Doubly labelled water-calibration approach attenuates the underestimation of energy intake calculated from self-reported dietary assessment data in Japanese older adults.

OBJECTIVE: Self-reported energy intake (EI) estimation may incur systematic errors that could be attenuated through biomarker calibration. We aimed to confirm whether calibrated EI was comparable to total energy expenditure (TEE) measured using the doubly labelled water (DLW) technique. DESIGN: Cross-sectional study. SETTING: General older population from the Kyoto-Kameoka Study, Japan. PARTICIPANTS: This study included sub- and main cohorts of 72 and 8058 participants aged≥ 65 years, respectively. EI was evaluated using a validated FFQ, and calibrated EI was obtained using a previously developed equation based on the DLW method. TEE was considered representative of true EI and also measured using the DLW method. We used a Wilcoxon signed-rank test and correlation analysis to compare the uncalibrated and calibrated EI with TEE. RESULTS: In the sub-cohort, the median TEE, uncalibrated EI and calibrated EI were 8559 kJ, 7088 kJ and 9269 kJ, respectively. The uncalibrated EI was significantly lower than the TEE (median difference = -1847 kJ; interquartile range (IQR): -2785 to -1096), although the calibrated EI was not (median difference = 463 kJ; IQR: -330 to 1541). The uncalibrated (r = 0·275) and calibrated EI (r = 0·517) significantly correlated with TEE. The reproducibility was higher for calibrated EI (interclass correlation coefficient (ICC) = 0·982) than for uncalibrated EI (ICC = 0·637). Similar findings were observed when stratifying the sample by sex. For medians, uncalibrated EI was lower (about 17 %) than calibrated EI in the main cohort. CONCLUSIONS: Biomarker calibration may improve the accuracy of self-reported dietary intake estimation.

Validity of the Use of a Triaxial Accelerometer and a Physical Activity Questionnaire for Estimating Total Energy Expenditure and Physical Activity Level among Elderly Patients with Type 2 Diabetes Mellitus: CLEVER-DM Study.

INTRODUCTION: Evaluation of total energy expenditure (TEE) and physical activity level (PAL) is important for treatment of patients with type 2 diabetes mellitus (T2DM). However, the validity of accelerometers (ACC) and physical activity questionnaires (PAQ) for estimating TEE and PAL remains unknown in elderly populations with T2DM. We evaluated the accuracy of TEE and PAL results estimated by an ACC (TEEACC and PALACC) and a PAQ (TEEPAQ and PALPAQ) in elderly patients with T2DM. METHODS: Fifty-one elderly patients with T2DM (aged 61-79 years) participated in this study. TEEACC was calculated with PALACC using a triaxial ACC (Active style Pro HJA-750c) over 2 weeks and predicted basal metabolic rate (BMR) by Ganpule's equation. TEEPAQ was estimated using predicted BMR and the PALPAQ from the -Japan Public Health Center Study-Long questionnaire. We compared the results to TEEDLW measured with the doubly labeled water (DLW) method and PALDLW calculated with BMR using indirect calorimetry. RESULTS: TEEDLW was 2,165 ± 365 kcal/day, and TEEACC was 2,014 ± 339 kcal/day; TEEACC was strongly correlated with TEEDLW (r = 0.87, p < 0.01) but significantly underestimated (-150 ± 183 kcal/day, p < 0.05). There was no significant difference in TEEPAQ and TEEDLW (-49 ± 284 kcal/day), while the range of difference seemed to be larger than TEEACC. PALDLW, PALACC, and PALPAQ were calculated to be 1.71 ± 0.17, 1.69 ± 0.16, and 1.78 ± 0.24, respectively. -PALACC was strongly correlated with PALDLW (r = 0.71, p < 0.01), and there was no significant difference between the 2 values. PALPAQ was moderately correlated with PALDLW (r = 0.43, p < 0.01) but significantly overestimated. Predicted BMR was significantly lower than the BMR -measured by indirect calorimetry (1,193 ± 186 vs. 1,262 ± 155 kcal/day, p < 0.01). CONCLUSIONS: The present ACC and questionnaire showed acceptable correlation of TEE and PAL compared with DLW method in elderly patients with T2DM. Systematic errors in estimating TEE may be improved by the better equation for predicting BMR.

Effect of the Health Tourism weight loss programme on body composition and health outcomes in healthy and excess-weight adults.

Excess weight loss while minimising fat-free mass (FFM) loss is important for health. Travel is a particular period at risk for weight gain and for which the effects of a short-term intensive weight loss programme have not been studied. Therefore, we studied the effect of a novel, 1-week supervised health travel programme combining high volume, low-to-moderate intensity exercise and energy intake restriction on weight, body composition and health outcomes in adults. Weight was also monitored for 12 weeks after the programme. In all, thirty-six subjects (nineteen men, seventeen women) consisting of sixteen excess-weight (BMI: 27·1 (sd 1·7) kg/m2) and twenty healthy-weight (BMI: 22·3 (sd 1·8) kg/m2) individuals participated. Subjects performed 1 h of slow-paced intermittent jogging three times per d and other leisure activities, whereas consuming only provided foods without water restriction. Body mass significantly decreased from pre- to post-intervention in excess-weight and healthy-weight individuals (-3·5 (sd 1·5) and -3·5 (sd 1·3) %, respectively; P<0·001 for both), and losses were maintained at 12 weeks post-intervention in both groups (-6·3 (sd 3·8) and -1·7 (sd 4·0) %, respectively; P<0·01 for both). Fat mass also significantly decreased in both groups (excess weight: -9·2 (sd 4·6) %: healthy weight: -13·4 (sd 9·0) %; P<0·01 for both), whereas FFM was maintained. Similar improvements were observed for blood biochemistry and pressure in both groups. This short-term weight loss intervention yielded favourable outcomes in both excess- and healthy-weight adults, particularly a 3·5 % weight loss with no significant change to FFM. In addition, participants maintained weight loss for at least 12 weeks. Of multiple programme choices, the Health Tourism weight loss programme's results indicate that it is a viable option.

Energy Requirement Assessment in Japanese Table Tennis Players Using the Doubly Labeled Water Method.

Total daily energy expenditure (TEE) and physical activity level (PAL) are important for adequate nutritional management in athletes. The PAL of table tennis has been estimated to about 2.0: it is categorized as a moderateactivity sport (4.0 metabolic equivalents [METs]) in the Compendium of Physical Activities. However, modern table tennis makes high physiological demands. The aims of the current study were to examine (1) TEE and PAL of competitive table tennis players and (2) the physiological demands of various types of table tennis practice. In Experiment 1, we measured TEE and PAL in 10 Japanese college competitive table tennis players (aged 19.9 ± 1.1 years) using the doubly labeled water (DLW) method during training and with an exercise training log and self-reported energy intake. TEE was 15.5 ± 1.9 MJ·day-1 (3695 ± 449 kcal·day-1); PAL was 2.53 ± 0.25; and the average training duration was 181 ± 38 min·day-1. In Experiment 2, we measured METs of five different practices in seven college competition players (20.6 ± 1.2 years). Three practices without footwork were 4.5-5.2 METs, and two practices with footwork were 9.5-11.5 METs. Table tennis practices averaged 7.1 ± 3.2 METS demonstrating similarities with other vigorous racket sports. In conclusion the current Compendium of Physical Activities underestimates the physiological demands of table tennis practice for competition; the estimated energy requirement should be based on DLW method data.

Factors associated with water consumption measured using the stable isotope techniques among Japanese adults: a cross-sectional study.

BACKGROUND/OBJECTIVES: While some dietary guidelines have established daily water requirements for adults, those for older adults are not well defined. Factors associated with water turnover (WT), indicating water requirements and preformed water (PW), referring to fluids consumed from food and beverages, remain poorly understood. Therefore, we aimed to investigate these factors in Japanese adults. SUBJECTS/METHODS: This cross-sectional study included 57 participants aged 54-85 years, living in Fukuoka City, Japan. The WT and PW were measured using the doubly labelled water (DLW) methods from August 2015 to September 2015. Dietary intake and physical activity were evaluated using a 3-day dietary record (DR) and a validated triaxial accelerometer, respectively. Fasting blood and urine samples, as well as environmental conditions, were assessed using a validated technique. We evaluated the variables for predicting water consumption by using a multivariate generalised linear model, with forward stepwise selection using these covariates. RESULTS: The median WT and PW were 2842 ml/day and 2227 ml/day, respectively. In the multivariate model, WT (R2 = 0.629) and PW (R2 = 0.621) were moderately predicted by variables such as sex, body weight, moderate-to-vigorous physical activity, water consumption estimated by DR, urinary aldosterone and osmolality, creatinine clearance and wet-bulb globe temperature. The PW estimates from DR were ~40% lower than those from DLW method, despite a significant correlation between the values. CONCLUSIONS: WT and PW are associated not only with lifestyle and environmental factors but also with urinary markers and kidney function. These findings provide useful insights into the differences in each individual's water requirement.

Prevalence of Poor Sleep Quality and its Association with Lifestyle Habits, Competition-Based Activities, and Psychological Distress in Japanese Student-Athletes During the COVID-19 Pandemic.

Objectives The present study clarified the prevalence of poor sleep quality and its relation to lifestyle habits, competitive-based activities, and psychological distress among Japanese student-athletes in the initial pandemic period (2020) and 1 year later (2021). Methods In the present study, student-athletes were defined as individuals belonging to university athletic clubs. The data of two cross-sectional surveys (2020: n = 961 and 2021: n = 711) were collected from student-athletes in 6 universities in Japan. First, the prevalence of poor sleep quality (Pittsburgh sleep quality index score > 5) was investigated. Relationships between poor sleep quality and lifestyle habits, competition-based activities, and psychological distress were then explored using multivariate logistic regression analysis adjusted for age, sex, and body mass index. Results The prevalence of poor sleep quality was 33.6% in 2020 and 36.6% in 2021. Poor sleep quality in 2020 was related to late bedtime, taking supplements before bed, part-time job (no late night), stressors of expectations and pressure from others, and psychological distress, whereas that in 2021 was related to early wake-up time, skipping breakfast, taking caffeinated drinks before bed, use of smartphone/cellphone after lights out, stressors of motivation loss, and psychological distress. Conclusions In both 2020 and 2021, one-third of student-athletes had poor sleep quality and psychological distress was its common risk factor. Lifestyle habits and competition stressors associated with poor sleep quality were pandemic-specific in 2020, but similar to the prepandemic period in 2021.

Alterations in step frequency and muscle activities using body weight support influence the ventilatory response to sinusoidal walking in humans.

The use of body weight support (BWS) can reveal important insights into the relationship between lower-limb muscle activities and the ventilatory response during sinusoidal walking. Here, healthy participants (n = 15) walked on a treadmill while 0%, 30%, and 50% of their body weight was supported with BWS. The walking speed was varied sinusoidally between 3 and 6 km h-1, and three different frequencies, and periods ranging from 2 to 10 min were used. Breath-by-breath ventilation ([Formula: see text]) and CO2 output ([Formula: see text]) were measured. The tibialis anterior (TA) muscle activity was measured by electromyography throughout the walking. The amplitude (Amp), normalized Amp [Amp ratio (%)], and phase shift (PS) of the sinusoidal variations in measurement variables were calculated using a Fourier analysis. The results revealed that the Amp ratio in [Formula: see text] increased with the increase in BWS. A steeper slope of the [Formula: see text]-[Formula: see text] relationship and greater [Formula: see text]/[Formula: see text] values were observed under reduced body weight conditions. The Amp ratio in TA muscle was significantly positively associated with the Amp ratio in the [Formula: see text] (p < 0.001). These findings indicate that the greater amplitude in the TA muscle under BWS may have been a potent stimulus for the greater response of ventilation during sinusoidal walking.

Effects of High-Intensity Anaerobic Exercise on the Scavenging Activity of Various Reactive Oxygen Species and Free Radicals in Athletes.

High-intensity exercise in athletes results in mainly the production of excess reactive oxygen species (ROS) in skeletal muscle, and thus athletes should maintain greater ROS scavenging activity in the body. We investigated the changes in six different ROS-scavenging activities in athletes following high-intensity anaerobic exercise. A 30-s Wingate exercise test as a form of high-intensity anaerobic exercise was completed by 10 male university track and field team members. Blood samples were collected before and after the exercise, and the ROS-scavenging activities (OH•, O2•−, 1O2, RO• and ROO•, and CH3•) were evaluated by the electron spin resonance (ESR) spin-trapping method. The anaerobic exercise significantly increased RO• and ROO• scavenging activities, and the total area of the radar chart in the ROS-scavenging activities increased 178% from that in pre-exercise. A significant correlation between the mean power of the anaerobic exercise and the 1O2 scavenging activity was revealed (r = 0.72, p < 0.05). The increase ratio in OH• scavenging activity after high-intensity exercise was significantly greater in the higher mean-power group compared to the lower mean-power group (n = 5, each). These results suggest that (i) the scavenging activities of some ROS are increased immediately after high-intensity anaerobic exercise, and (ii) an individual's OH• scavenging activity responsiveness may be related to his anaerobic exercise performance. In addition, greater pre-exercise 1O2 scavenging activity might lead to the generation of higher mean power in high-intensity anaerobic exercise.

The Acute Effects of a Single Dose of Molecular Hydrogen Supplements on Responses to Ergogenic Adjustments during High-Intensity Intermittent Exercise in Humans.

This research examined the effects of single-dose molecular hydrogen (H2) supplements on acid-base status and local muscle deoxygenation during rest, high-intensity intermittent training (HIIT) performance, and recovery. Ten healthy, trained subjects in a randomized, double-blind, crossover design received H2-rich calcium powder (HCP) (1500 mg, containing 2.544 µg of H2) or H2-depleted placebo (1500 mg) supplements 1 h pre-exercise. They performed six bouts of 7 s all-out pedaling (HIIT) at 7.5% of body weight separated by 40 s pedaling intervals, followed by a recovery period. Blood gases' pH, PCO2, and HCO3- concentrations were measured at rest. Muscle deoxygenation (deoxy[Hb + Mb]) and tissue O2 saturation (StO2) were determined via time-resolved near-infrared spectroscopy in the vastus lateralis (VL) and rectus femoris (RF) muscles from rest to recovery. At rest, the HCP group had significantly higher PCO2 and HCO3- concentrations and a slight tendency toward acidosis. During exercise, the first HIIT bout's peak power was significantly higher in HCP (839 ± 112 W) vs. Placebo (816 ± 108 W, p = 0.001), and HCP had a notable effect on significantly increased deoxy[Hb + Mb] concentration during HIIT exercise, despite no differences in heart rate response. The HCP group showed significantly greater O2 extraction in VL and microvascular (Hb) volume in RF during HIIT exercise. The HIIT exercise provided significantly improved blood flow and muscle reoxygenation rates in both the RF and VL during passive recovery compared to rest in all groups. The HCP supplement might exert ergogenic effects on high-intensity exercise and prove advantageous for improving anaerobic HIIT exercise performance.

Use of doubly labeled water to validate a physical activity questionnaire developed for the Japanese population.

BACKGROUND: No study has attempted to use the doubly labeled water (DLW) method to validate a physical activity questionnaire administered to a Japanese population. The development and refinement of such questionnaires require that physical activity components related to physical activity level be examined. METHODS: Among 226 Japanese men and women 20 to 83 years of age, total energy expenditure (TEE) was assessed using the Japan Arteriosclerosis Longitudinal Study Physical Activity Questionnaire (JALSPAQ), and the results were compared with TEE measured by the DLW method as a gold standard. Resting metabolic rate (RMR) was measured using the Douglas Bag method. RESULTS: The median TEE by DLW and physical activity level (PAL: TEE/RMR) were 11.21 MJ/day and 1.88, respectively, for men, and 8.42 MJ/day and 1.83 for women. JALSPAQ slightly underestimated TEE: the differences in mean and standard error were -1.15 ± 1.92 MJ/day. JALSPAQ and DLW TEE values were moderately correlated (Spearman correlation = 0.742, P < 0.001; intraclass correlation coefficient = 0.648, P < 0.001), and the 95% limit of agreement was -4.99 to 2.69 MJ. Underestimation of TEE by JALSPAQ was greater in active subjects than in less active subjects. Moderate and vigorous physical activity and physical activity during work (ie, occupational tasks and housework) were strongly related to physical activity level. However, the physical activity components that differentiated sedentary from moderately active subjects were not clear. CONCLUSIONS: Physical activity level values on JALSPAQ and DLW were weakly correlated. In addition, estimation of TEE in active subjects should be improved, and the use of a questionnaire to differentiate activity in sedentary and moderately active subjects must be reassessed.

Application of Molecular Hydrogen as an Antioxidant in Responses to Ventilatory and Ergogenic Adjustments during Incremental Exercise in Humans.

We investigated effects of molecular hydrogen (H2) supplementation on acid-base status, pulmonary gas exchange responses, and local muscle oxygenation during incremental exercise. Eighteen healthy, trained subjects in a randomized, double-blind, crossover design received H2-rich calcium powder (HCP) (1500 mg/day, containing 2.544 µg/day of H2) or H2-depleted placebo (1500 mg/day) for three consecutive days. They performed cycling incremental exercise starting at 20-watt work rate, increasing by 20 watts/2 min until exhaustion. Breath-by-breath pulmonary ventilation (V˙E) and CO2 output (V˙CO2) were measured and muscle deoxygenation (deoxy[Hb + Mb]) was determined via time-resolved near-infrared spectroscopy in the vastus lateralis (VL) and rectus femoris (RF). Blood gases' pH, lactate, and bicarbonate (HCO3-) concentrations were measured at rest and 120-, 200-, and 240-watt work rates. At rest, the HCP group had significantly lower V˙E, V˙CO2, and higher HCO3-, partial pressures of CO2 (PCO2) versus placebo. During exercise, a significant pH decrease and greater HCO3- continued until 240-watt workload in HCP. The V˙E was significantly lower in HCP versus placebo, but HCP did not affect the gas exchange status of V˙CO2 or oxygen uptake (V˙O2). HCP increased absolute values of deoxy[Hb + Mb] at the RF but not VL. Thus, HCP-induced hypoventilation would lead to lower pH and secondarily impaired balance between O2 delivery and utilization in the local RF during exercise, suggesting that HCP supplementation, which increases the at-rest antioxidant potential, affects the lower ventilation and pH status during incremental exercise. HPC induced a significantly lower O2 delivery/utilization ratio in the RF but not the VL, which may be because these regions possess inherently different vascular/metabolic control properties, perhaps related to fiber-type composition.

Association Between the Prevalence of Frailty and Doubly Labeled Water-Calibrated Energy Intake Among Community-Dwelling Older Adults.

BACKGROUND: Appropriate energy intake (EI) is essential to prevent frailty. Because self-reported EI is inaccurate and has systematic errors, adequate biomarker calibration is required. This study examined the association between doubly labeled water (DLW)-calibrated EI and the prevalence of frailty among community-dwelling older adults. METHOD: A cross-sectional study was performed using baseline data of 7,022 older adults aged ≥65 years in the Kyoto-Kameoka Study. EI was evaluated using a validated food frequency questionnaire (FFQ), and calibrated EI was obtained from a previously established equation using the DLW method. Physical and comprehensive frailty were defined by the Fried phenotype (FP) model and the Kihon Checklist (KCL), respectively. We used multivariable-adjusted restricted cubic spline logistic regression analysis. RESULTS: The prevalence of physical frailty was 14.8% and 13.6% in women and men, respectively. The spline models showed significant reverse J-shaped or U-shaped relationships between the prevalence of physical or comprehensive frailty against the DLW-calibrated EI, respectively. The lowest prevalence of both types of frailty was found at 1,900-2,000 kcal/d in women and 2,400-2,500 kcal/d in men, which corresponded to approximately 40 kcal/d/kg IBW (ideal body weight = 22 × height2) with DLW-calibrated EI. Uncalibrated EI underestimated approximately 20% compared with calibrated EI; underestimated EI were attenuated by calibration approach. CONCLUSIONS: This study suggests that low EI has a greater detrimental effect compared with excessive EI, particularly on physical frailty. Using biomarkers to calibrate EI holds promise for providing accurate energy requirements to establish guidelines used in public health and clinical nutrition.

Ground golf-induced changes in the blood pressure of healthy elderly people.

BACKGROUND: Ground golf is a popular sport among the elderly in Japan. Several types of exercise can reduce the body's mean arterial pressure (MAP), but little is known about how ground golf affects the MAP. We investigated the effects of ground golf on the MAP and the oxygen uptake ([Formula: see text]) in a healthy elderly population. PARTICIPANTS AND METHODS: Thirteen elderly Japanese people (3 males and 10 females, mean age of 66 years) participated. All participants played 8 holes of ground golf 6 times, as game (G)1 to G6. The MAP, heart rate (HR), and [Formula: see text] were measured at rest and every 5 min during each game. RESULTS: A linear trend analysis revealed that participants' MAP values progressively decreased as each game proceeded with marginal differences (p = 0.054). There were no significant differences in HR between at rest and any of the games. The [Formula: see text] during the games (except for G6) were significantly higher than that at-rest (p < 0.05). The resting MAP values were negatively associated with the ground golf-induced changes in MAP (r = 0.786, p = 0.001). The participants with greater changes in [Formula: see text] during the games showed significantly greater reductions in MAP (r = 0.276, p = 0.043). CONCLUSIONS: Playing ground golf reduced the participants' MAP and increased their [Formula: see text]. Participants with higher resting MAP experienced greater reductions in MAP by playing ground golf, which suggests that ground golf can be a useful recreational sport for the elderly.

Impact of obesity on underreporting of energy intake in type 2 diabetic patients: Clinical Evaluation of Energy Requirements in Patients with Diabetes Mellitus (CLEVER-DM) study.

BACKGROUND & AIMS: Although accurate assessment of energy intake (EI) is critical in diabetes care, underreporting of EI on dietary records (DR) is often an issue. However, few studies have examined EI with doubly labeled water (DLW) in patients with diabetes mellitus. We aimed to investigate the impact of sex and obesity on the dissociation of DR from total energy expenditure (TEE) evaluated with DLW in patients with type 2 diabetes. METHODS: Fifty-two patients with type 2 diabetes aged 60-79 years were enrolled for the Clinical Evaluation of Energy Requirements in Patients with Diabetes Mellitus (CLEVER-DM) study at a single university hospital. TEE was measured over 14 days by the DLW method as standard. EI was calculated by assessment of 3-day DR by registered dietitians. RESULTS: The mean difference between EI and TEE was 238 ± 412 kcal/day (~10% of TEE). Neither EI nor TEE was significantly different between obese (body mass index (BMI) ≥25 kg/m2) and non-obese (BMI <25 kg/m2) patients. There was a negative correlation between EI/TEE ratio and BMI in women (R = -0.437, P = 0.033) but not in men (R = -0.174, P = 0.377). There was a significant difference in EI/TEE ratio between obese and non-obese patients among women (0.85 ± 0.15 vs. 1.01 ± 0.21, P = 0.045) but not men (0.85 ± 0.20 vs. 0.87 ± 0.17, P = 0.79). CONCLUSIONS: EI calculated by 3-day DR may underestimate habitual intake, which is assumed to be equal to TEE measured by the DLW method except in non-obese women with diabetes. CLINICAL TRIAL REGISTRATION NUMBER: UMIN000023051.

Effects of cow's milk on reproduction in ICR male mice.

OBJECTIVE: To study the effects of Cow's milk on the reproduction in male mice. METHODS: Twenty-four male mice were divided randomly into two groups: milk group (M) and control group (C). Each mouse was given 10 mL milk per day from 4 to 16 weeks in the group M. At the age of 17 weeks, all the mice were sacrificed. RESULTS: Serum testosterone was decreased in the group M (P=0.037). No significant difference was found in weight of testes, seminal vesicle or adrenal gland of mice between the groups C and M. However, the weight of seminal vesicle decreased when expressed in g/100 g body weight in the group M. Epididymal sperm concentration, motility, morphology, and sperm head number were not affected by milk. CONCLUSION: Cow's milk has adverse effects on the reproductive system in ICR male mice. Further studies are needed to clarify the specific effects of milk on reproductive health.

Physical Activity and/or High Protein Intake Maintains Fat-Free Mass in Older People with Mild Disability; the Fukuoka Island City Study: A Cross-Sectional Study.

Body composition changes with age, with fat mass (FM) increasing and fat-free mass (FFM) decreasing. Higher physical activity and high or adequate protein intake are thought to be beneficial in preventing the loss of skeletal muscle mass in the elderly. We aimed to investigate the relationships between physical activity, protein intake, and FFM in older people with mild disability. Total energy expenditure (TEE) under free-living conditions was assessed using the doubly-labelled water (DLW) method, and physical activity was measured using a triaxial accelerometer. Dietary intake was assessed using a self-recorded food intake diary during the DLW period. Percent FFM was significantly positively correlated with protein intake and physical activity level (PAL) after adjustment for age and sex (protein intake r = 0.652, p < 0.001, PAL r = 0.345, p = 0.011). In multiple linear regression analysis, when PAL, moderate-to-vigorous physical activity (MVPA), or protein intake were included, 31%, 32%, and 55%, respectively, of the variation in %FFM was explained. Moreover, the addition of both PAL/MVPA and protein intake explained 61%/60%, respectively, of the variation in %FFM. Either protein intake above the currently recommended level or higher levels of physical activity would be beneficial for the maintenance of high %FFM.

Estimation of Energy Intake by a Food Frequency Questionnaire: Calibration and Validation with the Doubly Labeled Water Method in Japanese Older People.

Accurate assessments of a target population's energy intake (EI) are essential to prevent poor nutritional status. However, self-reported dietary records (DRs) or food frequency questionnaires (FFQs) are not always accurate, thereby requiring validation and calibration studies. This study aimed to validate the EI estimated by a FFQ using the doubly labeled water (DLW) method. Participants were 109 Japanese older adults (50 women and 59 men) aged 65-88 years. The EI was obtained by a DR and 47-item FFQ over 1 year. The total energy expenditure (TEE) was measured by DLW for ~2 weeks. EI was significantly lower than TEE (p < 0.01); ratios of EI assessed by DR and FFQ against TEE were 0.91 ± 0.17 and 0.82 ± 0.22, respectively. TEE was significantly and moderately correlated with the EI estimated by the DR (r = 0.45, p < 0.01) and FFQ (r = 0.37, p < 0.01). Furthermore, the EI correlation coefficients estimated by DR and the FFQ in this study were not significantly different (p = 0.46). The EI/TEE ratio was significantly and negatively correlated with the body mass index (BMI). In conclusion, EI estimated with a DR or FFQ modestly correlated with TEE, and calibrating EI with a developed equation in this study can attenuate the underestimation of EI.

Total energy expenditure is comparable between patients with and without diabetes mellitus: Clinical Evaluation of Energy Requirements in Patients with Diabetes Mellitus (CLEVER-DM) Study.

Objective: Assessment of total energy expenditure (TEE) is essential for appropriate recommendations regarding dietary intake and physical activity in patients with and without diabetes mellitus (DM). However, few reports have focused on TEE in patients with DM, particularly in Asian countries. Therefore, we evaluated TEE in Japanese patients with DM using the doubly labeled water (DLW) method and physical activity level (PAL). Research design and methods: In this cross-sectional observational study, we evaluated 52 patients with type 2 DM and 15 patients without DM. Free-living TEE was measured over 12-16 days by the DLW method, and PAL was calculated as TEE divided by the basal metabolic rate (BMR) as assessed by indirect calorimetry. The equivalence margin was defined as 5 kcal/kg/day. Results: The numbers of patients with DM treated with insulin, oral antidiabetic drugs, and diet were 18 (34.6%), 20 (38.5%), and 14 (26.9%), respectively. The mean±SD level of glycated hemoglobin was 6.9%±0.8% and 5.5%±0.3% in the DM and non-DM group, respectively (p<0.001). The mean body mass index was 23.3±3.0 and 22.7±2.1 kg/m2 in the DM and non-DM group, respectively. The mean TEE per kilogram body weight adjusted for sex and age was 36.5 kcal/kg/day and 37.5 kcal/kg/day in the DM and non-DM group, respectively, with no significant difference (mean difference, -1.0 kcal/kg/day; 95% CI -4.2 to 2.3 kcal/kg/day). The BMR tended to be higher in the DM than in the non-DM group (mean difference, 33 kcal/day; 95% CI, -15 to 80 kcal/day). The mean PAL adjusted for sex and age was 1.71 and 1.81 in the DM and non-DM group, respectively, without a significant difference (mean difference, -0.10; 95% CI -0.21 to 0.01). Conclusion: TEE was comparable between Japanese patients with and without DM. Trial registration number: UMIN000023051.

Corn fiber oil and sitostanol decrease cholesterol absorption independently of intestinal sterol transporters in hamsters.

OBJECTIVE: The aim of this study was to investigate the cholesterol-lowering mechanisms of corn fiber oil (CFO), ferulate phytostanyl esters (FPEs) and parent compounds of FPE, including sitostanol and ferulic acid, in hamsters. METHOD: Seventy male Golden Syrian hamsters were randomly assigned to six experimental diets for 4 weeks: (1) cornstarch-casein-sucrose-based control diet (control); and (2) control diet plus 0.1% (wt/wt) cholesterol (cholesterol-control). The remaining four groups were given cholesterol-control diet with: (3) 10% (wt/wt) CFO; (4) 0.5% (wt/wt) sitostanol; (5) 0.23% (wt/wt) ferulic acid; and (6) 0.73% (wt/wt) FPE. At the end of dietary intervention, total plasma cholesterol, high-density lipoprotein cholesterol and triglyceride concentrations were determined. Parameters of cholesterol kinetics, including cholesterol absorption and synthesis, as well as mRNA expression of sterol transporters such as Niemann-Pick C1 like 1 (NPC1L1), ATP-binding cassette G5 (ABCG5) and ABCG8, were assessed. RESULTS: Supplementation with CFO decreased (P<.0001) plasma total cholesterol levels by 29% as compared with the cholesterol-control group, while FPE and sitostanol reduced (P<.02) cholesterolemia by 15% and 14%, respectively. CFO and sitostanol decreased (P<.05) cholesterol absorption by 24% compared to the cholesterol-control group. Dietary intervention did not alter the intestinal gene expression of ABCG5, ABCG8 and NPC1L1. CONCLUSION: The present results show that the CFO-induced and sitostanol-induced decrease in cholesterol absorption is independent of intestinal enterocyte sterol transporters such as ABCG5, ABCG8 and NPC1L1 in hamsters.