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Rydin AA, Severn C, Pyle L, Morelli N, Shoemaker AH, Chung ST, Yanovski JA, Han JC, Higgins JA, Nadeau KJ, Fox C, Kelly AS, Cree MG. Prediction of resting energy expenditure for adolescents with severe obesity: A multi-centre analysis. Pediatr Obes 2024:e13123. [PMID: 38658523 DOI: 10.1111/ijpo.13123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 04/26/2024]
Abstract
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.
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Affiliation(s)
- Amy A Rydin
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Cameron Severn
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Laura Pyle
- Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA
| | - Nazeen Morelli
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ashley H Shoemaker
- Division of Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Stephanie T Chung
- Section on Pediatric Diabetes, Obesity, and Metabolism, National Institutes of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, Maryland, USA
| | - 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, Maryland, USA
| | - Joan C Han
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine, New York, New York, USA
| | - Janine A Higgins
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Section of Nutrition, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kristen J Nadeau
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Ludeman Family Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Claudia Fox
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Aaron S Kelly
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Melanie G Cree
- Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
- Ludeman Family Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Mezzomo TR, Dias MRMG, Vilela RM, Pereira RM. Accuracy of equations for estimating resting energy expenditure in children and adolescents living with phenylketonuria. J Hum Nutr Diet 2023; 36:1661-1674. [PMID: 37421197 DOI: 10.1111/jhn.13200] [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] [Received: 04/05/2023] [Accepted: 06/12/2023] [Indexed: 07/10/2023]
Abstract
BACKGROUND Measuring resting energy expenditure (REE) in individuals living with phenylketonuria (PKU) using indirect calorimetry (IC) is unusual in healthcare facilities because it requires specific protocols and expensive equipment. Considering that determining REE is crucial for devising nutritional strategies for the management of PKU, the aim of this study was to identify the predictive equations that provide the best estimates of REE in children and adolescents living with PKU and to propose a predictive equation for determining REE in this population. METHODS An REE concordance study was conducted with children and adolescents living with PKU. Anthropometric and body composition assessments using bioimpedance and REE assessment using IC were performed. The results were compared to 29 predictive equations. RESULTS Fifty-four children and adolescents were evaluated. The REE obtained using IC differed from all estimated REE, except Henry's equation for male children (p = 0.058). Only this equation showed good agreement (0.900) with IC. Eight variables were associated with the REE obtained using IC with emphasis on fat-free mass (kg) (r = 0.786), weight (r = 0.775), height (r = 0.759) and blood phenylalanine (r = 0.503). With these variables, three REE equations were suggested, with R2 = 0.660, 0.635 and 0.618, respectively, and the third equation, which involves weight and height, showed adequate sample size for a statistical power of 0.942. CONCLUSION Most equations, not specific for individuals living with PKU, overestimate the REE of this population. We propose a predictive equation for assessing REE for children and adolescents living with PKU to be used in settings where IC is not available.
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Affiliation(s)
- Thais R Mezzomo
- Graduate Master's and Doctoral Program in Child and Adolescent Health, Federal University of Parana, Curitiba, Brazil
| | | | - Regina M Vilela
- Department of Nutrition and Graduate Program in Food and Nutrition, Federal University of Parana, Curitiba, Brazil
| | - Rosana Marques Pereira
- Graduate Master's and Doctoral Program in Child and Adolescent Health, Federal University of Parana, Curitiba, Brazil
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Acar-Tek N, Ağagündüz D, Şahin TÖ, Baygut H, Uzunlar EA, Zakkour HK, Karaçallı A. Validation of predictive equations for resting energy expenditure in children and adolescents with different body mass indexes. Nutr J 2023; 22:39. [PMID: 37559059 PMCID: PMC10413768 DOI: 10.1186/s12937-023-00868-3] [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] [Received: 04/01/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
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.
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Affiliation(s)
- Nilüfer Acar-Tek
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Duygu Ağagündüz
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey.
| | - Teslime Özge Şahin
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Hatice Baygut
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Süleyman Demirel University, Isparta, Turkey
| | - Elif Adanur Uzunlar
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Karadeniz Technical University, Trabzon, Turkey
| | - Hazal Küçükkaraca Zakkour
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Ondokuz Mayıs University, Samsun, Turkey
| | - Ayşegül Karaçallı
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Tokat Gaziosmanpaşa University, Tokat, Turkey
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Soares IF, Vasconcellos F, Cunha FA. Time to achieve steady state for an accurate assessment of resting energy expenditure in adolescents with healthy weight and obesity: A cross-sectional study. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:206-213. [PMID: 35315987 PMCID: PMC9832904 DOI: 10.20945/2359-3997000000450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective The present study investigated the time needed to achieve a steady state for an accurate assessment of resting energy expenditure (REE) in adolescents with healthy weight and obesity. Methods Thirty adolescents aged 12-17 years were assigned to a group with healthy weight (GHW; n = 12, body mass index [BMI] 22.5 ± 3.6 kg/m2) and another group with obesity (GO; n = 18, BMI 34.1 ± 5.2 kg/m2). Participants underwent test-retest reliability of REE assessment as follows: a) 24 h of abstention from physical exercise, soft drinks, or caffeine; b) fasting for ~12 h; c) acclimation period of 10 min; d) 30-min assessment in a supine position. Results A significant change occurred during the 30 min in REE. Significant differences existed between consecutive means until the 20th and 25th min for the GHW and GO, respectively. Although significant differences between trials 1 and 2 were detected during the first 5-10 min of assessment, the REE for each 5-min time point exhibited high test-retest reliability across trials in both groups (intraclass correlation coefficients range 0.79-0.99). Conclusion The following recommendations are provided to promote accurate assessment of REE among adolescents: a) initiate the REE assessment with 10 min of acclimation to decrease restlessness; b) determine REE for a minimum of 20 min if healthy weight and 25 min if obesity; c) determine REE for a further 5 min, with the average of this last 5 min of REE data being regarded as the REE.
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Affiliation(s)
- Isabela F Soares
- Programa de Pós-graduação em Ciências do Exercício e Esportes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Fabrício Vasconcellos
- Programa de Pós-graduação em Ciências do Exercício e Esportes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.,Laboratório de Atividade Física e Promoção da Saúde, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil
| | - Felipe A Cunha
- Programa de Pós-graduação em Ciências do Exercício e Esportes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.,Laboratório de Atividade Física e Promoção da Saúde, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil,
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Abawi O, Koster EC, Welling MS, Boeters SC, van Rossum EFC, van Haelst MM, van der Voorn B, de Groot CJ, van den Akker ELT. Resting Energy Expenditure and Body Composition in Children and Adolescents With Genetic, Hypothalamic, Medication-Induced or Multifactorial Severe Obesity. Front Endocrinol (Lausanne) 2022; 13:862817. [PMID: 35898454 PMCID: PMC9309560 DOI: 10.3389/fendo.2022.862817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Pediatric obesity is a multifactorial disease which can be caused by underlying medical disorders arising from disruptions in the hypothalamic leptin-melanocortin pathway, which regulates satiety and energy expenditure. AIM To investigate and compare resting energy expenditure (REE) and body composition characteristics of children and adolescents with severe obesity with or without underlying medical causes. METHODS This prospective observational study included pediatric patients who underwent an extensive diagnostic workup in our academic centre that evaluated endocrine, non-syndromic and syndromic genetic, hypothalamic, and medication-induced causes of obesity. REE was assessed by indirect calorimetry; body composition by air displacement plethysmography. The ratio between measured REE (mREE) and predicted REE (Schofield equations), REE%, was calculated, with decreased mREE defined as REE% ≤90% and elevated mREE ≥110%. Additionally, the influence of fat-free-mass (FFM) on mREE was evaluated using multiple linear regression. RESULTS We included 292 patients (146 [50%] with body composition measurements), of which 218 (75%) patients had multifactorial obesity and 74 (25%) an underlying medical cause: non-syndromic and syndromic genetic (n= 29 and 28, respectively), hypothalamic (n= 10), and medication-induced (n= 7) obesity. Mean age was 10.8 ± 4.3 years, 59% were female, mean BMI SDS was 3.8 ± 1.1, indicating severe obesity. Mean REE% was higher in children with non-syndromic genetic obesity (107.4% ± 12.7) and lower in children with hypothalamic obesity (87.6% ± 14.2) compared to multifactorial obesity (100.5% ± 12.6, both p<0.01). In 9 children with pseudohypoparathyroidism type 1a, mean REE% was similar (100.4 ± 5.1). Across all patients, mREE was decreased in 60 (21%) patients and elevated in 69 (24%) patients. After adjustment for FFM, mREE did not differ between patients within each of the subgroups of underlying medical causes compared to multifactorial obesity (all p>0.05). CONCLUSIONS In this cohort of children with severe obesity due to various etiologies, large inter-individual differences in mREE were found. Consistent with previous studies, almost half of patients had decreased or elevated mREE. This knowledge is important for patient-tailored treatment, e.g. personalized dietary and physical activity interventions and consideration of pharmacotherapy affecting central energy expenditure regulation in children with decreased mREE.
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Affiliation(s)
- Ozair Abawi
- Dept. of Pediatrics, div. of Endocrinology, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Emma C. Koster
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dept. of Dietetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Mila S. Welling
- Dept. of Pediatrics, div. of Endocrinology, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dept. of Internal Medicine, div. of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sanne C.M. Boeters
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dept. of Dietetics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Elisabeth F. C. van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dept. of Internal Medicine, div. of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Mieke M. van Haelst
- Dept. of Human Genetics, Amsterdam University Medical Center, Location AMC, University of Amsterdam & Location VUmc, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Bibian van der Voorn
- Dept. of Pediatrics, div. of Endocrinology, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dept. of Internal Medicine, div. of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Cornelis J. de Groot
- Dept. of Pediatrics, div. of Endocrinology, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Dept. of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, Netherlands
| | - Erica L. T. van den Akker
- Dept. of Pediatrics, div. of Endocrinology, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- *Correspondence: Erica L. T. van den Akker,
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Kim EK, Ndahimana D, Ishikawa-Takata K, Lee S, Kim H, Lim K, Lee IS, Tanaka S, Kim YJ, Choi YJ, Ju MJ, Park J. Validation of Dietary Reference Intakes for predicting energy requirements in elementary school-age children. Nutr Res Pract 2018; 12:336-341. [PMID: 30090171 PMCID: PMC6078864 DOI: 10.4162/nrp.2018.12.4.336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/OBJECTIVES Dietary Reference Intakes (DRI) for energy are derived from total energy expenditure (TEE) measured using the doubly labelled water (DLW) method. The objective of this study was to assess the validity of DRI for predicting the energy requirements of elementary school-age children. SUBJECTS/METHODS The present study involved 25 elementary school-age children aged between 9 and 11 years. TEE was assessed by the DLW method, and the results were compared with the TEE predicted by the DRI equations in order to evaluate accuracy. RESULTS The subjects' TEE measured by the DLW method was 1,925.2 ± 380.9 kcal/day in boys and 1,930.0 ± 279.4 kcal/day in girls, whereas resting energy expenditure was 1,220.2 ± 176.9 kcal/day in boys and 1,245.9 ± 171.3 kcal/day for girls. The physical activity level was 1.58 ± 0.20 in boys and 1.55 ± 0.13 in girls. The mean bias between the predicted and measured TEE was 12.6% in boys and −1.6% in girls, and the percentage of accurate predictions was 28.6% and 63.6%, respectively. In boys, the equation resulted in underprediction of TEE among the subjects having low TEE values, whereas there was overprediction among subjects having high TEE values as shown by the Bland-Altman plot. On the contrary, this proportional bias was not observed in girls. CONCLUSIONS The findings of this study suggest that the DRI equation for energy could result in the overestimation of energy requirements in elementary school-age boys. In the case of girls, the equations could be accurate at the group level. However, the DRI appears to be invalid for individual girls, as more than one third of girls had their TEE inaccurately predicted. We recommend more studies for confirmation of these results.
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Affiliation(s)
- Eun-Kyung Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Didace Ndahimana
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Kazuko Ishikawa-Takata
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Sangjik Lee
- Division of Physical Education, Uiduk University, Gyeongju 38004, Korea
| | - Hyungryul Kim
- Division of Physical Education, Uiduk University, Gyeongju 38004, Korea
| | - Kiwon Lim
- Department of Physical Education, Konkuk University, Seoul 05029, Korea
| | - In-Sook Lee
- Division of Food Service Industry, Uiduk University, Gyeongju 38004, Korea
| | - Shigeho Tanaka
- Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo 162-8636, Japan
| | - Ye-Jin Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Yeon-Jung Choi
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Mun-Jeong Ju
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea
| | - Jonghoon Park
- Department of Physical Education, Korea University, 145 Anam-Ro, Seongbuk-Gu, Seoul 02841, Korea
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Park J, Ishikawa-Takata K, Lee S, Kim E, Lim K, Kim H, Lee IS, Tanaka S. Comparison of daily physical activity parameters using objective methods between overweight and normal-weight children. JOURNAL OF SPORT AND HEALTH SCIENCE 2018; 7:210-217. [PMID: 30356488 PMCID: PMC6180554 DOI: 10.1016/j.jshs.2017.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 07/19/2016] [Accepted: 11/28/2016] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of the present study was to determine if there were any differences in various aspects of physical activity such as energy expenditure, intensity, and type of activity between normal-weight and overweight boys. METHODS Children aged 9-12 years were recruited from 2 elementary schools located in different urban districts in Republic of Korea. The present study included 45 Korean boys, of which 19 were normal-weight and 26 were overweight. Daily physical activity was estimated over the same 1-week study period under free-living conditions using the doubly labeled water (DLW) method and a tri-axial accelerometer. Resting metabolic rate (RMR) was measured using the Douglas bag method and open-circuit indirect calorimetry. We calculated the physical activity level (PAL) as the total energy expenditure (TEE)/RMR. RESULTS PAL was not significantly different between the groups. In the accelerometer data, time spent in locomotive moderate-to-vigorous physical activity (MVPA) was significantly lower in overweight boys than in normal-weight subjects, whereas other variables including non-locomotive activity did not differ between groups. In addition, among all participants, time spent in total locomotive activity was significantly associated with PAL. Time spent in locomotive MVPA was significantly associated with PAL. CONCLUSION Overweight boys may be less physically active based on locomotive MVPA, which was positively related with PAL. Our findings suggest that the contribution of locomotive MVPA to the increase in PAL was relatively significant.
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Affiliation(s)
- Jonghoon Park
- Department of Physical Education, Korea University, Seoul 02841, Republic of Korea
| | - Kazuko Ishikawa-Takata
- Department of Nutritional Education, National Institute of Health and Nutrition, Tokyo 162-8636, Japan
| | - Sangjik Lee
- Division of Physical Education, Uiduk University, Gyeongju 38004, Republic of Korea
| | - Eunkyung Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea
| | - Kiwon Lim
- Department of Physical Education, Konkuk University, Seoul 05029, Republic of Korea
| | - Hyungryul Kim
- Division of Physical Education, Uiduk University, Gyeongju 38004, Republic of Korea
| | - In-Sook Lee
- Division of Food Service Industry, Uiduk University, Gyeongju 38004, Republic of Korea
| | - Shigeho Tanaka
- Department of Nutritional Science, National Institute of Health and Nutrition, Tokyo 162-8636, Japan
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Acar-Tek N, Ağagündüz D, Çelik B, Bozbulut R. Estimation of Resting Energy Expenditure: Validation of Previous and New Predictive Equations in Obese Children and Adolescents. J Am Coll Nutr 2017; 36:470-480. [PMID: 28749749 DOI: 10.1080/07315724.2017.1320952] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Accurate estimation of resting energy expenditure (REE) in childrenand adolescents is important to establish estimated energy requirements. The aim of the present study was to measure REE in obese children and adolescents by indirect calorimetry method, compare these values with REE values estimated by equations, and develop the most appropriate equation for this group. METHODS One hundred and three obese children and adolescents (57 males, 46 females) between 7 and 17 years (10.6 ± 2.19 years) were recruited for the study. REE measurements of subjects were made with indirect calorimetry (COSMED, FitMatePro, Rome, Italy) and body compositions were analyzed. RESULTS In females, the percentage of accurate prediction varied from 32.6 (World Health Organization [WHO]) to 43.5 (Molnar and Lazzer). The bias for equations was -0.2% (Kim), 3.7% (Molnar), and 22.6% (Derumeaux-Burel). Kim's (266 kcal/d), Schmelzle's (267 kcal/d), and Henry's equations (268 kcal/d) had the lowest root mean square error (RMSE; respectively 266, 267, 268 kcal/d). The equation that has the highest RMSE values among female subjects was the Derumeaux-Burel equation (394 kcal/d). In males, when the Institute of Medicine (IOM) had the lowest accurate prediction value (12.3%), the highest values were found using Schmelzle's (42.1%), Henry's (43.9%), and Müller's equations (fat-free mass, FFM; 45.6%). When Kim and Müller had the smallest bias (-0.6%, 9.9%), Schmelzle's equation had the smallest RMSE (331 kcal/d). The new specific equation based on FFM was generated as follows: REE = 451.722 + (23.202 * FFM). According to Bland-Altman plots, it has been found out that the new equations are distributed randomly in both males and females. CONCLUSION Previously developed predictive equations mostly provided unaccurate and biased estimates of REE. However, the new predictive equations allow clinicians to estimate REE in an obese children and adolescents with sufficient and acceptable accuracy.
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Affiliation(s)
- Nilüfer Acar-Tek
- a Gazi University , Faculty of Health Sciences, Department of Nutrition and Dietetics , Besevler, Ankara , Turkey
| | - Duygu Ağagündüz
- a Gazi University , Faculty of Health Sciences, Department of Nutrition and Dietetics , Besevler, Ankara , Turkey
| | - Bülent Çelik
- b Gazi University , Faculty of Sciences, Department of Statistics , Besevler, Ankara , Turkey
| | - Rukiye Bozbulut
- a Gazi University , Faculty of Health Sciences, Department of Nutrition and Dietetics , Besevler, Ankara , Turkey
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Gupta RD, Ramachandran R, Venkatesan P, Anoop S, Joseph M, Thomas N. Indirect Calorimetry: From Bench to Bedside. Indian J Endocrinol Metab 2017; 21:594-599. [PMID: 28670546 PMCID: PMC5477450 DOI: 10.4103/ijem.ijem_484_16] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Accurate determination of energy expenditure (EE) is vitally important yet often neglected in clinical practice. Indirect calorimetry (IC) provides one of the most sensitive, accurate, and noninvasive measurements of EE in an individual. Over the last couple of decades, this technique has been applied to clinical circumstances such as acute illness and parenteral nutrition. Beyond assessing the nutritional needs, it has also shed light on various aspects of nutrient assimilation, thermogenesis, the energetics of physical exercise, and the pathogenesis of obesity and diabetes. However, because of little or no experience with IC provided during medical education, the benefits of IC are poorly appreciated. Newer technology, cost-effectiveness, and a better understanding of how to interpret measurements should lead to more frequent use of IC. This review focuses on the physicochemical background of IC, the various indications for use, techniques and instruments, potential pitfalls in measurement, and the recent advances in technology that has adapted the technique to long-term studies in humans.
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Affiliation(s)
- Riddhi Das Gupta
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Roshna Ramachandran
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Shajith Anoop
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mini Joseph
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
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Park JH, Ishikawa-Takata K, Lee SJ, Kim EK, Lim KW, Kim HR, Lee IS, Tanaka S. Association between daily step counts and physical activity level among Korean elementary schoolchildren. J Exerc Nutrition Biochem 2016; 20:51-55. [PMID: 27757388 PMCID: PMC5067418 DOI: 10.20463/jenb.2016.09.20.3.8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/31/2016] [Accepted: 08/31/2016] [Indexed: 11/26/2022] Open
Abstract
[Purpose] The purpose of the current study was to investigate steps per day (steps/d) and physical activity level (PAL) in Korean elementary school children having normal weight (normal-weight). We also clarified whether a gender difference exited between steps/d and PAL. [Methods] Children aged 9 to 12 y were recruited from two elementary schools located in different urban districts in Korea. The present study included 33 Korean children, of which 18 were normal-weight boys and 15 were normal-weight girls. During the same 1 week study period under free-living conditions the total energy expenditure (TEE) and step counts were estimated using the doubly labeled water (DLW) method and an accelerometer, respectively. We calculated PAL as the TEE/ resting metabolic rate. [Results] The range of PAL was 1.25 – 1.93 with a mean value of 1.57. None of the variables of energy expenditure was significantly different by sex. However, steps/d were significantly higher in boys than in girls. When adjusting regression analysis by gender, steps/ d were positively associated with PAL among all subjects (r = 0.56, P < 0.01). Furthermore, steps/d were positively associated with PAL in boys (r = 0.68, P < 0.01), but not in girls (r = 0.27, P = 0.34). [Conclusion] Our results suggest that locomotive activity may be the main contributor to the individual PAL differences for elementary school boys, while non-locomotive activity may be the main contributor for elementary school girls.
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Affiliation(s)
- Jong-hoon Park
- Department of Physical Education, Korea University, Seoul Republic of Korea
| | - Kazuko Ishikawa-Takata
- Department of Nutritional Education, National Institute of Health and Nutrition, Tokyo Japan
| | - Sang-jik Lee
- Division of Physical Education, Uiduk University, Gyeongju Republic of Korea
| | - Eun-kyung Kim
- Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung Republic of Korea
| | - Ki-won Lim
- Department of Physical Education, Konkuk University, Seoul Republic of Korea
| | - Hyung-ryul Kim
- Division of Physical Education, Uiduk University, Gyeongju Republic of Korea
| | - In-Sook Lee
- Division of Physical Education, Uiduk University, Gyeongju Republic of Korea
| | - Shigeho Tanaka
- Department of Nutritional Education, National Institute of Health and Nutrition, Tokyo Japan
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Becker P, Carney LN, Corkins MR, Monczka J, Smith E, Smith SE, Spear BA, White JV. Consensus Statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition. Nutr Clin Pract 2014; 30:147-61. [DOI: 10.1177/0884533614557642] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Patricia Becker
- University of North Carolina Health Care, Chapel Hill, North Carolina
| | | | - Mark R. Corkins
- University of Tennessee Health Sciences Center, Memphis, Tennessee
| | | | - Elizabeth Smith
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | - Jane V. White
- University of Tennessee Graduate School of Medicine, Knoxville, Tennessee
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Kaneko K, Ito C, Koizumi K, Watanabe S, Umeda Y, Ishikawa-Takata K. Resting energy expenditure (REE) in six- to seventeen-year-old Japanese children and adolescents. J Nutr Sci Vitaminol (Tokyo) 2014; 59:299-309. [PMID: 24064730 DOI: 10.3177/jnsv.59.299] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Accurate estimation of resting energy expenditure (REE) in children and adolescents is important to establish estimated energy requirements for the Japanese population. Our objectives were 1) to determine the REE of 6- to 17-y-old Japanese children and adolescents by indirect calorimetry in order to estimate energy expenditure for this group, 2) to compare measured REE with predicted REE to determine the accuracy of predictive equations of REE for Japanese children and adolescents, and 3) to derive new predictive equations for REE for Japanese children and adolescents based on measured REE. REE was measured in 221 Japanese children and adolescents, aged 6 to 17 y old (113 boys and 108 girls) using a ventilated indirect calorimeter. Anthropometric and body composition measurements were also performed. REE expressed as absolute values increased with age in both genders, and there was a significant difference between genders in the 12-17 y age group. REE was strongly correlated with body weight (BW) and fat-free mass (FFM). REE adjusted for BW or FFM decreased with age in both genders, and a gender difference was still observed in the 12-17 y age group after this adjustment. The highest accuracy of prediction was achieved using the Dietary Reference Intake for Japanese (1969) for boys and the Molnar equation for girls. Step-down multiple regression analysis was carried out using either a combination of age, gender, BW, and height, or a combination of age, gender, FFM, and fat mass (FM). The predictive equation accounted for 75% (R2) and 76% of the variance, respectively. In conclusion, absolute REE increased and REE adjusted for BW or FFM decreased with age. The major determinant of REE was FFM, but significant gender differences were observed in the 12-17 y range for both absolute REE and adjusted REE.
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Affiliation(s)
- Kayoko Kaneko
- Faculty of Education and Human Sciences, Yokohama National University
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