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McCue MD. CO 2 scrubbing, zero gases, Keeling plots, and a mathematical approach to ameliorate the deleterious effects of ambient CO 2 during 13 C breath testing in humans and animals. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2023; 37:e9639. [PMID: 37817343 DOI: 10.1002/rcm.9639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/17/2023] [Accepted: 08/26/2023] [Indexed: 10/12/2023]
Abstract
13 C breath testing is increasingly used in physiology and ecology research because of what it reveals about the different fuels that animals oxidize to meet their energetic demands. Here I review the practice of 13 C breath testing in humans and other animals and describe the impact that contamination by ambient/background CO2 in the air can have on the accuracy of 13 C breath measurements. I briefly discuss physical methods to avoid sample contamination as well as the Keeling plot approach that researchers have been using for the past two decades to estimate δ13 C from breath samples mixed with ambient CO2 . Unfortunately, Keeling plots are not suited for 13 C breath testing in common situations where (1) a subject's VCO2 is dynamic, (2) ambient [CO2 ] may change, (3) a subject is sensitive to hypercapnia, or (4) in any flow-through indirect calorimetry system. As such, I present a mathematical solution that addresses these issues by using information about the instantaneous [CO2 ] and the δ13 CO2 of ambient air as well as the diluted breath sample to back-calculate the δ13 CO2 in the CO2 exhaled by the animal. I validate this approach by titrating a sample of 13 C-enriched gas into an air stream and demonstrate its ability to provide accurate values across a wide range of breath and air mixtures. This approach allows researchers to instantaneously calculate the δ13 C of exhaled gas of humans or other animals in real time without having to scrub ambient CO2 or rely on estimated values.
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Ide R, Ogata M, Iwasaki N, Babazono T. Low resting energy expenditure in postmenopausal Japanese women with type 2 diabetes mellitus. Diabetol Int 2019; 10:268-278. [DOI: 10.1007/s13340-019-00391-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/21/2019] [Indexed: 11/30/2022]
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Indirect Calorimetry in Clinical Practice. J Clin Med 2019; 8:jcm8091387. [PMID: 31491883 PMCID: PMC6780066 DOI: 10.3390/jcm8091387] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/28/2019] [Accepted: 08/30/2019] [Indexed: 12/14/2022] Open
Abstract
Indirect calorimetry (IC) is considered as the gold standard to determine energy expenditure, by measuring pulmonary gas exchanges. It is a non-invasive technique that allows clinicians to personalize the prescription of nutrition support to the metabolic needs and promote a better clinical outcome. Recent technical developments allow accurate and easy IC measurements in spontaneously breathing patients as well as in those on mechanical ventilation. The implementation of IC in clinical routine should be promoted in order to optimize the cost–benefit balance of nutrition therapy. This review aims at summarizing the latest innovations of IC as well as the clinical indications, benefits, and limitations.
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Measurement of Children's Real-Time Physical Activity Enjoyment Using a New Visual Analog Scale. J Phys Act Health 2019; 16:406-415. [PMID: 31104555 DOI: 10.1123/jpah.2018-0074] [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] [Indexed: 11/18/2022]
Abstract
Background: This study validated the How(e) Happy Scale (HHS) for measuring children's real-time physical activity (PA) enjoyment across PA type, intensity, sex, and weight status and compared state versus trait enjoyment. Methods: Children's (N = 31; 9.7 [1.7] y) PA intensity was measured during sport, play, and locomotive PA. Following each activity, children rated their perceived state (HHS) of enjoyment across 4 constructs (social engagement). Questionnaires measured trait PA enjoyment prior to play. Rasch Rating Scale analysis assessed model-data fit and probability distribution of HHS responses. Analyses of variance compared state versus trait PA enjoyment across main effects, and correlations assessed relationships between measured PA intensity versus state and trait PA enjoyment. Results: Trait PA enjoyment was neither different across sex and weight status nor correlated with PA intensity (r = -.16 to .22). By contrast, HHS responses differed across sex, weight status, and PA type and intensity and correlated with PA type (r = -.56 to -.28) and intensity (r = -.29 to -.32). HHS responses were ordered along the probability curve and showed good infit (0.76-1.22) and outfit (0.71-1.28) statistics and good person (r = .62) and item (r = .88) reliability. Conclusion: HHS is valid for detecting differences in real-time enjoyment across PA type and intensity in all children.
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Poulsen MK, Thomsen LP, Kjaergaard S, Rees SE, Karbing DS. Reliability of, and Agreement Between, two Breath-by-Breath Indirect Calorimeters at Varying Levels of Inspiratory Oxygen. Nutr Clin Pract 2019; 34:767-774. [PMID: 30714634 DOI: 10.1002/ncp.10250] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Indirect calorimetry (IC) is considered the accurate way of measuring energy expenditure (EE). IC devices often apply the Haldane transformation, introducing errors at inspiratory oxygen fraction (FiO2 ) >60%. The aim was to assess measurement reliability and agreement between an unevaluated IC (device 2) (Beacon Caresystem, Mermaid Care A/S, Noerresundby, Denmark) not using Haldane transformation and an IC that does (device 1) (Ecovx, GE, Helsinki, Finland) at varying FiO2 . METHODS Twenty healthy male subjects participated, with 16 completing the study (33 ± 9 years, 83.3 ± 16 kg, 1.83 ± 0.08 m). Subjects were mechanically ventilated in pressure support (3cmH2 O; positive end-expiratory pressure: 3cmH2 O) at FiO2 of 21%, 50%, 85%, and 21% for 15 minutes at each FiO2 . Mean EE, oxygen consumption (VO2 ), and CO2 production (VCO2 ) were compared within and between devices across FiO2 levels. RESULTS Device 2 showed within-device EE significant differences at 21% vs 50% FiO2 and device 1 for VCO2 at 50% vs. 85% FiO2 . For all variables, both devices showed reliable measurements at 21% and 50% FiO2 , but at 85%, FiO2 bias and limits of agreement increased. Between devices, there were significant differences for EE at both 21% and 85% FiO2 for VO2 and for VCO2 at 85% FiO2 . CONCLUSION Both systems measured EE, VO2 , and VCO2 at 21%-85% FiO2 reliably but with bias at 85% FiO2 . The devices were in agreement at 21% and 50% FiO2 , but further studies need to confirm accuracy at high FiO2 .
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Affiliation(s)
- Mathias Krogh Poulsen
- Respiratory and Critical Care Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Lars Pilegaard Thomsen
- Respiratory and Critical Care Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Søren Kjaergaard
- Department of Anesthesiology, Aalborg University Hospital, Aalborg, Denmark
| | - Stephen Edward Rees
- Respiratory and Critical Care Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Dan Stieper Karbing
- Respiratory and Critical Care Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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Kaviani S, Schoeller DA, Ravussin E, Melanson EL, Henes ST, Dugas LR, Dechert RE, Mitri G, Schoffelen PFM, Gubbels P, Tornberg A, Garland S, Akkermans M, Cooper JA. Determining the Accuracy and Reliability of Indirect Calorimeters Utilizing the Methanol Combustion Technique. Nutr Clin Pract 2018; 33:206-216. [PMID: 29658183 DOI: 10.1002/ncp.10070] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Several indirect calorimetry (IC) instruments are commercially available, but comparative validity and reliability data are lacking. Existing data are limited by inconsistencies in protocols, subject characteristics, or single-instrument validation comparisons. The aim of this study was to compare accuracy and reliability of metabolic carts using methanol combustion as the cross-laboratory criterion. METHODS Eight 20-minute methanol burn trials were completed on 12 metabolic carts. Respiratory exchange ratio (RER) and percent O2 and CO2 recovery were calculated. RESULTS For accuracy, 1 Omnical, Cosmed Quark CPET (Cosmed), and both Parvos (Parvo Medics trueOne 2400) measured all 3 variables within 2% of the true value; both DeltaTracs and the Vmax Encore System (Vmax) showed similar accuracy in measuring 1 or 2, but not all, variables. For reliability, 8 instruments were shown to be reliable, with the 2 Omnicals ranking best (coefficient of variation [CV] < 1.26%). Both Cosmeds, Parvos, DeltaTracs, 1 Jaeger Oxycon Pro (Oxycon), Max-II Metabolic Systems (Max-II), and Vmax were reliable for at least 1 variable (CV ≤ 3%). For multiple regression, humidity and amount of combusted methanol were significant predictors of RER (R2 = 0.33, P < .001). Temperature and amount of burned methanol were significant predictors of O2 recovery (R2 = 0.18, P < .001); only humidity was a predictor for CO2 recovery (R2 = 0.15, P < .001). CONCLUSIONS Omnical, Parvo, Cosmed, and DeltaTrac had greater accuracy and reliability. The small number of instruments tested and expected differences in gas calibration variability limits the generalizability of conclusions. Finally, humidity and temperature could be modified in the laboratory to optimize IC conditions.
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Affiliation(s)
- Sepideh Kaviani
- Department of Foods and Nutrition, University of Georgia, Athens, Georgia, USA
| | - Dale A Schoeller
- Department of Nutritional Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Edward L Melanson
- Division of Endocrinology, Metabolism, & Diabetes, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA
| | - Sarah T Henes
- Department of Nutrition, Georgia State University, Atlanta, Georgia, USA
| | - Lara R Dugas
- Public Health Sciences, Loyola University, Chicago, Illinois, USA
| | - Ronald E Dechert
- Pediatric Respiratory Care, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - George Mitri
- Pediatric Respiratory Care, University of Michigan Health System, Ann Arbor, Michigan, USA
| | - Paul F M Schoffelen
- Department of Human Biology & Movement Sciences, NUTRIM School for Nutrition, Toxicology & Metabolism, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Pim Gubbels
- Topsport Expertise & Innovation Centre, Sittard, the Netherlands
| | - Asa Tornberg
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Stephen Garland
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Marco Akkermans
- Center of Expertise for Chronic Organ Failure, Horn, the Netherlands
| | - Jamie A Cooper
- Department of Foods and Nutrition, University of Georgia, Athens, Georgia, USA
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Howe CA, Clevenger KA, Leslie RE, Ragan MA. Comparison of Accelerometer-Based Cut-Points for Children's Physical Activity: Counts vs. Steps. CHILDREN-BASEL 2018; 5:children5080105. [PMID: 30081457 PMCID: PMC6111715 DOI: 10.3390/children5080105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/29/2018] [Accepted: 08/01/2018] [Indexed: 11/26/2022]
Abstract
Background: Accelerometers measure complex movements of children’s free play moderate-vigorous physical activity (MVPA), including step and non-step movements. Current accelerometer technology has introduced algorithms to measure steps, along with counts. Precise interpretation of accelerometer-based cadence (steps/min) cut-points is necessary for accurately measuring and tracking children’s MVPA. The purpose of this study was to assess the relationships and agreement between accelerometer-based cut-points (cadence and counts/min) to estimate children’s MVPA compared to measured values. Methods: Forty children (8–12 years; 25 boys) played 6–10 games while wearing a portable metabolic analyzer and GT3X+ to measure and estimate MVPA, respectively. Correlation, kappa, sensitivity, and specificity assessed the relationships and agreement between measured and estimated MVPA. Results: Games elicited, on average, 6.3 ± 1.6 METs, 64.5 ± 24.7 steps/min, and 3318 ± 1262 vertical (V) and 5350 ± 1547 vector-magnitude (VM) counts/min. The relationship between measured and estimated MVPA intensity was higher for cadence (r = 0.50) than V and VM counts/min (r = 0.38 for both). Agreement using V and VM counts/min for measuring PA intensity varied by cut-points (range: 6.8% (κ = −0.02) to 97.6% (κ = 0.49)), while agreement was low using cadence cut-points (range: 4.0% (κ = 0.0009) to 11.3% (κ = 0.001)). Conclusion: While measured and estimated values were well correlated, using cadence tended to misclassify children’s free-play MVPA.
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Affiliation(s)
- Cheryl A Howe
- School of Applied Health Sciences and Wellness, Ohio University, 1 University Terrace, Grover Center E154, Athens, OH 45701, USA.
| | - Kimberly A Clevenger
- Department of Kinesiology, Michigan State University, East Lansing, MI 48824, USA.
| | - Ryann E Leslie
- School of Applied Health Sciences and Wellness, Ohio University, 1 University Terrace, Grover Center E154, Athens, OH 45701, USA.
| | - Moira A Ragan
- Gladys W. and David H. Patton College of Education, Ohio University, Athens, OH 45701, USA.
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Eto E, Maki J, Tamada S, Mitsui T, Hayata K, Hiramatsu Y, Masuyama H. Assessment of resting energy expenditure and body composition in Japanese pregnant women with diabetes. J Diabetes Investig 2018; 9:959-966. [PMID: 29280333 PMCID: PMC6031507 DOI: 10.1111/jdi.12795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/27/2017] [Accepted: 12/11/2017] [Indexed: 11/30/2022] Open
Abstract
AIMS/INTRODUCTION To measure longitudinal changes in resting energy expenditure and body composition of Japanese pregnant women with or without diabetes. MATERIALS AND METHODS The study population consisted of women who had delivered a live singleton neonate after 22 weeks' gestation at Okayama University Hospital from July 2013 to June 2017. Resting energy expenditure and body composition were measured in the first trimester, second trimester, third trimester and postpartum. RESULTS A total of 144 women participated in this study: 103 with normal glucose tolerance and 41 with diabetes. The resting energy expenditure (kcal/day) of pregnant women with normal glucose tolerance was significantly higher in the third trimester (1,644 ± 234) than in the first (1,461 ± 215) and second trimesters (1,491 ± 219), and postpartum (1,419 ± 254), whereas that of pregnant women with diabetes did not significantly change during all periods (1,568 ± 404, 1,710 ± 332, 1,716 ± 251, 1,567 ± 249). The resting energy expenditure of women with good glycemic control was lower than that of women with poor control. Fat-free mass was closely correlated with resting energy expenditure. CONCLUSIONS The resting energy expenditure of Japanese pregnant women with normal glucose tolerance was significantly increased in the third trimester. The resting energy expenditure of women with good glycemic control was lower than that of women with poor control. Resting energy expenditure and fat-free mass are potential indexes for medical nutrition therapy in pregnant women with diabetes.
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Affiliation(s)
- Eriko Eto
- Department of Obstetrics and GynecologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Jota Maki
- Department of Obstetrics and GynecologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Shoko Tamada
- Department of Obstetrics and GynecologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Takashi Mitsui
- Department of Obstetrics and GynecologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Kei Hayata
- Department of Obstetrics and GynecologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
| | - Yuji Hiramatsu
- Department of Obstetrics and GynecologyOkayama City General Medical CenterOkayamaJapan
| | - Hisashi Masuyama
- Department of Obstetrics and GynecologyOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
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Templeman I, Thompson D, Gonzalez J, Walhin JP, Reeves S, Rogers PJ, Brunstrom JM, Karagounis LG, Tsintzas K, Betts JA. Intermittent fasting, energy balance and associated health outcomes in adults: study protocol for a randomised controlled trial. Trials 2018; 19:86. [PMID: 29394908 PMCID: PMC5797418 DOI: 10.1186/s13063-018-2451-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/04/2018] [Indexed: 12/03/2022] Open
Abstract
Background Prior studies have shown that intermittent fasting is capable of producing improvements in body weight and fasted health markers. However, the extent to which intermittent fasting incurs compensatory changes in the components of energy balance and its impact on postprandial metabolism are yet to be ascertained. Methods A total of 30–36 lean participants and 30–36 overweight/obese participants will be recruited to provide two separate study groups who will undergo the same protocol. Following an initial assessment of basic anthropometry and key health markers, measurements of habitual energy intake (weighed food and fluid intake) and physical activity energy expenditure (combined heart rate and accelerometry) will be obtained over 4 weeks under conditions of energy balance. Participants will then be randomly allocated to one of three experimental conditions for 20 days, namely (1) daily calorie restriction (reduce habitual daily energy intake by 25%), (2) intermittent fasting with calorie restriction (alternate between 24-hour periods of fasting and feeding to 150% of habitual daily energy intake), (3) intermittent fasting without calorie restriction (alternate between 24-hour periods of fasting and feeding to 200% of habitual daily energy intake). In addition to continued monitoring of energy intake and physical activity during the intervention, participants will report for laboratory-based assessments of various metabolic parameters both before and after the intervention. Specifically, fasting and postprandial measurements of resting metabolic rate, substrate oxidation, appetite, food preference, and plasma concentrations of key metabolites and hormones will be made, in addition to subcutaneous abdominal adipose tissue biopsies in the fasted state and an assessment of body composition via dual-energy x-ray absorptiometry. Discussion Comparing observed changes in these measures across the three intervention arms in each group will establish the impact of intermittent fasting on postprandial metabolism and the components of energy balance in both lean and overweight/obese populations. Furthermore, this will be benchmarked against current nutritional interventions for weight management and the relative contributions of negative energy balance and fasting-dependent mechanisms in inducing any observed effects will be elucidated. Trial registration Trial retrospectively registered at clinicaltrials.gov under reference number NCT02498002 (version: IMF-02, date: July 6, 2015). Electronic supplementary material The online version of this article (10.1186/s13063-018-2451-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iain Templeman
- Department for Health, University of Bath, Bath, BA2 7AY, UK.
| | - Dylan Thompson
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | - Javier Gonzalez
- Department for Health, University of Bath, Bath, BA2 7AY, UK
| | | | - Sue Reeves
- Department of Life Sciences, University of Roehampton, London, SW15 4JD, UK
| | - Peter J Rogers
- School of Experimental Psychology, University of Bristol, Bristol, BS8 1TU, UK
| | - Jeffrey M Brunstrom
- School of Experimental Psychology, University of Bristol, Bristol, BS8 1TU, UK
| | - Leonidas G Karagounis
- Faculty of Sport and Health Sciences, University of St Mark and St John, Plymouth, PL6 8BH, UK
| | - Kostas Tsintzas
- School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - James A Betts
- Department for Health, University of Bath, Bath, BA2 7AY, UK
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Wang X, Wang Y, Ma Z, Xu Y, Wu Q. Indirect calorimetry using a ventilated hood may be easier than using a facemask to achieve steady state when measuring resting energy expenditure. Nutr Res 2017; 48:33-39. [PMID: 29246279 DOI: 10.1016/j.nutres.2017.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/27/2017] [Accepted: 10/06/2017] [Indexed: 10/18/2022]
Abstract
Previous studies have demonstrated differences in subjective comfort between different gas collecting methods during resting energy expenditure (REE) measurement. We hypothesized that gas collecting methods may have an influence on the time to achieve steady state and the optimum abbreviated period to estimate REE. Gas exchange variables were obtained using IIM-IC-100 (ventilated hood) and VO2000 (facemask) alternately among 32 healthy adults. A 10-minute test period was divided into 5-minute sliding time windows to obtain a subtle profile process of the coefficient of variation (CV) and REE. Friedman's test was used to compare the CVs during the test process. To compare the REE between abbreviated measurements and the reference, paired t test, linear regression, and Bland-Altman test were used. There were no significant differences between the CVs in each adjacent group of 5-minute intervals for IIM-IC-100 (P = .896). CV1 and CV2 were significantly higher than CV3-CV6 for VO2000 (P = .001). The proportion of subjects achieving steady state was lower with VO2000 (59.4-81.3%) than with IIM-IC-100 (84.4-91.8%). REE of the 2nd and 3rd 5-minute intervals did not differ from the reference, and they explained 94.7% (P < .001) and 94.9% (P < .001) of the last 5-minute REE variance, with the 95% limits of agreement ranging from -100.0 to 139.2 kcal/d and -139.5 to 182.5 kcal/d for IIM-IC-100 and VO2000, respectively. In conclusion, using a ventilated hood may be easier than using a facemask to achieve steady state and reduce the time required to estimate REE.
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Affiliation(s)
- Xi Wang
- Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, Anhui, PR China; Department of Automation, University of Science and Technology of China, Hefei, Anhui, PR China
| | - Yuan Wang
- Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, Anhui, PR China
| | - Zuchang Ma
- Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, Anhui, PR China.
| | - Yang Xu
- Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, Anhui, PR China
| | - Qingyuan Wu
- Research Center for Information Technology of Sports and Health, Institute of Intelligent Machines, Chinese Academy of Sciences, Hefei, Anhui, PR China; Department of Automation, University of Science and Technology of China, Hefei, Anhui, PR China
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Rubenbauer JR, Johannsen DL, Baier SM, Litchfield R, Flakoll PJ. The Use of a Handheld Calorimetry Unit to Estimate Energy Expenditure During Different Physiological Conditions. JPEN J Parenter Enteral Nutr 2017; 30:246-50. [PMID: 16639072 DOI: 10.1177/0148607106030003246] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Accurately determining rates of energy expenditure (EE) under free-living conditions is important in understanding the mechanisms involved in the development and prevention of obesity. Metabolic carts are not portable enough for most free-living situations. The purpose of this study was to compare a portable, handheld indirect calorimetry device (HealtheTech Incorporated, Golden, CO) to a metabolic cart (Physio-Dyne Instrument Corporation, Quogue, NY) during 3 different physiologic states. METHODS EE was measured by both the handheld calorimeter (5-10 minutes) and the metabolic cart (15-20 minutes) in 20 healthy subjects (18-35 years of age). Measurements were made during 3 physiologic states: (1) postabsorptive rest (REE), (2) postprandial rest (fed energy expenditure, FEE), and (3) while walking in place (activity energy expenditure, AEE). RESULTS There were no significant differences between the means of the cart vs the hand-held device for REE (mean +/- SE; kcal/d; 1552 +/- 64 vs 1551 +/- 63), FEE (1875 +/- 99 vs 1825 +/- 86), and AEE (3333 +/- 218 vs 3489 +/- 152). The range over which the techniques were tested was 1300-5000 kcal/d. The agreement between the 2 methods was excellent for REE (0.80, p < .0001), FEE (0.89, p < .0001), and AEE (0.75, p < .0002). CONCLUSIONS Compared with the metabolic cart, the handheld device provided similar estimates of energy expenditure during resting, postprandial, and physically active states. This suggests that portable indirect calorimetry devices can provide reliable and valuable information in free-living research situations for which maximal energy expenditure is <5000 kcal/d.
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Affiliation(s)
- Justine R Rubenbauer
- Center for Designing Foods to Improve Nutrition, Department of Food Science and Human Nutrition, Iowa State University, Ames, Iowa 50011-1120, USA
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Comparison of the GEM and the ECAL indirect calorimeters against the Deltatrac for measures of RMR and diet-induced thermogenesis. J Nutr Sci 2014; 3:e52. [PMID: 26101620 PMCID: PMC4473179 DOI: 10.1017/jns.2014.58] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 07/02/2014] [Accepted: 09/11/2014] [Indexed: 11/05/2022] Open
Abstract
The Deltatrac™ II Metabolic Monitor (Datex-Ohmeda Inc.) is considered the standard reference machine in indirect calorimetry; however, it is no longer commercially available thus there is a need for new machines. The gas exchange measurement (GEM; GEM Nutrition Ltd) and the ECAL (Health Professional Solutions) are alternative measuring systems. The aim of this study was to compare the ECAL and GEM with Deltatrac for measures of RMR and the GEM to the Deltatrac for measures of diet-induced thermogenesis (DIT). Twenty healthy participants were tested on test day 1 (T1) and test day 2 (T2). RMR was measured in a randomised order for 30 min on the Deltatrac, the GEM and the ECAL. Following this, a 1553 kJ meal was consumed and DIT was measured on the Deltatrac and the GEM in alternating 15 min intervals for 4 h. The GEM reported consistently higher values than the Deltatrac for VO2, VCO2, RMR and fat oxidation (P < 0·005). The ECAL was significantly higher than the Deltatrac for measures of VO2, RMR, carbohydrate oxidation (T2) and respiratory quotient and fat oxidation (T1, T2) (P < 0·05). There were no significant differences within repeated RMR measures on the ECAL, the GEM or the Deltatrac. DIT measures were consistently higher on the GEM (T1) (P < 0·005); however, there were no significant differences between repeated measures. The findings suggest that while the GEM and the ECAL were not accurate alternatives to the Deltatrac, they may be reliable for repeated measures.
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Robins K, Stankorb SM, Salgueiro M. Energy expenditure in acute posttraumatic amputation: comparison of four methods for assessment. Nutr Clin Pract 2013; 28:758-65. [PMID: 24170581 DOI: 10.1177/0884533613507605] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Adequate energy intake is a component of successful recovery after injury, yet little is known about the energy requirements in the acute period following traumatic amputation. The purpose of this study was to compare the clinical applicability of resting energy expenditure (REE) measured by a handheld calorimeter and estimated by 3 different predictive equations to that measured by the gold standard, indirect calorimetry using a metabolic cart, during the acute postamputation period of inpatient hospitalization. MATERIALS AND METHODS Indirect calorimetry measured using both a metabolic cart and handheld calorimeter and predicted by 3 equations were used to assess energy needs of eligible subjects admitted to Brooke Army Medical Center with traumatic amputation(s). REE measured by the handheld calorimeter and estimated using 3 predictive equations (Mifflin St. Jeor, Ireton-Jones 1992, and the American College of Chest Physicians [ACCP]) were compared to the gold standard metabolic cart. Each measure was assessed for significant differences and level of clinical acceptability defined as ± 10% REE by metabolic cart. RESULTS Thirteen male service members with traumatic amputation(s) were included. The majority of subject's measurements using the handheld calorimeter (n = 9, 69%) and 3 predictive equations (Mifflin St. Jeor [n = 7, 54%], Ireton-Jones 1992 [n = 8, 62%], ACCP [n = 7, 54%]) fell outside of the ± 10% range of clinical acceptability. CONCLUSION Use of the metabolic cart for measuring energy needs remains optimal in this population.
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Affiliation(s)
- Kathleen Robins
- Marybeth Salgueiro, DCN, Brooke Army Medical Center, 3551 Roger Brooke Drive, MCHE-DF, San Antonio, TX 78248, USA.
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Yao E, Buchholz AC, Edwards AM, Simpson JAR. Predicted and measured resting metabolic rate in young, non-obese women. CAN J DIET PRACT RES 2013; 74:124-30. [PMID: 24018004 DOI: 10.3148/74.3.2013.124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE Measured resting metabolic rate (RMR) was compared with predicted RMR in a sample of young, non-obese women. METHODS In 52 women aged 19 to 30 with a body mass index of 16 to 29 kg/m2, RMR was measured with a MedGem indirect calorimeter and predicted with five commonly used equations: the Harris-Benedict (1919), Mifflin (1989), Owen (1985), Schofield (weight) (1985), and Schofield (weight and height) (1985) equations. Measured RMR and predicted RMR were compared through the use of various measures. RESULTS In comparison with the measured RMR, the RMR predicted with four of the five equations was significantly higher (by 16 to 225 kcal/day, p < 0.001). At the group level, the Owen equation performed best and captured the greatest proportion of individuals (65%) for whom predicted RMR differed from measured RMR by less than 10%. With the other four equations, residuals exceeded 10% for more than two-thirds of participants. For the Harris-Benedict, Mifflin, and Owen equations, every 100 kcal/day increase in measured RMR was associated with a 6% to 8% decrease in error. The optimal prediction range (within 10% of the measured RMR) was different for each: Owen equation 1105 to 1400 kcal/day, Mifflin equation 1280 to 1595 kcal/day, and Harris-Benedict equation 1345 to 1630 kcal/day. CONCLUSIONS Prediction equations should be modified according to the amount of corresponding percentage error. Where possible, RMR should be measured. Barring this, the Owen equation should be used for young, non-obese women.
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Madden AM, Parker LJF, Amirabdollahian F. Accuracy and preference of measuring resting energy expenditure using a handheld calorimeter in healthy adults. J Hum Nutr Diet 2013; 26:587-95. [PMID: 23650967 DOI: 10.1111/jhn.12045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Accurate estimates of energy expenditure are required in clinical nutrition in order to determine the requirements of individuals and to inform feeding regimes. Calorimetry can provide accurate measurements but is often impractical in clinical or community settings; prediction equations are widely used to estimate resting energy expenditure (REE) but have limited accuracy. A portable, self-calibrating, handheld calorimeter (HHC) may offer an alternative way of determining REE. The aim of the study was to evaluate whether estimates of REE derived using an HHC are closer to accurate measurements than values calculated using selected prediction equations. METHODS REE was measured in 36 healthy adults aged 21-58 years using a flow-through indirect calorimeter (FIC) and HHC. Estimated REE was calculated using three predictive equations (Harris & Benedict; Schofield; Henry). Differences in REE between the 'gold standard' values derived using the FIC and those derived using the HHC and equations were examined using paired t-tests and Bland Altman plots. RESULTS Mean REEHHC was significantly lower than mean REEFIC [4556 ± 1042 kJ (1089 ± 249 kcal) versus 6230 ± 895 kJ (1489 ± 214 kcal), P = 0.000] and also significantly lower than mean values calculated using all three equations. The mean difference between REEHHC and REEFIC [1674 ± 908 kJ (400 ± 217 kcal)] was significantly greater (P = 0.000) than the mean differences between the values calculated using the three prediction equations [272 ± 490 kJ (65 ± 117 kcal) (Harris-Benedict), 264 ± 510 kJ (63 ± 122 kcal) (Schofield), 84 ± 502 kJ (20 ± 120 kcal) (Henry)]. CONCLUSIONS The HHC provides estimates of REE in healthy people that are less accurate than those calculated using the prediction equations and so does not provide a useful alternative.
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Affiliation(s)
- A M Madden
- Department of Human & Environmental Sciences, University of Hertfordshire, Hatfield, UK
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16
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Frankenfield DC, Coleman A. An evaluation of a handheld indirect calorimeter against a standard calorimeter in obese and nonobese adults. JPEN J Parenter Enteral Nutr 2013; 37:652-8. [PMID: 23334358 DOI: 10.1177/0148607112473340] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Handheld indirect calorimetry has the potential to allow simple and inexpensive measurement of resting metabolic rate in spontaneously breathing people. However, validation work on these devices is contradictory. The purpose of the current study was to determine the bias and level of agreement of oxygen consumption and resting metabolic rate as measured by a handheld indirect calorimeter against a standard open-circuit indirect calorimetry cart. MATERIALS AND METHODS One hundred community-living, spontaneously breathing, ambulatory nonobese and obese adults were studied in single sessions by a single investigator. Sequential measurements were undertaken using the handheld indirect calorimeter and the standard metabolic cart. Measurement sequence was varied randomly. RESULTS The mean value for oxygen consumption and metabolic rate of the 2 devices was not significantly different. However, agreement between the 2 devices was only 43% in nonobese and obese participants, and there was proportional and fixed bias, with the handheld calorimeter tending to produce a higher value for oxygen consumption and resting metabolic rate. Limits of agreement for resting metabolic rate between the 2 calorimeters were -240 to +300 kcal/d. CONCLUSIONS Measurements of resting metabolic rate by the handheld indirect calorimeter tested in this study are not equivalent to measurements by standard indirect calorimetry.
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Affiliation(s)
- David C Frankenfield
- Department of Clinical Nutrition and Department of Nursing, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.
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A comparison of indirect calorimeters' measures of resting metabolic rate. Proc Nutr Soc 2013. [DOI: 10.1017/s002966511300178x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Rao ZY, Wu XT, Liang BM, Wang MY, Hu W. Comparison of five equations for estimating resting energy expenditure in Chinese young, normal weight healthy adults. Eur J Med Res 2012; 17:26. [PMID: 22937737 PMCID: PMC3477055 DOI: 10.1186/2047-783x-17-26] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 07/25/2012] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Most resting energy expenditure (REE) predictive equations for adults were derived from research conducted in western populations; whether they can also be used in Chinese young people is still unclear. Therefore, we conducted this study to determine the best REE predictive equation in Chinese normal weight young adults. METHODS Forty-three (21 male, 22 female) healthy college students between the age of 18 and 25 years were recruited. REE was measured by the indirect calorimetry (IC) method. Harris-Benedict, World Health Organization (WHO), Owen, Mifflin and Liu's equations were used to predictREE (REEe). REEe that was within 10% of measured REE (REEm) was defined as accurate. Student's t test, Wilcoxon Signed Ranks Test, McNemar Test and the Bland-Altman method were used for data analysis. RESULTS REEm was significantly lower (P < 0.05 or P < 0.01) than REEe from equations, except for Liu's, Liu's-s, Owen, Owen-s and Mifflin in men and Liu's and Owen in women. REEe calculated by ideal body weight was significantly higher than REEe calculated by current body weight ( P < 0.01), the only exception being Harris-Benedict equation in men. Bland-Altman analysis showed that the Owen equation with current body weight generated the least bias. The biases of REEe from Owen with ideal body weight and Mifflin with both current and ideal weights were also lower. CONCLUSIONS Liu's, Owen, and Mifflin equations are appropriate for the prediction of REE in young Chinese adults. However, the use of ideal body weight did not increase the accuracy of REEe.
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Affiliation(s)
- Zhi-yong Rao
- Department of Clinical Nutrition, West China Hospital of Sichuan University, Chengdu, China
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Sandboge S, Moltchanova E, Blomstedt PA, Salonen MK, Kajantie E, Osmond C, Barker DJP, Eriksson JG. Birth-weight and resting metabolic rate in adulthood - sex-specific differences. Ann Med 2012; 44:296-303. [PMID: 21352083 DOI: 10.3109/07853890.2010.549147] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Low birth-weight is associated with an increased risk of cardiovascular disease, hypertension, and the metabolic syndrome (MetS) in adulthood. Resting metabolic rate (RMR) has been suggested to be associated with the development of obesity as well as MetS and might be an indirect indicator of sympathetic activity. This study's aim was to examine the association between birth-weight and adult RMR. METHODS A total of 896 men and women from the Helsinki Birth Cohort Study born 1934-44, for whom a detailed set of birth records were available, underwent measurement of body composition and RMR in adulthood. RESULTS Among women, birth-weight adjusted for age and fat-free mass (FFM) was inversely associated with RMR (r = -0.12; P < 0.01). For men, a u-shaped relationship was observed, both independently and after adjustment for age, fat mass, and FFM (P = 0.05 for final model). DISCUSSION The sex-specific differences for the association between birth-weight and adult RMR might partly be explained by differences in the developmental programming of the sympathetic nervous system between men and women. The higher adjusted RMR among those with the lowest birth-weights is consistent with previous evidence of higher sympathetic drive among these individuals.
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Affiliation(s)
- Samuel Sandboge
- National Institute for Health and Welfare, Department of Chronic Disease Prevention, Diabetes Prevention Unit, Helsinki, Finland.
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Hipskind P, Glass C, Charlton D, Nowak D, Dasarathy S. Do handheld calorimeters have a role in assessment of nutrition needs in hospitalized patients? A systematic review of literature. Nutr Clin Pract 2012; 26:426-33. [PMID: 21775638 DOI: 10.1177/0884533611411272] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Indirect calorimetry is a noninvasive and reliable means of determining resting metabolic rate in humans. Barriers to obtaining an accurate measure of resting metabolic rate (RMR) in hospitalized patients include the expense and the requirement of technical expertise for maintenance. METHODS A literature search on handheld calorimeters was conducted using PubMed and OVID. The search resulted in a total of 54 published articles; 23 of these specifically are about handheld calorimeter devices. RESULTS Results from a handheld calorimeter were similar to those obtained from metabolic cart studies. The Douglas bag method compared with the MedGem indicated a significant agreement (P = .286). The handheld device was compared with metabolic carts in 9 studies with mixed results. The predictive equations (Harris-Benedict, Mifflin-St Jeor, and FAO/WHO equations) over- and underestimated RMR compared with the MedGem. The Harris-Benedict equation overestimated the RMR by 3%-11%, the Mifflin-St Jeor equation overestimated the RMR by 1%, and the FAO/WHO equation overestimated RMR by 12%. CONCLUSION The present study examines the validity and reliability of handheld calorimeters for measuring resting energy expenditure based on published literature. Handheld calorimeters are more accurate than predictive equations based on gender, age, and ethnicity for determining resting metabolic rate and are therefore a viable alternative for clinical evaluation of the hospitalized patient.
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Affiliation(s)
- Peggy Hipskind
- Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44106, USA
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Hedayati KK, Dittmar M. Body circumferences are predictors of weight adjusted resting energy expenditure in older people. J Nutr Health Aging 2011; 15:803-8. [PMID: 22159765 DOI: 10.1007/s12603-011-0072-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate predictors of resting energy expenditure (REE) in older people which are more comfortable for them than indirect calorimetry and which are suitable for field studies. DESIGN Cross-sectional study. SETTING Department of Human Biology, Kiel University. PARTICIPANTS 100 (51 males, 49 females) healthy independently-living normal-weight (BMI, males 26.0±2.67 kg/m², females 25.0±3.29 kg/m²) Germans, aged 60-83 years. MEASUREMENTS REE, body composition, anthropometry, peak expiratory flow rate (PEF), and physical activity level were determined using indirect calorimetry, bioimpedance analysis, anthropometrics, peak-flow-meter, and standardized questionnaire, respectively. Stepwise linear multiple regression analysis was performed with REE or weight adjusted REE as dependent variables. Independent variables were body height, weight, body mass index (BMI), waist circumference, abdomen circumference, hip circumference, waist-to-hip ratio (WHR), lean body mass (LBM), PEF, and physical activity level. RESULTS The only significant predictor of REE was LBM in males and BMI in females. Trunk circumferences emerged as strong predictors of weight adjusted REE. Abdomen circumference and hip circumference explained in males and females 69% and 70% of variation in adjusted REE, respectively. Weaker predictors were LBM in males (R² increased from 0.69 to 0.80) as well as body height and BMI in females (R² increased from 0.70 to 0.91). Waist circumference, WHR, physical activity level, and PEF were no significant determinants of adjusted REE. CONCLUSION These findings demonstrate that trunk circumferences, but not WHR, are very strong predictors of weight adjusted REE in non-geriatric older people. This implies that the sex-specific use of abdomen or hip circumference in combination with LBM or body height and BMI seems to be well sufficient to predict weight adjusted REE in the aged. These measures might also be of clinical relevance, because they are more comfortable for older sick people than indirect calorimetry. Further studies are needed to test the applicability of the prediction equations to frail older populations.
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Affiliation(s)
- K Khalaj Hedayati
- Department of Human Biology, Zoological Institute, Christian-Albrechts-University, Kiel, Germany.
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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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Khalaj-Hedayati K, Bosy-Westphal A, Müller MJ, Dittmar M. Validation of the BIOPAC indirect calorimeter for determining resting energy expenditure in healthy free-living older people. Nutr Res 2009; 29:531-41. [DOI: 10.1016/j.nutres.2009.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 08/03/2009] [Accepted: 08/13/2009] [Indexed: 10/20/2022]
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Hand-Held Indirect Calorimeter Offers Advantages Compared with Prediction Equations, in a Group of Overweight Women, to Determine Resting Energy Expenditures and Estimated Total Energy Expenditures during Research Screening. ACTA ACUST UNITED AC 2009; 109:836-45. [DOI: 10.1016/j.jada.2009.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Accepted: 11/18/2008] [Indexed: 11/23/2022]
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Cooper JA, Watras AC, O'Brien MJ, Luke A, Dobratz JR, Earthman CP, Schoeller DA. Assessing validity and reliability of resting metabolic rate in six gas analysis systems. ACTA ACUST UNITED AC 2009; 109:128-32. [PMID: 19103333 DOI: 10.1016/j.jada.2008.10.004] [Citation(s) in RCA: 154] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Accepted: 05/23/2008] [Indexed: 11/18/2022]
Abstract
The Deltatrac Metabolic Monitor (DTC) (VIASYS Healthcare Inc, SensorMedics, Yorba Linda, CA), one of the most popular indirect calorimetry systems for measuring resting metabolic rate (RMR) in human subjects, is no longer being manufactured. This study compared five different gas analysis systems to the DTC. RMR was measured by the DTC and at least one other instrument at three study sites for a total of 38 participants. The five indirect calorimetry systems included the MedGraphics CPX Ultima (Medical Graphics Corp, St Paul, MN), the MedGem (Microlife USA, Golden, CO), Vmax Encore 29 System (VIASYS Healthcare Inc, Yorba Linda, CA), the TrueOne 2400 (Parvo Medics, Sandy, UT), and the Korr ReeVue (Korr Medical Technologies, Salt Lake City, UT). Validity was assessed using paired t tests to compare means; reliability was assessed by using both paired t tests and root mean square calculations with F tests for significance. Within-subject comparisons for validity of RMR revealed a significant difference between the DTC and the Ultima system. Bland-Altman plot analysis showed significant bias with increasing RMR values for the Korr and MedGem systems. Respiratory exchange ratio (RER) analysis showed a significant difference between the DTC and the Ultima system and a trend for a difference with the Vmax system (P=0.09). Reliability assessment for RMR revealed that all instruments had a significantly larger coefficient of variation (CV) (ranging from 4.8% to 10.9%) for RMR compared to the 3.0% CV for the DTC. Reliability assessment for RER data showed none of the instrument CVs was significantly larger than the DTC CV. The results were quite disappointing because none of the instruments equaled the within-person reliability of the DTC. The TrueOne and Vmax systems were the most valid instruments in comparison with the DTC for both RMR and RER assessment. Further testing is needed to identify an instrument with the reliability and validity of the DTC.
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Affiliation(s)
- Jamie A Cooper
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
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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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Skouroliakou M, Giannopoulou I, Kostara C, Vasilopoulou M. Comparison of predictive equations for resting metabolic rate in obese psychiatric patients taking olanzapine. Nutrition 2009; 25:188-93. [DOI: 10.1016/j.nut.2008.08.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Revised: 08/08/2008] [Accepted: 08/12/2008] [Indexed: 11/29/2022]
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Froehle AW. Climate variables as predictors of basal metabolic rate: New equations. Am J Hum Biol 2008; 20:510-29. [DOI: 10.1002/ajhb.20769] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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Fares S, Miller MD, Masters S, Crotty M. Measuring energy expenditure in community-dwelling older adults: are portable methods valid and acceptable? ACTA ACUST UNITED AC 2008; 108:544-8. [PMID: 18313438 DOI: 10.1016/j.jada.2007.12.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2007] [Indexed: 11/18/2022]
Abstract
The objective of this study was to assess the validity and acceptability of a handheld indirect calorimeter for measurement of resting energy expenditure in a sample of community-dwelling older adults. It was a measurement study involving 48 healthy community-dwelling older adults. Assessment of resting energy expenditure was performed in 48 healthy older adults under fasting conditions using the Europa Gas Exchange Monitor (GEM; ventilated hood indirect calorimeter, NutrEn Technology Ltd, Cheshire, UK) and the MedGem (handheld indirect calorimeter, HealtheTech Inc, Golden, CO). An eight-item self-administered survey was used to determine the acceptability of the two measurement devices. Bias and limits of agreement were calculated to determine the level of agreement between the two measurements. The Wilcoxon signed-ranks test was used to test for significant differences across items of the self-administered survey. Participants mean age was 80 years and mean body mass index (calculated as kg/m(2)) was 23. Mean (95% confidence interval) resting energy expenditure was 1,149 kcal/day (1,086, 1,194) and 1,489 kcal/day (1,386, 1,592) for the traditional and handheld indirect calorimeter, respectively; paired t test P<0.001. Mean bias and limits of agreement were 349 kcal (-270, 969) or 5 kcal/kg/day (-3.6, 13.2) with least products regression resulting in a slope of b(1)=1.9 (95% confidence interval 1.2, 2.7, P<0.05). The handheld indirect calorimeter was less acceptable to participants than the ventilated hood indirect calorimeter. Measurement of resting energy expenditure from the handheld indirect calorimeter used in this study is not acceptable for use in healthy older adults given the magnitude of the overestimate, the wide limits of agreement, the significant slope of the bias, and the discomfort experienced by the participants.
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Affiliation(s)
- Samira Fares
- Flinders University Department of Rehabilitation and Aged Care, Repatriation General Hospital, Daw Park, South Australia, Australia
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Van Loan MD. Do hand-held calorimeters provide reliable and accurate estimates of resting metabolic rate? J Am Coll Nutr 2008; 26:625-9. [PMID: 18187425 DOI: 10.1080/07315724.2007.10719639] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This paper provides an overview of a new technique for indirect calorimetry and the assessment of resting metabolic rate. Information from the research literature includes findings on the reliability and validity of a new hand-held indirect calorimeter as well as use in clinical and field settings. Research findings to date are of mixed results. The MedGem instrument has provided more consistent results when compared to the Douglas bag method of measuring metabolic rate. The BodyGem instrument has been shown to be less accurate when compared to standard metabolic carts. Furthermore, when the Body Gem has been used with clinical patients or with under nourished individuals the results have not been acceptable. Overall, there is not a large enough body of evidence to definitively support the use of these hand-held devices for assessment of metabolic rate in a wide variety of clinical or research environments.
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Affiliation(s)
- Marta D Van Loan
- FACSM, USDA, ARS, Western Human Nutrition Research Center, University of California, 430 West Health Sciences Drive, Davis, CA 95616, USA.
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Comparison of Handheld to Metabolic Cart Indirect Calorimetry for Resting Energy Expenditure Assessment in Extremely Obese Women. TOP CLIN NUTR 2007. [DOI: 10.1097/01.tin.0000270131.48518.76] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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da Rocha EEM, Alves VGF, da Fonseca RBV. Indirect calorimetry: methodology, instruments and clinical application. Curr Opin Clin Nutr Metab Care 2006; 9:247-56. [PMID: 16607124 DOI: 10.1097/01.mco.0000222107.15548.f5] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW This review aims to identify the basic methods for accurately measuring a patient's energy expenditure in clinical nutrition practice by indirect calorimetry, and the impact upon a disease state of applying the results obtained. RECENT FINDINGS The open-circuit method is the most widely used in the majority of classical instruments for measuring energy consumption. Advances in gas exchange measurement have made this technique readily and precisely available at the bedside. Nevertheless, it is important to understand its intricate primary methodology for safe and correct application. The stress and activity factors should be carefully and specifically applied, and the respiratory quotient abandoned, for tailoring a patient's daily nutrition regimens. Caloric expenditure measured by indirect calorimetry coupled with the doubly labeled water technique introduced the concept of physical activity energy expenditure, which added to resting energy expenditure results in total daily energy expenditure. Compact modular and handheld devices have been introduced into the market, together with similar technology for evaluating exercise energy expenditure, making utilization easier, safer and precise. In the critically ill population, which is exposed to medical and surgical interventions, indirect calorimetry has greatly changed the practice of caloric administration, significantly reducing the total daily amount. SUMMARY In conclusion, one has to be careful when choosing devices, and understanding and clinically applying the results obtained by indirect calorimetry, bearing in mind that measured resting energy expenditure should be the daily caloric goal in order to diminish clinical morbidity.
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