Dataset Information

Resting Energy Expenditure and Body Composition in Overweight Men and Women Living in a Temperate Climate.

ABSTRACT: This study aimed to determine whether the measured resting energy expenditure (REE) in overweight and obese patients living in a temperate climate is lower than the predicted REE; and to ascertain which equation should be used in patients living in a temperate climate. REE (indirect calorimetry) and body composition (DXA) were measured in 174 patients (88 men and 86 women; 20-68 years old) with overweight or obesity (BMI 27-45 kg m-2). All volunteers were residents in Gran Canaria (monthly temperatures: 18-24 °C). REE was lower than predicted by most equations in our population. Age and BMI were similar in both sexes. In the whole population, the equations of Mifflin, Henry and Rees, Livingston and Owen, had similar levels of accuracy (non-significant bias of 0.7%, 1.1%, 0.6%, and -2.2%, respectively). The best equation to predict resting energy expenditure in overweight and moderately obese men and women living in a temperate climate all year round is the Mifflin equation. In men, the equations by Henry and Rees, Livingston, and by Owen had predictive accuracies comparable to that of Mifflin. The body composition-based equation of Johnston was slightly more accurate than Mifflin's in men. In women, none of the body composition-based equations outperformed Mifflin's.

SUBMITTER: Martin-Rincon M

PROVIDER: S-EPMC7020055 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Resting Energy Expenditure and Body Composition in Overweight Men and Women Living in a Temperate Climate.

Martin-Rincon Marcos M Perez-Valera Mario M Morales-Alamo David D Perez-Suarez Ismael I Dorado Cecilia C Gonzalez-Henriquez Juan J JJ Juan-Habib Julian W JW Quintana-Garcia Cristian C Galvan-Alvarez Victor V Pedrianes-Martin Pablo B PB Acosta Carmen C Curtelin David D Calbet Jose A L JAL de Pablos-Velasco Pedro P

Journal of clinical medicine 20200111 1

This study aimed to determine whether the measured resting energy expenditure (REE) in overweight and obese patients living in a temperate climate is lower than the predicted REE; and to ascertain which equation should be used in patients living in a temperate climate. REE (indirect calorimetry) and body composition (DXA) were measured in 174 patients (88 men and 86 women; 20-68 years old) with overweight or obesity (BMI 27-45 kg m<sup>-2</sup>). All volunteers were residents in Gran Canaria (mo ...[more]

PMID: 31940840

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Project description:The carbohydrate-insulin model of obesity posits that habitual consumption of a high-carbohydrate diet sequesters fat within adipose tissue because of hyperinsulinemia and results in adaptive suppression of energy expenditure (EE). Therefore, isocaloric exchange of dietary carbohydrate for fat is predicted to result in increased EE, increased fat oxidation, and loss of body fat. In contrast, a more conventional view that "a calorie is a calorie" predicts that isocaloric variations in dietary carbohydrate and fat will have no physiologically important effects on EE or body fat.We investigated whether an isocaloric low-carbohydrate ketogenic diet (KD) is associated with changes in EE, respiratory quotient (RQ), and body composition.Seventeen overweight or obese men were admitted to metabolic wards, where they consumed a high-carbohydrate baseline diet (BD) for 4 wk followed by 4 wk of an isocaloric KD with clamped protein. Subjects spent 2 consecutive days each week residing in metabolic chambers to measure changes in EE (EEchamber), sleeping EE (SEE), and RQ. Body composition changes were measured by dual-energy X-ray absorptiometry. Average EE during the final 2 wk of the BD and KD periods was measured by doubly labeled water (EEDLW).Subjects lost weight and body fat throughout the study corresponding to an overall negative energy balance of ?300 kcal/d. Compared with BD, the KD coincided with increased EEchamber (57 ± 13 kcal/d, P = 0.0004) and SEE (89 ± 14 kcal/d, P < 0.0001) and decreased RQ (-0.111 ± 0.003, P < 0.0001). EEDLW increased by 151 ± 63 kcal/d (P = 0.03). Body fat loss slowed during the KD and coincided with increased protein utilization and loss of fat-free mass.The isocaloric KD was not accompanied by increased body fat loss but was associated with relatively small increases in EE that were near the limits of detection with the use of state-of-the-art technology. This trial was registered at clinicaltrials.gov as NCT01967563.

Project description:BackgroundPediatric 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.AimTo investigate and compare resting energy expenditure (REE) and body composition characteristics of children and adolescents with severe obesity with or without underlying medical causes.MethodsThis 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.ResultsWe 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).ConclusionsIn 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.

Dataset Information

Resting Energy Expenditure and Body Composition in Overweight Men and Women Living in a Temperate Climate.

Publications

Resting Energy Expenditure and Body Composition in Overweight Men and Women Living in a Temperate Climate.

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