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Body mass index in relation to energy intake and expenditure among adults in Greece.

The empirical evidence concerning the quantitative relations between energy intake and expenditure on the one hand and body mass index (BMI) on the other is inconclusive. We have used a large database of 14,281 individuals, for whom habitual dietary intake and expenditure have been ascertained with adequate methodology, to examine the mutually adjusted associations of these variables with BMI. Study subjects were adult participants in the Greek component of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. After adjustment for age and gender and exclusion of dieting individuals and energy underreporters, an increment of about 500 kcal intake was found to correspond to an increment of about 0.33 kg/m2 of BMI, whereas an increment of about 5 MET-hours of energy expenditure was associated with a decrease of about 0.18 kg/m2 of BMI, where MET is the ratio of the metabolic rate associated with a given activity to the resting metabolic rate. Our results indicate that increasing physical activity is about half as effective as decreasing energy intake in reducing BMI.

Adult↗

Conjugated linoleic acid rapidly reduces body fat content in mice without affecting energy intake.

Recent reports have demonstrated that conjugated linoleic acid (CLA) has effects on body fat accumulation. In our previous work, CLA reduced body fat accumulation in mice fed either a high-fat or low-fat diet. Although CLA feeding reduced energy intake, the results suggested that some of the metabolic effects were not a consequence of the reduced food intake. We therefore undertook a study to determine a dose of CLA that would have effects on body composition without affecting energy intake. Five doses of CLA (0.0, 0.25, 0.50, 0.75, and 1.0% by weight) were studied in AKR/J male mice (n = 12/group; age, 39 days) maintained on a high-fat diet (%fat 45 kcal). Energy intake was not suppressed by any CLA dose. Body fat was significantly lower in the 0.50, 0.75, and 1.0% CLA groups compared with controls. The retroperitoneal depot was most sensitive to the effects of CLA, whereas the epididymal depot was relatively resistant. Higher doses of CLA also significantly increased carcass protein content. A time-course study of the effects of 1% CLA on body composition showed reductions in fat pad weights within 2 wk and continued throughout 12 wk of CLA feeding. In conclusion, CLA feeding produces a rapid, marked decrease in fat accumulation, and an increase in protein accumulation, at relatively low doses without any major effects on food intake.

Adipose Tissue↗

Acute effects of mycoprotein on subsequent energy intake and appetite variables.

The effect of mycoprotein, a food produced by continuous fermentation of Fusarium graminearum (Schwabe), on energy intake and appetite was investigated. Female subjects, all classified as nonrestrained eaters, participated in two 3-d study periods. Subjects weighed food consumed on the day before the study, on the day of the meal, and on the following day. Subjects were presented with an isoenergetic meal containing either mycoprotein or chicken and visual analogue scales were completed immediately premeal, postmeal, and at hourly intervals for 3 h. Energy intake was significantly reduced the day of the study (by 24%) and the next day (by 16.5%) after eating mycoprotein compared with chicken. When measured 3 h after consumption, prospective food consumption and desire to eat decreased after mycoprotein compared with chicken. Evidence is increasing that fiber can have an effect on appetite and we have demonstrated that fiber-containing mycoprotein also has this affect.

Adult↗

Physiological, metabolic, and performance implications of a prolonged hill walk: influence of energy intake.

We aimed to examine the effects of different energy intakes on a range of responses that are relevant to the safety of hill walkers. In a balanced design, 16 men completed a strenuous self-paced mountainous hill walk over 21 km, under either a low-energy (2.6 MJ; 616 kcal) intake (LEI) or high-energy (12.7 MJ; 3,019 kcal) intake (HEI) condition. During the hill walk, rectal temperatures were measured continuously, and blood samples for the analysis of metabolites and hormones were drawn before breakfast and immediately after the walk. Subjects also completed a battery of performance tests that included muscular strength, reaction times, flexibility, balance, and kinesthetic differentiation tests. During the LEI, mean blood glucose concentrations leveled off at the low-middle range of normoglycemia, whereas, on the HEI, they were significantly elevated compared with the LEI. The maintained blood glucose concentrations, during the LEI, were probably mediated via the marked fat mobilization, reflected by a two- to fivefold increase in nonesterified fatty acids, 3-hydroxybutyrate, and glycerol concentrations. The LEI group showed significantly slower one- and two-finger reaction time, had an impaired ability to balance, and were compromised in their ability to maintain body temperature, when compared with the HEI group. The modestly impaired performance (particularly with respect to balance) and thermoregulation during the LEI condition may increase susceptibility to both fatigue and injury during the pursuit of recreational activity outdoors.

Adult↗

Energy intake, overweight, physical exercise and colorectal cancer risk.

Epidemiological studies on risk factors for CRC have focused mainly on diet. In any case, the results of these studies show several inconsistencies, except for the beneficial role of high intake of vegetables and, to some lesser extent, of fruit. Weight and height have also been studied, partly because they reflect the balance between energy intake and expenditure in different age periods. Energy intake, body size and physical activity will be reviewed in this paper focusing mostly on recent data coming from Italian, English and Scandinavian studies. Overweight has long been recognized as a risk factor for hormone related and other cancers and this is confirmed not simply from case-control studies but from large cohort studies as well. The major findings of recent Italian studies are that excessive weight at various ages predicts colorectal cancer risk in men while in women, abdominal obesity, as indicated by a high WHR, represents a more reliable risk indicator. If all men could reduce their BMI below 25, about 9% of male colorectal cancer might be avoided in Italy. A decrease of WHR below 0.82 might reduce colorectal cancer in women by 19%. In addition, the epidemiological evidence consistently shows that physical activity reduces the risk of colon cancer. On the contrary, evidence on rectal cancer is less impressive. Some uncertainty still exists in relation to the intensity and duration of physical activity. In conclusion, body size control along all life and physical activity represent important factors to prevent colon cancer and a wide range of chronic conditions. Therefore, strategies to favour these goals through counselling from health-care providers, regulatory changes and programs aimed at individuals and communities should be implemented.

Adult↗

Photoperiodic regulation in energy intake, thermogenesis and body mass in root voles (Microtus oeconomus).

The present study was designed to examine whether photoperiod alone was effective to induce seasonal regulations in physiology in root voles (Microtus oeconomus) from the Qinghai-Tibetan plateau noted for its extreme cold environment. Root voles were randomly assigned into either long photoperiod (LD; 16L:8D) or short photoperiod (SD; 8L:16D) for 4 weeks at constant temperature (20 degrees C). At the end of acclimation, SD voles showed lower body mass and body fat coupled with higher energy intake than LD voles. SD greatly enhanced thermogenic capacities in root voles, as indicated by elevated basal metabolic rate (BMR), nonshivering thermogenesis (NST), mitochondrial protein content and uncoupling protein-1 (UCP1) content in brown adipose tissue (BAT). Although no variations in serum leptin levels were found between SD and LD voles, serum leptin levels were positively correlated with body mass and body fat mass, and negatively correlated with energy intake and UCP1 content in BAT, respectively. To summarize, SD alone is effective in inducing higher thermogenic capacities and energy intake coupled with lower body mass and body fat mass in root voles. Leptin is potentially involved in the photoperiod induced body mass regulation and thermogenesis in root voles.

Adipose Tissue↗

Insufficient fluid and energy intake in hospitalised patients with hip fracture. A prospective randomised study of 80 patients.

AIMS: Evaluate nutritional status and fluid and energy intake during the first ten days of hospitalisation in a selection of otherwise healthy patients with a hip fracture. METHODS: A prospective randomised controlled study of 80 patients. Nutritional status was assessed at inclusion. The energy and fluid intake was recorded and calculated daily whilst hospitalised. All patients were given ordinary hospital food and beverage. In the treatment group (n = 40) patients also received intraveneous supplementary nutrition (1000 kcal/day) for three days followed by oral supplementary nutrition (400 kcal/day) for seven days or until discharge. RESULTS: One third of patients were classified as malnourished in both groups. The average daily fluid intake/patient was 1300 ml in the control group compared to 1856 ml in the treatment group (P<0.0001). The average daily energy intake/patient was 916 kcal in the control group compared to 1296 kcal in the treatment group (P = 0.003). The mean difference between actual and needed daily fluid intake was -739 ml in the control group and +27 ml in the treatment group (P<0.0001). Corresponding numbers for energy intake was -783 kcal/day in the control group and -228 kcal/day in the treatment group (P = 0.0003). CONCLUSIONS: Malnutrition is common even in a selection of healthy patients with hip fractures. During hospital stay the fluid and energy intake was considerably lower than that needed in the control group. Supplementary nutritional intake for ten days increased the total fluid and energy intake in the treatment group to near needed levels.

Aged↗

Energy intake patterns in obese women with binge eating disorder.

OBJECTIVE: For binge eating disorder (BED) to be accepted as a distinct diagnostic category in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition, it must be demonstrated that the criteria identify a diagnostic entity that is distinct from bulimia nervosa and obesity. This study examined the difference in total energy intake per day, patterns of energy intake throughout the day, and nutrient content of foods consumed in obese individuals who met the criteria for BED (on binge and non-binge days) and those who did not. RESEARCH METHODS AND PROCEDURES: Twenty women, 12 who met Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, criteria for BED and 8 matched obese controls, participated in the study. All participants underwent six random 24-hour dietary recall telephone interviews conducted by experienced interviewers using the Nutrition Data Software System. RESULTS: The BED group ingested significantly more kilocalories on days when they had binge eating episodes than the obese control group on average. The BED group ate significantly more in the evening on binge days than their control group counterparts. There is some indication in the data that those with BED may be restricting caloric intake. Finally, data indicated that the BED group ate significantly more protein, carbohydrate, and fat on binge days than on non-binge days. However, the proportion of kilocalories from each nutrient shifted on BED binge days compared with non-binge days to favor consumption of fat over carbohydrates. DISCUSSION: More research needs to be done to determine if these findings are reproducible. Then, the neurobiological underpinnings of these differences in nutrient intake patterns and nutrient selection can be studied to help to determine the biological basis of the disorder.

Adolescent↗

The effect of (-)-hydroxycitrate on energy intake and satiety in overweight humans.

OBJECTIVE: Assessment of the effects of 2 weeks of daily administration of HCA on energy intake and satiety in overweight men and women. DESIGN: A 6-week randomized placebo-controlled single-blinded cross-over trial. SUBJECTS: consumed three times daily for 2 weeks 100 ml tomato juice (placebo) and, separated by a 2 week wash-out period, 100 ml tomato juice with 300 mg HCA.Subjects: Twelve males and 12 females (body mass index 27.5+/-2.0 kg/m(2); age 37+/-10 y). MEASUREMENTS: After 2 weeks, 24 h energy intake (EI), appetite profile, hedonics, mood and possible change in dietary restraint were assessed in the laboratory restaurant. Prevention of degradation and bio-availability was documented. RESULTS: Twenty-four-hour EI was decreased by 15-30% (P<0.05) with HCA treatment compared to placebo, without changes in the appetite profile, dietary restraint, mood, taste perception and hedonics, while body weight tended to decrease (P=0.1). CONCLUSION: HCA treatment reduced 24 h EI in humans while satiety was sustained.

Adult↗

Longitudinal changes in the accuracy of reported energy intake in girls 10-15 y of age.

BACKGROUND: Dietary records are often used to estimate individual energy needs and population energy requirements. However, significant underreporting of total energy intake (EI) has been found when EI is compared with total energy expenditure (EE) measured by doubly labeled water. OBJECTIVE: This study aimed to determine whether the accuracy of reported EI decreases from middle childhood to adolescence. DESIGN: In this longitudinal study of 26 healthy girls, EI and EE were measured at ages 10, 12, and 15 y. Accuracy of reported EI (EI/EE x 100%) was calculated at each age. At study entry, girls had a mean (+/- SD) body mass index (in kg/m(2)) of 16.8 +/- 1.9 and percentage body fat of 24.0 +/- 4.6%. Measurements of EI were a 7-d dietary record and those of EE were by doubly labeled water. RESULTS: As they got older, girls tended to report EI less accurately: the average accuracy was 88 +/- 13% at age 10 y, 77 +/- 21% at age 12 y, and 68 +/- 17% at age 15 y. The declines in reporting accuracy from age 10 y to age 12 y and from age 10 y to age 15 y were statistically significant (P = 0.03 and P = 0.001, respectively). Reporting accuracy also declined from age 12 to age 15 y but not significantly. When percentage body fat was added to the model, results were essentially unchanged. CONCLUSION: Because of the decline in EI reporting accuracy with age, the use of EI data obtained from dietary records in adolescent girls will result in substantial underestimation of energy needs.

Adolescent↗

Energy intakes of children after preloads: adjustment, not compensation.

BACKGROUND: Young children accurately compensate for energy-dense preloads consumed before test meals. The accuracy of compensation seems to deteriorate as a function of age. OBJECTIVE: The hypothesis that accurate energy compensation varies by age, body mass index, and individual characteristics of children and their mothers was tested. DESIGN: Energy intake (EI) from a test meal was measured in 74 children aged 6-9 y 90 min after the ingestion of no-energy (NE), low-energy (LE), or high-energy (HE) preload snacks. The NE preload consisted of 250 mL water, the LE preload consisted of a 56-g muffin + a 250-mL orange drink (783 kJ), and the HE preload consisted of a 56-g muffin + a 250-mL orange drink (1628 kJ). RESULTS: A significant dose-related reduction in EI was found after the preloads; younger children adjusted more effectively than did older children, although total EI (including preload energy) indicated that the adjustment was not accurate. The compensation index (COMPX) differed by preload and age group; COMPX scores were higher between the NE and LE preloads (younger children: 44.4 +/- 9.3%; older children: 57.0 +/- 11.6%) than between the NE and HE preloads (39.6 +/- 4.9%; 31.3 +/- 6.2%) and the LE and HE preloads (35.2 +/- 7.8%; 7.4 +/- 9.8%). This finding indicates a more consistent response across preloads and a greater sensitivity to energy load by younger than by older children. High interindividual variation and low intraindividual variation in COMPX was found. The tendency to over- or undereat in response to the preloads (deviation from perfect) correlated directly and positively with maternal concerns about child overweight, not with actual BMI. CONCLUSIONS: The children adjusted their EIs in response to different preloads, and the younger children did so more effectively than did the older children. Poor short-term energy compensation may constitute a behavioral marker for positive energy balance.

Age Factors↗

Energy density, diet composition and palatability: influences on overall food energy intake in humans.

This paper considers the role of energy density (ED), diet composition and palatability in the control of energy intake (EI) in humans through several related considerations: (i) the relationship between ED and diet composition, (ii) the relationship between ED, diet composition and EI, (iii) the relationship between palatability and EI, (iv) the relationship between ED, palatability and EI, (v) the importance of postingestive factors in influencing palatability in the longer term, (vi) the contribution of sensory and nutritional factors to dietary hyperphagia and (vii) the implications these considerations have for people living their normal lives in their natural environment. The main factors influencing ED are the fat and water content of foods. Energy density does elevate EI, especially in short-term studies where it can account for >40% of the variance in EI. In real life, ED accounts for only approximately 7% of the variance in EI. This is because the determinants of EI are multifactorial and also because the short-term effects of ED on EI do not translate into the longer term. We argue that part of the longer term amelioration of short-term effects of ED on EI is due to learned compensation, based on the postingestive consequences of consuming familiar food that differ in ED. More energy-dense foods tend to be more palatable but we learn to consume them in smaller portion sizes. In the longer term, the perceived palatability of a food is strongly influenced by the postingestive consequences of eating it. This effect can override sensory factors alone. This implies that nutrient mimetics, if used continuously, would not be as efficacious as initially supposed and that their ad hoc use may undermine the stability of learned appetites and satieties for foods with different EDs and contribute to the poor weight control capability exhibited by consumers at large.

Diet↗

Validation of energy intake measurements determined from observer-recorded food records and recall methods compared with the doubly labeled water method in overweight and obese individuals.

BACKGROUND: Measurements of dietary intake in obese and overweight populations are often inaccurate because food intakes are underestimated. OBJECTIVE: The purpose of this study was to evaluate the validity of the combined use of observer-recorded weighed-food records and 24-h snack recalls in estimating energy intakes in overweight and obese individuals. DESIGN: Subjects were 32 healthy women and 22 healthy men with mean body mass indexes (in kg/m(2)) of 29.5 and 30.3, respectively. Energy intake (EI) was measured over 2 wk in a university cafeteria. No restrictions were made on meal frequency or EI. To document food consumed outside the cafeteria, 24-h snack recalls were conducted before meals. Energy expenditure (EE) was measured with the doubly labeled water (DLW) method (EE(DLW)). Energy balance was determined by measuring body weight at the beginning and end of the 2-wk period. RESULTS: The mean EI in the women (10.40 +/- 1.94 MJ/d) and men (14.37 +/- 3.21 MJ/d) was not significantly lower than the EE(DLW) in the women (10.86 +/- 1.76 MJ/d) and men (14.14 +/- 2.83 MJ/d). The mean EI represented 96.9 +/- 17.0% and 103 +/- 18.9% of the measured EE for women and men, respectively. There were no significant changes in weight in the group as a whole or by sex at the end of the testing period; the men lost 0.23 +/- 1.58 kg and the women lost 0.25 +/- 1.09 kg. CONCLUSION: The combination of observer-recorded food records and 24-h snack recalls is a valid method for measuring EI in overweight and obese individuals.

Adult↗

Estimated energy intake, macronutrient intake and meal pattern of Flemish adolescents.

OBJECTIVE: To describe the energy and macronutrient intake and the meal patterns of Flemish adolescents, aged 13-18 y. METHODS: A 7 day estimated food record was administered to the whole sample. SETTING: Secondary schools in the city of Ghent, Belgium. SUBJECTS: A total of 341 adolescents (13-18 y) selected by a multistage clustered sampling (participation: 72.7%). MAIN RESULTS: A significant increase with age was observed in total energy intake in adolescent boys (P<0.01), but not in girls. The energy distribution over the macronutrients showed no significant difference between boys and girls. On average, 35.7% (s.d. 4.81%) of energy came from total fat and 15.4% (s.d. 2.46%) from saturated fatty acids; 49.0% (s.d. 5.28%) from total carbohydrates with 25.1% (s.d. 4.49%) from complex carbohydrates and 23.9% (s.d. 5.86%) from free sugars. The energy contribution of alcohol in the 16-18 y-old-group was significantly higher as compared with the 13-15 y-old-group, for both boys and girls. Snacks between meals accounted for almost 20% of the total energy intake. Lunch and dinner were characterized by high total fat content. CONCLUSION: These students consumed a diet high in total fat and in saturated fatty acids and also high in mono- and disaccharides. Observed mean intakes deviate considerably from the Belgian dietary guidelines. A low energy intake at breakfast was observed, while a higher proportion of energy was derived from snacks.

Adolescent↗

Increased leptin expression in the dorsal vagal complex suppresses adiposity without affecting energy intake and metabolic hormones.

OBJECTIVE: Increased leptin transgene expression locally in hypothalamic sites suppresses weight and energy intake, enhances thermogenic energy expenditure, and differentially modulates metabolic hormones for an extended period. We evaluated whether a similar localized expression of leptin transgene in the dorsal vagal complex (DVC) in the caudal brain stem that also displays the biologically relevant leptin receptor would reproduce these varied responses and thus demonstrate functional connectivity between the hypothalamus and DVC. RESEARCH METHODS AND PROCEDURES: Adult female rats were microinjected with a recombinant adeno-associated virus encoding either rat leptin or green fluorescent protein gene (control) in the DVC. Food intake and body weight were monitored weekly, and metabolic variables were analyzed at the end of 10 weeks. RESULTS AND DISCUSSION: Increased leptin transgene expression in the DVC suppressed the time-related increase in body weight accompanied by a transient decrease in food intake at week 1 post-injection and little effect on thermogenic energy expenditure. That suppression of weight was due to decreased adiposity is shown by the markedly suppressed white adipose tissue-derived hormones, leptin and adiponectin. Circulating concentrations of pancreatic insulin, gastric ghrelin, and glucose levels were unchanged. This segregation of the varied effects of leptin expression in hypothalamic sites vs. DVC endorses the view that among the various endocrine organs under sympathetic nervous system control, only those leptin-activated neural circuits in the hypothalamus that suppress weight and adiposity on a long-term basis transverse through DVC en route to white adipose tissue.

Adiponectin↗

Effects of varying protein and energy intakes on growth and metabolic response in low birth weight infants.

Growth (weight, length, head circumference, and skinfold thickness), retention of major nutrients (nitrogen, sodium, potassium, chloride, calcium, and phosphorus), and chemical indices of protein adequacy (plasma albumin and transthyretin concentrations) and excess (blood urea nitrogen concentration and acid-base status; plasma amino acid concentrations) were determined serially from the time desired intake was tolerated until discharge weight (2200 gm) was reached in low birth weight infants (birth weight 900 to 1750 gm) fed one of three formulas, which provided protein and energy intakes, respectively, of 2.24 gm/kg/day and 115 kcal/kg/day (group 1), 3.6 gm/kg/day and 115 kcal/kg/day (group 2), and 3.5 gm/kg/day and 149 kcal/kg/day (group 3). Weight gain and rate of increase in length and head circumference were less in group 1 than in groups 2 and 3. Retention of most major nutrients also was less in group 1, as was blood urea nitrogen concentration, plasma albumin and transthyretin concentrations, and plasma concentrations of several amino acids. The rate of weight gain was not significantly greater in group 3 than in group 2, but the rate of increase in skinfold thickness was greater in this group. Neither nutrient retention nor metabolic indices differed between groups 2 and 3. These results suggest that a protein intake of 2.24 gm/kg/day is inadequate for the type of LBW infants studied, that the higher protein intakes are well tolerated, and that an energy intake of 149 vs 115 kcal/kg/day does not enhance utilization of the higher protein intakes studied.

Acid-Base Equilibrium↗

Energy intake and gross efficiency comparisons from calorimetric and field data on the same lactating cows.

Field estimates on gross efficiency were obtained from intake and production data on 30 pluriparous Holsteins cows during wk 5, 7, 9, 11, 13, and 15 postpartum. Energy intake and efficiency from the energy chamber on the same cows were measured during wk 6, 10, and 14 postpartum. Measures of gross efficiency were expressed in terms of the utilization of metabolizable energy or net energy for lactation and maintenance. Within corresponding postpartum periods, chamber measures and field estimates were compared by canonical correlation analysis. All estimates from field data of energy and gross efficiencies closely approximated measures of the same traits from energy chamber data. Variation among cows in traits of energy partition and gross efficiency was similar for field estimates and energy chamber measures. Correlations were > .66 between field estimates and chamber measures on observations of maintenance energy and milk energy. Field estimates and chamber measurements of metabolizable energy and net energy had correlations of .76 and .70, respectively.

Animal Nutritional Physiological Phenomena↗