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Speakman JR, de Jong JMA, Sinha S, Westerterp KR, Yamada Y, Sagayama H, Ainslie PN, Anderson LJ, Arab L, Bedu-Addo K, Blanc S, Bonomi AG, Bovet P, Brage S, Buchowski MS, Butte NF, Camps SGJA, Cooper JA, Cooper R, Das SK, Davies PSW, Dugas LR, Ekelund U, Entringer S, Forrester T, Fudge BW, Gillingham M, Ghosh S, Goris AH, Gurven M, Halsey LG, Hambly C, Haisma HH, Hoffman D, Hu S, Joosen AM, Kaplan JL, Katzmarzyk P, Kraus WE, Kushner RF, Leonard WR, Löf M, Martin CK, Matsiko E, Medin AC, Meijer EP, Neuhouser ML, Nicklas TA, Ojiambo RM, Pietiläinen KH, Plange-Rhule J, Plasqui G, Prentice RL, Racette SB, Raichlen DA, Ravussin E, Redman LM, Roberts SB, Rudolph MC, Sardinha LB, Schuit AJ, Silva AM, Stice E, Urlacher SS, Valenti G, Van Etten LM, Van Mil EA, Wood BM, Yanovski JA, Yoshida T, Zhang X, Murphy-Alford AJ, Loechl CU, Kurpad A, Luke AH, Pontzer H, Rodeheffer MS, Rood J, Schoeller DA, Wong WW. Total daily energy expenditure has declined over the past three decades due to declining basal expenditure, not reduced activity expenditure. Nat Metab 2023; 5:579-588. [PMID: 37100994 PMCID: PMC10445668 DOI: 10.1038/s42255-023-00782-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/08/2023] [Indexed: 04/28/2023]
Abstract
Obesity is caused by a prolonged positive energy balance1,2. Whether reduced energy expenditure stemming from reduced activity levels contributes is debated3,4. Here we show that in both sexes, total energy expenditure (TEE) adjusted for body composition and age declined since the late 1980s, while adjusted activity energy expenditure increased over time. We use the International Atomic Energy Agency Doubly Labelled Water database on energy expenditure of adults in the United States and Europe (n = 4,799) to explore patterns in total (TEE: n = 4,799), basal (BEE: n = 1,432) and physical activity energy expenditure (n = 1,432) over time. In males, adjusted BEE decreased significantly, but in females this did not reach significance. A larger dataset of basal metabolic rate (equivalent to BEE) measurements of 9,912 adults across 163 studies spanning 100 years replicates the decline in BEE in both sexes. We conclude that increasing obesity in the United States/Europe has probably not been fuelled by reduced physical activity leading to lowered TEE. We identify here a decline in adjusted BEE as a previously unrecognized factor.
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Affiliation(s)
- John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK.
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
- CAS Center of Excellence in Animal Evolution and Genetics, Kunming, China.
| | - Jasper M A de Jong
- Department of Comparative Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Srishti Sinha
- St Johns Medical college, Bengaluru, India
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Klaas R Westerterp
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands.
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
- Institute for Active Health, Kyoto University of Advanced Science, Kyoto, Japan.
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan.
| | - Philip N Ainslie
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Liam J Anderson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Lenore Arab
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Kweku Bedu-Addo
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stephane Blanc
- Nutritional Sciences, University of Wisconsin, Madison, WI, USA
- Institut Pluridisciplinaire Hubert Curien, CNRS Université de Strasbourg, Strasbourg, France
| | | | - Pascal Bovet
- University Center for Primary care and Public Health (Unisanté), Lausanne University Hospital, Lausanne, Switzerland
- Ministry of Health, Victoria, Seychelles
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Maciej S Buchowski
- Division of Gastroenterology, Hepatology and Nutritiion, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Nancy F Butte
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Stefan G J A Camps
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Jamie A Cooper
- Nutritional Sciences, University of Wisconsin, Madison, WI, USA
- Nutritional Sciences, University of Georgia, Athens, GA, USA
| | - Richard Cooper
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL, USA
| | - Sai Krupa Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Peter S W Davies
- Child Health Research Centre, Centre for Children's Health Research, University of Queensland, South Brisbane, Queensland, Australia
| | - Lara R Dugas
- Department of Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, IL, USA
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Sonja Entringer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
- University of California Irvine, Irvine, CA, USA
| | - Terrence Forrester
- Solutions for Developing Countries, University of the West Indies, Kingston, Jamaica
| | | | - Melanie Gillingham
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR, USA
| | | | - Annelies H Goris
- IMEC within OnePlanet Research Center, Wageningen, the Netherlands
| | - Michael Gurven
- Department of Anthropology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Lewis G Halsey
- School of Life and Health Sciences, University of Roehampton, London, UK
| | - Catherine Hambly
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Hinke H Haisma
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, the Netherlands
| | - Daniel Hoffman
- Department of Nutritional Sciences, Program in International Nutrition, Rutgers University, New Brunswick, NJ, USA
| | - Sumei Hu
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- State Key Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, Beijing Engineering and Technology Research Center of Food Additives, National Soybean Processing Industry Technology Innovation Center, Beijing Technology and Business University, Beijing, China
| | - Annemiek M Joosen
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Jennifer L Kaplan
- Department of Comparative Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | | | | | - William R Leonard
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Corby K Martin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Eric Matsiko
- Department of Human Nutrition and Dietetics, University of Rwanda, Kigali, Rwanda
| | - Anine C Medin
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Erwin P Meijer
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle, WA, USA
| | - Theresa A Nicklas
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA
| | - Robert M Ojiambo
- Moi University, Eldoret, Kenya
- University of Global Health Equity, Kigali, Rwanda
| | | | - Jacob Plange-Rhule
- Department of Physiology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, the Netherlands
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Center and School of Public Health, University of Washington, Seattle, WA, USA
| | - Susan B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - David A Raichlen
- Biological Sciences and Anthropology, University of Southern California, Los Angeles, CA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | | | - Susan B Roberts
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Michael C Rudolph
- Department of Physiology and Harold Hamm Diabetes Center, Oklahoma University Health Sciences, Oklahoma City, OK, USA
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | | | - Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal
| | | | - Samuel S Urlacher
- Department of Anthropology, Baylor University, Waco, TX, USA
- Child and Brain Development program, CIFAR, Toronto, Ontario, Canada
| | - Giulio Valenti
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Ludo M Van Etten
- School of Nutrition and Translational Research in Metabolism (NUTRIM), University of Maastricht, Maastricht, the Netherlands
| | - Edgar A Van Mil
- Maastricht University, Campus Venlo and Lifestyle Medicine Center for Children, Jeroen Bosch Hospital's-Hertogenbosch, Hertogenbosch, the Netherlands
| | - Brian M Wood
- University of California Los Angeles, Los Angeles, CA, USA
- Department of Human Behavior, Ecology, and Culture, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, UK
| | - Alexia J Murphy-Alford
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | - Cornelia U Loechl
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
| | | | - Amy H Luke
- Division of Epidemiology, Department of Public Health Sciences, Loyola University School of Medicine, Maywood, IL, USA.
| | - Herman Pontzer
- Evolutionary Anthropology, Duke University, Durham, NC, USA.
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Matthew S Rodeheffer
- Department of Comparative Medicine, Yale School of Medicine, New Haven, CT, USA.
- Center of Molecular and Systems Metabolism, Yale University, New Haven, CT, USA.
- Department of Physiology, Yale University, New Haven, CT, USA.
| | - Jennifer Rood
- Pennington Biomedical Research Center, Baton Rouge, LA, USA.
| | - Dale A Schoeller
- Biotech Center and Nutritional Sciences, University of Wisconsin, Madison, WI, USA.
| | - William W Wong
- Department of Pediatrics, Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, Houston, TX, USA.
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5
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Costa F, Janela D, Molinos M, Moulder RG, Lains J, Bento V, Scheer J, Yanamadala V, Correia FD, Cohen SP. Digital Rehabilitation for Acute Low Back Pain: A Prospective Longitudinal Cohort Study. J Pain Res 2022; 15:1873-1887. [PMID: 35813029 PMCID: PMC9261956 DOI: 10.2147/jpr.s369926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
Background Low back pain (LBP) has a lifetime prevalence of 70–80%. Access to timely and personalized, evidence-based care is key to prevent chronic progression. Digital solutions may ease accessibility to treatment while reducing healthcare-related costs. Purpose We aim to report the results of a fully remote digital care program (DCP) for acute LBP. Patients and Methods This was an interventional, single-arm, cohort study of patients with acute LBP who received a DCP. Primary outcome was the mean change in disability (Oswestry Disability Index – ODI) after 12 weeks. Secondary outcomes included change in pain (NPRS), analgesic consumption, surgery likelihood, depression (PHQ-9), anxiety (GAD-7), fear-avoidance beliefs (FABQ-PA), work productivity (WPAI) and engagement. Results A total of 406 patients were enrolled in the program and of those, 332 (81.8%) completed the intervention. A significant disability reduction of 55.1% (14.93, 95% CI 13.95; 15.91) was observed, corresponding to a 76.1% responder rate (30% cut-off). Disability reduction was accompanied by significant improvements in pain (61.0%), depression (55.4%), anxiety (59.5%), productivity (65.6%), fear-avoidance beliefs (46.3%), intent to pursue surgery (59.1%), and analgesic consumption (from 35.7% at baseline to 10.8% at program end). DCP-related patient satisfaction score was 8.7/10.0 (SD 1.4). Conclusion This study demonstrated the utility of a multimodal DCP for patients with acute LBP. Very high adherence rates and patient satisfaction were observed, alongside significant reductions in all assessed outcomes, consistent with the growing body of evidence supporting the management of acute LBP with DCPs.
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Affiliation(s)
- Fabíola Costa
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
| | - Dora Janela
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
| | - Maria Molinos
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
| | - Robert G Moulder
- Institute for Cognitive Science, University of Colorado Boulder, Boulder, CO, USA
| | - Jorge Lains
- Rovisco Pais Medical and Rehabilitation Centre, Tocha, Portugal
- Faculty of Medicine, Coimbra University, Coimbra, Portugal
| | | | - Justin Scheer
- Department of Neurological Surgery, University of California, San Francisco, CA, USA
| | - Vijay Yanamadala
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
- Department of Surgery, Quinnipiac University Frank H. Netter School of Medicine, Hamden, CT, USA
- Department of Neurosurgery, Hartford Healthcare Medical Group, Westport, CT, USA
| | - Fernando Dias Correia
- SWORD Health, Inc, Clinical Research, Draper, UT, USA
- Neurology Department, Centro Hospitalar e Universitário do Porto, Porto, Portugal
- Correspondence: Fernando Dias Correia, 65 E Wadsworth Park Dr Ste 230, Draper, UT, 84020, USA, Tel +1 385-308-8034, Fax +1 801-206-3433, Email
| | - Steven P Cohen
- Departments of Anesthesiology & Critical Care Medicine, Physical Medicine and Rehabilitation, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Departments of Anesthesiology and Physical Medicine and Rehabilitation and Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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