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Energy Expenditure Measurement: A Challenge

Energy Expenditure Measurement: A Challenge. Presented at NFI, May 30 th ,2008. Dr Anupa Siddhu , Lady Irwin College, New Delhi. Lady Irwin College, New Delhi. History. 1950 FAO Report on Energy 1957 FAO Report on Energy 1964 FAO Report on Energy and Proteins separately

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Energy Expenditure Measurement: A Challenge

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  1. Energy Expenditure Measurement: A Challenge Presented at NFI, May 30th,2008 DrAnupaSiddhu, Lady Irwin College, New Delhi Lady Irwin College, New Delhi

  2. History • 1950 FAO Report on Energy • 1957 FAO Report on Energy • 1964 FAO Report on Energy and Proteins separately • 1973 FAO/WHO Report on Energy and Proteins • 1985 FAO/WHO/UNU Report on Energy and Proteins • 2004 FAO Report on Energy

  3. Definition- Energy requirement “is the amount of food energy needed to balance energy expenditure in order to maintain body size, body composition and a level of necessary and desirable physical activity consistent with long term good health. This includes the energy needed for the optimal growth and development of children, for deposition of tissues during pregnancy, and for the secretion of milk during lactation consistent with the good health of mother and child.” FAO/WHO/UNU 2004

  4. Energy Expenditure Conventionally two principles- • Measure heat produced ie. Direct calorimetry- accurate, golden method • Compute heat produced from gaseous exchange ie. Indirect calorimetry-practical, energy costs to be used in factorial method FAO 2004 recommends only two methods- DLW, HRM method as ‘Direct Methods’ of EE. (conventional indirect calorimetry ?)

  5. Disposal of food energy FAO 2004

  6. Methods for 24h TEE • Weir’s equation- 16.5 O2 + 4.62 CO2 - 9.06 N • Metabolic chamber- open circuit or closed circuit ventilation • Factorial method- diary method, standard or measured costs. ex. standard costs proposed by Satyanarayan (NIN) method, FAO/WHO/UNU 1985 method. • Continuous heart rate method- Polar • Double labeled water technique • Accelerometry- Actical, Actigraph,Tri Trac- R3D

  7. Experiences on 24h TEE measurements • Factorial method- standard or measured costs, FAO/WHO/UNU 1985 method, activity record of soldiers • Continuous heart rate method • Double labeled water technique • Accelerometry- Actical

  8. Factorial method Advantage- • Can be used in field • Subject is not confined • Free living habitual activity • Not expensive • Subject is not under stress • Predictable if not variable activity profile

  9. Factorial method Disadvantages- • Faulty timings • Faulty description • Inaccurate energy costs, especially standard costs if not applicable or well measured • Using same costs for every one- Cal/min vs PAR x BMR • Time consuming and laborious-1440min • Valid for groups and not individuals • Costs may not be known-yoga, gym

  10. FAO/WHO/UNU 1985 method • Calculate BMR from weight- dependent equation ( or W and H dependent equations) • Categorize day’s activities broadly into- Occupational, Discretionary and Residual (FAO/WHO/UNU 1985) but 2004 the data on activities under different activity categories is given as PAR to calculate TEE by factorial method. Factorial method - practical • Express TDEE/BMR = PAL

  11. Calculate BMR from weight

  12. FAO/WHO/UNU 1985 method Age 25y, weight 65y, height 1.72m, BMI 22,estimated BMR: 70 Cal/h Occupational : Light-1.7; Moderate-2.7; Heavy- 3.8x BMR for men

  13. FAO/WHO/UNU 2004 committee The categorizations in broad categories are now split into PAR for- Sedentary; Moderate; and Vigorous

  14. Oxylog: measurement of energy expenditure Actual energy costs measured according to activities in various postures to compute TDEE instead of std costs. • Wasuja Monika Gambhir and Siddhu Anupa (2002). Age related alterations in energy cost, energy requirement and energy status of affluent women (30-88 years) : A cross sectional study. PhD Thesis • Sirohy Raksha, Siddhu Anupa and Sundararaj Pushpa (2001). Age related changes in body composition and physical work capacity of women. • Talwar Surabhy , Bhargava Usha and Siddhu Anupa (1998) : Age related changes in the energy status of office going men (20 – 60 years). cond.

  15. Oxylog: measurement of energy expenditure • Bhutani Shella and Siddhu Anupa (1995). Age related changes in the energy status of women from middle income group (20-69 years). • Nagpal Neetu and Siddhu Anupa (1996). Comparative study of pre- and post- menopausal women on body composition, energy status and energy cost of physical activity. • Goel Parul and Siddhu Anupa (1997). Energy expenditure in normal and spastic hemiplegic women (18 – 20 years).

  16. Energy Cost of Lying (EL) as measured with OXYLOG II.( 30-88 years; n=83) (Mean + S.D with Range) (M) Premenopausal ( ) denote range; [ ] denote percentage a , EL (Kcal/min) ; p<0.05 (ANOVA), D4>D3,D6,D7 b , EL (Kcal/min) ; p<0.05 (ANOVA), D5>D6,D7 c , EL (Kcal/min/kg BW) ; p<0.05 (ANOVA), D6<D3,D4

  17. Using Standard Costs Vasudha Shukla, Som Nath Singh and Siddhu Anupa (2007). Studies of the energy requirements of Indian soldiers and influence of appetite regulatory peptides on their nutritional status at high altitude.PhD Thesis

  18. TDEE of trainee at sea level estimated by three methods (n=18, 19.3y,BMI=18.7,BF%= 12.8) *4.85% less than DLW,ANOVA; **P<0.001 in comparison to factorial method, Actical and DLW # Malhotra et al 1962 Vasudha Shukla et al 2007

  19. Energy requirement: PAL values * PAL>2.4 not sustainable; mid-point value can be used for computations for group average Short term relief= 1.4 x BMR , FAO 2004

  20. Features • Values are applicable to groups not individuals • Reference man and woman- discontinued since 1985 report • Energy expenditure is the criteria not intake. Obese under report intake. Recommended method to measure expenditure is DLW or HRM for adults. • Descriptor is average not safe level. Population is healthy normal BMI 18.5 -25 for western (or -23 in Asians) • PAL > 1.7 desirable physical activity to prevent obesity and its co morbidities and 30-60min of moderate activity like brisk walkas part of everyday life (FAO 2004)

  21. Terms used PAL = Total energy expenditure per day BMR per day PAR = Energy cost of an individual activity per min energy cost of BMR per min

  22. Continuous heart rate monitoring (HRM) method • Min- to- min heart rate recording • VO2 – HR relationship graph; individual relationship curves • Applicable to moderate to heavy workers • Most suitable on active adolescents and children • Applicable to field- swimming, sports, dance, children in play etc.

  23. Experiences with HRM as a method of EE • Vangipuram Sujata and Siddhu Anupa (1993). Use of Heart rate technique to determine energy cost of a training camp for young sportswomen. • Mehta Manisha and Siddhu Anupa (1993). Mapping energy requirements from minute- to-minute heart rate recording for sedentary and active sportswomen (18-25 y). • Menon Purnima and Siddhu Anupa (1994). Energy status of young women (18-24y) performing Indian classical dance. • Saxena Shilpa and Siddhu Anupa (1994). Use of heart rate technique to determine the energy cost of Kathak dance and Dietetic Internship. • Rishi Priti and Siddhu Anupa (1998). Mapping RDA for energy for Indian sportswomen. PhD Thesis • Priyanka Gupta and Siddhu Anupa (2007). Measuring free-living energy expenditure with accelerometry in young collegiate girls.

  24. Experiences with HRM as a method of EE • Excellent for swimmers, dances, sports as not interfere and not affected by hydration. • Individual energy costs can be measured • Not recommended on sedentary population • Tedious and expensive due to individual HR-VO2 relationship in well established sophisticated lab. Limits field selection of sample.

  25. Double labeled water technique An accurately weighed dose of deuterium oxide-0.15g/kgBW and 18O-0.12g/kg BW is given orally to volunteers with 50ml distilled water. The samples of urine are taken under free living conditions at 6h, 1d,7d,10d 14d after the dose. Isotopic determination is done on Isotope mass spectrometer( Europa Scientific). The CO2 is calculated by Schoeller’s equation. 2H2O urine H218O Urine 2H218O C18O2 breath

  26. Double labeled water technique (DLW) Advantage • Simple • Applicable to field • Cumulative energy expenditure over a period of time under free living conditions • More accurate Disadvantage • Cannot give energy costs • Need accurate collection of urine, blood and saliva • Need uniform distribution of body fluids • Costly

  27. Accelerometry: Actical Priyanka Gupta and Siddhu Anupa (2007). Measuring free-living energy expenditure with accelerometry in young collegiate girls. Vasudha Shukla, Som Nath Singh and Siddhu Anupa (2007). Studies of the energy requirements of Indian soldiers and influence of appetite regulatory peptides on their nutritional status at high altitude. Accelerometers detect low frequency (0.5- 3.2Hz)and G-forces(0.05-2.0 Hz) common to human movements and generate analog voltage signal that is filtered and amplified. The actual number stored by actical are proportional to the magnitude and duration of sensed acceleration and correspond to changes in physical activity energy expenditure.

  28. Accelerometry: Actical - n=33 collegiate women • Actical gave significantly higher (p<0.001) 7d EE than Factorial Method • Actical gave significantly higher (p<0.05) EE than HRM • HRM and factorial method correlate well. PAL=1.59(HRM); 1.52(Fac M): and 1.73(Actical) • Energy cost of activities by Actical was significantly higher than factorial method (p<0.001) but in complete agreement with HRM for cost of walking at 6km/h. Actical is a potential tool to measure AEE but overestimates TEE. Priyanka Gupta et al 2007

  29. Accelerometry: Actical • HRM has a limitation to measure cost of sitting, yoga/asanas. • Actical need more standardisations. • CV% of Actical was 13.37% (inter-) and 7.47%(intra-variability) • Waist was found to be better than wrist and 3d(2h+1H) was as good as 7d. Priyanka Gupta et al 2007

  30. Accelerometry: Actical • Actical overestimates by 2.8% as compared to DLW • The comparisons were done on 18 Trainees at sea level. • TDEE by Actical(3331 Cal/d) was higher than DLW (3240Cal) and Factorial method(3083 Cal/d) but Activity record(4378 Cal/d) was significantly higher than other three methods. Vasudha Shukla et al 2007

  31. PAL:FAO 2004 Method PAL>2.4 not sustainable, FAO 2004 PAL 2.24(Actical); 2.18(DLW) on n=18 sea level Vasudha Shukla et al 2007

  32. Acknowledgement • Human Performance Lab, Sports Authority of India, JLN Stadium, New Delhi • UGC/DSA grant to buy equipment • DIPAS, New Delhi • St John’s Medical College, Bangalore • Students and staff of Lady Irwin College • MSc Dissertation students • PhD students

  33. Select reading • FAO (2004) Human energy requirements. Jt FAO/WHO/UNU Expert consultation . Rome • WHO (1985) Energy and protein requirements. Jt FAO/WHO/UNU Expert consultation. Technical Report Series 724. Geneva • ICMR (1990) Nutrient requirements and recommended dietary allowances for Indians.

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