.3390/nu13061744] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 01/30/2023] Open
Abstract
PURPOSE To describe the primary barriers to adequately adhering to a structured nutritional intervention. PATIENTS AND METHODS A total of 106 participants diagnosed with dyslipidemia and without a medical nutrition therapeutic plan were included in this two-year study conducted at the INCMNSZ dyslipidemia clinic in Mexico City. All patients were treated with the same structured strategies, including three face-to-face visits and two telephone follow-up visits. Diet plan adherence was evaluated at each site visit through a 3-day or 24-h food recall. RESULTS Barriers to adhere to the nutritional intervention were: lack of time to prepare their meals (23%), eating outside the home (19%), unwillingness to change dietary patterns (14%), and lack of information about a correct diet for dyslipidemias (14%). All barriers decreased significantly at the end of the intervention. Female gender, current smoking, and following a plan of more than 1500 kcal (R2 = 0.18 and p-value = 0.004) were associated with good diet adherence. Participants showed good levels of adherence to total caloric intake at visit 2 and 3, reporting 104.7% and 95.4%, respectively. Adherence to macronutrient intake varied from 65.1% to 126%, with difficulties in adhering to recommended carbohydrate and fat consumption being more notable. CONCLUSION The study findings confirm that a structured nutritional intervention is effective in reducing barriers and improving dietary adherence and metabolic control in patients with dyslipidemias. Health providers must identify barriers to adherence early on to design interventions that reduce these barriers and improve adherence.
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Affiliation(s)
- Fabiola Mabel Del Razo-Olvera
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | | | - Griselda X. Brito-Córdova
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | - Daniel Elías-López
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | - María Victoria Landa-Anell
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico;
| | - Marco Antonio Melgarejo-Hernández
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
- Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico;
| | - Ivette Cruz-Bautista
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | - Iliana Manjarrez-Martínez
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
| | - Donají Verónica Gómez-Velasco
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
| | - Carlos Alberto Aguilar-Salinas
- Research Unit of Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (F.M.D.R.-O.); (D.E.-L.); (I.C.-B.); (D.V.G.-V.)
- Deparment of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), Mexico City 14080, Mexico; (G.X.B.-C.); (M.A.M.-H.); (I.M.-M.)
- Division of Nutrition, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubirán (INCMNSZ), Vasco de Quiroga #15, Tlalpan, Mexico City 14080, Mexico
- Correspondence: ; Tel.: +52-55-54-87-09-00 (ext. 1501); Fax: +52-55-55-13-45-07
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The Effect of Semirecumbent and Right Lateral Positions on the Gastric Residual Volume of Mechanically Ventilated, Critically Ill Patients. J Nurs Res 2021; 28:e108. [PMID: 32398578 DOI: 10.1097/jnr.0000000000000377] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Delay in stomach discharge is a challenge for patients who are tube fed and may result in serious side effects such as pneumonia and malnutrition. PURPOSE This study was designed to determine the respective effects of the semirecumbent (SR) supine and right lateral (RL) with a flatbed positions on the gastric residual volume (GRV) of mechanically ventilated, critically ill adult patients. METHODS A randomized, crossover clinical trial design was used to investigate GRV in 36 critically ill, ventilated adult patients who were hospitalized in the intensive care unit. GRV was measured at 3 hours after three consecutive feedings. GRV was first measured in all of the participants in the supine position; after which, participants were randomly assigned into one of two therapeutic positioning groups (Group A: assessment in the SR position and then the RL position; Group B: assessment in the RL position and then the SR position). RESULTS GRV was significantly lower in both the SR and RL positions than in the supine position. GRV in the SR and RL positions did not vary significantly. The in-group measurements for GRV did not significantly differ for any of the three positions. In Group A, GRV was significantly lower at each subsequent measurement point. CONCLUSION/IMPLICATIONS FOR PRACTICE Positioning patients in the RL and SR positions rather than in the supine position is an effective strategy to reduce GRV. Furthermore, placing patients in either the RL or SR position is an effective intervention to promote faster digestion and feedings.
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Hasegawa Y, Yoshida M, Sato A, Fujimoto Y, Minematsu T, Sugama J, Sanada H. A change in temporal muscle thickness is correlated with past energy adequacy in bedridden older adults: a prospective cohort study. BMC Geriatr 2021; 21:182. [PMID: 33722195 PMCID: PMC7962248 DOI: 10.1186/s12877-021-02086-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Energy inadequacy has a great impact on health outcomes in older adult patients; however, it is difficult to evaluate energy adequacy in these patients, especially in home-care settings. We recently reported that temporal muscle thickness can be an indicator of nutritional status. The present study aims to examine whether a change in temporal muscle thickness is directly correlated with energy adequacy and, if so, to determine the cutoff value of a change in temporal muscle thickness to detect energy inadequacy. Methods A prospective cohort study was conducted from September 2015 to June 2016 in two hospitals in Japan, and included bedridden older adult patients aged ≥65 years. Temporal muscle thickness was measured using ultrasonography. Energy intake was estimated by photographic diet records. Total energy expenditure (TEE) was estimated by multiplying basal energy expenditure calculated using the Harris– Benedict equation by activity and stress factors. Energy adequacy was then calculated by dividing TEE by energy intake. Pearson’s correlation coefficient was used to examine the relationship between percentage change in temporal muscle thickness and energy adequacy. Multiple logistic regression analysis was conducted to determine the direct relationship between percentage change in temporal muscle thickness and moderate energy inadequacy (energy adequacy< 75%). Receiver operating characteristic (ROC) analysis was performed to determine the cutoff point for percentage change in temporal muscle thickness to detect moderate energy inadequacy. Results Forty-eight patients were analyzed (mean age 84.4 ± 7.8 years; 54.2% were women). The percentage change in muscle thickness was significantly correlated with energy adequacy (r = 0.733, p < 0.001). ROC analysis identified a percentage change in temporal muscle thickness of − 3.6% as the optimal cutoff point for detecting moderate energy inadequacy. Percentage change in muscle thickness was independently correlated with energy inadequacy after adjusting for age, sex, and masticatory status (AOR 0.281, 95% CI 0.125–0.635). Conclusions Changes in temporal muscle thickness are directly correlated with energy adequacy and can indicate moderate energy inadequacy in bedridden older adults. These results suggest the assessment of changes in temporal muscle thickness could be useful for guiding nutritional care in older adult patients in home-care settings.
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Affiliation(s)
- Yoko Hasegawa
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Clinical Nutrition Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mikako Yoshida
- Department of Women's Health Nursing & Midwifery, Tohoku University Graduate School of Medicine, 2-1 Seiryoumachi, Aoba-ku, Sendai city, Miyagi, 980-8575, Japan
| | - Aya Sato
- Department of Gerontological Nursing, Kawasaki City College of Nursing, 4-30-1 Ogura, Saiwai-ku, Kawasaki city, Kanagawa, 212-0054, Japan
| | - Yumiko Fujimoto
- Department of Gerontological Nursing, School of Health and Nursing Science, Wakayama Medical University, 580 Mikazura, Wakayama city, Wakayama, 641-0011, Japan
| | - Takeo Minematsu
- Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Junko Sugama
- Institute for Frontier Science Initiative, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa city, Ishikawa, 920-0942, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. .,Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Turner-McGrievy G, Hutto B, Bernhart JA, Wilson MJ. Comparison of the Diet ID Platform to the Automated Self-administered 24-hour (ASA24) Dietary Assessment Tool for Assessment of Dietary Intake. J Am Coll Nutr 2021; 41:360-382. [PMID: 33705267 PMCID: PMC8634522 DOI: 10.1080/07315724.2021.1887775] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Collecting multiple 24-hour recalls (24HR) can be burdensome, necessitating alternative methods to assess dietary intake in the research setting. METHOD This cross-sectional study compared the use of the Diet ID™ online platform with three unannounced 24HR assessed via the Automated Self-Administered 24-Hour recall (ASA24) among participants in the Nutritious Eating with Soul (NEW Soul) study. NEW Soul participants (n = 68; 100% African American, 79% female, mean age 50.7 ± 9.6 years) were randomized to follow one of two healthy soul food diets: vegan or omnivorous. For the present study, data from both groups were combined. Energy intake, dietary quality (Healthy Eating Index), and macro-/micronutrient densities per 1000 kcals, as assessed by either the averaged values of the three 24HR or the Diet ID. Descriptive statistics (means, standard deviations, and Spearman rank correlations) summarized each nutrient as measured by the Diet ID and ASA24. Bland-Altman plots were used as the main method to assess agreement between the two measures. RESULTS Nutrients from the Diet ID were generally higher than the 24HR except for the Healthy Eating Index (HEI) score (69.6 ± 12.2 ASA24 vs 51.1 ± 34.5 Diet ID). Diet ID reported 950 kcals higher energy intake than ASA24, with the difference being most pronounced at lower ASA24-reported energy intake. There were significant correlations among measures for HEI score, protein, carbohydrates, cholesterol, potassium, copper, thiamin, and vitamins B12 and E. There was higher reporting of nutrients using Diet ID compared to the 24HR. Diet ID is a rapid way to assess dietary intake. CONCLUSIONS Future studies should consider comparing these two methods with objective assessments of energy and nutrient intake and using multiple instruments to ensure that the strengths of all methods are included.
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Affiliation(s)
- Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - John A Bernhart
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Mary J Wilson
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
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McClung HL, Armstrong NJ, Hennigar SR, Staab JS, Montain SJ, Karl J. Randomized Trial Comparing Consumption of Military Rations to Usual Intake for 21 Consecutive Days: Nutrient Adequacy and Indicators of Health Status. J Acad Nutr Diet 2020; 120:1791-1804. [DOI: 10.1016/j.jand.2020.06.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/15/2020] [Accepted: 06/18/2020] [Indexed: 12/17/2022]
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BDNF and orexin-A response to aerobic exercise are moderated by the meal consumption before exercise in overweight men: Effect of high-carbohydrate, high-protein and high-fat meals. Sci Sports 2020. [DOI: 10.1016/j.scispo.2020.01.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Yoshida T, Shoji S, Shiraishi Y, Kawana M, Kohno T, Inoue K, Fukuda K, Heidenreich PA, Kohsaka S. Hospital meal intake in acute heart failure patients and its association with long-term outcomes. Open Heart 2020; 7:openhrt-2020-001248. [PMID: 32393659 PMCID: PMC7223464 DOI: 10.1136/openhrt-2020-001248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 12/24/2022] Open
Abstract
Background Risk prediction for hospitalised heart failure (HF, HHF) patients remains suboptimal. We aimed to determine the prognostic value of hospital food intake (FI) immediately before discharge among HHF patients. Method We analysed the data of 255 HHF patients extracted from the records of a single university hospital. The FI percentage of the three meals the day before hospital discharge was averaged. Patients were stratified into adequate FI (100% consumption) and inadequate FI (less than 100% consumption) groups. The primary outcome was the composite of all-cause mortality and/or HF readmission within 1 year. Results Only 49.3% of HHF patients consumed 100% of their meals. Patients with inadequate FI were older; predominantly women; and had a lower body mass index, higher brain natriuretic peptide levels and Clinical Frailty Scale scores at discharge than those with adequate FI. Inadequate FI was significantly associated with adverse outcomes after adjustments (HR 2.00; 95% CI 1.09 to 3.67; p=0.026). The effect of interaction by ejection fraction (EF) was highly significant: HF with preserved EF (≥40%) was significantly associated with inadequate FI with adverse outcomes (HR 4.95; 95% CI 1.71 to 14.36; p=0.003) but HF with reduced EF (<40%) was not (HR 0.77; 95% CI 0.31 to 1.95; p=0.590). Conclusions The hospital FI assessment might be a simple, useful tool for predicting and stratifying risk for HHF patients.
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Affiliation(s)
- Taizo Yoshida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Satoshi Shoji
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyuki Shiraishi
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Masataka Kawana
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University, Stanford, California, USA
| | - Takashi Kohno
- Department of Cardiovascular Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Kenji Inoue
- Department of Cardiology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Paul A Heidenreich
- Department of Medicine, Division of Cardiovascular Medicine, Stanford University, Stanford, California, USA
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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Handayani A, Tanuwijaya LK, Arfiani EP. Annalisa Kesesuaian Antara Preskripsi Diet Dengan Kebutuhan Gizi Secara Individu pada Pasien Diabetes Mellitus di Rumah Sakit X. AMERTA NUTRITION 2019. [DOI: 10.20473/amnt.v3i4.2019.276-283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Medical nutrition management in DM patients must be done individually because it must consider eating habits, metabolism, physical activity and comorbidities. Calculation of nutritients adequacy can use the PERKENI formula by calculating basal energy then added or reduced by several factors, namely age, weight, physical activity, gender, metabolic stress.Objective: The aim of the study was to analysis the conformity of diet prescription and nutrients adequacy of DM patients. Method: This study used observational methods related to assessment data such as weight, hight, biochemical, and physic-clinic data and diet prescription. The number of samples in this study were 27 DM patients at X Hospital. Results: Results showed that there was discrepancies of diet prescription and nutrients adequacy of DM patients. Category of nutrient adequacy devided by 8 category, 1100 kkal, 1200 kkal, 1300 kkal, 1400 kkal, 1500 kkal, 1600 kkal, 1700 kkal, 1800 kkal. Diet prescription of DM patients was 1700 kkal. Conclusion: Comparison between diet prescription and nutrients adequacy 48% were mostly fall in appropriate category, and 52% were in inappropriate category. This was due to several factors such as the use of formulas in calculating nutrition adequacy of DM patients and the limited type of diet mannuals provided by hospitals to be prescribed for DM patients' diets.ABSTRAKLatar Belakang: Penatalaksanaan gizi medis pada pasien DM harus dilakukan secara individual karena harus mempertimbangkan kebiasaan makan, metabolisme, aktivitas fisik dan adanya komorbid. Perhitungan kebutuhan pasien secara individu dapat menggunakan rumus PERKENI dengan memperhitungkan energi basal kemudian ditambahkan atau dikurangi dengan beberapa faktor yaitu umur, berat badan, aktivitas fisik, jenis kelamin, stress metabolik.Tujuan: Penelitian ini dilakukan untuk menganalisis kesesuaian antara preskripsi diet dengan kebutuhan gizi secara individu pada pasien DM.Metode: Penelitian ini menggunakan metode observasi terkait data asesmen pasien yang meliputi data BB, TB, data biokimia, dan data fisik klinis, dan preskripsi diet. Data tersebut didapatkan berdasarkan informasi dari ahli gizi. Jumlah sampel pada penelitian ini sebanyak 27 pasien DM di RS X.Hasil: Hasil penelitian menunjukkan bahwa terdapat ketidaksesuaian preskripsi diet dengan kebutuhan gizi secara individu pada pasien DM di RS X. Kategori kebutuhan energi secara individu terbagi menjadi 8 kategori, yaitu 1100 kkal (n=1), 1200 kkal (n=1), 1300 kkal (n=4), 1400 kkal (n=4), 1500 kkal (n=6), 1600 kkal (n=5), 1700 kkal (n=2), 1800 kkal (n=4). Preskripsi diet pasien DM adalah 1700 kkal.Kesimpulan: Perbandingan preskripsi diet dengan kebutuhan gizi secara individu adalah sebanyak 13 orang (48%) berada pada kategori cukup atau sesuai, dan sebanyak 14 orang (52%) berada pada kategori lebih atau tidak sesuai. Hal ini dikarenakan oleh beberapa faktor seperti penggunaan rumus dalam menghitung kebutuhan gizi pasien DM dan terbatasnya jenis standar diet yang disediakan rumah sakit untuk dituliskan menjadi preskripsi diet pasien DM.
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Intensity-Weighted Physical Activity Volume and Risk of All-Cause and Cardiovascular Mortality: Does the Use of Absolute or Corrected Intensity Matter? J Phys Act Health 2019; 16:1054-1059. [PMID: 31521056 DOI: 10.1123/jpah.2019-0117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/12/2019] [Accepted: 07/14/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Previous epidemiological studies examining the association between physical activity (PA) and mortality risk have measured absolute PA intensity using standard resting metabolic rate reference values that fail to consider individual differences. This study compared the risk of all-cause and cardiovascular mortality between absolute and corrected estimates of PA volume. METHODS 49,982 adults aged ≥40 years who participated in the Health Survey for England and Scottish Health Survey in 1994-2008 were included in our study. PA was classified as absolute or corrected metabolic equivalent (MET)-hours per week, taking participant's weight, height, age, and sex into account. Cox regression models were used to examine the association between absolute and corrected PA volumes and all-cause and cardiovascular mortality. RESULTS The authors found no difference in the association between levels of PA and risk of all-cause and cardiovascular mortality for absolute and corrected MET-hours per week, although there was a consistent decrease in mortality risk with increasing PA. There was no difference in mortality when analyses were stratified by sex, age, and body mass index. CONCLUSIONS The association between PA volume and risk of mortality was similar regardless of whether PA volume was estimated using absolute or corrected METs. There is no empirical justification against the use of absolute METs to estimate PA volume from questionnaires.
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Van Soom T, El Bakkali S, Gebruers N, Verbelen H, Tjalma W, van Breda E. The effects of chemotherapy on energy metabolic aspects in cancer patients: A systematic review. Clin Nutr 2019; 39:1863-1877. [PMID: 31420208 DOI: 10.1016/j.clnu.2019.07.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/06/2019] [Accepted: 07/25/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND & AIMS Cancer survival rates have increased significantly creating more awareness for comorbidities affecting the Quality of Life. Chemotherapy may induce serious metabolic alterations. These complications can create an energy imbalance, worsening prognosis. The effect of chemotherapy on energy metabolism remains largely unknown. The purpose of this systematic review is to determine the impact of chemotherapy on energy metabolism, creating more insight in a patients' energy requirements. METHODS We identified relevant studies up to May 2nd, 2019 using PubMed and Web of Science. Studies including all types of cancer and stages were selected. Only patients that underwent chemotherapy whether or not followed by surgery or radiotherapy were selected. Maximum follow-up was set at 6 months. Resting energy expenditure (REE), measured by indirect calorimetry (IC) or predicted by the Harris-Benedict equation (HBEq), was our primary outcome. Results regarding body composition were considered as secondary outcome parameter. RESULTS 16 studies were selected, including 267 patients. Overall, a significant decrease in REE [-1.5% to -24.91%] 1-month post-chemotherapy was reported. Two studies on breast cancer conducted a 3 and 6-month follow-up and found an increase in REE of 4.01% and 5.72% (p < .05), revealing a U-shaped curve in the expression of REE. Changes are accompanied by (non)significant variations in body composition (Fatmass (FM) and Fatfree Mass (FFM)). HBEq tends to underestimate REE by 4.03%-27.1%. CONCLUSION Alterations in REE, accompanied by changes in body composition, are found during and after chemotherapy in all cancer types and stages, revealing a U-shaped curve. Changes in FFM are suggested to induce variations in REE concomitant to catabolic effects of the disease and administered drug. HBEq tends to underestimate REE, stressing the need for adequate assessment to meet patients' energy requirements and support dietary needs.
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Affiliation(s)
- Timia Van Soom
- University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610, Wilrijk, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Research Group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN), Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Samera El Bakkali
- University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610, Wilrijk, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Research Group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN), Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Nick Gebruers
- University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610, Wilrijk, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Research Group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN), Universiteitsplein 1, 2610, Wilrijk, Belgium; Antwerp University Hospital (UZA), Multidisciplinary Edema Clinic, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Hanne Verbelen
- University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610, Wilrijk, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Research Group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN), Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Wiebren Tjalma
- Antwerp University Hospital (UZA), Multidisciplinary Edema Clinic, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - Eric van Breda
- University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610, Wilrijk, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Research Group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN), Universiteitsplein 1, 2610, Wilrijk, Belgium.
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Koninckx PR, Ussia A, Adamyan L, Wattiez A, Gomel V, Martin DC. Heterogeneity of endometriosis lesions requires individualisation of diagnosis and treatment and a different approach to research and evidence based medicine. Facts Views Vis Obgyn 2019; 11:57-61. [PMID: 31695858 PMCID: PMC6822957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Statistical significance is used to analyse research findings and is together with biased free trials the cornerstone of evidence based medicine. However traditional statistics are based on the assumption that the population investigated is homogeneous without smaller hidden subgroups. The clinical, inflammatory, immunological, biochemical, histochemical and genetic-epigenetic heterogeneity of similar looking endometriosis lesions is a challenge for research and for diagnosis and treatment of endometriosis. The conclusions obtained by statistical testing of the entire group are not necessarily valid for subgroups. The importance is illustrated by the fact that a treatment with a beneficial effect in 80% of women but with exactly the same but opposite effect, worsening the disease in 20%, remains statistically highly significant. Since traditional statistics are unable to detect hidden subgroups, new approaches are mandatory. For diagnosis and treatment it is suggested to visualise individual data and to pay specific attention to the extremes of an analysis. For research it is important to integrate clinical, biochemical and histochemical data with molecular biological pathways and genetic-epigenetic analysis of the lesions.
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Affiliation(s)
- PR Koninckx
- Latifa Hospital, Dubai, United Arab Emirates;,Professor emeritus OBGYN, KULeuven Belgium, University of Oxford-Hon Consultant, UK, University Cattolica, Roma, Moscow State Univ.;,Gruppo Italo Belga, Villa Del Rosario Rome Italy
| | - A Ussia
- Professor emeritus OBGYN, KULeuven Belgium, University of Oxford-Hon Consultant, UK, University Cattolica, Roma, Moscow State Univ.;,Consultant Università Cattolica, Roma Italy
| | - L Adamyan
- Department of Operative Gynecology, Federal State Budget Institution V. I. Kulakov Research Centre for Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, Moscow, Russia; and e Department of Reproductive Medicine and Surgery, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - A Wattiez
- Latifa Hospital, Dubai, United Arab Emirates;,Professor Department of obstetrics and gynaecology, University of Strasbourg
| | - V Gomel
- Professor emeritus Department of Obstetrics and Gynecology, University of British Columbia and Women’s Hospital, Vancouver, BC, Canada
| | - DC Martin
- Professor emeritus School of Medicine, University of Tennessee Health Science Centre, Memphis Tennessee, USA; Institutional Review Board, Virginia Commonwealth University, Richmond, Virginia. USA
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Van Soom * T, Tjalma * W, El Bakkali S, Verbelen H, Gebruers N, van Breda E. Perspective: Towards Personalised Metabolic Coaching in Cancer. Facts Views Vis Obgyn 2018; 10:125-130. [PMID: 31191846 PMCID: PMC6548411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Although cancer survivorship has improved over the last decades, numbers of cancer incidence and prevalence are rising. Evidence is growing that lifestyle factors, such as physical activity, a healthy weight management and -diet, play an important role in first- and second line preventive strategies. When implementing a healthy lifestyle, the maintenance of the energy balance should be taken into account. The energy equilibrium is achieved when the energy intake (Ei) for one day is equal to the total daily energy expenditure (TEE). The latter is, among others, made up of the resting energy expenditure, its largest contributor (60-80% of TEE), and can be assessed by indirect calorimetry (i.e. the gold standard). The resting energy expenditure reflects the individual's minimal caloric need in 24h to support basal functions. In cancer patients, energy imbalances, expressed as a positive (Ei > TEE) or negative (Ei & TEE) energy balance, may occur and are characterised by weight gain or -loss respectively. As a corollary, shifts in fatmass and fatfree mass are reported. Adequate nutritional follow-up is necessary in order to meet the energy needs, since both positive and negative energy balances are known to have deteriorating effects on cancer prognosis and mortality. In the clinical setting, predictive formulas (e.g. Harris-Benedict equation) are often used to estimate the caloric need. However, both under- and overfeeding are reported when using equations. Therefore, we advise to use indirect calorimetry in the standard assessment of a patient's energy need in order to provide adequate metabolic coaching and -follow up.
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Affiliation(s)
- T Van Soom *
- University of Antwerp, Faculty of Medicine and Health Sciences; Department of Rehabilitation Sciences and Physiotherapy, Research group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN); Universiteitsplein 1 2610 Wilrijk. Belgium
| | - W Tjalma *
- Antwerp University Hospital (UZA), Multidisciplinary Edema Clinic; Wilrijkstraat 10 2650 Edegem. Belgium,Antwerp University Hospital (UZA), Multidisciplinary Breast Clinic, Wilrijkstraat 10 2650 Edegem. Belgium
| | - S El Bakkali
- University of Antwerp, Faculty of Medicine and Health Sciences; Department of Rehabilitation Sciences and Physiotherapy, Research group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN); Universiteitsplein 1 2610 Wilrijk. Belgium
| | - H Verbelen
- University of Antwerp, Faculty of Medicine and Health Sciences; Department of Rehabilitation Sciences and Physiotherapy, Research group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN); Universiteitsplein 1 2610 Wilrijk. Belgium
| | - N Gebruers
- University of Antwerp, Faculty of Medicine and Health Sciences; Department of Rehabilitation Sciences and Physiotherapy, Research group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN); Universiteitsplein 1 2610 Wilrijk. Belgium,Antwerp University Hospital (UZA), Multidisciplinary Edema Clinic; Wilrijkstraat 10 2650 Edegem. Belgium,Antwerp University Hospital (UZA), Multidisciplinary Breast Clinic, Wilrijkstraat 10 2650 Edegem. Belgium
| | - E van Breda
- University of Antwerp, Faculty of Medicine and Health Sciences; Department of Rehabilitation Sciences and Physiotherapy, Research group MOVANT, Antwerp Multidisciplinary Research Unit (AM2RUN); Universiteitsplein 1 2610 Wilrijk. Belgium
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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. J ASEAN Fed Endocr Soc 2018; 33:152-159. [PMID: 33442121 PMCID: PMC7784146 DOI: 10.15605/jafes.033.02.07] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/14/2018] [Indexed: 01/01/2023] Open
Abstract
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.
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CARTERI RB, FELDMANN M, GROSS JS, KRUGER RL, LOPES AL, REISCHAK-OLIVEIRA Á. Comparison between resting metabolic rate and indirect calorimetry in postmenopausal women. REV NUTR 2017. [DOI: 10.1590/1678-98652017000500004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- Randhall Bruce CARTERI
- Universidade Federal do Rio Grande do Sul, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
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Conchola EC, Smith-Ryan AE, Thompson BJ, Sobolewski EJ, Ryan ED. Occupational differences for nutrient intake and physical-activity levels in young and middle-aged men. Work 2016; 55:187-196. [PMID: 27567793 DOI: 10.3233/wor-162371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Physical demands may vary between white collar and blue collar occupations when evaluating specific physiological differences such as one's weight, body mass index and body fat percentage. OBJECTIVE To explore nutritional, anthropometric, and physical-activity differences between young and middle-aged WC and BC workers. METHODS Ninety-one male participants aged 19-64 that were either WC and/or BC workers completed a 3-day food recall, modified Baecke Questionnaire, and had their height, weight, body mass index and body fat percentage measured. Participants were classified as: young-white-collar, young-blue-collar, middle-white-collar or middle-blue-collar workers. RESULTS No nutritional differences within ages or between occupations were reported. Body mass index and body fat percentage were lower for young vs. middle-aged workers. Lastly, physical-activity at work was higher for young and middle-aged Blue collar workers, while White collar workers participated in more physical activity outside of work. CONCLUSIONS The present findings suggest that the observed increases in body fat percentage and body mass index with age, are independent of occupation.
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Affiliation(s)
- Eric C Conchola
- Department of Wellness, Oklahoma State University, Stillwater, OK, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Brennan J Thompson
- Department of Health, Physical Education, and Recreation, Utah State University, Logan, UT, USA
| | - Eric J Sobolewski
- Human Performance Laboratory, Department of Health, Exercise, and Sport Sciences, Texas Tech University, Lubbock, TX, USA
| | - Eric D Ryan
- Department of Exercise and Sport Science, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
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Olivier N, Wenhold FAM, Becker P. Resting Energy Expenditure of Black Overweight Women in South Africa Is Lower than of White Women. ANNALS OF NUTRITION AND METABOLISM 2016; 69:24-30. [PMID: 27403525 DOI: 10.1159/000447720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 06/19/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Overweight affects 65% of black South African women. Effective weight management requires accurate measurement or estimation of energy expenditure. AIMS The study aimed to determine, among overweight women, whether measured resting energy expenditure (REE) differs between black and white participants, and the performance of REE estimation equations. METHODS The REE of 44 black (age 39.6 ± 9.7 years, body mass index (BMI) 35.1 ± 6.2 kg/m2) and 41 white (age 38.0 ± 11.6 years, BMI 33.9 ± 7.6 kg/m2) women was measured with indirect calorimetry and estimated with equations. Body composition was assessed with multi-frequency bioelectrical impedance analysis. Differences in REE were determined with t tests (Welch), and included adjustment for fat free mass (FFM) and BMI, and for FFM index (FFMI). RESULTS Measured REE was 585 kJ/day (95% CI 264-905; p = 0.0005) and 861 kJ/day (95% CI 499-1,221; p < 0.0001) lower in black than in white women when adjusted for FFM and BMI, and FFMI, respectively. Out of 14 equations, 13 underestimated REE (error range 2,261 ± 727 kJ/day (Bernstein equation, white women) to 8 ± 782 kJ/day (BMI equation, black women)). CONCLUSIONS Black overweight women have significantly lower REE than their white counterparts. No tested estimation equation provided satisfactory results across race/ethnicity. REE measurements or development of overweight- or race/ethnicity-specific estimation equations are recommended.
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Affiliation(s)
- Natascha Olivier
- Department of Human Nutrition, University of Pretoria, Faculty of Health Sciences, Pretoria, South Africa
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Best Practices for Determining Resting Energy Expenditure in Critically Ill Adults. Nutr Clin Pract 2013; 29:44-55. [DOI: 10.1177/0884533613515002] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Seo DY, Lee S, Figueroa A, Kim HK, Baek YH, Kwak YS, Kim N, Choi TH, Rhee BD, Ko KS, Park BJ, Park SY, Han J. Yoga training improves metabolic parameters in obese boys. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2012; 16:175-80. [PMID: 22802698 PMCID: PMC3394919 DOI: 10.4196/kjpp.2012.16.3.175] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 04/25/2012] [Accepted: 05/12/2012] [Indexed: 12/03/2022]
Abstract
Yoga has been known to have stimulatory or inhibitory effects on the metabolic parameters and to be uncomplicated therapy for obesity. The purpose of the present study was to test the effect of an 8-week of yoga-asana training on body composition, lipid profile, and insulin resistance (IR) in obese adolescent boys. Twenty volunteers with body mass index (BMI) greater than the 95th percentile were randomly assigned to yoga (age 14.7±0.5 years, n=10) and control groups (age 14.6±1.0 years, n=10). The yoga group performed exercises three times per week at 40~60% of heart-rate reserve (HRR) for 8 weeks. IR was determined with the homeostasis model assessment of insulin resistance (HOMA-IR). After yoga training, body weight, BMI, fat mass (FM), and body fat % (BF %) were significantly decreased, and fat-free mass and basal metabolic rate were significantly increased than baseline values. FM and BF % were significantly improved in the yoga group compared with the control group (p<0.05). Total cholesterol (TC) was significantly decreased in the yoga group (p<0.01). HDL-cholesterol was decreased in both groups (p<0.05). No significant changes were observed between or within groups for triglycerides, LDL-cholesterol, glucose, insulin, and HOMA-IR. Our findings show that an 8-week of yoga training improves body composition and TC levels in obese adolescent boys, suggesting that yoga training may be effective in controlling some metabolic syndrome factors in obese adolescent boys.
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Affiliation(s)
- Dae Yun Seo
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Cardiovascular and Metabolic Disease Center, Inje University, Busan 614-735, Korea
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Daily L-Leucine Supplementation in Novice Trainees During a 12-Week Weight Training Program. Int J Sports Physiol Perform 2011; 6:38-50. [DOI: 10.1123/ijspp.6.1.38] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose:To investigate the effects of daily oral L-leucine ingestion on strength, bone mineral-free lean tissue mass (LTM) and fat mass (FM) of free living humans during a 12-wk resistance-training program.Methods:Twenty-six initially untrained men (n = 13 per group) ingested either 4 g/d of L-leucine (leucine group: age 28.5 ± 8.2 y, body mass index 24.9 ± 4.2 kg/m2) or a corresponding amount of lactose (placebo group: age 28.2 ± 7.3 y, body mass index 24.9 ± 4.2 kg/m2). All participants trained under supervision twice per week following a prescribed resistance training program using eight standard exercise machines. Testing took place at baseline and at the end of the supplementation period. Strength on each exercise was assessed by fve repetition maximum (5-RM), and body composition was assessed by dual energy X-ray absorptiometry (DXA).Results:The leucine group demonstrated significantly higher gains in total 5-RM strength (sum of 5-RM in eight exercises) and 5-RM strength in five out of the eight exercises (P < .05). The percentage total 5-RM strength gains were 40.8% (± 7.8) and 31.0% (± 4.6) for the leucine and placebo groups respectively. Significant differences did not exist between groups in either total percentage LTM gains or total percentage FM losses (LTM: 2.9% ± 2.5 vs 2.0% ± 2.1, FM: 1.6% ± 15.6 vs 1.1% ± 7.6).Conclusion:These results suggest that 4 g/d of L-leucine supplementation may be used as a nutritional supplement to enhance strength performance during a 12-week resistance training program of initially untrained male participants.
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Variability in results from predicted resting energy needs as compared to measured resting energy expenditure in Korean children. Nutr Res 2010; 29:777-83. [PMID: 19932866 DOI: 10.1016/j.nutres.2009.10.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 10/15/2009] [Accepted: 10/15/2009] [Indexed: 11/23/2022]
Abstract
Energy needs are influenced by many factors, including ethnicity. Multiple studies have shown that the accuracy of an energy prediction equation varies with the ethnic background of the study population. Therefore, it is crucial to identify the most accurate energy prediction equation to use for a given population. This study compared measured resting energy expenditure to results from commonly-used energy prediction equations to identify the most accurate equation to use for Korean children. Based on previous literature showing wide variation in accuracy of energy prediction equations in different ethnic groups, we hypothesized that results from measured- vs. predicted energy needs would be significantly different in this population. Subjects were 92 South Korean children (38 boys, 54 girls) age 7.7 +/- 2.7 years (mean +/- SD). Measurements included: resting metabolic rate (TrueOne 2400 metabolic cart), weight/height (digital scale/stadiometer); body fat (BIA, Inbody720), blood pressure (sphingomanometer), triceps skinfold thickness (MD-500 skinfold calipers), muscle mass (Heymsfield's formula) and body surface area (Dubois formula) calculations. Resting energy needs were predicted using the Harris-Benedict, WHO/NAO/FAO, Altman and Dittmer, Maffeis, and Schofield-HW equations, and the Dietary Reference Intake recommendations. Measured and predicted energy needs were significantly correlated (P < .001 for all; range R(2) = 0.54-0.56), yet significantly different for all equations studied (P < .05) except the Maffeis and Schofield-HW equations. Differences (means +/- SD) between measured vs. predicted energy needs ranged from 9.5 +/- 123.2 (Schofield-HW) to 199.6 +/- 132.7 (WHO/NAO/FAO) kcal/day, where a value closer to zero indicates increased accuracy of the prediction equation to correspond to measured energy needs. Although results from equations studied were significantly correlated with measured resting energy needs, notable discrepancies existed which, over time, could produce undesirable weight changes in Korean children.
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Chandler-Laney PC, Hunter GR, Bush NC, Alvarez JA, Roy JL, Byrne NM, Gower BA. Associations among body size dissatisfaction, perceived dietary control, and diet history in African American and European American women. Eat Behav 2009; 10:202-8. [PMID: 19778748 PMCID: PMC2752653 DOI: 10.1016/j.eatbeh.2009.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 06/09/2009] [Accepted: 06/24/2009] [Indexed: 11/21/2022]
Abstract
European American (EA) women report greater body dissatisfaction and less dietary control than do African American (AA) women. This study investigated whether ethnic differences in dieting history contributed to differences in body dissatisfaction and dietary control, or to differential changes that may occur during weight loss and regain. Eighty-nine EA and AA women underwent dual-energy X-ray absorptiometry to measure body composition and completed questionnaires to assess body dissatisfaction and dietary control before, after, and one year following, a controlled weight-loss intervention. While EA women reported a more extensive dieting history than AA women, this difference did not contribute to ethnic differences in body dissatisfaction and perceived dietary control. During weight loss, body satisfaction improved more for AA women, and during weight regain, dietary self-efficacy worsened to a greater degree for EA women. Ethnic differences in dieting history did not contribute significantly to these differential changes. Although ethnic differences in body image and dietary control are evident prior to weight loss, and some change differentially by ethnic group during weight loss and regain, differences in dieting history do not contribute significantly to ethnic differences in body image and dietary control.
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Assessing individual dietary intake from common-plate meals: a new tool for an enduring practice. Public Health Nutr 2009; 12:2464-72. [DOI: 10.1017/s1368980009005618] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveThe purposes of the present study were to estimate individual intake from common-plate meals among Bedouin Arabs using a modified 24 h recall questionnaire, and to evaluate reported energy intake (EI) by comparison with estimated energy requirement (EER).DesignWeighed records were used to develop a method of quantifying intake from common plates. Reported EI and nutrient intakes were obtained from administration of the modified 24 h recall. The relative standard error (RSE) was used to evaluate the reliability of reported nutrient intakes. The FAO/WHO/United Nations University and Oxford equations and reported physical activity levels were used to compute ratios of reported EI to BMR and EER.SettingPopulation centres of traditionally semi-nomadic Bedouin Arabs undergoing sedentarization/urbanization in southern Israel.SubjectsA convenience sample of 451 adults (aged 19–82 years).ResultsMean (se) energy intake was 9648 (276) kJ/d (2306 (66) kcal/d) for men and 8230 (172) kJ/d (1967 (41) kcal/d) for women, of which carbohydrates accounted for 63–64 %. The nutrient intakes evaluated had RSE ratios of less than 25 %. EI:EER ratios ranged from 0·86 to 0·89, and from 0·87 to 0·93 among non-dieters who ate the usual amount on the recall day.ConclusionsThe modified 24 h recall produced plausible estimates of energy and nutrient intakes, comparable to those obtained with the 24 h recall in other populations. The modified questionnaire makes an important contribution to facilitating large-scale nutritional surveillance in the Bedouin population, and may serve as a model for modifying dietary instruments to quantify individual intake in other populations that practise common-plate eating.
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Martínez de Morentin BE, Pérez-Díez S, Hernández M, Alfredo Martínez J. Comparación de diferentes métodos de estimación del gasto energético de adultos obesos en reposo. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1138-0322(09)71392-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Weijs PJM. Validity of predictive equations for resting energy expenditure in US and Dutch overweight and obese class I and II adults aged 18-65 y. Am J Clin Nutr 2008; 88:959-70. [PMID: 18842782 DOI: 10.1093/ajcn/88.4.959] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individual energy requirements of overweight and obese adults can often not be measured by indirect calorimetry. OBJECTIVE The objective was to analyze which resting energy expenditure (REE) predictive equation was the best alternative to indirect calorimetry in US and Dutch adults aged 18-65 y with a body mass index (in kg/m(2)) of 25 to 40. DESIGN Predictive equations based on weight, height, sex, age, fat-free mass, and fat mass were tested. REE in Dutch adults was measured with indirect calorimetry, and published data from the Institute of Medicine were used for US adults. The accuracy of the equations was evaluated on the basis of the percentage of subjects predicted within 10% of the REE measured, the root mean squared prediction error (RMSE), and the mean percentage difference (bias) between predicted and measured REE. RESULTS Twenty-seven predictive equations (9 of which were based on FFM) were included. Validation was based on 180 women and 158 men from the United States and on 154 women and 54 men from the Netherlands aged <65 y with a body mass index (in kg/m(2)) of 25 to 40. Most accurate and precise for the US adults was the Mifflin equation (prediction accuracy: 79%; bias: -1.0%; RMSE: 136 kcal/d), for overweight Dutch adults was the FAO/WHO/UNU weight equation (prediction accuracy: 68%; bias: -2.5%; RMSE: 178), and for obese Dutch adults was the Lazzer equation (prediction accuracy: 69%; bias: -3.0%; RMSE: 215 kcal/d). CONCLUSIONS For US adults aged 18-65 y with a body mass index of 25 to 40, the REE can best be estimated with the Mifflin equation. For overweight and obese Dutch adults, there appears to be no accurate equation.
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Affiliation(s)
- Peter J M Weijs
- Department of Nutrition and Dietetics, Hogeschool van Amsterdam, University of Applied Science, Amsterdam, Netherlands.
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