Estudo do gasto energético por meio da água duplamente marcada: fundamentos, utilização e aplicações

Use of the activPAL® triaxial accelerometer to estimate total energy expenditure in low-income women: differences between body mass index classifications

Objective

This study aimed to assess the agreement between the total energy expenditure (TEE) estimated by the activPAL® triaxial accelerometers (ACC) and the TEE measured by the doubly labeled water method (DLW), as well as to assess if these values differ between the classifications of body mass index (BMI).

Materials and methods

This is a cross-sectional study. Low-income adult women (19-45y) with BMI ≥ 18.5 kg/m2 were included. Accelerometry data (activPAL® ) were collected over 7 consecutive days, which were used to calculate TEE-ACC and compared with DLW data. The Bland-Altman method, concordance correlation coefficient and root mean square error were used to assess agreement between methods.

Results

The sample consisted of 55 women with a mean age of 31 ± 5 years. The agreement between TEE-ACC and TEE-DLW showed a bias of -142.5 kcal (-7.1%). Among the BMI classifications, participants with normal weight show a bias of -417.1 kcal (-21.0%), participants with overweight, -87.5 kcal (-3.9%) and participants with obesity, 97.5 kcal (4.3%). Furthermore, the bias between the methods showed a significant and positive correlation with the body weight (r = 0.49; p < 0.01).

Conclusion

The TEE-ACC estimates from activPAL® were reasonably accurate when compared to the TEE-DLW, especially in women with overweight and obesity, being much less accurate in individuals with normal weight.

Resting energy expenditure in critically ill patients: Evaluation methods and clinical applications

Patients on intensive care present systemic, metabolic, and hormonal alterations that may adversely affect their nutritional condition and lead to fast and important depletion of lean mass and malnutrition. Several factors and medical conditions can influence the energy expenditure (EE) of critically ill patients, such as age, gender, surgery, serious infections, medications, ventilation modality, and organ dysfunction. Clinical conditions that can present with EE change include acute kidney injury, a complex disorder commonly seen in critically ill patients with manifestations that can range from minimum elevations in serum creatinine to renal failure requiring dialysis. The nutritional needs of this population are therefore complex, and determining the resting energy expenditure is essential to adjust the nutritional supply and to plan a proper diet, ensuring that energy requirements are met and avoiding complications associated with overfeeding and underfeeding. Several evaluation methods of EE in this population have been described, but all of them have limitations. Such methods include direct calorimetry, doubly labeled water, indirect calorimetry (IC), various predictive equations, and, more recently, the rule of thumb (kcal/kg of body weight). Currently, IC is considered the gold standard.

Notificação imprecisa da ingestão energética entre usuários de Serviços de Promoção à Saúde

Resumo A avaliação da ingestão alimentar é importante na ciência da nutrição, no entanto, os métodos utilizados para tal fim podem levar à notificação imprecisa comprometendo os resultados associados à dieta. Assim, este estudo teve como objetivo avaliar a prevalência de notificação imprecisa da ingestão energética e seus fatores associados. Trata-se de um estudo transversal com usuários de nove academias da cidade de Belo Horizonte, Minas Gerais. Coletou-se dados sociodemográficos e econômicos, história e percepção de saúde, hábitos alimentares e estado nutricional. A avaliação da ingestão energética deu-se por Recordatórios Alimentares de 24 horas e a notificação imprecisa pela metodologia de McCrory. Avaliaram-se 487 usuários, 82,3% do sexo feminino e 50,5% idosos. A prevalência de subnotificação do consumo alimentar foi de 11,9%, sendo mais prevalente entre os participantes com dislipidemias e circunferência da cintura muito elevada, e menos prevalente entre os adultos, os satisfeitos com o peso corporal e com fracionamento da dieta igual ou superior a cinco refeições diárias. A supernotificação foi encontrada em 0,8% da amostra. Identificou-se a subnotificação como um problema nessa população, demandando estratégias para o aprimoramento da notificação dietética.

Brazilian pregnant and lactating women do not change their food intake to meet nutritional goals

BACKGROUND

Nutritional requirements are increased during pregnancy and lactation. The aim of this study was to compare the food intake and prevalence of inadequate nutrient intake among pregnant, lactating and reproductive-age women.

METHODS

Two-day dietary records of 322 pregnant and 751 lactating women were compared to those of 6837 non-pregnant and non-lactating women aged 19 to 40 years from a nationwide representative sample. The usual nutrient intake was estimated using the National Cancer Institute method, and compared to nutritional goals to estimate prevalence of inadequate intake.

RESULTS

Pregnant, lactating and reproductive-age women did not differ in their average consumption of 18 food groups, except for rice, with greatest intake among lactating women. The prevalence of nutrient inadequacy in pregnant women was higher than in reproductive-age women for folate (78% versus 40%) and vitamin B6 (59% versus 33%). In lactating women, prevalence was higher than in reproductive-age women for vitamin A (95% versus 72%), vitamin C (56% versus 37%), vitamin B6 (75% vs. 33%), folate (72% versus 40%) and zinc (64% versus 20%). The percentage of sodium intake above the upper limit was greater than 70% in the three groups.

CONCLUSIONS

Inadequate intake is frequent in women and increases during pregnancy and lactation, because women do not change their food intake. Guidelines should stimulate healthy food intake for women across the lifespan.