Estimating free-living human energy expenditure: Practical aspects of the doubly labeled water method and its applications

The accuracy and noninvasive nature of the doubly labeled water (DLW) method makes it ideal for the study of human energy metabolism in free-living conditions. However, the DLW method is not always practical in many developing and Asian countries because of the high costs of isotopes and equipment for isotope analysis as well as the expertise required for analysis. This review provides information about the theoretical background and practical aspects of the DLW method, including optimal dose, basic protocols of two- and multiple-point approaches, experimental procedures, and isotopic analysis. We also introduce applications of DLW data, such as determining the equations of estimated energy requirement and validation studies of energy intake.

Total energy expenditure of 16 Chinese young men measured by the doubly labeled water method / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Doubly labeled water (DLW) method is the gold standard for measuring total energy expenditure (TEE). We used this method to measure TEE in Chinese young men.</p><p><b>METHODS</b>Sixteen healthy young men age 23±1 years with body mass index 22.0±1.4 kg/m2 were recruited. TEE was measured by the DLW method, and basal energy expenditure (BEE) was determined by indirect calorimetry. We also conducted 24-h activity, energy balance and factorial approach to estimate energy requirements of the subjects.</p><p><b>RESULTS</b>TEE of subjects by DLW method was 9.45±0.57 MJ/day (2258±180 kcal/day). The 24-h activity was 10.80±0.33 MJ/day (2582±136 kcal/day). The energy requirement, derived from energy balance observations, was 9.93±1.32 MJ/day (2373±315 kcal/day). The BEE of 6.65±0.28 MJ/day (1589±67 kcal/day), calculated by the adjusted Schofield equation, was significantly higher (P<0.001) than that measured by indirect calorimetry, 5.99±0.66 MJ/day (1433±158 kcal/day). The TEE derived from the factorial approach was 10.31±0.43 MJ/day (2463±104 kcal/day).</p><p><b>CONCLUSION</b>The TEE of Chinese young men measured by the DLW method was about 10% lower than the current recommended nutrient intake (RNI), suggesting that the RNI for Chinese men maybe overestimated. Further studies are warranted to determine the value of the estimated energy requirement.</p>

Assessment of Energy Intake and Physical Activity Level for Korean Farmers to Establish Estimated Energy Requirements during the Off-Season for Farmers / 대한지역사회영양학회지

The purpose of this study was to assess the physical activity level of Korean farmers to establish estimated energy requirements during the off-season. Subjects were 90 healthy males (n = 25) and females (n = 65). Body weight, height and body fat and muscles of subjects were measured. The prevalence of obesity among farmers was 56.7% according to the BMI. The farmers spent about 18 hours 7 minutes (75.5%) in sleeping and resting. The farmers spent about 19 hours 56 minutes (83.1%) out of 24 hours (one day) in "sedentary activities" and spent about 3 hours 56 minutes (16.4%) in "light activities". Physical activity level (PAL, activity coefficient) of female farmers was 1.42 which was not significantly higher than that (1.37) of male farmers. Estimated energy requirements (EER) for farmers who were different in age groups and gender were calculated. For example, the EERs for male and female farmers were 2190 kcal/day and 1712 kcal/day, respectively. The daily energy intakes of male and female farmers were 1803 kcal/day and 1610 kcal/day, respectively. The EER of male farmers was 2190 kcal/day which was significantly higher than that (1803 kcal/day) of the recommended daily energy intake of male farmers. The results of this study suggest that estimated EER of farmers should be modified according to seasonal workload and energy balance of farmers should be evaluated to prevent obesity.

Physical activity level, total daily energy expenditure, and estimated energy expenditure in normal weight and overweight or obese children and adolescents

The purposes of this study were to assess the physical activity level (PAL) and the total daily energy expenditure (TEE) as well as to evaluate the validity of prediction equation for the estimated energy requirement (EER) in normal weight and overweight or obese children and adolescents. The subjects comprised of 100 healthy Korean students aged between 7-18. The anthropometric data was collected. PAL was calculated from the physical activity diary by the 24-hour recall method, and the resting metabolic rate (RMR) was measured by an open-circuit indirect calorimetry using a ventilated hood system. Daily energy expenditure was PAL multiplied by RMR. EER was calculated by using the prediction equation published in KDRIs. There was no significant difference in the means of age and height between the 46 obese subjects and 54 nonobese subjects. The weight and BMI of the obese group (60.2 kg, 25.3 kg/m2) were significantly higher than those of the nonobese group (42.4 kg, 18.4 kg/m2). However, PAL was not significantly different between the two groups (nonobese 1.45, obese 1.46). TEE of the obese group (2,212 kcal/day) was significantly higher than that of the nonobese group (1,774 kcal/day). EER (individual PA) and EER (light PA) were significantly higher than TEE (p < 0,001); however, EER (sedentary PA) was not significantly different with TEE in the two groups. These results showed that the levels of physical activity were the same as the sedentary activity both in the nonobese and obese Korean students; moreover, the predictive equation for EER published in KDRI overestimated the TEE of Korean children and adolescents. Therefore, in further research, a new predictive equation for EER should be developed for Korean children and adolescents through the doubly labeled water method.

Assessment of Physical Activity Level of Korean Farmers to Establish Estimated Energy Requirements during Busy Farming Season / 대한지역사회영양학회지

The purpose of this study was to assess the physical activity level of Korean farmers to establish their estimated energy requirements during busy farming season. 113 farmers (mean age 51.9 +/- 7.2 years, male 42, female 71) who own farmland area above 300 pyung participated in measurement of body weight and height and interviewing of one-day activity diaries. There was no significant difference in age, BMI between male and female. Obesity prevalence according to BMI among male and female farmers was 40.5% and 50.7% respectively. The farmers spent about 7 hours in sleeping and spent about 4 hours 35 minutes working on the farm and spent about 15 hours 30 minutes (64.6% of 24 hours) in "very light activities" and spent about 3 hours 31 minutes (14.7%) in "light activities". Physical activity level (PAL, activity coefficient) of male farmers was 2.63 which was significantly higher than that (2.19) of female farmers (p < 0.05). Estimated energy requirements (EER) for farmers who were different in age and gender were suggested. For example, the estimated energy requirements for male and female farmers were 3058 kcal/day and 2279 kcal/day, respectively. The results of this study suggest that estimated energy requirements (EER) of farmers should be differentiated according to seasonal workload and energy balance of farmers should be evaluated to prevent obesity.

The Analysis of Activity Energy, Total Energy, and Estimated Energy Expenditures in 5th and 6th Grade Primary School Students / 대한지역사회영양학회지

This study was conducted to investigate the time spent, activity coefficient and energy expenditure on 7 different types of activity. Total of 386 5th and 6th grade primary school boys and girls in Seoul participated in this study. The participants spent 8 hrs for rest, 4 hrs for out of school study, 3 hrs for leisure, 1 hr 45 mins. for hygiene, 1 hr for commute, and 15 mins. for house choir activity in the day of 6 class hours. The average activity coefficient of 1 day for boys and girls were 1.69 and 1.64, respectively. The TEEs were 2,382 kcal and 2,050 kcal for boys and girls, respectively. The energy cost for study related activity (in school and study activities) was 40% of the TEE, and for rest 20%, for commute 9%, and for hygiene 10% of the TEE. The energy cost for house choir was only about 2% of TEE. The 91.2% participant's EER was higher than the EER shown in the table of 2010 DRI for Koreans. When the participant's EER was compared with the energy allowance calculated by the method in 2000 RDA for Korean, 81.6% was in the range of +/- 5%, and the correlation coefficients between the 2 values were 0.981 for boys and 0.978 for girls, which means high agreements.

Criterion Development of 4 Activity Levels for Estimated Energy Requirement Calculation for Primary School Students / 대한지역사회영양학회지

The purpose of this study is finding the easy way of 4 categories activity level confirmation for estimated energy requirement calculation. Total of 386, 5th and 6th grade primary school students participated. The time spent on 7 kinds of activity were collected for 1 day by the internet program developed. Judged by the activity coefficient, sedentary were 6.7% and 5.1%, low active 33.2% and 40.4%, active 43.8%, and45.5%, and very active 16.3% and 9.0% for boy and girl, respectively. The highest and significant correlation coefficient between activity coefficient and time spent on activities shown were 0.339 in commute activity for boys, and 0.466 in leisure for girls. The sensitivity of the sedentary conformation by commute hour for boys was 0.79, and that of very active was 0.56. The sensitivity of the sedentary conformation by leisure hour for girls was 0.67, and that of very active was 0.63. The sensitivity of low active and active by 7 different types of activity was quite low, 0.04~0.37. The exact agreement of activity level conformed by easy way developed was 30.8% and 33.7%, for boys and girls, respectively. More accurate way to identify 4 categories activity level needs to be developed, especially sensitive to conformation of low active and active levels.