Resting energy expenditure of a diverse group of South African men and women.

BACKGROUND: In South Africa, overweight/obesity is a public health concern, disproportionally affecting Black females. A contributory role of a lower resting energy expenditure (REE) is suggested for African Americans. The present study assessed the REE of Black and White South African adults aiming to better understand the underlying predictors to overweight/obesity and transform this into locally appropriate recommendations. METHODS: In 328 (63% female; 39% Black) healthy South African adults, REE was measured with indirect calorimetry and body composition with multifrequency bioelectrical impedance analysis. The REE was estimated with 30 sets of published equations. Black-White differences in REE, as measured and adjusted (analysis of covariance), were determined with quantile regression. Reliability/agreement of estimated (against measured) REE was determined with intra-class correlations (ICCs) and Bland-Altman analysis. A new equation was developed by median regression followed by preliminary validation. RESULTS: Measured REE (adjusted for age along with fat-free mass [FFM], FFM index, FFM plus fat mass, FFM index plus fat mass index) in White subjects was significantly higher (p < 0.001) than in Black subjects for men and women alike, regardless of obesity class. None of the sets of estimation equations had good agreement with measured REE for Black, White, male and female subjects simultaneously. A new estimation equation, based on whole-body variables, had good reliability (ICC = 0.79) and agreement (mean difference: 27 kJ) and presents practical opportunities for groups at the local grass-roots level. CONCLUSIONS: The REE in Black South African adults is lower than in White adults. Tailored REE equations may improve REE estimation of racially/ethnically diverse South African groups and contribute to improved obesity management.

Resting Energy Expenditure and Related Factors in 6- to 9-Year-Old Southern African Children of Diverse Population Groups.

Lower resting energy expenditure (REE) may partially explain the disproportionate prevalence of overweight/obesity among black African women. As no previous studies have investigated the REE of Southern African (South. Afr.) children, we aimed to determine, by sex and population group, the REE of 6- to 9-year-old urban school children. In a cross-sectional study with quota sampling, REE was measured with indirect calorimetry (IC). Confounders considered were: body composition (BC) (fat-free mass (FFM), FFM index, fat mass (FM), FM index), assessed using multifrequency bioelectrical impedance analysis, and physical activity (PA) measured with a pedometer. Multivariate regression was used to calculate REE adjusted for phenotypes (BC, z-scores of weight-for-age, height-for-age, body mass index-for-age) and PA. Sex and population differences in REE were determined with two-way ANOVA. Ninety-four healthy children (59.6% girls; 52.1% black) with similar socioeconomic status and PA opportunities participated. Despite BC variations, sex differences in REE were not significant (41 kcal/day; P = 0.375). The REE of black participants was lower than of white (146 kcal/day; P = 0.002). When adjusted for FFM and HFA z-score, the differences in REE declined but remained clinically meaningful at 91 kcal/day (P = 0.039) and 82 kcal/day (P = 0.108), respectively. We recommend the development of population-specific REE prediction equations for South. Afr. children.