Energy Expenditure Energy Expenditure Measurement: A ChallengeMeasurement: A Challenge

Dr Anupa Siddhu,Dr Anupa Siddhu,

Lady Irwin College, New Delhi

Lady Irwin College, New Delhi

Presented at NFI, May 30th,2008

HistoryHistory

1950 FAO Report on Energy 1950 FAO Report on Energy 1957 FAO Report on Energy1957 FAO Report on Energy1964 FAO Report on Energy and Proteins 1964 FAO Report on Energy and Proteins separatelyseparately1973 FAO/WHO Report on Energy and 1973 FAO/WHO Report on Energy and Proteins Proteins 1985 FAO/WHO/UNU Report on Energy 1985 FAO/WHO/UNU Report on Energy and Proteins and Proteins 2004 FAO Report on Energy 2004 FAO Report on Energy

Definition-Definition-

Energy requirement Energy requirement “is the amount of food “is the amount of food energy needed to balance energy energy needed to balance energy expenditureexpenditure in in order to maintain body size, order to maintain body size, body compositionbody composition and a level of necessary and and a level of necessary and desirabledesirable physical physical activity consistent with activity consistent with long termlong term good health. good health.

This includes the energy needed for the optimal This includes the energy needed for the optimal growth and development of children, for growth and development of children, for deposition of tissues during pregnancy, and for deposition of tissues during pregnancy, and for the secretion of milk during lactation consistent the secretion of milk during lactation consistent with the with the good healthgood health of mother and child.” of mother and child.”

FAO/WHO/UNU 2004

Energy ExpenditureEnergy Expenditure

Conventionally two principles-Conventionally two principles-

Measure heat produced ie. Measure heat produced ie. Direct Direct calorimetrycalorimetry- - accurate, golden methodaccurate, golden method

Compute heat produced from gaseous Compute heat produced from gaseous exchange ie. exchange ie. Indirect calorimetry-Indirect calorimetry- practical, practical, energy costs to be used in factorial methodenergy costs to be used in factorial method

FAO 2004 recommends only two methods- DLW, HRM method as ‘Direct Methods’ of EE. (conventional indirect calorimetry ?)

Disposal of food energyDisposal of food energy

ComponentsComponents %Contribution%Contribution

Basal metabolic rateBasal metabolic rate 5353(45-70)(45-70)

Physical activityPhysical activity 2525

Thermic effect of foodThermic effect of food 66(10)(10)

GrowthGrowth 88(35 for 0-3mth;1-2 for (35 for 0-3mth;1-2 for adolescents)adolescents)

FecesFeces 55

UrineUrine 33

FAO 2004

Methods for 24h TEEMethods for 24h TEE

Weir’s equation-Weir’s equation-

16.5 O16.5 O2 2 + 4.62 CO+ 4.62 CO2 2 - 9.06 N- 9.06 N

Metabolic chamber- open circuit or closed circuit Metabolic chamber- open circuit or closed circuit ventilationventilationFactorial method- diary method, standard or Factorial method- diary method, standard or measured costs. ex. standard costs proposed by measured costs. ex. standard costs proposed by Satyanarayan (NIN) method, FAO/WHO/UNU 1985 Satyanarayan (NIN) method, FAO/WHO/UNU 1985 method.method.Continuous heart rate method- PolarContinuous heart rate method- PolarDouble labeled water techniqueDouble labeled water techniqueAccelerometry- Actical, Actigraph,Tri Trac- R3DAccelerometry- Actical, Actigraph,Tri Trac- R3D

Experiences on 24h TEE Experiences on 24h TEE measurementsmeasurements

Factorial method- standard or Factorial method- standard or measured costs, FAO/WHO/UNU measured costs, FAO/WHO/UNU 1985 method, activity record of 1985 method, activity record of soldierssoldiers

Continuous heart rate methodContinuous heart rate method

Double labeled water techniqueDouble labeled water technique

Accelerometry- ActicalAccelerometry- Actical

Factorial methodFactorial method

Advantage-Advantage-

Can be used in fieldCan be used in field

Subject is not confinedSubject is not confined

Free living habitual activityFree living habitual activity

Not expensiveNot expensive

Subject is not under stressSubject is not under stress

Predictable if not variable activity profilePredictable if not variable activity profile

Factorial methodFactorial method

Disadvantages-Disadvantages-Faulty timingsFaulty timingsFaulty descriptionFaulty descriptionInaccurate energy costs, especially standard Inaccurate energy costs, especially standard costs if not applicable or well measuredcosts if not applicable or well measuredUsing same costs for every one- Cal/min vs Using same costs for every one- Cal/min vs PAR x BMRPAR x BMRTime consuming and laborious-1440minTime consuming and laborious-1440minValid for groups and not individualsValid for groups and not individualsCosts may not be known-yoga, gymCosts may not be known-yoga, gym

FAO/WHO/UNU 1985 methodFAO/WHO/UNU 1985 method

Calculate BMR from weight- dependent Calculate BMR from weight- dependent equation ( or W and H dependent equations) equation ( or W and H dependent equations)

Categorize day’s activities broadly into- Categorize day’s activities broadly into- Occupational, Discretionary and Residual Occupational, Discretionary and Residual (FAO/WHO/UNU 1985) but 2004 the data on (FAO/WHO/UNU 1985) but 2004 the data on activities under different activity categories activities under different activity categories is given as PAR to calculate TEE by factorial is given as PAR to calculate TEE by factorial method. Factorial method - practicalmethod. Factorial method - practical

Express TDEE/BMR = PALExpress TDEE/BMR = PAL

Calculate BMR from weightCalculate BMR from weight

SexSex AgeAge FAO/WHO/UNU FAO/WHO/UNU

1985 1985 ✔✔ ICMR 1990 ICMR 1990 ??MaleMale 18-3018-30 15.3 W + 67915.3 W + 679 14.5 W + 64514.5 W + 645

30-6030-60 11.6 W + 87911.6 W + 879 10.9 W + 83310.9 W + 833

>60>60 13.5 W + 48713.5 W + 487 12.8 W + 46312.8 W + 463

FemaleFemale 18-3018-30 14.7 W + 49614.7 W + 496 14.0 W + 47114.0 W + 471

30-6030-60 8.7 W + 8298.7 W + 829 8.3 W + 7888.3 W + 788

>60>60 10.5 W + 59610.5 W + 596 10.0 W + 56510.0 W + 565

FAO/WHO/UNU 1985 methodFAO/WHO/UNU 1985 method

Age 25y, weight 65y, height 1.72m, BMI 22,estimated BMR: 70 Cal/hAge 25y, weight 65y, height 1.72m, BMI 22,estimated BMR: 70 Cal/h

hourshours TEETEE

In bed 1.0xBMRIn bed 1.0xBMR 88 560560

Occupational 1.7xBMROccupational 1.7xBMR 66 710710

Discretionary: Socially Discretionary: Socially desirable and desirable and household at 3xBMRhousehold at 3xBMR

22 420420

Discretionary: Discretionary: Cardiovascular Cardiovascular maintenance at 6xBMRmaintenance at 6xBMR

1/31/3 140140

Residual 1.4xBMRResidual 1.4xBMR 7 2/37 2/3 750750

TotalTotal 2424 2580 PAL=1.542580 PAL=1.54

Occupational : Light-1.7; Moderate-2.7; Heavy- 3.8x BMR for men

FAO/WHO/UNU 2004 committeeFAO/WHO/UNU 2004 committee

The categorizations in The categorizations in broad categories are broad categories are now split into PAR now split into PAR for- Sedentary; for- Sedentary; Moderate; and Moderate; and VigorousVigorous

SedentarySedentary PARPARSleepingSleeping 11

Personal carePersonal care 2.32.3

EatingEating 1.51.5

CookingCooking 2.12.1

SittingSitting 1.51.5

General General houseworkhousework

2.82.8

DrivingDriving 2.02.0

Walking ( no Walking ( no load)load)

3.23.2

Light leisureLight leisure 1.41.4

Oxylog: measurement of energy Oxylog: measurement of energy expenditureexpenditure

Actual energy costs measured according to activities Actual energy costs measured according to activities in various postures to compute TDEE instead of in various postures to compute TDEE instead of std costs.std costs.

1.1. Wasuja Monika Gambhir and Siddhu Anupa (2002). Wasuja Monika Gambhir and Siddhu Anupa (2002). AgeAge related alterations in energy cost, energy requirement and related alterations in energy cost, energy requirement and energy status of affluent women (30-88 years) : A cross energy status of affluent women (30-88 years) : A cross sectional study. PhD Thesissectional study. PhD Thesis

2.2. Sirohy Raksha, Siddhu Anupa and Sundararaj Pushpa Sirohy Raksha, Siddhu Anupa and Sundararaj Pushpa (2001). (2001). AgeAge related changes in body composition and related changes in body composition and physical work capacity of women.physical work capacity of women.

3.3. Talwar Surabhy , Bhargava Usha and Siddhu Anupa (1998) : Talwar Surabhy , Bhargava Usha and Siddhu Anupa (1998) : Age Age related changes in the energy status of office going related changes in the energy status of office going menmen (20 – 60 years). cond.(20 – 60 years). cond.

Oxylog: measurement of energy Oxylog: measurement of energy expenditureexpenditure

Bhutani Shella and Siddhu Anupa (1995). Bhutani Shella and Siddhu Anupa (1995). Age Age related changes in the energy status of women related changes in the energy status of women from middle income group (20-69 years).from middle income group (20-69 years).

Nagpal Neetu and Siddhu Anupa (1996). Nagpal Neetu and Siddhu Anupa (1996). Comparative study of pre- and post- menopausal Comparative study of pre- and post- menopausal womenwomen on body composition, energy status and on body composition, energy status and energy cost of physical activity.energy cost of physical activity.

Goel Parul and Siddhu Anupa (1997). Energy Goel Parul and Siddhu Anupa (1997). Energy expenditure in expenditure in normal and spastic hemiplegicnormal and spastic hemiplegic women (18 – 20 years).women (18 – 20 years).

Energy Cost of Lying (EL) as measured with OXYLOG II.( 30-88 years; n=83) (Mean + S.D with Range)

ENERGY COST ENERGY COST OF ACTIVITIESOF ACTIVITIES

D3D330-39y30-39yn=22n=22

D4 (M)D4 (M)40-49y40-49yn=20n=20

D5D550-59y50-59yn=20n=20

D6D660-69y60-69yn=14n=14

D7D770-88y70-88yn=07n=07

D7-D3D7-D3[%][%]

LYING (EL)LYING (EL)Kcal/minKcal/min

Kcal/min/Kcal/min/kgBWkgBW

1.091.09++0.180.18(0.85-1.43)(0.85-1.43)

0.0190.019++0.0040.004(0.012-0.027)(0.012-0.027)

1.241.24++0.190.19(0.88-1.60)(0.88-1.60)

0.0190.019++0.000.0022

(0.016-(0.016-0.024)0.024)

1.221.22++0.190.19(0.85-1.53)(0.85-1.53)

0.0170.017++0.000.0022

(0.015-(0.015-0.024)0.024)

1.011.01++0.110.11aa

(0.85-1.21)(0.85-1.21)

0.0160.016++0.0030.003cc

(0.011-0.023)(0.011-0.023)

0.900.90++0.060.06bb

(0.80-1.01)(0.80-1.01)

0.0160.016++0.000.0033

(0.013-(0.013-0.021)0.021)

--0.190.19[17.4][17.4]

--0.0.000033

[15.8[15.8]]

(M) Premenopausal( ) denote range; [ ] denote percentagea , EL (Kcal/min) ; p<0.05 (ANOVA), D4>D3,D6,D7b , EL (Kcal/min) ; p<0.05 (ANOVA), D5>D6,D7c , EL (Kcal/min/kg BW) ; p<0.05 (ANOVA), D6<D3,D4

Using Standard CostsUsing Standard Costs

Vasudha Shukla, Som Nath Singh and Siddhu Vasudha Shukla, Som Nath Singh and Siddhu Anupa (2007). Studies of the energy Anupa (2007). Studies of the energy requirements of Indian requirements of Indian soldierssoldiers and and influence of appetite regulatory peptides on influence of appetite regulatory peptides on their nutritional status at high altitude.PhD their nutritional status at high altitude.PhD ThesisThesis

TDEE of trainee at sea level estimated by three TDEE of trainee at sea level estimated by three

methods (n=18, 19.3y,BMI=18.7,BF%= 12.8)methods (n=18, 19.3y,BMI=18.7,BF%= 12.8)

ParameterParameter Factorial Factorial methodmethod

Activity Activity method#method#

ActicalActical DLWDLW

TDEETDEE 3083 3083 ±±85*85*

4378 4378 ±±279 **279 **

3331 3331 ±±253253

3240 3240 ±±639639

PALPAL 2.072.07 2.942.94±± 0.240.24

2.242.24±± 0.180.18

2.182.18±± 0.45 0.45

*4.85% less than DLW,ANOVA; **P<0.001 in comparison to factorial method, Actical and DLW

# Malhotra et al 1962

Vasudha Shukla et al 2007

Energy requirement: PAL valuesEnergy requirement: PAL values

BodyBody SexSex SedentarySedentary ModerateModerate HeavyHeavy

ICMR 1990ICMR 1990 M/FM/F 1.61.6 1.91.9 2.52.5

FAO/FAO/WHO/WHO/UNU1985UNU1985

MM 1.551.55 1.781.78 2.102.10

FAO/FAO/WHO/WHO/UNU1985UNU1985

FF 1.561.56 1.641.64 1.821.82

FAO/FAO/WHO/UNU WHO/UNU 20042004

1.4-1.691.4-1.69 1.7-1.991.7-1.99 2.0-2.4*2.0-2.4*

Short term relief= 1.4 x BMR , FAO 2004

* PAL>2.4 not sustainable; mid-point value can be used for computations for group average

FeaturesFeatures

Values are applicable to groups not individualsValues are applicable to groups not individualsReference man and woman- discontinued since 1985 Reference man and woman- discontinued since 1985 report report Energy expenditure is the criteria not intake. Obese Energy expenditure is the criteria not intake. Obese under report intake. Recommended method to under report intake. Recommended method to measure expenditure is DLW or HRM for adults.measure expenditure is DLW or HRM for adults.Descriptor is average not safe level. Population is Descriptor is average not safe level. Population is healthy normal BMI 18.5 -25 for western (or -23 in healthy normal BMI 18.5 -25 for western (or -23 in Asians)Asians)PAL > 1.7PAL > 1.7 desirable physical activity to prevent desirable physical activity to prevent obesity and its co morbidities and 30-60min of obesity and its co morbidities and 30-60min of moderate activity like brisk walkmoderate activity like brisk walk as part of everyday as part of everyday lifelife ( (FAO 2004)FAO 2004)

Terms usedTerms used

PAL = PAL = Total energy expenditure per dayTotal energy expenditure per day

BMR per dayBMR per day

PAR PAR = = Energy cost of an individual activity per minEnergy cost of an individual activity per min

energy cost of BMR per minenergy cost of BMR per min

Continuous heart rate Continuous heart rate monitoring (HRM) methodmonitoring (HRM) method

Min- to- min heart rate recordingMin- to- min heart rate recording

VOVO22 – HR relationship graph; individual – HR relationship graph; individual

relationship curvesrelationship curves

Applicable to moderate to heavy workersApplicable to moderate to heavy workers

Most suitable on active adolescents and Most suitable on active adolescents and childrenchildren

Applicable to field- swimming, sports, dance, Applicable to field- swimming, sports, dance, children in play etc.children in play etc.

Experiences with HRM as a Experiences with HRM as a method of EEmethod of EE

Vangipuram Sujata and Siddhu Anupa (Vangipuram Sujata and Siddhu Anupa (19931993). Use of Heart ). Use of Heart rate technique to determine energy cost of a training camp rate technique to determine energy cost of a training camp for young sportswomen. for young sportswomen. Mehta Manisha and Siddhu Anupa (1993). Mapping energy Mehta Manisha and Siddhu Anupa (1993). Mapping energy requirements from minute- to-minute heart rate recording for requirements from minute- to-minute heart rate recording for sedentary and active sportswomen (18-25 y). sedentary and active sportswomen (18-25 y). Menon Purnima and Siddhu Anupa (1994). Energy status of Menon Purnima and Siddhu Anupa (1994). Energy status of young women (18-24y) performing Indian classical dance.young women (18-24y) performing Indian classical dance.Saxena Shilpa and Siddhu Anupa (1994). Use of heart rate Saxena Shilpa and Siddhu Anupa (1994). Use of heart rate technique to determine the energy cost of Kathak dance and technique to determine the energy cost of Kathak dance and Dietetic Internship.Dietetic Internship.Rishi Priti and Siddhu Anupa (1998). Mapping RDA for energy Rishi Priti and Siddhu Anupa (1998). Mapping RDA for energy for Indian sportswomen. PhD Thesisfor Indian sportswomen. PhD ThesisPriyanka Gupta and Siddhu Anupa (Priyanka Gupta and Siddhu Anupa (20072007). Measuring free-). Measuring free-living energy expenditure with living energy expenditure with accelerometry accelerometry in young in young collegiate girls.collegiate girls.

Experiences with HRM as a Experiences with HRM as a method of EEmethod of EE

Excellent for swimmers, dances, sports as Excellent for swimmers, dances, sports as not interfere and not affected by hydration.not interfere and not affected by hydration.

Individual energy costs can be measuredIndividual energy costs can be measured

Not recommended on sedentary populationNot recommended on sedentary population

Tedious and expensive due to individual HR-Tedious and expensive due to individual HR-VOVO22 relationship in well established relationship in well established

sophisticated lab. Limits field selection of sophisticated lab. Limits field selection of sample.sample.

Double labeled water techniqueDouble labeled water techniqueAn accurately weighed dose of deuterium oxide-0.15g/kgBW and An accurately weighed dose of deuterium oxide-0.15g/kgBW and

1818O-0.12g/kg BW is given orally to volunteers with 50ml distilled O-0.12g/kg BW is given orally to volunteers with 50ml distilled water. The samples of urine are taken under free living water. The samples of urine are taken under free living conditions at 6h, 1d,7d,10d 14d after the dose. Isotopic conditions at 6h, 1d,7d,10d 14d after the dose. Isotopic determination is done on Isotope mass spectrometer( Europa determination is done on Isotope mass spectrometer( Europa Scientific). The COScientific). The CO22 is calculated by Schoeller’s equation. is calculated by Schoeller’s equation.

2H218O

2H2Ourine

C18O2

breath

H218O

Urine

Double labeled water technique Double labeled water technique (DLW)(DLW)

AdvantageAdvantageSimple Simple Applicable to fieldApplicable to fieldCumulative energy expenditure over a period of time Cumulative energy expenditure over a period of time under free living conditionsunder free living conditionsMore accurateMore accurate

DisadvantageDisadvantageCannot give energy costsCannot give energy costsNeed accurate collection of urine, blood and salivaNeed accurate collection of urine, blood and salivaNeed uniform distribution of body fluidsNeed uniform distribution of body fluidsCostlyCostly

Accelerometry: ActicalAccelerometry: Actical

Priyanka Gupta and Siddhu Anupa (2007). Measuring free-living Priyanka Gupta and Siddhu Anupa (2007). Measuring free-living energy expenditure with accelerometry in young collegiate energy expenditure with accelerometry in young collegiate girls.girls.

Vasudha Shukla, Som Nath Singh and Siddhu Anupa (2007). Vasudha Shukla, Som Nath Singh and Siddhu Anupa (2007). Studies of the energy requirements of Indian soldiers and Studies of the energy requirements of Indian soldiers and influence of appetite regulatory peptides on their nutritional influence of appetite regulatory peptides on their nutritional status at high altitude.status at high altitude.

Accelerometers detect low frequency (0.5- 3.2Hz)and G-forces(0.05-2.0 Hz) common to human movements and generate analog voltage signal that is filtered and amplified. The actual number stored by actical are proportional to the magnitude and duration of sensed acceleration and correspond to changes in physical activity energy expenditure.

Accelerometry: Actical - n=33 Accelerometry: Actical - n=33 collegiate womencollegiate women

Actical gave significantly higher (p<0.001) 7d EE than Actical gave significantly higher (p<0.001) 7d EE than Factorial MethodFactorial MethodActical gave significantly higher (p<0.05) EE than HRMActical gave significantly higher (p<0.05) EE than HRM

HRM and factorial method correlate well. HRM and factorial method correlate well. PAL=1.59(HRM); 1.52(Fac M): and PAL=1.59(HRM); 1.52(Fac M): and 1.731.73(Actical)(Actical)

Energy cost of activities by Actical was significantly Energy cost of activities by Actical was significantly higher than factorial method (p<0.001) but in complete higher than factorial method (p<0.001) but in complete agreement with HRM for cost of walking at 6km/h. Actical agreement with HRM for cost of walking at 6km/h. Actical is a potential tool to is a potential tool to measure AEEmeasure AEE but overestimates but overestimates TEE.TEE.

Priyanka Gupta et al 2007

Accelerometry: ActicalAccelerometry: Actical

HRM has a limitation to measure cost of HRM has a limitation to measure cost of sitting, yoga/asanas.sitting, yoga/asanas.

Actical need more standardisations.Actical need more standardisations.

CV% of Actical was 13.37% (inter-) and CV% of Actical was 13.37% (inter-) and 7.47%(intra-variability)7.47%(intra-variability)

WaistWaist was found to be better than wrist was found to be better than wrist and 3d(2h+1H) was as good as 7d.and 3d(2h+1H) was as good as 7d.

Priyanka Gupta et al 2007

Accelerometry: ActicalAccelerometry: Actical

Actical overestimates by Actical overestimates by 2.8%2.8% as compared as compared to DLWto DLW

The comparisons were done on 18 Trainees The comparisons were done on 18 Trainees at sea level.at sea level.

TDEE by Actical(3331 Cal/d) was higher than TDEE by Actical(3331 Cal/d) was higher than DLW (3240Cal) and Factorial method(3083 DLW (3240Cal) and Factorial method(3083 Cal/d) but Activity record(4378 Cal/d) was Cal/d) but Activity record(4378 Cal/d) was significantly higher than other three significantly higher than other three methods.methods.

Vasudha Shukla et al 2007

PAL:FAO 2004 MethodPAL:FAO 2004 Method

LocationLocation TraineeTrainee InfantryInfantry SupportSupport

Sea LevelSea Level 2.07(n=101)2.07(n=101) 2.3(n=50)2.3(n=50) 2.05(n=69)2.05(n=69)

High High AltitudeAltitude

-- 2.73(n=52)2.73(n=52) 2.52(n=24)2.52(n=24)

Vasudha Shukla et al 2007

PAL>2.4 not sustainable, FAO 2004

PAL 2.24(Actical); 2.18(DLW) on n=18 sea level

AcknowledgementAcknowledgement

Human Performance Lab, Sports Authority of Human Performance Lab, Sports Authority of India, JLN Stadium, New DelhiIndia, JLN Stadium, New Delhi

UGC/DSA grant to buy equipmentUGC/DSA grant to buy equipment

DIPAS, New DelhiDIPAS, New Delhi

St John’s Medical College, BangaloreSt John’s Medical College, Bangalore

Students and staff of Lady Irwin CollegeStudents and staff of Lady Irwin College

MSc Dissertation studentsMSc Dissertation students

PhD studentsPhD students

Select readingSelect reading

FAO (2004) Human energy requirements. Jt FAO (2004) Human energy requirements. Jt FAO/WHO/UNU Expert consultation . RomeFAO/WHO/UNU Expert consultation . Rome

WHO (1985) Energy and protein requirements. WHO (1985) Energy and protein requirements. Jt FAO/WHO/UNU Expert consultation. Jt FAO/WHO/UNU Expert consultation. Technical Report Series 724. GenevaTechnical Report Series 724. Geneva

ICMR (1990) Nutrient requirements and ICMR (1990) Nutrient requirements and recommended dietary allowances for Indians.recommended dietary allowances for Indians.