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Evaluation of four methods for determining energy intake in young and older women: comparison with doubly labeled water measurements of total energy expenditure.

The accuracy and precision of four different food intake assessment methods were evaluated in young and older women by comparing reported energy intakes with doubly labeled water measurements total energy expenditure (TEE). A study lasting 8 d was conducted in 10 young women aged 25.2+/-1.1 y (-x+/-SEM) and in 10 older women aged 74.0+/-1.4 y. Free-living TEE was measured over 7 d and food consumption was determined from weighed food intake data (7 d), a 24-h food recall (in duplicate), and two different food-frequency questionnaires [Fred Hutchinson Cancer Research Center (FHCRC)/Block and Willett, both in duplicate]. In addition, body composition was determined by using hydrodensitometry, and strenuous physical activity and the extent of dietary restraint were determined by questionnaire. In young women, 24-h recall gave mean energy intakes that were closest to measures of TEE (-0.34+/-3.71 MJ/d compared with TEE, P=0.178), and energy intakes by food-frequency questionnaires were the only intake data that correlated significantly with individual values for TEE (P<0.05). In older women, food-frequency questionnaires gave mean energy intakes that were closest to measured TEE (+0.53+/-2.95 MJ/d with the Willett questionnaire and -1.19+/-3.02 MJ/d with FHCRC/Block questionnaire). No energy intake data from this group correlated significantly with values for TEE. The 7-d weighed dietary intakes were significantly lower than measured TEE in both young and older women (-2.0 MJ/d in young and older women combined, P<0.001), and did not correlate significantly with values for TEE, although they did most closely mirror the mean difference in TEE between the young and older women (2.30 MJ/d for TEE and 2.11 MJ/d for 7-d weighed intake). These data suggest that none of the methods studied gave accurate estimates of the usual energy requirements of individual subjects. In addition, the results suggest that for some types of studies, simple methods for assessing group mean dietary intake may actually give more accurate information than weighed dietary intakes.

Adult↗

The effect of exercise on energy intake and body composition in overweight women.

Twelve moderately overweight women with mild obesity were studied to determine the effect of exercise on nutrient intake and body composition. The women, 16 to 42 percent above desired body weight (BW) and 30 to 41 percent body fat, rotated through three 18-day treatment periods: no exercise (NO-EX), moderate duration exercise (M-EX), and long duration exercise (L-EX). Daily exercise was prescribed to increase energy expenditure by 12.5 (M-EX) or 25 percent (L-EX) of energy intake required for BW maintenance during baseline. Diets were self-selected from a variety of conventional foods, and intake was monitored. Exercise did not affect quantity of energy intake or macronutrient composition of diets during the treatment periods. Energy and carbohydrate intakes tended to be higher in response to M-EX and L-EX compared to NO-EX during the last 5-day interval of the treatment periods, but these trends were not statistically significant. Exercise did affect BW and fat-free mass (FFM); mean FFM values were 49.3, 49.7 and 50.8 kg at the end of NO-EX, M-EX and L-EX, respectively (P = 0.017). Body fat mass (FM) was not consistently affected by exercise. It appears that exercise affects FFM but has no consistent effect on nutrient intake in mildly obese women who are choosing food intake from a variety of foods.

Adipose Tissue↗

Restricted energy intake and elevated calcium and phosphorus intake for gilts during growth. IV. Characterization of metacarpal, metatarsal, femur, humerus and turbinate bones of sows during three parities.

The effect of early nutrition on subsequent bone development was studied using gilts that had previously been fed ad libitum or 75% ad libitum intake and 100 or 150% National Research Council-recommended daily Ca and P from weaning to 100 kg. During the three-parity reproductive study, sows were fed a 14% protein diet. Metacarpals and metatarsals were taken from sows culled due to lameness or failure to breed and from sows after completing three parities. Femur and humerus articular cartilage and turbinates were described at necropsy. Metacarpals and metatarsals were heavier and tended to have thicker walls when sows were previously fed ad libitum or fed 150% Ca and P. Energy intake produced the greater response. Metacarpal breaking strength was greatest for sows previously fed ad libitum. Metatarsals were not affected by energy intake. Stiffness, Young's modulus of elasticity (YME) and flexural modulus for metacarpals and metatarsals were not affected by energy intake. Previously fed Ca and P intakes did not affect any of the mechanical bone characteristics. Metacarpals were heavier, had a greater breaking strength, were more elastic and exhibited slightly less resistance to bending than the metatarsals. The ether extract, ash, Ca and P content and the Ca:P ratio of metacarpals and metatarsals were not affected by previously fed energy or Ca and P intakes. The ether extract content tended to decrease and the ash, Ca and P content tended to increase with age. Articular cartilage and turbinate scores were not influenced by previously fed energy or Ca and P intakes. The YME and flexural modulus were the only bone characteristics that were even poorly correlated (average r = .25) with soundness scores, suggesting that high values result in poorer soundness scores. Energy and Ca and P intakes during growth and development had only minimal effects on bone characteristics and no apparent effect on structural soundness and longevity of sows kept for three parities.

Animals↗

A critical analysis of measured food energy intakes during infancy and early childhood in comparison with current international recommendations.

An examination of published reports of measured energy intakes of infants and young children reveals that during the first year of life the pattern of change in food energy intake differs fundamentally from the WHO/FAO (1973) Recommendations. In contrast to the progressive linear decline in intake per kg body weight that has previously been assumed, measured intakes are not only substantially lower, but fall much more rapidly up to six months. In even greater contrast, they then rise again, to coincide with the recommendations, reaching a peak at around two years. These findings enable a more realistic assessment to be made of the adequacy of breast milk as the sole source of food in the early months of life.

Age Factors↗

Evidence for genetic influences on human energy intake: results from a twin study using measured observations.

Human obesity is associated with greater-than-average energy intake, although relatively few studies have tested the heritability of food intake. The present study examined the genetic architecture of measured caloric intake during laboratory test meals in 36 monozygotic and 18 dizygotic twin pairs. A series of analyses tested the hypotheses that (1) there would be a genetic influence on total caloric intake, (2) there would be genes influencing total caloric intake above and beyond those influencing body composition, (3) there would be a phenotypic association between total caloric intake and fat mass above and beyond any genetic influences, and (4) there would be genetic influences on macronutrient intake (i.e., fat, carbohydrate, and protein intake) above and beyond total caloric intake. Results suggested genetic influences on age- and sex-adjusted total caloric intake (24-33% of the variance), although 95% confidence intervals were wide and suggested that "true" heritability estimates might be considerably lower or higher. Caloric intake was influenced by both common and unique environmental factors. Greater-than-average caloric intake was associated with increased adiposity, despite probable genetic influences on both phenotypes. Finally, there was evidence for macronutrient-specific familial influences, although the extent to which they were genetic or environmental in origin could not be teased apart. Results suggest that human obesity may be influenced by behaviors that are themselves genetically regulated. However, further studies are needed to obtain more precise heritability estimates and a better understanding of the conditions under which genetic influences on energy intake emerge.

Adult↗

Rate and extent of compensatory changes in energy intake and expenditure in response to altered exercise and diet composition in humans.

We assessed the effect of no exercise (Nex; control) and high exercise level (Hex; approximately 4 MJ/day) and two dietary manipulations [a high-fat diet (HF; 50% of energy, 700 kJ/100 g) and low-fat diet (LF; 20% of energy, 300 kJ/100 g)] on compensatory changes in energy intake (EI) and energy expenditure (EE) over 7-day periods. Eight lean men were each studied four times in a 2 x 2 randomized design. EI was directly quantified by weight of food consumed. EE was assessed by heart rate (HR) monitoring. Body weight was measured daily. Mean daily EE was 17.6 and 11.5 MJ/day (P < 0.001) on the pooled Hex and Nex treatments, respectively. EI was higher on HF diets (13.4 MJ/day pooled) compared with the LF diets (9.0 MJ/day). Regression analysis showed that these energy imbalances induced significant compensatory changes in EB over time of approximately 0.3-0.4 MJ/day (P < 0.05). These were due to changes in both EI and EE in the opposite direction to the perturbation in energy balance. These changes were significant, small but persistent, amounting to approximately 0.2 and approximately 0.35 MJ/day for EI and EE, respectively.

Adaptation, Physiological↗

Estimating energy intake of urban women in Colombia: comparison of diet records and recalls.

As part of a larger study of energy-nutrition, we compared the performance of 24 h diet recalls with estimated diet records kept by trained observers. The subjects were economically disadvantaged women (n = 85) in the city of Cali, Colombia. A 24 h recall and an estimated diet record were collected for each woman at 0 and approximately 3 and 6 months. Energy intake obtained from the estimated dietary records was validated against energy expenditure and used as the reference method. Energy and macronutrient intake were calculated from published food composition tables and proximate analyses of common foods. The number of food items consumed per woman per day, total and in each of 16 food groups, was tabulated. Energy and macronutrient intakes were 11-13% lower in the 24 h recalls. The discrepancy energy could be largely accounted for by the lower number of food items in the recalls. The number of food items in eight of 16 food groups was significantly lower in the recalls compared to the records. Underreporting on the recalls was a general tendency in these subjects and not clearly related to average energy intake. We conclude that 24 h diet recalls underestimate energy and nutrient intake in this population and are not suitable for studies of human energetics.

Body Composition↗

Intravenous nitrogen and energy intakes required to duplicate in utero nitrogen accretion in prematurely born human infants.

In order to determine the intravenous energy and nitrogen intakes required to achieve intrauterine rates of nitrogen accretion and growth, 30 studies were completed in 22 premature infants who were provided with various intakes of amino acids and energy (glucose +/- lipid) by peripheral vein infusion. At constant nitrogen intake, increasing energy intake (as lipid) from 50 to 80 nonprotein kcal/kg/day resulted in significant increases in nitrogen retention and weight gain. Increasing nitrogen intake from 494 to 655 mg/kg/day at constant low energy intake (mean = 53 kcal/kg/day) had no effect on nitrogen retention or weight change; however, at higher energy intakes (mean = 81 kcal/kg/day) increasing nitrogen intake correlated significantly with increasing nitrogen retention. At energy intakes greater than 70 kcal/kg/day the major determinant of nitrogen retention was nitrogen intake. When energy intake was greater than 70 kcal/kg/day, the infusion of nitrogen providing 430 to 560 mg/kg/day (2.7 to 3.5 gm protein/kg/day) resulted in the duplication of intrauterine nitrogen accretion rates.

Amino Acids↗

The measurement of food and energy intake in man-an evaluation of some techniques.

A dietary survey was carried out on an Antarctic base over a period of 6 to 12 months on twelve individuals. Three methods of determining individual food and energy intake were used-weighing and recording of food as eaten in combination with food tables, dietary recall, and bomb calorimetry of duplicate meals. Use of weighed food intakes and food composition tables underestimated energy intake by 7% when compared to analysis of duplicate meals by bomb calorimetry. One week was found to be the most practical period over which intake should be measured to determine "habitual" food intake.

Adult↗

A positive correlation between energy intake and body mass index in a population of 1312 overweight subjects.

The energy intake (EI) of 1312 overweight subjects was assessed using the research dietary history method. EI was positively associated with overweight--as expressed by the body mass index (BMI)--in both males and females. Such findings are at variance with earlier reports of low dietary intakes in the obese and of an inverse relationship between EI and BMI. This discrepancy could be related to the dietary-interviews method used and/or to differences in the degree of motivation of the obese subjects in the various studies. On the other hand, our results are consistent with the positive relationship between energy expenditure (EE) and BMI previously reported in the literature and with the expected EE of our subjects.

Adult↗

Total energy expenditure and physical activity as assessed by the doubly labeled water method in Swedish adolescents in whom energy intake was underestimated by 7-d diet records.

Swedish children and adolescents may be adopting a sedentary lifestyle with low energy expenditures and intakes, but no quantitative data are available. The purpose of the present study in 50 adolescents aged 15 y was to investigate whether assessment of total energy expenditure (TEE) and physical activity level (PAL) by the doubly labeled water method and indirect calorimetry and estimation of energy intake by a 7-d diet record would indicate physical inactivity. The boys' (n = 25) mean weight was 112% and the girls' (n = 25) was 109% of Swedish reference values from 1976; the mean height of both boys and girls was 102% of those reference values. Mean TEE in the boys and girls, 13.82 +/- 1.90 and 10.70 +/- 1.59 MJ/d, and mean PAL (TEE/basal metabolic rate), 1.89 +/- 0.16 and 1.79 +/- 0.22, respectively, were nonsignificantly higher than corresponding figures from other published studies. Mean energy intake as a percentage of TEE was 81.9 +/- 17.9% in the boys and 78.3 +/- 16.4% in the girls. Significant negative correlations were found both between energy intake as a percentage of TEE and percentage body fat and between energy intake as a percentage of TEE and body mass index. These results add to the evidence that 7-d diet records underestimate energy intake in adolescents, particularly those with a tendency for overweight and increased body fat. The results support indications of a trend of increasing body weight and height in Swedish adolescents, but conflict with the presumptions of low physical activity, low energy expenditure, and low energy intake. These results support the view that current recommendations for energy intake during adolescence are too low.

Adipose Tissue↗

Body composition, energy expenditure, and energy intake in patients with Williams syndrome.

OBJECTIVE: To evaluate the body composition, resting energy expenditure (REE), and energy intake of adolescents and adults with Williams syndrome (WS) compared with matched healthy control subjects. METHODS: Body composition was determined by total body electrical conductivity and anthropometric measurements in six subjects with WS from the WS Clinic at Children's Hospital of Philadelphia and six healthy control subjects matched for age, height, and pubertal stage. REE was measured by open-circuit indirect calorimetry. Dietary intake was assessed by 3-day dietary records. RESULTS: Subjects with WS had similar anthropometric measurements to the control group except for a significantly lower percent body fat (17.1%+/-5.2% vs. 25.0%+/-6.7%). Dietary intake (measured in kilocalories per day) was similar between the two groups. REE was statistically higher by 155 kcal/day in the WS group after controlling for age, gender, and body composition. In addition, the WS group had a significantly higher percent predicted REE according to the World Health Organization equation, which adjusts for age, gender, and body weight. CONCLUSION: Adolescents and adults with WS have a similar dietary intake but a lower body fat than healthy control subjects. A higher REE may contribute to the thin body habitus and reduced total body fat stores of people with WS.

Adolescent↗

Can prescription of sip-feed supplements increase energy intake in hospitalised older people with medical problems?

A blinded randomised controlled trial of prescribed oral sip-feed supplements compared with routine hospital practice was undertaken in acute admissions to a geriatric medicine department. Patients were eligible for inclusion if they were admitted from home, were not obese (BMI>75th percentile), had no swallowing difficulties and were not deemed to be in the terminal stage of illness. On admission they were stratified by nutritional status (BMI<5th, >5th to <25th, >25th to <75th percentile) and randomised. The intervention group received 120 ml oral sip-feed supplement prescribed three times per d in the medicine prescription chart (22.5 g protein, 2260 kJ (540 kcal) energy/d) distributed at medication rounds for the duration of hospital stay. The control group received routine hospital care. Outcomes were patient compliance with supplement, total energy intake and nursing staff views of the method. Patients were randomised to receive supplements (n 186 of total n 381). Half had full compliance and three-quarters at least moderate compliance. Total energy intake was significantly increased, on average, in the intervention group (P=0.001). The proportion of patients meeting estimated minimum energy requirements was significantly increased (P=0.023), but was still <50 % for the sample of patients in the intervention group. The present study suggests this method is acceptable to patients and staff and improves total energy intake. However, the amount prescribed did not ensure minimum energy requirements were met in all cases.

Administration, Oral↗

[Insulin-like growth factor I (somatomedin C) in premature infants on total parenteral nutrition. Relations with nutritional status and protein-energy intakes].

Insulin-like growth factor I (IGF I) is like prealbumin and transferrin a marker of nutritional status. Its level increases with gestational age. The levels of IGF I (96 times), transferrin (86 times) and prealbumin (69 times) were measured in blood samples from 26 premature infants aged 8 to 78 days (gestational age: 28 to 34 weeks, birth weight: 840 to 1,800 g). At the time of sampling, all the infants were on total parenteral nutrition (360 +/- 42 kJ/kg/day and 2.5 +/- 0.3 g of proteins/kg/day). The results were analysed with reference to anthropometric parameters (weight, height, head circumference, skinfolds and arm circumference). There was no correlation between plasma IGF I and anthropometric measurements. There were significant correlations between IGF I and transferrin (p less than 0.01), prealbumin (p less than 0.05), protein intake (p less than 0.01) an energy intake (p less than 0.05). Plasma IGF I increased at the end of the first week of parenteral nutrition in all the 5 infants having initial low values. The plasma IGF I was not correlated with the duration of parenteral nutrition in the 26 infants after the second week of nutrition. IGF I measurement is useful for evaluating the protein nutritional status of premature infants on total parenteral nutrition.

Energy Intake↗

The reduced energy intake of rats fed a high-protein low-carbohydrate diet explains the lower fat deposition, but macronutrient substitution accounts for the improved glycemic control.

The metabolic effect of high-protein low-carbohydrate (HP) diets on body composition and glucose homeostasis remains incompletely understood. This study assesses the respective roles of the increased protein:carbohydrate ratio (P:C) and the resulting moderate decrease in energy intake in the metabolic effects of HP diets. Rats had free access to normal (NP; 14%) or high (HP; 53%) total milk protein isoenergetic diets, or were fed the NP diet but restricted to the energy intake of HP rats (NPr), which was 89.1 +/- 9.3% that of NP rats. After 8 wk, body weight was lower in HP and NPr rats than in NP rats. In HP rats, the lower body weight was associated with a lower adipose tissue mass and a reduced proportion of large adipocytes. HP rats also had an improved oral glucose tolerance and insulin sensitivity, as assessed by the homeostatic model assessment index, compared with NPr and NP rats, and these effects were related solely to the increased P:C. These data suggest that the reduced energy intake of rats fed a high-protein, low-carbohydrate diet explains the lower fat deposition but an increased P:C per se improves glucose homeostasis.

Animals↗

Energy intake and the appearance of 5,8,11-eicosatrienoic acid in serum lipids during parenteral nutrition without fat.

During parenteral nutrition without fat, biochemical changes in fatty acid composition of serum lipids may occur, such as a decrease in the concentration of linoleic and arachidonic acid and an increase of 5,8,11-eicosatrienoic acid. In various reports on essential fatty acid deficiency in parenteral nutrition, the rates and degrees of these changes in fatty acid composition of serum lipids are different. We have tested the hypothesis that a relationship exists between the energy intake and the increase in 5,8,11-eicosatrienoic acid in parenteral nutrition without fat. The hypothesis is based on the assumption that mobilization of lipids from body fat, and thus of stored essential fatty acids, only takes place when energy intake is below requirements. Seventeen patients with gastrointestinal diseases were fed parenterally without fat during 1 to 5 weeks (mean 3.5 week). The energy supply to the patients varied from 88 to 222 kilo Joules per kilogram per day. In all patients, the fatty acid pattern of the serum phospholipid fraction was determined weekly. It appeared that those patients with the highest energy intake per kilogram body weight showed the lowest increase in 5,8,11-eicosatrienoic acid. In ten patients, energy was given as glucose and fructose, in seven patients as sorbitol. The type of carbohydrate investigated did not influence the changes in the fatty acid pattern. Results show further that the individual values of the concentrations of 5,8,11-eicosatrienoic acid and of arachidonic acid provide more information concerning the essential fatty acid status of a patient than the commonly used ratio of these two fatty acids.

8,11,14-Eicosatrienoic Acid↗

The influence of dietary composition on energy intake and body weight.

We review evidence regarding the influence of dietary fat, fiber, the glycemic index and sugar on energy intake and body weight. Although data from comprehensive long-term studies are lacking, published investigations suggest that the previous focus on lowering dietary fat as a means for promoting negative energy balance has led to an underestimation of the potential role of dietary composition in promoting reductions in energy intake and weight loss. More randomized clinical trials are needed to examine the relative utility of different putative dietary factors in the treatment of obesity.

Blood Glucose↗

Energy intake and monounsaturated fat in relation to bone mineral density among women and men in Greece.

BACKGROUND: Several variables have been established as risk factors for osteoporosis: it is more common among women and the gender difference increases with age and with years since menopause. Estrogens, androgens, physical activity, and body mass index have been previously shown to be positively associated with bone mineral density and inversely with risk for fractures. METHODS: To assess the effect on bone mineral content of energy-generating nutrients, healthy men (n = 36) and women (n = 118) ages 25-69 years were interviewed among visitors and staff of the University of Athens Department of Medical Physics. Bone mineral density (BMD) was measured by single photon absorptiometry. RESULTS: Demographic and lifestyle variables were not significantly related to BMD in this study, although the patterns were consistent with those previously reported by other investigators. Total energy intake, which also reflects energy expenditure through physical activity, was positively associated with BMD among both men (P = 0.003) and women (P = 0.04). After adjustment for nonnutritional variables and energy intake, monounsaturated fat, which in the Greek population is mostly derived from olive oil, was associated with BMD. The association was positive among both men (P = 0.01) and women (P = 0.03). There was evidence for an inverse association between carbohydrate intake and BMD, but the association was significant only with respect to mono- and disaccharides. CONCLUSIONS: In this population, consumption of monounsaturated fat and physical activity were predictive of bone mineral density, but larger studies are needed.

Adult↗