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Energy expenditure in disease: time to revisit?

  • Eileen R. Gibney (a1)

Abstract

Knowledge of energy expenditure is especially important in disease, and may in fact help in the understanding of the pathophysiology of wasting associated with disease. Energy requirements in a clinical setting are often ‘prescribed’ by health professionals, either directly through enteral or parenteral feeding, or perhaps controlled through a hospital diet. Studies initially suggested an increase in energy expenditure, and thus energy requirements, as a direct result of an increase in basal metabolic rate often seen in disease. However, many problems exist in the measurement of BMR in a disease situation, due to the effects of drugs, clinical practice, feeding or possibly anxiety either as a cause of the disease or the measurement itself. These problems could in themselves contribute to the rise in metabolism seen in disease. More recently, however, with the use of tracer techniques such as doubly-labelled water and the bicarbonate–urea method, more accurate estimates of energy expenditure, and thus energy requirements, have been made. Some such measurements have in fact shown that even with an elevated BMR, free-living total energy expenditure can in fact be reduced in many disease situations, suggesting a reduced rather than an increased energy requirement. The present review investigates measurements of total energy expenditure in disease to explore the hypothesis that energy expenditure in disease, even with an elevated BMR, can in fact be reduced due to a concurrent reduction in physical activity.

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Corresponding author

*Corresponding author: Eileen Gibney, fax +44 (0)1224 715349, email erg22@cam.ac.uk

References

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Baarends, EM, Schols, AMWJ, Pannemans, DLE, Westerterp, KR & Wouters, EFM (1997) Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease. American Journal of Respiratory Critical Care Medicine 155, 549554.
Bandini, LG, Schoeller, DA, Fukagawa, NK, Wykes, LJ & Dietz, W (1991) Body composition and energy expenditure in adolescents with cerebral palsy or myelodysplasia. Pediatric Research 29, 7077.
Berke, EM, Gardner, AW, Goran, MI & Poehlman, ET (1992) Resting metabolic rate and the influence of the pretesting environment. American Journal of Clinical Nutrition 55, 626629.
Black, AE, Coward, WA, Cole, TJ & Prentice, AM (1996) Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements. European Journal of Clinical Nutrition 50, 7292.
Bruder, N, Lassegue, D, Pelissier, D, Graziani, N & Francois, G (1994) Energy expenditure and withdrawal of sedation in severe head-injured patients. Critical Care Medicine 22, 11141119.
Carlsson, M, Nordenstrom, J & Hedenstierna, G (1984) Clinical implications of continuous measurement of energy expenditure in mechanically ventilated patients. Clinical Nutrition 3, 103110.
Ceesay, SM, Prentice, AM, Day, KC, Murgatroyd, PR, Goldberg, GR & Scott, W (1989) The use of heart rate monitoring in the estimation of energy expenditure: a validation study using indirect whole-body calorimetry. British Journal of Nutrition 61, 175186.
Centers for Disease Control Center for Infectious Diseases (1987) Acquired Immunodeficiency Syndrome Weekly Surveillance Report. US AIDS Program, 7 September issue. Washington, DC: Centers for Disease Control.
Coward, WA (1988) Stable isotopic methods for measuring energy expenditure: the doubly labelled water (2H218O) method; principles and practice. Proceedings of the Nutrition Society 47, 209218.
Cunningham, JJ (1980) A reanalysis of the factors influencing basal metabolic rate in normal adults. American Journal of Clinical Nutrition 33, 23722374.
Cunningham, JJ, Hegarty, MT, Meara, PA & Burke, JF (1989) Measured and predicted calorie requirements of adults during recovery from severe burn trauma. American Journal of Clinical Nutrition 49, 404408.
Cuthbertson, DP (1942) Post-shock metabolic response. Lancet i, 432437.
Dauncey, MJ & James, WPT (1979) Assessment of heart rate method for determining energy expenditure in man, using a whole body calorimeter. British Journal of Nutrition 42, 113.
Deitrick, JE, Whedon, GD, Shorr, E, Toscani, V & Davis, VB (1948) Effect of immobilization upon various metabolic and physiologic functions of normal men. American Journal of Medicine 4, 335.
Demark-Wahnefried, W, Hars, V, Conaway, MR, Halvin, K, Rimer, BK, McElveen, G & Winer, EP (1997) Reduced rate of metabolism and decreased physical activity in breast cancer patients receiving adjuvant chemotherapy. American Journal of Clinical Nutrition 65, 14951501.
Dempsey, DT, Guenter, P, Mullen, JL, Fairman, R, Crosby, LO, Speilman, G & Gennarelli, T (1985) Energy expenditure in acute trauma to the head with and without barbiturate therapy. Surgical Gynecological Obstetrics 160, 128134.
Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no.41. London: H.M. Stationery Office.
Diffey, B, Piers, LS, Soares, MJ & O'Dea, K (1997) The effect of oral contraceptive agents on the basal metabolic rate of young women. British Journal of Nutrition 77, 853862.
Elia, M (1991) The energy equivalents of carbon dioxide (EeqCO2) and their importance in assessing energy expenditure with the use of tracer techniques. American Journal of Physiology 260, E75-E88.
Elia, M (1995) Changing concepts of nutrient requirements in disease: implications for artificial nutritional support. Lancet 345, 12791284.
Elia, M, Jones, MG, Jennings, G, Poppitt, SD, Fuller, NJ, Murgatroyd, PR & Jebb, SA (1995) Estimation of energy expenditure from specific activity of urine urea during lengthy subcutaneous NaH14CO3 infusion. American Journal of Physiology 269, E172-E182.
Freid, RC, Dickerson, RN, Guenter, PA, Stein, TP, Gennarelli, TA, Dempsey, DT, Buzby, GP & Mullen, JL (1989) Barbiturate therapy reduces nitrogen excretion in acute head injury. Journal of Trauma 29, 15581564.
Garrow, JS & James, WPT (editors) (1993) Human Nutrition and Dietetics, 9th ed. London: Churchill Livingstone.
Gibney, E, Elia, M, Jebb, SA, Murgatroyd, P & Jennings, G (1996) Total energy expenditure in patients with small cell lung cancer: Results of a validated study using the bicarbonate-urea method. Metabolism 46, 14121417.
Goran, MI, Broemeling, L, Herndon, DN, Peters, EJ & Wolfe, RR (1991) Estimating energy requirements in burned children: a new approach derived from measurements of resting energy expenditure. American Journal of Clinical Nutrition 54, 3540.
Goran, MI, Peters, EJ, Herndon, DN & Wolfe, RR (1985) Total energy expenditure in burned children using the doubly labelled water technique. American Journal of Physiology 259, E576E585.
Goran, MI, Poehlman, ET & Johnson, RK (1994) Energy requirements across the lifespan: new findings based on measurement of total energy expenditure with doubly labelled water. Nutrition Research 15, 115150.
Guzman, FA, Plank, LD, Monk, DN, Gupta, R, Maher, K, Gillanders, L & Hill, G (1994) A new method for the estimation of the components of energy expenditure in patients with major trauma. American Journal of Physiology 267, E1002-E1009.
Heijligenberg, R, Romijn, JA, Westerterp, KR, Jonkers, CF, Prins, JM & Sauerwein, HP (1997) Total energy expenditure in Human Immunodeficiency Virus-Infected men and healthy control. Metabolism 46, 13241326.
Hellerstein, MK, Kahn, J, Mudie, H & Viteri, F (1990) Current approach to the treatment of human immunodeficiency virus associated weight loss: pathophysiological considerations and emerging management strategies. Seminars in Oncology 17, 1733.
Jebb, SA, Osborne, RJ, Dixon, AK, Bleehan, NM & Elia, M (1994) Measurement of resting energy expenditure and body composition before and after treatment of small cell lung cancer. Annals of Oncology 5, 915919.
Klein, PD, James, WPT, Wong, WW, Irving, CS, Murgatroyd, PR, Cabrera, M, Dallasso, HM, Klein, ER & Nichols, BL (1984) Calorimetric validation of the doubly labelled water method for determination of energy expenditure in man. Human Nutrition Clinical Nutrition 38, 95106.
Koea, JB, Wolfe, RR & Shaw, JHF (1995) Total energy expenditure during total parenteral nutrition: ambulatory patients at home versus patients with sepsis in surgical intensive care. Surgery 118, 5462.
Kushner, RF & Schoeller, DA (1991) Resting and total energy expenditure in patients with inflammatory bowel disease. American Journal of Clinical Nutrition 53, 161165.
Lifson, N & McClintock, R (1966) Theory of use of the turnover rates of body water for measuring energy and material balance. Journal of Theoretical Biology 12, 4674.
Long, C (1979) Energy expenditure of major burns. Journal of Trauma 19, 904906.
Long, CL, Schaffel, N, Geiger, JW, Schiller, WR & Blakemore, WS (1979) Metabolic responses to injury and illness: Estimation of energy and protein needs from indirect calorimetry and nitrogen balance. Journal of Parenteral and Enteral Nutrition 3, 452456.
McClave, SA, Lowen, CC, Kleber, MJ, Nicholson, JF, Jimmerson, SC, McConnell, JW & Jung, LY (1998) Are patients fed appropriately according to their caloric requirements?. Journal of Parenteral and Enteral Nutrition 22, 375381.
Mildreth, M & Carvajal, HF (1982) Caloric requirements in burned children: A simple formula to estimate daily caloric requirements. Journal of Burn Care Rehabilitation 3, 7880.
Mitchell, IM, Davies, PSW, Day, JME, Pollock, JCS, Jamieson, MPG & Wheatley, DJ (1994) Energy expenditure in children with congenital heart disease, before and after cardiac surgery. Journal of Thoracic Cardiovascular Surgery 107, 374380.
Molinger, LA, Spurr, GB, El, Ghatit AZ, Barboriak, JJ, Rooney, CB, Davidoff, DD & Bongard, RD (1985) Daily energy expenditure and basal metabolic rates of patients with spinal cord injury. Archives of Physical Medical Rehabilitation 66, 420426.
Murgatroyd, PR, Shetty, PS & Prentice, AM (1993) Techniques for the measurement of human energy expenditure: a practical guide. International Journal of Obesity Related Metabolic Disorders 17, 549568.
Nelson, KA, Walsh, D & Sheehan, FA (1994) The cancer anorexia-cachexia syndrome. Journal of Clinical Oncology 12, 213225.
Novick, WM, Nusbaum, N & Stein, TP (1988) The energy costs of surgery as measured by the doubly labelled water method. Surgery 103, 99106.
Parkinson, SA (1990)In vivo measurement of changes in body composition. PhD Thesis, University of Cambridge.
Paton, NIJ, Elia, M, Jebb, SA, Jennings, G, Macallan, DC & Griffin, GE (1996) Total energy expenditure and physical activity measured with the bicarbonate urea method in patients with human immunodeficiency virus infection. Clinical Science 91, 241245.
Pullicino, EA (1991) Aspects of energy metabolism in hospitalised patients. PhD Thesis, University of Cambridge.
Pullicino, E, Coward, A & Elia, M (1993) Total energy expenditure in intravenously fed patients measured by the doubly labelled water technique. Metabolism 42, 5864.
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 24, E402E409.
Reed, GW & Hill, JO (1996) Measuring the thermic effect of food. American Journal of Clinical Nutrition 63, 164169.
Romon, M, Edme, J-L, Boulenguez, C, Lescroat, J-L & Frimat, P (1993) Circadian variation of diet-induced thermogenesis. American Journal of Clinical Nutrition 57, 476480.
Royall, D, Fairholm, L, Peters, WJ, Jeejeebhoy, KN & Allard, JP (1994) Continuous measurement of energy expenditure in ventilated burn patients: an analysis. Critical Care Medicine 22, 399406.
Schoeller, DA, Ravussin, E & Schutz, Y (1986) Energy expenditure by the doubly labelled water method: validation in humans. American Journal of Physiology 250, R823-R830.
Schoeller, DA & Webb, P (1984) Five-day comparison of the doubly labelled water method with respiratory gas exchange. American Journal of Clinical Nutrition 40, 153158.
Schofield, WN, Schofield, C & James, WPT (1985) Basal metabolic rate. Human Nutrition Clinical Nutrition 39, 196.
Schwenk, A, Hoffer-Belitz, E, Jung, B, Kremer, G, Burger, B, Salzberger, B, Diehl, V & Schrappe, M (1996) Resting energy expenditure, weight loss, and altered body composition in HIV infection. Nutrition 12, 595601.
Shepherd, RW, Holt, TL, Vasques-Velasquez, L, Coward, WA, Prentice, A & Lucas, A (1988) Increased energy expenditure in young children with cystic fibrosis. Lancet i, 13001303.
Soares, MJ & Shetty, PS (1986) Intra individual variations in resting metabolic rates of human subjects. Human Nutrition Clinical Nutrition 40, 365369.
Spurr, GB, Prentice, AM, Murgatroyd, PR, Goldberg, GR, Reina, JC & Christman, BS (1988) Energy expenditure from minute-minute heart rate recording: comparison with indirect calorimetry. American Journal of Clinical Nutrition 48, 552559.
Stallings, VA, Zemel, BS, Davies, JC, Cronk, CE & Charney, EB (1996) Energy expenditure of children and adolescents with severe disabilities: a cerebral palsy model. American Journal of Clinical Nutrition 64, 627634.
Taggart, DP, McMillan, DC, Preston, C, Richardson, R, Burns, RJG & Wheatley, DJ (1991) Effects of cardiac surgery and intraoperative hypothermia on energy expenditure as measured by the doubly labelled water. British Journal of Surgery 78, 237241.
Tomesko, JL, Stallings, VA, Kawchak, DA, Goin, JE, Diamond, G & Scanlin, TF (1994) Energy expenditure and genotype of children with cystic fibrosis. Pediatric Research 35, 451460.
Turner, WW, Ireton, CS, Hunt, JL & Baxter, CR (1985) Predicting energy expenditures in burned patients. Journal of Trauma 25, 1116.
Weekes, E & Elia, M (1996) Observations on the patterns of 24 h energy expenditure and changes in body composition and gastric emptying in head injured patients. Journal of Parenteral and Enteral Nutrition 20, 3137.
Weissman, C, Kemper, M, Elwyn, DH, Asksanazi, J, Hyman, AI & Kinney, JM (1986) The energy expenditure of the mechanically ventilated critically ill patient. Chest 89, 254259.
Westerterp, KR, Brouns, F, Saris, WHM & Tenhoor, F (1988) Comparison of doubly labelled water with respirometry at low and high activity levels. American Journal of Physiology 65, 5356.
Wolfe, RR (1982) Caloric requirements of the burned patient. Journal of Trauma 21, 712714.
Young, B, Ott, L, Norton, J, Tibbs, P, Rapp, R, McClain, C & Dempsey, R (1985) Metabolic and nutritional sequelae in the non-steroid treated head injured patient. Neurosurgery 17, 784791.

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Energy expenditure in disease: time to revisit?

  • Eileen R. Gibney (a1)

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