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Biomedical subjects

A M Prentice

Publications and source records attributed to A M Prentice.

At least 73 records · Page 4Linked to original sources
PubMed1996

Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements.

OBJECTIVES: To describe average levels of free-living energy expenditure in people from affluent societies and to determine the influence of body weight, height, age and sex. DESIGN: Analysis of 574 measurements of total energy expenditure (TEE, assessed by the doubly-labelled water method); basal metabolic rate (BMR, directly measured or derived from similar directly measured proxy measures such as during sleep); activity energy expenditure (AEE, derived as TEE-BMR); and physical activity level (PAL, derived as TEE/BMR) from people aged 2-95 years. The dataset was extracted from 1614 published and unpublished measurements in 1156 subjects after exclusion of repeat estimates and subjects in special physiological or behavioural states (eg pregnancy, athletic or military training etc). RESULTS: A separate analysis of data from non-ambulant subjects, and from elite endurance athletes (all excluded from the main dataset) established the limits of human daily energy expenditure at around 1.2 x BMR and 4.5 x BMR. In the main analysis, the validity of PAL as an index of TEE adjusted for BMR was tested and confirmed. Regression equations were then derived to describe TEE, BMR, AEE and PAL in terms of body weight, height, age and sex. As anticipated, TEE, BMR and AEE were all positively related to weight and height, while age was a negative predictor, especially of activity. The influence of weight disappeared when TEE was expressed as PAL, but height and age remained as highly significant predictors. For all three components, females expended 11% less energy on average than males after adjustment for weight, height and age. Average levels of energy expenditure in different age and sex groups are tabulated. CONCLUSIONS: There now exists a large and robust database of energy expenditure measurements obtained by the doubly-labelled water method. Analysis of the data from affluent societies shows that, in general, levels of energy expenditure are similar to the recommendations for energy requirements adopted by FAO/WHO/UNU (1985) and UK Department of Health (1991). PAL values for active subjects tend to be higher than is currently assumed. The current analysis provides a substantial body of normal data against which other estimates can be compared.

Adolescent↗
PubMed1996

Energy expenditure in overweight and obese adults in affluent societies: an analysis of 319 doubly-labelled water measurements.

OBJECTIVES: To describe the relationship between graded levels of obesity and free-living energy expenditure in men and women in affluent societies. DESIGN: Analysis of 319 measurements of energy expenditure in adults aged 18-64 years. The variables analysed were: total energy expenditure (TEE, assessed by the doubly-labelled water method); measured basal metabolic rate (BMR); activity energy expenditure (AEE, derived as TEE-BMR); and physical activity level (PAL, derived as TEE/BMR). Results were analysed according to four categories of body mass index (BMI): < 25.0, 25.0-29.9, 30.0-35.0 and > 35.0 kg/m2. RESULTS: TEE increased steadily with increasing BMI (9.5 to 13.5 MJ/d in women, 12.9 to 17.5 MJ/d in men, ANOVA, P < 0.0001 for both sexes). BMR also increased (5.7 to 8.2 MJ/d in women, 7.2 to 11.6 MJ/d in men, P < 0.0001 for both). AEE increased steadily in women (3.8 to 5.3 MJ/d, P < 0.0003), but in men increased up to the third BMI category (5.7 to 7.5 MJ/d, n.s.) and then declined in the most obese group (5.9 MJ/d, n.s.). The increases in energy expenditure were not in direct proportion to body weight since, when expressed per kg, both TEE and AEE declined significantly with increasing BMI. PAL remained quite constant across the three lowest BMI groups, indicating similar levels of physical activity. There was a non-significant decrease in PAL in the most obese men and women. CONCLUSIONS: This analysis confirms that habitual energy expenditure is substantially and progressively raised in obesity. It contradicts the claim, based on self-reported food intake, that obesity develops and is maintained in spite of very low levels of energy intake. The analysis suggests that, except in massive obesity, patterns of physical activity are quite similar at different levels of BMI. This does not exclude the possibility that an inactive lifestyle may be an important general risk factor for the development of obesity.

Adolescent↗
PubMed1996

Metabolic fuel utilisation in obese women before and after weight loss.

OBJECTIVE: To test the hypothesis that weight rebound following slimming diets may be caused by an adaptive alteration in fuel utilisation involving a suppression of fat oxidation thus favouring fat storage in adipose tissue. DESIGN: Repeat measurements before and after two 14 d cycles of controlled weight loss using a very low energy diet (1.9MJ/d). SUBJECTS: Eight moderately obese women (body weight: 85.6 +/- 10.1 kg, BMI: 31 +/- 2 kg/m2, age: 42.6 +/- 10.1 years). MEASUREMENTS: Energy expenditure and substrate balances using 24-h whole-body indirect calorimetry and naturally labelled 13C-glucose. RESULTS: Aggregate weight loss was 5.1 +/- 0.8 kg. Twenty-four hour energy expenditure declined by 12% (8359 +/- 282 to 7366 +/- 191 kJ/d, p < 0.001). Net fat utilisation was not significantly depressed (4009 +/- 366) to 3613 +/- 191 kJ/d, NS), and the proportion of energy derived from fat was unchanged at 48.0% before weight loss and 49.0% after weight loss. CONCLUSION: The well-recognised phenomenon of reduced energy expenditure is unlikely to be a major cause of weight regain. The results do not support the theory that altered fuel selection in post-obese subjects may be the cause of difficulty in maintaining weight loss.

Adaptation, Physiological↗
PubMed1996

Free-living energy expenditure assessed by two different methods in rural Gambian men.

OBJECTIVE: To assess total free-living energy expenditure (EE) in Gambian farmers with two independent methods, and to determine the most realistic free-living EE and physical activity in order to establish energy requirements for rural populations in developing countries. DESIGN: In this cross-sectional study two methods were applied at the same time. SETTING: Three rural villages and Dunn Nutrition Centre Keneba, MRC, The Gambia. SUBJECTS: Eight healthy, male subjects were recruited from three rural Gambian villages in the sub-Sahelian area (age: 25 +/- 4y; weight: 61.2 +/- 10.1 kg; height: 169.5 +/- 6.5 cm, body mass index: 21.2 +/- 2.5 kg/m2). INTERVENTION: We assessed free-living EE with two inconspicuous and independent methods: the first one used doubly labeled water (DLW) (2H2 18O) over a period of 12 days, whereas the second one was based on continuous heart rate (HR) measurements on two to three days using individual regression lines (HR vs EE) established by indirect calorimetry in a respiration chamber. Isotopic dilution of deuterium (2H2O) was also used to assess total body water and hence fat-free mass (FFM). RESULTS: EE assessed by DLW was found to be 3880 +/- 994 kcal/day (16.2 +/- 4.2 MJ/day). Expressed per unit body weight the EE averaged 64.2 +/- 9.3 kcal/kg/d (269 +/- 38 kJ/kg/d). These results were consistent with the EE results assessed by HR: 3847 +/- 605 kcal/d (16.1 +/- 2.5 MJ/d) or 63.4 +/- 8.2 kcal/kg/d (265 +/- 34kJ/kg/d). Physical activity index, expressed as a multiple of basal metabolic rate (BMR), averaged 2.40 +/- 0.41 (DLW) or 2.40 +/- 0.28 (HR). CONCLUSIONS: These findings suggest an extremely high level of physical activity in Gambian men during intense agricultural work (wet season). This contrasts with the relative food shortage, previously reported during the harvesting period. We conclude that the assessment of EE during the agricultural season in non-industrialized countries needs further investigations in order to obtain information on the energy requirement of these populations. For this purpose the use of the DLW and HR methods have been shown to be useful and complementary.

Adult↗
PubMed1996

Covert manipulation of the dietary fat to carbohydrate ratio of isoenergetically dense diets: effect on food intake in feeding men ad libitum.

OBJECTIVE: High-fat, high energy-density (HF, HED) diets promote an increase in energy intakes relative to low-fat lower-energy density diets (LF, LED). This study examined whether HF diets promote higher levels of energy intake when isoenergetically dense (IE) relative to LF (high carbohydrate) diets, as predicted by glucostatic and glycogenostatic models for energy intake regulation. SUBJECTS: Six normal-weight healthy men [mean age (SD) = 37.33 (13.32 y) mean weight = 73.03 (5.14 kg), mean height = 1.80 (0.05 m)]. DESIGN: Six men were each studied three times (factorial design) during 14-d throughout which they had ad libitum access to one of three covertly-manipulated diets. The fat, carbohydrate (CHO) and protein in each diet (as % energy) were 20:68:12, [low-fat (LF)]; 40:48:12, [medium-fat (MF)]; 60:28:12 [high-fat (HF)], with 2-d maintenance (1.4 x BMR, MF) beforehand. Within each diet every item was of the same composition and offered as a 3-d rotating menu. MEASUREMENTS: Energy and nutrient intakes, body weight, subjective pleasantness and satisfaction of the food. RESULTS: Energy intakes were 10.69, 11.02 and 10.90 MJ/d on the LF, MF and HF diets respectively. The increase in energy intake that occurred in previous studies when the energy density of the diet was increased by addition of fat was not apparent when LF, MF and HF diets were of the same energy density. CONCLUSION: Neither carbohydrate nor fat intake were tightly regulated. These data do not support an entirely glucostatic or glucogenostatic model of food intake regulation.

Adult↗
PubMed1996

Physical activity and obesity: problems in correcting expenditure for body size.

OBJECTIVE: To explore the best method of adjusting energy expended on physical activity (AEE) for differences in body size. Many publications have expressed AEE per kg body weight (i.e. using weight 1.0 as denominator). This makes the unjustified assumption that all activities are weight-dependent. DESIGN: Retrospective analysis of data from ninety-two 24-h whole-body calorimetry measurements in women, and 574 doubly-labelled water measurements in men and women to calculate the optimal exponents of body weight for adjusting AEE. RESULTS: The analysis proved that weight 1.0 over-corrects for size differences and yields invalid conclusions about relationships between physical activity and obesity. An exponent close to 0.5 is more appropriate for sedentary lifestyles. However the correct exponent is itself dependent on the relative mix of weight-dependent and non-weight-dependent activities undertaken. CONCLUSION: We conclude that it is impossible to recommend a generalizable coefficient for adjusting AEE, and that great caution must be exercised when interpreting AEE data from individuals of markedly different body sizes.

Body Constitution↗
PubMed1996

Circadian patterns of total 24-h hydrogen and methane excretion in humans ingesting nonstarch polysaccharide (NSP) diets and the implications for indirect calorimetric and D2 18O methodologies.

OBJECTIVES: To quantify the relationship between substrate fermentation and total 24-h H2 and CH4 excretion on mixed diets and to assess errors incurred in the calculation of energy expenditure and fuel selection by the exclusion of these gases from standard calculations. DESIGN AND SUBJECTS: Twelve healthy, lean men were studied over two consecutive dietary periods of 3 weeks. Measurements of total H2 and CH4 excretion were made during 24h within a whole body calorimeter. Subjects were fed a diet containing 16 g or 38 g of nonstarch polysaccharide (NSP) and 16 g or 19 g resistant starch (RS). Colonic fermentation was measured by balance techniques during the two dietary treatments. RESULTS: There was an inverse non-linear relationship between H2 and CH4 excretion on both diets (r2 = 0.53; P < 0.001), but absolute excretion did not increase significantly as the intake of NSP and RS (from 28 +/- 3 and 48 +/- 4 g/day) increased. No relationship was found between daytime and 24-h measurements of H2 and CH4. H2 and CH4 excretion introduces an error of less than 0.2% and 1% in calculations of energy expenditure and CO2 production from the standard human equations used in indirect calorimetric (IC) and doubly labelled water (DLW) methodologies respectively, and less than 2% in fuel utilisation calculated as % non-protein energy expenditure from IC. CONCLUSIONS: This study provides evidence that neither daytime nor total 24-h rates of H2 or CH4 excretion accurately predict degree of fermentation of NSP+RS in either individual subjects or groups of subjects, probably because of changes in the stochiometry of the fermentation process.

Adult↗
PubMed1995

Obesity in Britain: gluttony or sloth?

The prevalence of clinical obesity in Britain has doubled in the past decade. The Health of the Nation initiative has set ambitious targets for reversing the trend in recognition of the serious health burden which will accrue, but efforts to develop prevention and treatment strategies are handicapped by uncertainty as to the aetiology of the problem. It is generally assumed that ready access to highly palatable foods induces excess consumption and that obesity is caused by simple gluttony. There is evidence that a high fat diet does override normal satiety mechanisms. However, average recorded energy intake in Britain has declined substantially as obesity rates have escalated. The implication is that levels of physical activity, and hence energy needs, have declined even faster. Evidence suggests that modern inactive lifestyles are at least as important as diet in the aetiology of obesity and possibly represent the dominant factor.

Diet↗
PubMed1995

Energy expenditure and wasting in human immunodeficiency virus infection.

BACKGROUND: Increased expenditure of energy at rest has been considered a contributing factor to the negative energy balance and weight loss that occur in patients with human immunodeficiency virus (HIV) infection. However, the true determinant of energy balance is not resting but total energy expenditure. We sought to determine the contribution of total energy expenditure to weight changes in patients with HIV-associated wasting. METHODS: We performed 51 assessments of energy metabolism in 27 men with HIV infection at different stages of disease, including periods of both rapid and slow weight loss. Resting energy expenditure was measured by indirect calorimetry, total energy expenditure by the doubly-labeled-water technique, and energy intake by recording the weight of food consumed. The results were compared with the rate of weight loss or gain. RESULTS: The mean (+/- SD) total energy expended by the HIV-infected men was 2750 +/- 670 kcal per day, no more than that expended by normal men. There was a significant positive relation between total energy expenditure and the rate of weight change (r = 0.61, P < 0.001); thus, during rapid weight loss, total energy expenditure was reduced to 2180 +/- 580 kcal per day (P = 0.009), primarily because of reduced physical activity. During rapid weight loss, the negative energy balance (-850 +/- 580 kcal per day) was primarily the result of the reduction in energy intake, to 1330 +/- 610 kcal per day; intake correlated strongly with the rate of weight change (r = 0.84, P < 0.001). CONCLUSIONS: In patients with HIV infection, total energy expenditure is reduced during episodes of weight loss. Reduced energy intake, not elevated energy expenditure, is the prime determinant of weight loss in HIV-associated wasting.

Adult↗
PubMed1995

Food intake and the menstrual cycle: a retrospective analysis, with implications for appetite research.

The biological regulation of appetite is currently an important topic in nutrition, since hyperphagia has been implicated as the prime cause of obesity. Cyclical fluctuations in food intake occur in women across the menstrual cycle, with a periovulatory nadir and a peak in the luteal phase. These alterations in food intake, in response to ovarian steroid hormone changes may be more than 2.5 MJ/day, with the mean reported changes shown in 19 separate studies of 1.0 MJ/day. Hormonal induced fluctuations in food intake could, therefore, contribute to energy imbalance and consequent weight gain. Further, in nutrition studies involving women subjects where the menstrual cycle phase is not controlled, hormonally induced changes in food selection and intake may mask the often considerably smaller changes in response to experimental variables in appetite research.

Appetite↗