Evaluating the contribution of differences in lean mass compartments for resting energy expenditure in African American and Caucasian American children

Prediction of resting energy expenditure for adolescents with severe obesity: A multi-centre analysis

BACKGROUND AND OBJECTIVES

Resting energy expenditure (REE) assessments can help inform clinical treatment decisions in adolescents with elevated body mass index (BMI), but current equations are suboptimal for severe obesity. We developed a predictive REE equation for youth with severe obesity and obesity-related comorbidities and compared results to previously published predictive equations.

METHODS

Data from indirect calorimetry, clinical measures, and body composition per Dual x-ray absorptiometry (DXA) were collected from five sites. Data were randomly divided into development (N = 438) and validation (N = 118) cohorts. A predictive equation was developed using Elastic Net regression, using sex, race, ethnicity, weight, height, BMI percent of the 95th%ile (BMIp95), waist circumference, hip circumference, waist/hip ratio, age, Tanner stage, fat and fat-free mass. This equation was verified in the validation cohort and compared with 11 prior equations.

RESULTS

Data from the total cohort (n = 556, age 15 ± 1.7 years, 77% female, BMIp95 3.3 ± 0.94) were utilized. The best fit equation was REE = -2048 + 18.17 × (Height in cm) - 2.57 × (Weight in kg) + 7.88 × (BMIp95) + 189 × (1 = male, 0 = female), R2 = 0.466, and mean bias of 23 kcal/day.

CONCLUSION

This new equation provides an updated REE prediction that accounts for severe obesity and metabolic complications frequently observed in contemporary youth.

Validation of predictive equations for resting energy expenditure in children and adolescents with different body mass indexes

BACKGROUND

Accurate estimation of resting energy expenditure (REE) in children and adolescents is important to establish estimated energy requirements. The objective of this study was to assess the validity of existing equations in literature and a newly developed equation in estimating REE in children and adolescents.

METHODS

275 participants (148 boys, 127 girls) aged 6-18 years included in the study were classified as normal-weighted, overweight, obese based on BMI z-scores for age according to WHO-2007 growth curves for 5-19 years of age. REEs were measured using an indirect calorimeter, with various equations, and a newly established equation [REE = 505.412+(24.383*FFM);Adjusted R2 = 0.649] were compared with REE measured using Bland-Altman and further validation parameters.

RESULTS

When the predicted REEs were compared with the measured REEs, the highest prediction accuracy was achieved using the new Eq. (64.8%) and IOM (63.8%) for normal-weight participants, Müller FFM and new Eq. (59.6%) for overweight participants and Lazzer (44.9%) for obese participants. In normal and overweight participants, lowest root mean squared error (RMSE) values were acquired from Schmelzle's equation (respectively 136.2;159.9 kcal/d), and the highest values were found in Kim's Eq. (315.2; 295.2 kcal/d respectively). RMSE value of the new equation was 174.7 kcal/d for normal-weight children and adolescents, and 201.9 kcal/d for overweight ones. In obese participants, the lowest RMSE value was obtained from Schmelzle's Eq. (305.4 kcal/d) and the new Eq. (317.4 kcal/d), while the highest value was obtained from IOM Eq. (439.9 kcal/d). RMSE was higher in obese groups compared to the other BMI groups.

CONCLUSION

Indirect-calorimeter is the most suitable method for REE measurement in especially obese children and adolescents. The new equation and Schmelzle's equation appear to be most accurate equations for normal and overweight children and adolescents.

Longitudinal analysis of resting energy expenditure and body mass composition in physically active children and adolescents

Background

Monitoring body composition and changes in energy expenditure during maturation and growth is significant, as many components can influence body structure in adulthood. In the case of young players, when these changes can influence their strength and power, it seems to be equally important. Our aim was to examine whether resting energy expenditure (REE) and body composition would change after 10 months from baseline in physically active children and adolescents.

Methods

We obtained data from 80 children and adolescents aged 9 to 17 years at two measurement points: the baseline in September 2018 and after 10 months in July 2019. The study was carried out using a calorimeter (Fitmate MED, Cosmed, Rome, Italy), a device used to assess body composition using by the electrical bioimpedance method by means of a segment analyzer (TANITA MC-980). The Student’s t-test and linear regression analysis were used. Using the stepwise forward regression procedure, the selection of factors in a statistically significant way that describes the level of REE was made.

Results

We noticed that REE was not significantly different between baseline (1596.94 ± 273.01 kcal) and after 10 months (1625.38 ± 253.26 kcal). When analyzing the difference in REE between studies girls, we found body height as a significant predictor. The results of our study show a negative relationship between growth and REE. Differences between sexes and age in REE between baseline and after 10 months were not significant.

Conclusions

Our study involving physically active children and adolescents, which used repeated objective measures and longitudinal statistical modeling to analyze them, was unable to demonstrate any interaction between body weight change, body composition measurements, and REE.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03326-x.

Resting Energy Expenditure and Related Factors in 6- to 9-Year-Old Southern African Children of Diverse Population Groups

Lower resting energy expenditure (REE) may partially explain the disproportionate prevalence of overweight/obesity among black African women. As no previous studies have investigated the REE of Southern African (South. Afr.) children, we aimed to determine, by sex and population group, the REE of 6- to 9-year-old urban school children. In a cross-sectional study with quota sampling, REE was measured with indirect calorimetry (IC). Confounders considered were: body composition (BC) (fat-free mass (FFM), FFM index, fat mass (FM), FM index), assessed using multifrequency bioelectrical impedance analysis, and physical activity (PA) measured with a pedometer. Multivariate regression was used to calculate REE adjusted for phenotypes (BC, z-scores of weight-for-age, height-for-age, body mass index-for-age) and PA. Sex and population differences in REE were determined with two-way ANOVA. Ninety-four healthy children (59.6% girls; 52.1% black) with similar socioeconomic status and PA opportunities participated. Despite BC variations, sex differences in REE were not significant (41 kcal/day; P = 0.375). The REE of black participants was lower than of white (146 kcal/day; P = 0.002). When adjusted for FFM and HFA z-score, the differences in REE declined but remained clinically meaningful at 91 kcal/day (P = 0.039) and 82 kcal/day (P = 0.108), respectively. We recommend the development of population-specific REE prediction equations for South. Afr. children.

Effects of adiposity and body composition on adjusted resting energy expenditure in women

OBJECTIVES

Fat-free mass (FFM) accounts for ~80% of the variance in resting energy expenditure (REE), and this relationship is complicated by adiposity. The objective was to compare adjusted REE and contributions of skeletal lean mass and fat mass (FM) to adjusted REE in women with varying adiposity levels using a novel approach.

METHODS

Women were divided into tertiles by body fat percent (%fat): Tertile 1 (T1): %fat = 18.5%-28.4%; Tertile 2 (T2): %fat = 28.5%-33.8%; Tertile 3 (T3): %fat = 34.0%-61.0%. Outcome measures were measured and adjusted REE, body composition (skeletal lean mass, FM, %fat) from dual-energy X-ray absorptiometry, and percent contribution of skeletal lean mass and FM to adjusted REE.

RESULTS

The main effect for tertiles (T1 vs. T2 vs. T3) was significant (p = .001); REE was significantly higher in T3 versus both T1 by 281 kcal/day (p = .001) and T2 by 215 kcal/day (p = .001). Expenditure from skeletal lean mass in T1 was significantly higher than T3 by 3.2% (p = .001). T3 had a significantly higher FM contribution than T1 by 5.1% (p = .001) and T2 by 3.9% (p = .001).

CONCLUSIONS

Women with elevated %fat experienced lower skeletal lean mass contribution and higher FM contribution to adjusted REE. FM may explain more of the variance in REE between women of different levels of adiposity.

The Diagnostic-Measurement Method-Resting Energy Expenditure Assessment of Polish Children Practicing Football

Establishing the amount of energy needed to cover the energy demand of children doing sport training and thus ensuring they achieve an even energy balance requires the resting energy expenditure (REE) to be estimated. One of the methods that measures REE is the indirect calorimetry method, which may be influenced by many factors, including body composition, gender, age, height or blood pressure. The aim of the study was to assess the correlation between the resting energy expenditure of children regularly playing football and selected factors that influence the REE in this group. The study was conducted among 219 children aged 9 to 17 using a calorimeter, a device used to assess body composition by the electrical bioimpedance method by means of segment analyzer and a blood pressure monitor. The results of REE obtained by indirect calorimetry were compared with the results calculated using the ready-to-use formula, the Harris Benedict formula. The results showed a significant correlation of girls’ resting energy expenditure with muscle mass and body height, while boys’ resting energy expenditure was correlated with muscle mass and body water content. The value of the REE was significantly higher (p ≤ 0.001) than the value of the basal metabolic rate calculated by means of Harris Benedict formula. The obtained results can be a worthwhile suggestion for specialists dealing with energy demand planning in children, especially among those who are physically active to achieve optimal sporting successes ensuring proper functioning of their body.

Cardiovascular Risk Factors Following Vertical Sleeve Gastrectomy in Black Americans Compared with White Americans

OBJECTIVE

Bariatric surgery presents a long-term solution for clinical obesity. Given that Black Americans (BA) carry a greater burden of obesity-related comorbidities than White Americans (WA), understanding the racial disparities regarding remission of obesity comorbidities following the most common bariatric surgery, sleeve gastrectomy (SG). The goal of the current study was to provide quantitative values related to cardiovascular and lipid outcomes following SG and determine if racial disparities exist between BA and WA.

METHODS

Data was collected from de-identified electronic medical records for patients receiving SG surgery at the University of Mississippi Medical Center in Jackson, MS, USA.

RESULTS

Of 464 patients who obtained SG from (2013-2019), 64% were WA, and 36% were BA. Before surgery, BA had significantly greater body weight (BW), body mass index (BMI), and systolic (SBP) and diastolic (DBP) blood pressures (BP) in comparison with WA. Compared with WA, BA were predicted to lose 5.1 kg less BW than WA at 1-year follow-up. Reduction in SBP (- 0.96 vs. - 0.60 mmHg/doubling of days) and DBP (- 0.51 vs. - 0.26 mmHg/doubling of days) was significantly higher in WA compared with BA. There was no racial difference in the change to total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, or triglycerides by race. When normalized to weight loss, the racial disparity in BP reduction was mitigated.

CONCLUSIONS

These data indicate that BA lose less body weight following SG; however, loss of excess body weight loss is associated with improvement to BP similarly in both BA and WA.

Nutritional factors associated with femoral neck bone mineral density in children and adolescents

Background

Nutritional factors including vitamin D, magnesium, and fat are known to affect bone mineral accrual. This study aimed to evaluate associations between dietary nutrient intakes (both macronutrients and micronutrients) and bone mineral density (BMD) in children and adolescents.

Methods

Data for this cross-sectional, population-based study were derived from the National Health and Nutrition Examination Survey (NHANES). Participants aged from 8 to 19 years were included. The primary outcome was femoral neck BMD.

Results

Multivariate analyses revealed that for participants aged 8 to 11, daily sodium intake was significantly and positively associated with femoral neck BMD (B = 0.9 ×  10^− 5, p = 0.031); in particular, subgroup analyses by sex found that in male participants aged 8–11, daily total cholesterol intake (B = 5.3 × 10^− 5, p = 0.030) and calcium intake (B = − 2.0 × 10^− 5, p < 0.05) were significantly associated with femoral neck BMD in a positive and negative manner, respectively, but neither were observed in female participants of this age group. In contrast, daily intakes of vitamin D and magnesium were significantly and positively associated with femoral neck BMD in female participants aged 8–11 (B = 246.8 × 10^− 5 and 16.3 × 10^− 5, p = 0.017 and 0.033, respectively). For participants aged 16 to 19, daily total fat intake was significantly and negatively associated with femoral neck BMD (B = − 58 × 10^− 5, p = 0.048); further stratification by sex found that magnesium and sodium intakes were significantly and positively associated with femoral neck BMD only in females of this age group (B = 26.9 × 10^− 5 and 2.1 × 10^− 5, respectively; both p < 0.05). However, no significant associations between daily nutrient intakes and femoral neck BMD were identified in participants aged 12–15 before or after subgroup stratification.

Conclusion

The study found that associations of specific nutrition-related variables with BMD of the femoral neck is dependent upon age and gender.