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Techniques for the study of energy balance in man

Published online by Cambridge University Press:  08 December 2008

Marinos Elia ,
Rebecca Stratton  and
James Stubbs
Marinos Elia*
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
Rebecca Stratton
Affiliation:
Institute of Human Nutrition, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
James Stubbs
Affiliation:
ACERO, Rowett Research Institute, Bucksburn, Aberdeen, AB21 9SB, UK
*
*Corresponding author: Professor Marinos Elia, fax +44 23 8079 4277, M. [email protected]
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Abstract

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Energy balance can be estimated in tissues, body segments, individual subjects (the focus of the present article), groups of subjects and even societies. Changes in body composition in individual subjects can be translated into changes in the energy content of the body, but this method is limited by the precision of the techniques. The precision for measuring fat and fat-free mass can be as low as 0.5 kg when certain reference techniques are used (hydrodensitometry, air-displacement plethysmography, dual-energy X-ray absorptiometry), and approximately 0.7 kg for changes between two time points. Techniques associated with a measurement error of 0.7 kg for changes in fat and fat-free mass (approximately 18MJ) are of little or no value for calculating energy balance over short periods of time, but they may be of some value over long periods of time (18 MJ over 1 year corresponds to an average daily energy balance of 70 kJ, which is <1% of the normal dietary energy intake). Body composition measurements can also be useful in calculating changes in energy balance when the changes in body weight and composition are large, e.g. >5–10 kg. The same principles can be applied to the assessment of energy balance in body segments using dual-energy X-ray absorptiometry. Energy balance can be obtained over periods as short as a few minutes, e.g. during measurements of BMR. The variability in BMR between individuals of similar age, weight and height and gender is about 7–9%, most of which is of biological origin rather than measurement error, which is about 2%. Measurement of total energy expenditure during starvation (no energy intake) can also be used to estimate energy balance in a whole-body calorimeter, in patients in intensive care units being artificially ventilated and by tracer techniques. The precision of these techniques varies from 1 to 10%. Establishing energy balance by measuring the discrepancy between energy intake and expenditure has to take into consideration the combined validity and reliability of both components. The measurement error for dietary intake may be as low as 2–3% in carefully controlled environments, in which subjects are provided only with certain food items and bomb calorimetry can be undertaken on duplicate samples of the diet. Reliable results can also be obtained in hospitalised patients receiving enteral tube feeding or parenteral nutrition as the only source of nutrition. Unreliability increases to an unknown extent in free-living subjects eating a mixed and varied diet; thus, improved methodology is needed for the study of energy balance.

Keywords

Energy intakeEnergy expenditureMeasurement techniques
Type
Clinical Nutrition and Metabolism Group Symposium on ‘Control of energy balance in health and disease’
Information
Proceedings of the Nutrition Society , Volume 62 , Issue 2 , May 2003 , pp. 529 - 537
Copyright
Copyright © The Nutrition Society 2003

References

Benedict, FG (1915) A Study of Prolonged Fasting. Carnegie Institute of Washington Publication no. 203 Washington, DC: Carnegie Institute of WashingtonCrossRefGoogle Scholar
Bingham, S (1987) The dietary assessment of individuals; methods, accuracy, new techniques and recommendations. Nutrition Abstracts and Reviews 57, 705–742Google Scholar
Bingham, SA (1991) Limitations of the various methods for collecting dietary intake data. Annals of Nutrition Metabolism 35, 117–127CrossRefGoogle ScholarPubMed
Coward, WA, Prentice, AM, Murgatroyd, PR, Goldberg, GR, Halliday, D, MacNamara, JP, Davies, HL, Cole, TJ & Sower, M (1985) Measurement of CO 2 and water production rate in man using 2 H, 18 O-labelled H2O; comparisons between calorimeter and isotope values. In Human Energy Metabolism, Physical Activity and Energy Expenditure Measurements in Epidemiological Research Based upon Direct and Indirect Calorimetry. Report of an EC Workshop at Wageningen, The Netherlands: Euro-Nutr Report no. 5, pp. 126–128 [Esk, AJHV, editor]. Den Haag, The Netherlands: CIP-Gegevens KoninklijkeGoogle Scholar
Elia, M (1992a) An evaluation of two and more than two component models of body composition. Clinical Nutrition 11, 114–127CrossRefGoogle Scholar
Elia, M (1992b) Organ and tissue contribution to metabolic rate. In Energy Metabolism: Tissue Determinants and Cellular Corollaries, pp. 61–79 [Kinney, JM and Tucker, HN, editors]. New York: Raven PressGoogle Scholar
Elia, M (1997) Tissue distribution and energetics in weight loss and undernutrition. In Physiology, Stress and Malnutrition. Functional Correlates and Nutritional Intervention, pp. 383–412 [Kinney, JM, and Tucker, HN, editors] New York: Lippincott-Raven PublishersGoogle Scholar
Elia, M(edditor) (2000) Detection and Management of Undernutrition in the Community. A Report by The Malnutrition Advisory Group (A Working Group of The British Association for Parenteral and Enteral Nutrition).Maidenhead, Berks: British Association for Parenteral and Enteral NutritionGoogle Scholar
Elia, M & Livesey, G (1992) Energy expenditure and fuel selection in biological systems: the theory and practice of calculations based on indirect calorimetry and tracer methods. International Journal of Nutrition and Dietetics 70, 68–131Google ScholarPubMed
Elia, M, Ritz, P & Stubbs, RJ (2000) Energy expenditure in the elderly. European Journal of Clinical Nutrition 54, S92–S103 Suppl. 3CrossRefGoogle ScholarPubMed
Fuller, NJ, Jebb, SA, Laskey, MA, Coward, WA & Elia, M (1992) Four-component model for the assessment of body composition in humans: comparison with alternative methods and evaluation of the density and hydration of fat-free mass. Clinical Science 82, 687–693CrossRefGoogle ScholarPubMed
Fuller, NJ, Sawyer, MB & Elia, M (1995) Body composition changes after vertical band gastroplasty in obese females. Proceedings of the Nutrition Society 54, 95AGoogle Scholar
Gibney, ER (2002) The physical, psychological and metabolic effects of nutritional depletion and subsequent repletion. PhD Thesis, University of Cambridge.Google Scholar
Goldberg, GR, Blaak, AE, Jebb, SA, Cole, TJ, Murgatroyd, PR, Coward, WA & Prentice, AM (1991) Critical evaluation of energy intake data using fundamental physiological principles of energy physiology. 1. Derivation of cutoff limits to identify under-recording. European Journal of Clinical Nutrition 45, 569–581Google Scholar
Jensen, CL, Butte, NF, Wong, WW & Moon, JK (1992) Determining energy expenditure in preterm infants: comparison of 2H(2)18O method and indirect calorimetry. American Journal of Physiology 263, R685–R692Google ScholarPubMed
Jones, PJ, Winthrop, AL, Schoeller, DA, Filler, RM, Swyer, PR, Smith, J & Heim, T (1988) Evaluation of doubly labeled water for measuring energy expenditure during changing nutrition. American Journal of Clinical Nutrition 47, 799–804CrossRefGoogle ScholarPubMed
Jones, PJ, Winthrop, AL, Schoeller, DA, Swyer, PR, Smith, J, Filler, RM & Heim, T (1987) Validation of doubly labeled water for assessing energy expenditure in infants. Pediatric Research 21, 242–246CrossRefGoogle ScholarPubMed
Keys, A, Brozek, J, Henschel, A, Mickelsen, O & Taylor, HL (1950) The Biology of Human Starvation, pp. 81–535 Minneapolis, MN: University of Minnesota PressCrossRefGoogle Scholar
Klein, PD, James, WPT, Wong, WW, Irving, CS, Murgatroyd, PR, Cabrera, M, Dallosso, HM, Klein, E & Nichols, BL (1984) Calorimetric validation of the doubly-labelled water method for determination of energy expenditure in man. Human Nutrition Clinical Nutrition 38, 5–106Google ScholarPubMed
Liu, P, Arnold, M, Belenkie, I, Hewlett, J, Huckell, V, Ignazewski, A et al. (2001) The 2001 Canadian Cardiovascular Society consensus guideline update for the management and prevention of heart failure. Canadian Journal of Cardiology 17, 5E–25EGoogle Scholar
O'Reilley, L (2002) Mis-reporting of food intake in UK adults. PhD Thesis, University of Coleraine.Google Scholar
Parkinson, SA (1990) In vivo measurement of changes in body composition. PhD Thesis, University of Cambridge.Google Scholar
Ravussin, E, Harper, I, Rising, R & Bogardus, C (1991) Energy expenditure by doubly labelled water: validation in lean and obese subjects. American Journal of Physiology 261, E402–E409Google ScholarPubMed
Roberts, SB, Coward, WA, Schlingenseipen, K-H, Nohria, V & Lucas, A (1986) Comparison of the doubly labeled water ( 2 H 2 18 O) method with indirect calorimetry and a nutrient-balance study for simultaneous determination of energy expenditure, water intake and metabolizable energy intake in preterm infants. American Journal of Clinical Nutrition 44, 315–322CrossRefGoogle Scholar
Schoeller, DA & Hnilica, JM (1986) Reliability of the doubly labelled water method for the measurement of total energy expenditure in free-living subjects. Journal of Nutrition 126, 348S–354SGoogle Scholar
Schoeller, DA, Ravussin, E, Schutz, Y, Acheson, KJ, Baertschi, P & Jequier, E (1986) Energy expenditure by doubly labeled water: validation in humans. American Journal of Physiology 250, R823–R830Google ScholarPubMed
Schoeller, DA & Webb, P (1984) Five-day comparison of the doubly labeled water method with respiratory gas exchange. American Journal of Clinical Nutrition 40, 153–158CrossRefGoogle ScholarPubMed
Shetty, PS & James, WPT (1994) Body Mass Index: A Measure of Chronic Energy Deficiency in Adults. FAO Food and Nutrition Paper no. 56 1–57 Rome FAOGoogle Scholar
Stallone, DD, Brunner, EJ, Bingham, SA & Marmot, MG (1997) Dietary assessment in Whitehall II: the influence of reporting bias on apparent socioeconomic variation in nutrient intakes. European Journal of Clinical Nutrition 51, 815–825CrossRefGoogle ScholarPubMed
Stubbs, RJ, O'Reilley, L, Fuller, Z, Horgan, G, Meyer, C, Deary, I, Austin, E, Ritz, P, Milne, E & James, WPT (2003) Detecting and Modelling Mis-reporting of Food Intake in Adults. London: Food Standards AgencyGoogle Scholar
van, Wijk MCW (1999) The assessment of body composition in obese subjects using bioelectrical impedance spectroscopy. PhD Thesis, University of Aberdeen.Google Scholar
Westerterp, KR, Brouns, F, Saris, WHM & Hoor, FP (1988) Comparison of doubly labelled water with respirometry at low and high activity levels. Journal of Applied Physiology 65, 53–56CrossRefGoogle ScholarPubMed
Westerterp, KR, Schoffelen, PFM, Saris, WHM, ten, Hoor F (1984) Measurement of energy expenditure using doubly labelled water, a validation study. Report of Instituut voor de Voeding, pp. 129–131 Maastricht, The Netherlands: Instituut voor de VoedingGoogle Scholar