Effect of hypocaloric meals with different macronutrient compositions on energy metabolism and lung function in obese women

Estimating resting energy expenditure from dual-energy X-ray absorptiometry: A cross-sectional study in healthy young adults

OBJECTIVE

To qualify a 3C approach model of dual-energy X-ray absorptiometry (DXA) to estimate multicomponent resting energy expenditure (REE) referenced by indirect calorimetry (IC).

METHODS

A sample of 155 college students, of both sexes (18-30 years old) was evaluated. Anthropometric measures, REE by IC, and whole-body DXA-scans were performed. The REE for each body component was determined after transforming the components from the molecular (DXA) to the organ tissue level. Bland-Altman and proportional bias analyses were used to verify agreement between REE measured (REE_IC ) and estimated (REE_DXA ).

RESULTS

Statistically significant differences were found for all sex comparisons (P < .001), except for age (P = .950). Differences from the final sex-specific models' were not found between REE_IC and REE_DXA (P > .05). Men also presented greater expenditure (P < .001) in each component, except for adipose tissue. The plots confirmed the validity of the model for both sexes, with low difference values between the measured and estimated REE. The mean of the differences of REE_IC and REE_DXA showed heteroscedasticity of the data for men (P = .004). The same error tendency was not evident for women (P = .333).

CONCLUSIONS

This 3C model, estimating REE from a multicomponent approach, allows a new application of DXA as tool for understanding intraindividual differences in terms of the mass of metabolically active tissue. Sex and populational differences should be taken in account. Consequently, we present qualified sex-specific DXA models that can be applied in different contexts such as health and sports, besides considering interpersonal differences in terms of energy expenditure.

Assessment of energy requirements in patients with short bowel syndrome by using the doubly labeled water method

BACKGROUND

Short bowel syndrome (SBS) is a serious malabsorption disorder, and dietetic management of patients with SBS is extremely challenging. Once the degree of undernutrition has been assessed, successful dietary intervention is contingent on an accurate estimation and provision of energy needs.

OBJECTIVE

We quantified total energy expenditure (TEE) in patients with SBS by using the doubly labeled water (DLW) method to inform energy needs and nutritional therapy goals.

DESIGN

In this observational study, TEE was measured in 22 participants, 11 with SBS and 11 sex-, age-, and body mass index (BMI)-matched controls (non-SBS), for 14 d with the DLW method. Predicted energy requirements were determined by using the Escott-Stump equation and compared with TEE determined with DLW. Resting energy expenditure was measured by using indirect calorimetry, and an accelerometer was also used to determine physical activity level.

RESULTS

Participants were aged (mean ± SD) 53 ± 8 y. Measured TEE was significantly higher than predicted TEE for the SBS group (1875 ± 276 compared with 1517 ± 175 kcal/d, P = 0.001) and also for the non-SBS group (2393 ± 445 compared with 1532 ± 178 kcal/d, P < 0.01). Measured TEE was significantly lower in the SBS group than in the non-SBS group (P < 0.01); however, predicted TEE did not differ significantly between the groups (P = 0.84). No significant differences were seen between measured and predicted resting energy expenditure either within or between groups.

CONCLUSIONS

Measured TEE in patients with SBS was significantly higher than predicted by using standard equations but also lower than values for age-, BMI-, and sex-matched non-SBS controls. Currently used formulas in clinical practice appear to underestimate energy requirements of patients with SBS, and revision is needed to prevent underfeeding and improve long-term prognosis. This trial was registered at clinicaltrials.gov as NCT02113228.

Estilo de vida e fatores de risco associados ao aumento da gordura corporal de mulheres

Os objetivos eram descrever a associação entre índice de massa corporal (IMC, kg/m²), porcentagem de gordura e fatores de risco para doenças metabólicas; observar a prevalência da síndrome metabólica e relacionar às características de mulheres com sobrepeso e obesas. As voluntárias (n=50; IMC=31±6; idade=36±11 anos) eram avaliadas quanto ao exame clínico, medidas antropométricas, coletas de sangue e urina, gasto energético de repouso e registro alimentar. Fases em que se tornaram obesas em ordem decrescente: idade adulta, gravidez, adolescência, depois dos 40 anos e depois do casamento. O odds de ter um ou mais familiares obesos era de 316%. Eram ansiosas (60%), depressivas (12%), compulsivas (34%) e com distúrbios do sono (32%). O odds para dislipidemia era 28%, hipertensão, 25% e para glicemia acima de 100 mg/dL era de 35%. Elas estavam em déficit calórico, mas o balanço nitrogenado era positivo. A síndrome metabólica era presente em 25% delas e estava positivamente correlacionada a indicadores da gordura corporal e idade. A obesidade destas mulheres era multifatorial com influência familiar, podendo ter contribuições genéticas e ambientais. O equilíbrio físico/emocional parece ter influenciado neste processo.

Dietary Re-education, Exercise Program, Performance and Body Indexes Associated with Risk Factors in Overweight/Obese Women

This study observed the effect of a dietary re-education plus regular physical activity on body composition, risk factors and physical test performance of sedentary overweight/obese women and to correlate these variables one with each other. Fifty women (36 ± 10 yrs; 31 ± 6 body mass index (BMI, kg/m²)) volunteered for the study. Body compositions were obtained by anthropometry and bioimpedance and some body indexes were established. One-repetition maximum (1-RM) and treadmill VO₂max tests were carried out and blood samples were obtained for lipid, glucose and uric acid analyses before (T1) and after two months of intervention (T2). Diet was established by indirect calorimetry. Body fat, glucose, uric acid, total cholesterol, HDL-cholesterol and systolic blood pressure were significantly reduced. The 1-RM and VO₂max tests were significantly increased. Neck circumference (NC) was correlated with body composition, back muscle 1-MR, HDL and LDL cholesterol, total cholesterol/HDL ratio, uric acid, and resting energy expenditure. BMI was found to be significantly correlated with waist/hip ratio, circumference sum, and body fat percentage by anthropometry and bioimpedance. Body fat percentage determined by bioimpedance and anthropometry was significantly correlated with arm fat area and arm fat area corrected respectively, and both with BMI at T1 and T2. This study suggests that a dietary reeducation plus physical activity around 200 min/week improved body composition and the health of these women. Many anthropometry measurements have correspondence to risk factors and NC could be a simple approach to reflect these results, without other more complex techniques.