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Bossan FM, Dos Anjos LA, Wahrlich V, Ferriolli E, Pfrimer K. Comparison of total daily energy expenditure with dietary reference intakes values in a sample of urban, relatively active Brazilian adults: A doubly labeled water study. Am J Hum Biol 2024; 36:e24027. [PMID: 38040487 DOI: 10.1002/ajhb.24027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVE This report aimed to describe the results of total daily energy expenditure (TDEE) assessed by doubly labeled water (DLWTDEE) and the adequacy of the dietary reference intakes (DRI) equations to estimate energy requirements (DRIER). METHODS A cross-sectional and observational study in a convenience sample of 40 healthy Brazilian adults (≥20 years; 21 women) living in a tropical urban region. Basal metabolic rate (BMR) was measured by indirect calorimetry, DLWTDEE was compared with DRIER using individual calculated physical activity level (PAL = DLWTDEE/BMR) in its estimation. RESULTS BMR (5043 ± 548 kJ/day in women and 6213 ± 656 kJ/day in men), DLWTDEE (8372 ± 1324 kJ/day and 11 453 ± 1834 kJ/day), and PAL (1.66 ± 0.17 and 1.85 ± 0.30, respectively) were significantly higher in men. The DRIER significantly overestimated DLWTDEE by 13.7 ± 8.3% and 12.7 ± 10.7% in women and men, respectively. CONCLUSION In the present sample of relatively active urban Brazilian subjects, the DRIER yielded inaccurate estimation of DLWTDEE. More data from low- and moderate-income countries are necessary to develop accurate estimates of TDEE.
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Affiliation(s)
- Francine Moreira Bossan
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Luiz Antonio Dos Anjos
- Programa de Pós-Graduação em Alimentação, Nutrição e Saúde, Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
- Programa de Pós-Graduação em Ciências da Nutrição, Laboratório de Avaliação Nutricional e Funcional, Departamento de Nutrição Social, Universidade Federal Fluminense, Niterói, Brasil
| | - Vivian Wahrlich
- Programa de Pós-Graduação em Ciências da Nutrição, Laboratório de Avaliação Nutricional e Funcional, Departamento de Nutrição Social, Universidade Federal Fluminense, Niterói, Brasil
| | | | - Karina Pfrimer
- Departmento de Nutrição, Universidade de Ribeirão Preto, São Paulo, Brasil
- Programa de Nutrição e Metabolismo, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brasil
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Alabduljabbar K, Bonanos E, Miras AD, le Roux CW. Mechanisms of Action of Bariatric Surgery on Body Weight Regulation. Gastroenterol Clin North Am 2023; 52:691-705. [PMID: 37919021 DOI: 10.1016/j.gtc.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Bariatric surgery is an effective treatment modality for obesity and obesity-associated complications. Weight loss after bariatric surgery was initially attributed to anatomic restriction or reduced energy absorption, but now it is understood that surgery treats obesity by influencing the subcortical areas of the brain to lower adipose tissue mass. There are three major phases of this process: initially the weight loss phase, followed by a phase where weight loss is maintained, and in a subset of patients a phase where weight is regained. These phases are characterized by altered appetitive behavior together with changes in energy expenditure. The mechanisms associated with the rearrangement of the gastrointestinal tract include central appetite control, release of gut peptides, change in microbiota and bile acids. However, the exact combination and timing of signals remain largely unknown.
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Affiliation(s)
- Khaled Alabduljabbar
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland; Department of Family Medicine and Polyclinics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | | | | | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland.
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Macena ML, Silva Júnior AE, Melo JM, Paula DT, Praxedes DRS, Bueno NB. Estimates of Resting Energy Expenditure and Total Energy Expenditure Using Predictive Equations for Individuals After Bariatric Surgery: a Systematic Review with Meta-analysis. Obes Surg 2023; 33:3999-4006. [PMID: 37889369 DOI: 10.1007/s11695-023-06908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE Patients after metabolic bariatric surgery (MBS) require attention to maintain energy balance and avoid weight regain. Predictive equations for resting energy expenditure (REE) and total energy expenditure (TEE) are needed since gold standard methods like calorimetry and doubly labeled water are rarely available in routine clinical practice. This study aimed to determine which predictive equation for REE and TEE has the lowest bias in subjects after MBS. METHODS MEDLINE, Embase, Web of Science, and CENTRAL searches were performed. Meta-analyses were performed with the data calculated by the predictive equations and measured by the gold standard methods for those equations that had at least two studies with these data. The DerSimonian and Laird random-effects model and the I2 statistic were used to quantify heterogeneity in the quantitative analyses. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist. RESULTS Seven studies were included. The present study found that the Mifflin St. Jeor (1990) equation had the lowest bias (mean difference = - 39.71 kcal [95%CI = - 128.97; 49.55]) for calculating REE in post-BS individuals. The Harris-Benedict (1919) equation also yielded satisfactory results (mean difference = - 54.60 kcal [95%CI = - 87.92; - 21.28]). CONCLUSION The predictive equation of Mifflin St. Jeor (1990) was the one that showed the lowest bias for calculating the REE of patients following MBS.
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Affiliation(s)
- Mateus L Macena
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
- Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil
| | - André E Silva Júnior
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil.
- Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil.
| | - Jennifer M Melo
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
| | - Déborah T Paula
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
| | - Dafiny R S Praxedes
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
- Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil
| | - Nassib B Bueno
- Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil
- Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil
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Maury-Sintjago E, Rodríguez-Fernández A, Ruíz-De la Fuente M. Predictive Equations Overestimate Resting Metabolic Rate in Young Chilean Women with Excess Body Fat. Metabolites 2023; 13:metabo13020188. [PMID: 36837807 PMCID: PMC9964988 DOI: 10.3390/metabo13020188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 01/31/2023] Open
Abstract
Underestimating/overestimating resting metabolic rate (RMR) affects energy prescription. The objective was to compare RMR by indirect calorimetry (RMR IC) and RMR estimated by predictive equations in women with excess body fat. This was an analytical cross-sectional study with 41 women aged 18-28 with overnutrition according to body composition. The RMR IC was measured and RMR estimated using the FAO/WHO/UNU (1985), FAO/WHO/UNU (2004), Harris-Benedict, and Mifflin-St Jeor equations. The percentage of adequacy (90-110%), overestimation (>110%), and underestimation (<90%) were evaluated for RMR IC. Data were described by percentiles because of non-normal distribution according to the Shapiro-Wilk test. The Kruskal-Wallis test and Bland-Altman analysis were applied at a significance level of α < 0.05. The RMR IC was 1192 and 1183 calories/day (p = 0.429) in women with obesity and overweight, respectively. The FAO/WHO/UNU (1985), FAO/WHO/UNU (2004), Harris-Benedict, and Mifflin-St Jeor equations overestimated the RMR IC by 283.2, 311.2, 292.7, and 203.0 calories/day and by 296.7, 413.8, 280.0, and 176.6 calories/day for women with overweight and obesity (p < 0.001), respectively. The Harris-Benedict adjusted weight (0.5) equation underestimated RMR IC by 254.7 calories/day. The predictive equations overestimated RMR IC in women with excess body fat. The Mifflin-St Jeor equation showed less overestimation and better adequacy, but was not exempt from inaccuracy.
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Affiliation(s)
- Eduard Maury-Sintjago
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan 3780000, Chile
- Auxology, Bioanthropology, and Ontogeny Research Group (GABO), Faculty of Health and Food Sciences, Universidad del Bío-Bío, Chillan 3780000, Chile
| | - Alejandra Rodríguez-Fernández
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan 3780000, Chile
- Auxology, Bioanthropology, and Ontogeny Research Group (GABO), Faculty of Health and Food Sciences, Universidad del Bío-Bío, Chillan 3780000, Chile
- Correspondence: (A.R.-F.); (M.R.-D.l.F.); Tel.: +56-422463294 (A.R.-F.); +56-2-422463121 (M.R.-D.l.F.)
| | - Marcela Ruíz-De la Fuente
- Department of Nutrition and Public Health, Universidad del Bío-Bío, Chillan 3780000, Chile
- Auxology, Bioanthropology, and Ontogeny Research Group (GABO), Faculty of Health and Food Sciences, Universidad del Bío-Bío, Chillan 3780000, Chile
- Correspondence: (A.R.-F.); (M.R.-D.l.F.); Tel.: +56-422463294 (A.R.-F.); +56-2-422463121 (M.R.-D.l.F.)
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Akalestou E, Miras AD, Rutter GA, le Roux CW. Mechanisms of Weight Loss After Obesity Surgery. Endocr Rev 2022; 43:19-34. [PMID: 34363458 PMCID: PMC8755990 DOI: 10.1210/endrev/bnab022] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Indexed: 02/07/2023]
Abstract
Obesity surgery remains the most effective treatment for obesity and its complications. Weight loss was initially attributed to decreased energy absorption from the gut but has since been linked to reduced appetitive behavior and potentially increased energy expenditure. Implicated mechanisms associating rearrangement of the gastrointestinal tract with these metabolic outcomes include central appetite control, release of gut peptides, change in microbiota, and bile acids. However, the exact combination and timing of signals remain largely unknown. In this review, we survey recent research investigating these mechanisms, and seek to provide insights on unanswered questions over how weight loss is achieved following bariatric surgery which may eventually lead to safer, nonsurgical weight-loss interventions or combinations of medications with surgery.
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Affiliation(s)
- Elina Akalestou
- Section of Cell Biology and Functional Genomics, Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Alexander D Miras
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Guy A Rutter
- Section of Cell Biology and Functional Genomics, Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.,Lee Kong Chian Imperial Medical School, Nanyang Technological University, Singapore.,University of Montreal Hospital Research Centre, Montreal, QC, Canada
| | - Carel W le Roux
- Diabetes Complications Research Centre, University College Dublin, Ireland.,Diabetes Research Group, School of Biomedical Science, Ulster University, Belfast, UK
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Jabbour G, Salman A. Bariatric Surgery in Adults with Obesity: the Impact on Performance, Metabolism, and Health Indices. Obes Surg 2021; 31:1767-1789. [PMID: 33454846 PMCID: PMC8012340 DOI: 10.1007/s11695-020-05182-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/09/2020] [Accepted: 12/21/2020] [Indexed: 02/07/2023]
Abstract
This systematic review summarizes current evidence on the impact of bariatric surgery (BS) on physical performance, metabolic, and health indices in adults with obesity. This systematic review suggests that BS induced significant reductions in body weight, fat mass, and fat-free mass in individuals with obesity. Additionally, BS may improve many physical fitness and health indicators. Observed improvements manifest during a distinct period of time. To date, studies on BS and performance have been small in number, nonrandomized in design, and not controlled regarding gender distribution and/or post-surgery follow-up. Future studies should further investigate concerns associated with understanding of BS outcomes to improve these outcomes with potential benefits for quality of life, disability, mortality, morbidity, and overall BS success.
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Affiliation(s)
- Georges Jabbour
- Sport Science Program, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Ahmad Salman
- Sport Science Program, College of Arts and Sciences, Qatar University, P.O. Box 2713, Doha, Qatar
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Bendavid I, Lobo DN, Barazzoni R, Cederholm T, Coëffier M, de van der Schueren M, Fontaine E, Hiesmayr M, Laviano A, Pichard C, Singer P. The centenary of the Harris-Benedict equations: How to assess energy requirements best? Recommendations from the ESPEN expert group. Clin Nutr 2021; 40:690-701. [PMID: 33279311 DOI: 10.1016/j.clnu.2020.11.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/18/2020] [Accepted: 11/10/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS The year 2019 marked the centenary of the publication of the Harris and Benedict equations for estimation of energy expenditure. In October 2019 a Scientific Symposium was organized by the European Society for Clinical Nutrition and Metabolism (ESPEN) in Vienna, Austria, to celebrate this historical landmark, looking at what is currently known about the estimation and measurement of energy expenditure. METHODS Current evidence was discussed during the symposium, including the scientific basis and clinical knowledge, and is summarized here to assist with the estimation and measurement of energy requirements that later translate into energy prescription. RESULTS In most clinical settings, the majority of predictive equations have low to moderate performance, with the best generally reaching an accuracy of no more than 70%, and often lead to large errors in estimating the true needs of patients. Generally speaking, the addition of body composition measurements did not add to the accuracy of predictive equations. Indirect calorimetry is the most reliable method to measure energy expenditure and guide energy prescription, but carries inherent limitations, greatly restricting its use in real life clinical practice. CONCLUSIONS While the limitations of predictive equations are clear, their use is still the mainstay in clinical practice. It is imperative to recognize specific patient populations for whom a specific equation should be preferred. When available, the use of indirect calorimetry is advised in a variety of clinical settings, aiming to avoid under-as well as overfeeding.
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Affiliation(s)
- Itai Bendavid
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel
| | - Dileep N Lobo
- Gastrointestinal Surgery, Nottingham Digestive Diseases Centre, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden; Theme Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Moïse Coëffier
- Department of Nutrition, CIC1404, Rouen University Hospital and Normandie University, UNIROUEN, Inserm UMR1073, Rouen, France
| | - Marian de van der Schueren
- Department of Nutrition and Dietetics, HAN University of Applied Sciences, School of Allied Health, Nijmegen, the Netherlands
| | - Eric Fontaine
- Université Grenoble Alpes, LBFA, INSERM U1055, Grenoble, France
| | - Michael Hiesmayr
- Division of Cardiac, Thoracic, Vascular Anesthesia and Intensive Care Medicine, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
| | - Alessandro Laviano
- Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Claude Pichard
- Clinical Nutrition, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva 14, Switzerland
| | - Pierre Singer
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Israel.
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Agreement Between Body Composition Assessed by Bioelectrical Impedance Analysis and Doubly Labeled Water in Obese Women Submitted to Bariatric Surgery : Body Composition, BIA, and DLW. Obes Surg 2019; 29:183-189. [PMID: 30232726 DOI: 10.1007/s11695-018-3505-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Bariatric surgery has a significant influence on body composition (BC), which should be monitored. However, there is a need to recommend low-cost practical methods, with good estimation of BC for class III obese and/or bariatric patients. OBJECTIVE The aim of this study was to determine accuracy and agreement between BC assessed by direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA) and doubly labeled water (DLW) as reference method. MATERIAL AND METHODS Twenty class III obese women (age 29.3 ± 5.1 years; body mass index 44.8 ± 2.4 kg/m2) underwent Roux-en-Y gastric bypass surgery. BC (fat mass [FM], fat-free mass [FFM], and total body water [TBW]) was assessed by InBody 230 and DLW in the following periods: before and 6 and 12 months after surgery. Accuracy between the methods was evaluated by the bias and root mean square error. Pearson's correlation, concordance correlation coefficient (CCC), and Bland-Altman method were used to evaluate agreement between the methods. RESULTS Correlations were significant (p < 0.001) and CCC was good/excellent between both methods for the evaluation of FM (r = 0.84-0.92, CCC = 0.84-0.95), FFM (r = 0.73-0.90, CCC = 0.68-0.80), and TBW (r = 0.76-0.91, CCC = 0.72-0.81) before and after bariatric surgery. In addition, no significant bias was observed between DSM-BIA and DLW for FM (mean error [ME] = - 1.40 to 0.06 kg), FFM (ME = 0.91-1.86 kg), and TBW (ME = 0.71-1.24 kg) measurements. CONCLUSION The DSM-BIA was able to estimate the BC of class III obese women submitted to bariatric surgery with values consistent with those of the DLW method.
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Changes in Energy Expenditure of Patients with Obesity Following Bariatric Surgery: a Systematic Review of Prospective Studies and Meta-analysis. Obes Surg 2019; 29:2318-2337. [PMID: 31016456 DOI: 10.1007/s11695-019-03851-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We herein summarize the available literature on the effects of bariatric surgery (BS) on energy expenditure in individuals with obesity. We conducted a systematic literature review, and 35 prospective studies met our inclusion criteria. The findings indicate that BS contributes to increased diet-induced thermogenesis (DIT) and decreased total energy expenditure (TEE) and resting energy expenditure (REE) in patients with obesity. The meta-analysis demonstrated a significant decrease in TEE and REE within 6 months following BS. With the sustained decrease in REE, there was no further decrease in TEE between the 6- and 12-month follow-up. Increased DIT might explain the variance between the patterns of REE and TEE change. The postoperative decrease in REE/FFM and increase in REE/BW were observed. The changes in substrate utilization might be consistent with the change in the respiration quotient postoperatively.
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