Estimates of Resting Energy Expenditure and Total Energy Expenditure Using Predictive Equations for Individuals After Bariatric Surgery: a Systematic Review with Meta-analysis.

PURPOSE: Patients after metabolic bariatric surgery (MBS) require attention to maintain energy balance and avoid weight regain. Predictive equations for resting energy expenditure (REE) and total energy expenditure (TEE) are needed since gold standard methods like calorimetry and doubly labeled water are rarely available in routine clinical practice. This study aimed to determine which predictive equation for REE and TEE has the lowest bias in subjects after MBS. METHODS: MEDLINE, Embase, Web of Science, and CENTRAL searches were performed. Meta-analyses were performed with the data calculated by the predictive equations and measured by the gold standard methods for those equations that had at least two studies with these data. The DerSimonian and Laird random-effects model and the I2 statistic were used to quantify heterogeneity in the quantitative analyses. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist. RESULTS: Seven studies were included. The present study found that the Mifflin St. Jeor (1990) equation had the lowest bias (mean difference = - 39.71 kcal [95%CI = - 128.97; 49.55]) for calculating REE in post-BS individuals. The Harris-Benedict (1919) equation also yielded satisfactory results (mean difference = - 54.60 kcal [95%CI = - 87.92; - 21.28]). CONCLUSION: The predictive equation of Mifflin St. Jeor (1990) was the one that showed the lowest bias for calculating the REE of patients following MBS.

Prevalence of food addiction among patients undergoing metabolic/bariatric surgery: A systematic review and meta-analysis.

Candidates for metabolic/bariatric surgery show a high prevalence of food addiction (FA). However, few studies have investigated FA prevalence after bariatric surgery, especially using longitudinal studies. This systematic review with a meta-analysis aimed to determine pre- and postoperative prevalence of FA among patients undergoing metabolic/bariatric surgery. It included both cross-sectional and longitudinal studies that used the Yale Food Addiction Scale (YFAS). The following databases were searched: MEDLINE, ScienceDirect, LILACS, PsycArticles, CENTRAL, greylit.org, and opengrey.eu. Studies that used the YFAS to evaluate FA in pre- or postoperative patients were included. A random-effects meta-analysis was performed with cross-sectional studies to calculate the weighted prevalence of FA at the pre- and postoperative moments. For longitudinal studies, which measured FA at both time points for the same individuals, absolute prevalence reduction (APR) was calculated. Of the 6626 records, 40 studies were included in the meta-analysis. The preoperative weighted prevalence of FA was 32% (95% CI: 27-37%; 33 groups), whereas the postoperative prevalence was 15% (95% CI: 12-18%; 14 groups). Seven longitudinal studies showed a weighted APR of 26 p.p. (95% CI: 10-41 p.p.). Observational data suggest a reduction in the prevalence of FA among patients that undergo bariatric surgery. Interventional studies are needed to confirm these findings.

The relationship between total energy expenditure and physical activity level in women living in an impoverished Brazilian urban area.

OBJECTIVE: This study aimed to describe how strong is the relationship between TEE and PAL in women living in an impoverished Brazilian urban area. METHODS: Anthropometric, hormonal (insulin, TSH, FT4 , and FT3 ), body composition (deuterium), TEE (doubly labeled water) and PAL (metabolic equivalent task [MET]-7-day triaxial accelerometer, ActivPAL®) data were collected from 55 women (mean age: 31y, mean BMI: 27.4 kg/m2 ). Adjusted-TEE models were calculated incorporating the residuals of anthropometric, hormonal, and body composition variables in the TEE, to assess the relation between MET and adjusted-TEE, through three different analyzes: linear regression, nonlinear regression and change-point regression. RESULTS: Most participants (89.1%, n = 49) were classified as low-active. There was no association between crude TEE and MET.h/d (R2  = 0.05; p = 0.09). There was a positive, although weak, linear relationship between adjusted-TEE and MET.h/d (ß = 2705.26 kcal; 95% CI: 436.25; 4974.27; adj-R2  = 0.08). A change point of this relationship was identified in the MET.h/d value of 1.53 (SD = 0.02; adj-R2 = 0.13). The association between adjusted-TEE and MET.h/d before the change point (ß = 5101.46 kcal; 95%CI: 978.84; 9224.08; adj-R2  = 0.11) was stronger than the association in the full linear model, nevertheless, it was still weak. This association stop existing when it is assessed in individuals after the change point (ß = -6609.92 kcal; 95%CI: -16773.24; 3553.40; adj-R2  = 0.08). CONCLUSIONS: These results suggest that the relationship between TEE and PAL is weak and it is not completely linear in women living in an impoverished Brazilian urban area.

Prevalence of food addiction determined by the Yale Food Addiction Scale and associated factors: A systematic review with meta-analysis.

OBJECTIVE: To determine, through a systematic review with meta-analysis, the prevalence of food addiction (FA) using the Yale Food Addiction Scale (YFAS) and its derivatives exploring possible factors associated with the prevalence of FA in several contexts. METHODS: The following databases were searched: MEDLINE, ScienceDirect, LILACS, PsycArticles, CENTRAL, Greylit.org, and OpenGrey.eu. Studies that assessed FA using YFAS were included. Two independent reviewers assessed the eligibility of each report. Random-effects meta-analysis was performed to calculate the weighted prevalence of FA. Subgroup analyses and meta-regression were conducted to explore sources of heterogeneity. RESULTS: Of the 6425 abstracts reviewed, 272 studies were included. The weighted mean prevalence of FA diagnosis was 20% (95% CI: 18%; 21%). The prevalence of FA was higher in individuals with clinical diagnosis of binge eating (55%; 95% CI 34%; 75%). The prevalence in clinical samples was higher compared to non-clinical samples. Two studies included children only and no studies included only elderly people. CONCLUSIONS: Food addiction is a topic in which there has been a significant growth in studies. The highest prevalence was found in the group of participants with eating disorders and weight disorders. More studies with children and the elderly are needed.

Acute effects of time-restricted feeding in low-income women with obesity placed on hypoenergetic diets: Randomized trial.

OBJECTIVE: The aim of this study was to evaluate the acute effects of time-restricted feeding in obese women living in social vulnerability who were placed on diets with the same energy deficit. METHODS: Fifty-eight obese women (19-44 y of age) were randomized to a group with a hypoenergetic diet and 12 h of fasting daily or to a group with only a hypoenergetic diet for 21 d, with body weight and waist circumference monitoring up to 81 d of intervention. The determination of the individual's energy content of the diets was based on their resting metabolic rate (by indirect calorimetry) and physical activity level (by triaxial accelerometers). Body composition, temperature, blood pressure, appetite, adhesion difficulty, thyroid axis hormones, leptin, glucose concentration, and insulin were measured before and after 21 d of intervention. A mixed analysis of variance test was performed. RESULTS: The women had a mean age of 31 y and mean body mass index of 33 kg/m². Significant interaction between group × time was observed only in axillary temperature (0.44°C; 95% confidence interval [CI], 0.17-0.74°C; P < 0.01), which increased in the experimental group and in body fat (-0.75%; 95% CI, -1.43% to -0.07%; P = 0.02) decreased in the experimental group. Also, there was a significant decrease in waist circumference in the time-restricted feeding group after 81 d. There were no differences in hormonal profile, resting metabolic rate, reported appetite, or adherence difficulty. CONCLUSION: Time-restricted feeding may be considered an alternative strategy for treating obesity in socially vulnerable women.

Sitting/lying time is associated with waist-to-hip increase but not with body weight increase or blood cardiovascular risk factors changes in adult women living in social vulnerability: A 2-year longitudinal study.

OBJECTIVE: The present study aimed to determine whether physical activity and energy intake are associated with the anthropometric and blood cardiovascular risk factors alterations in women living in social vulnerability for a period of 2 years. METHODS: The study was carried out with women residing in the outskirts of Maceió-AL, aged between 19 and 45 years. We characterized the socioeconomic and biochemical profile (glucose, insulin, and blood lipids) at the beginning and at the end of the study. Anthropometric evaluation was performed in three moments: at the beginning, and after 1 and 2 years of follow-up. Energy expenditure, measured by doubly labeled water, physical activity, measured by 7-day triaxial accelerometry, and energy intake, measured by 3-day 24-hour food recall, were collected at baseline. RESULTS: After 2 years, 34 women were completely assessed, with a mean age of 33.7 years. Women spent around 16 hours of the day sitting/lying down. There was an increase in body weight (from 64.61 ± 11.69 to 66.37 ± 13.26 kg, P < .01), which was not associated with any of the predictors. There was also an increase in waist/hip ratio (WHR) (from 0.84 ± 0.07 to 0.87 ± 0.05, P < .01), which was positively associated with the amount of sitting/lying time per day. There were no significant alterations in blood cardiovascular risk factors. CONCLUSION: Energy intake did not predict anthropometrical changes. Sitting/lying time was associated with an increase in WHR, but not in body weight or blood cardiovascular risk factors in low-income women.

Agreement between the total energy expenditure calculated with accelerometry data and the BMR yielded by predictive equations v. the total energy expenditure obtained with doubly labelled water in low-income women with excess weight.

Low-income women are the group with the highest levels of obesity worldwide. In low-income settings, the use of predictive equations, which yield a measure of the individuals' BMR, is a feasible approach to estimate the individuals' total energy expenditure (TEE), using the factorial method (calculated-TEE = BMR × physical activity level), an important step of the obesity nutritional care. The present study aimed to identify the predictive equation that, in conjunction with metabolic equivalents of tasks (MET) data from accelerometers, yields the calculated-TEE with better agreement compared with the TEE measured by doubly labelled water (TEE-DLW). Forty-five women aged 19-45 years, with excess weight and mothers of undernourished children, were included. They received DLW to determine TEE (14 d); at the same time, they used triaxial accelerometers (7 d) to estimate their MET. The Bland-Altman method, paired-sample t tests, concordance correlation coefficient and root-mean-square error were used to assess the agreement. Maximum allowed differences were defined as 24 %, based on the within-variance coefficient of the energy intake of the sample. Eleven equations were studied. The calculated-TEE obtained by five equations showed non-significant bias: Dietary Reference Intake (Institute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids), FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series), Harris & Benedict ((1919) Proc Natl Acad Sci USA4, 370-373), Henry & Rees ((1991) Eur J Clin Nutr45, 177-185) and Schofield ((1985) Hum Nutr Clin Nutr39, 5-41). The mean percentage differences were -1·5, -0·8, 2·2, -2·2 and 2·0 %, respectively. Considering all parameters, FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series) equation performed slightly better than the others; nevertheless, no equation in conjunction with the estimated-MET showed a calculated-TEE with its CI for the Bland-Altman limits of agreement inside the pre-defined acceptable range.