Validity and reproducibility of VO2 max testing in a respiration chamber

The aim of this study was to investigate whether VO₂max can be accurately measured in a respiration chamber. Thirty participants aged 23.4 ± 3.9 years with a wide range in VO₂max were included. Participants performed four incremental cycle ergometer tests (VO₂max) with a minimum of 5 days between tests. These tests consisted of one familiarization test with face mask, followed by two VO₂max tests in the respiration chamber and one test with face mask in randomized order. Oxygen consumption and CO₂ production were measured continuously using Omnical (Maastricht University, the Netherlands) gas analysis system. The mean VO₂max was 3634 ± 766 ml, which resulted in mean VO₂max per lean body mass of 60.8 ± 8.0 ml/kg. Repeated respiration chamber tests showed a high concordance, and no significant differences were detected between tests (Lin's concordance correlation coefficient (Rc) = 0.99; ∆70 ± 302 ml/min; p = .38). There was high concordance between the mean VO₂max from both respiration chamber tests and the mean face mask tests, and no significant difference (Rc = 0.99; ∆41 ± 173 ml/min; p = .22) was observed. The Bland‐Altman plots showed no proportional bias between different tests. In conclusion, the respiration chamber has been found to be a valid and reproducible method for measuring VO₂max. New research opportunities are possible in the respiration chamber, such as maximal exercise testing during 24‐hour measurements.

Test-retest variability of VO2max using total-capture indirect calorimetry reveals linear relationship of VO2 and Power

This study aimed to analyze the intra‐individual variation in VO_2max of human subjects using total‐capture and free‐flow indirect calorimetry. Twenty‐seven men (27 ± 5 year; VO_2max 49‐79 mL•kg⁻¹•min⁻¹) performed two maximal exertion tests (CPETs) on a cycle ergometer, separated by a 7 ± 2 day interval. VO₂ and VCO₂ were assessed using an indirect calorimeter (Omnical) with total capture of exhalation in a free‐flow airstream. Thirteen subjects performed a third maximal exertion test using a breath‐by‐breath calorimeter (Oxycon Pro). On‐site validation was deemed a requirement. For the Omnical, the mean within‐subject CV for VO_2max was 1.2 ± 0.9% (0.0%‐4.4%) and for ergometer workload P_max 1.3 ± 1.3% (0%‐4.6%). VO_2max values with the Oxycon Pro were significantly lower in comparison with Omnical (P < 0.001; t test) with mean 3570 vs 4061 and difference SD 361 mL•min⁻¹. Validation results for the Omnical with methanol combustion were −0.05 ± 0.70% (mean ± SD; n = 31) at the 225 mL•min⁻¹ VO₂ level and −0.23 ± 0.80% (n = 31) at the 150 mL•min⁻¹ VCO₂ level. Results using gas infusion were 0.04 ± 0.75% (n = 34) and −0.99 ± 1.05% (n = 24) over the respective 500‐6000 mL•min⁻¹ VO₂ and VCO₂ ranges. Validation results for the Oxycon Pro in breath‐by‐breath mode were ‐ 2.2 ± 1.6% (n = 12) for VO₂ and 5.7 ± 3.3% (n = 12) for VCO₂ over the 1000‐4000 mL•min⁻¹ range. On a Visual analog scale, participants reported improved breathing using the free‐flow indirect calorimetry (score 7.6 ± 1.2 vs 5.1 ± 2.7, P = 0.008). We conclude that total capturing free‐flow indirect calorimetry is suitable for measuring VO₂ even with the highest range. VO_2max was linear with the incline in P_max over the full range.

Determining the Accuracy and Reliability of Indirect Calorimeters Utilizing the Methanol Combustion Technique

BACKGROUND

Several indirect calorimetry (IC) instruments are commercially available, but comparative validity and reliability data are lacking. Existing data are limited by inconsistencies in protocols, subject characteristics, or single-instrument validation comparisons. The aim of this study was to compare accuracy and reliability of metabolic carts using methanol combustion as the cross-laboratory criterion.

METHODS

Eight 20-minute methanol burn trials were completed on 12 metabolic carts. Respiratory exchange ratio (RER) and percent O₂ and CO₂ recovery were calculated.

RESULTS

For accuracy, 1 Omnical, Cosmed Quark CPET (Cosmed), and both Parvos (Parvo Medics trueOne 2400) measured all 3 variables within 2% of the true value; both DeltaTracs and the Vmax Encore System (Vmax) showed similar accuracy in measuring 1 or 2, but not all, variables. For reliability, 8 instruments were shown to be reliable, with the 2 Omnicals ranking best (coefficient of variation [CV] < 1.26%). Both Cosmeds, Parvos, DeltaTracs, 1 Jaeger Oxycon Pro (Oxycon), Max-II Metabolic Systems (Max-II), and Vmax were reliable for at least 1 variable (CV ≤ 3%). For multiple regression, humidity and amount of combusted methanol were significant predictors of RER (R² = 0.33, P < .001). Temperature and amount of burned methanol were significant predictors of O₂ recovery (R² = 0.18, P < .001); only humidity was a predictor for CO₂ recovery (R² = 0.15, P < .001).

CONCLUSIONS

Omnical, Parvo, Cosmed, and DeltaTrac had greater accuracy and reliability. The small number of instruments tested and expected differences in gas calibration variability limits the generalizability of conclusions. Finally, humidity and temperature could be modified in the laboratory to optimize IC conditions.

Classical experiments in whole-body metabolism: open-circuit respirometry-diluted flow chamber, hood, or facemask systems

For over two centuries, scientists have measured gas exchange in animals and humans and linked this to energy expenditure of the body. The aim of this review is to provide a comprehensive overview of open-circuit diluted flow indirect calorimetry and to help researchers to make the optimal choice for a certain system and its application. A historical perspective shows that 'open circuit diluted flow' is a technique first used in the 19th century and applicable today for room calorimeters, ventilated hood systems, and facemasks. Room calorimeters are a classic example of an open-circuit diluted flow system. The broadly applied ventilated hood calorimeters follow the same principle and can be classified as a derivative of these room calorimeters. The basic principle is that the subject breathes freely in a passing airflow that is fully captured and analyzed. Oxygen and CO2 concentrations are measured in inlet ambient air and captured outlet air. The airflow, which is adapted depending on the application (e.g., rest versus exercise), is measured. For a room indirect calorimeter, the dilution in the large room volume is also taken into account, and this is the most complex application of this type of calorimeter. Validity of the systems can be tested by alcohol burns, gas infusions and by performing repeated measurements on subjects. Using the latter, the smallest CV (%) was found for repeated VO2max tests (1.2%) with an SD of approximately 1 kJ min-1. The smallest SD was found for sleeping metabolic rate (0.11 kJ min-1) with a CV (%) of 2.4%.

Overnight energy expenditure determined by whole-body indirect calorimetry does not differ during different sleep stages

BACKGROUND

Sleep has been associated with the regulation of energy balance, yet the relation between sleep stages and energy expenditure remains unclear.

OBJECTIVE

The objective was to investigate the relation between sleep stages and energy expenditure, with sleep stage and overnight energy expenditure patterns taken into account.

DESIGN

Thirteen subjects aged (mean ± SD) 24.3 ± 2.5 y with a BMI (in kg/m(2)) of 23.6 ± 1.7 slept in a respiration chamber while sleep was polysomnographically recorded to determine wake after sleep onset (WASO), slow-wave sleep (SWS), and rapid eye movement (REM) sleep. Energy expenditure was calculated during each sleep stage for the whole night and separately for sleeping metabolic rate (SMR; ie, 3-h period during the night with the lowest mean energy expenditure) and non-SMR.

RESULTS

Energy expenditure and sleep stages showed characteristic patterns during the night, independently of each other. Sleep stages exerted no effect on energy expenditure during the whole night, except for WASO compared with SWS (P < 0.05) and WASO compared with REM sleep (P < 0.05). During the SMR and non-SMR periods of the night, no overall effect of sleep stage on energy expenditure, except for WASO compared with SWS (P < 0.05) and WASO compared with REM sleep (P < 0.01) during the non-SMR period of the night, was found. Energy expenditure and activity counts during the night were positively correlated (r = 0.927, P < 0.001).

CONCLUSIONS

Energy expenditure does not vary according to sleep stage overnight, except for higher energy expenditure during wake episodes than during SWS and REM sleep. Coincidence of the sleep stage pattern and the overnight energy expenditure pattern may have caused accidental relations in previous observations. This trial was registered at http://apps.who.int/trialsearch as NTR2926.

Intra-individual variability and adaptation of overnight- and sleeping metabolic rate

The largest component of daily energy expenditure is resting energy expenditure as reflected in overnight metabolic rate (OMR) and sleeping metabolic rate (SMR). Here, we determined the variation in OMR (24:00-6:00 h) and SMR values (3 h intervals) as affected by physical activity (PA) during the day and the night. Subjects were 32 females and 17 males, age 18-52 years. Energy expenditure (EE) was measured for 36 h in a whole room calorimeter (14 m3), starting in the evening, providing values before and after behavioral limitation. The mean intra-individual coefficient of variation was 1.8+/-1.4% for SMRmin (minimum EE), 2.8+/-2.0% for SMRact (minimum PA), 2.4+/-2.5% for SMRres (minimum residual EE, residual calculated from 24 h relationship between EE and PA) and 2.8+/-2.2% for OMR (n=49). Mean clock time for SMR ranged from 3:15 till 4:13 h. EE and PA increased in the hour before awakening. Surprisingly, OMR showed a significant 2.7% increase (P<0.05) during the second night of the 36 h measurement, but only for a second visit, and was related to increased physical activity during night period (R2=0.50, P<0.001). OMR measurements following unrestricted daily activity showed identical results for first and second (repeat) visits: 6.82+/-0.86 MJ/day and 6.79+/-0.93 MJ/day (n=49), respectively. It is advised to measure SMR based on minimum residual EE during nights following free-living conditions, and to exclude EE measures 1 h before awakening from SMR and OMR calculations to prevent influences of habitual wake-up time.

Heat production and body temperature during cooling and rewarming in overweight and lean men

OBJECTIVE

To compare overweight and lean subjects with respect to thermogenesis and physiological insulation in response to mild cold and rewarming.

RESEARCH METHODS AND PROCEDURES

Ten overweight men (mean BMI, 29.2 +/- 2.8 kg/m(2)) and 10 lean men (mean BMI, 21.1 +/- 2.0 kg/m(2)) were exposed to cold air for 1 hour, followed by 1 hour of rewarming. Body composition was determined by hydrodensitometry and deuterium dilution. Heat production and body temperatures were measured continuously by indirect calorimetry and thermistors, respectively. Muscle activity was recorded using electromyography.

RESULTS

In both groups, heat production increased significantly during cooling (lean, p = 0.004; overweight, p = 0.006). The increase was larger in the lean group compared with the overweight group (p = 0.04). During rewarming, heat production returned to baseline in the overweight group and stayed higher compared with baseline in the lean group (p = 0.003). The difference in heat production between rewarming and baseline was larger in the lean (p = 0.01) than in the overweight subjects. Weighted body temperature of both groups decreased during cold exposure (lean, p = 0.002; overweight, p < 0.001) and did not return to baseline during rewarming.

DISCUSSION

Overweight subjects showed a blunted mild cold-induced thermogenesis. The insulative cold response was not different among the groups. The energy-efficient response of the overweight subjects can have consequences for energy balance in the long term. The results support the concept of a dynamic heat regulation model instead of temperature regulation around a fixed set point.

Intra-individual variation of basal metabolic rate and the influence of daily habitual physical activity before testing

The present study determined the intra-individual variation of BMR measurements, using a standard out-patient protocol, with the subjects transporting themselves to the laboratory for the BMR measurements after spending the night at home. The effect of a non-fasting state and variation in daily habitual physical activity the day before testing was evaluated. Eight male and eleven female subjects participated in three BMR measurements with 2-week intervals. Physical activity was estimated with a tri-axial accelerometer for movement registration, during the 3 d before each BMR measurement. There were no significant differences in estimated BMR (ANOVA repeated measures, P=0.88) and in physical activity (ANOVA repeated measures, P=0.21). Mean within-subject CV in BMR was found to be 3.3 (SD 2.1) %, ranging from 0.4 to 7.2 %. Differences between BMR measurements could not be explained by differences in physical activity the day before; however the mean within-subject CV in BMR changed from 5.7 to 5.2 % after correcting for within-machine variability and from 5.2 to 3.3 % after excluding five measurements because of non-compliance to the protocol including fasting. In conclusion, BMR values measured with a standard out-patient protocol are sufficiently reproducible for most practical purposes despite the within-subject variability in physical activity the day before the measurement. For this purpose, however, non-fasting subjects must be excluded and a regular function check of the ventilated-hood system is recommendable.