SEARCH · PubMed Health

Results for “Energy Intake”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,387 records · Page 77Linked to original sources

PubMed2003

[Nutrition and health--obesity].

About 12% of the adult Dutch population is obese (Quetelet Index > or = 30 kg/m2). The prevalence has roughly doubled over the past 20 years. Obesity is strongly associated with a number of chronic diseases, such as type 2 diabetes mellitus, increased healthcare costs and a loss of productivity. Obesity is always the result of a mismatch between energy intake and energy expenditure. Foods with a high percentage of energy derived from fat are associated with weight gain, particularly when the rest of the energy is obtained from products containing little dietary fibre. Foods with a high content of refined added sugars or starch might be unfavourable with respect to the energy balance and the risk for type 2 diabetes mellitus and cardiovascular diseases. Slimming diets should aim for a gradual and sustained weight loss of about 10% of the initial weight over a period of six months, followed by weight maintenance over the next two years. Physical activity is an essential component of a weight loss strategy. Moderate sustained weight loss is associated with a strong reduction in the risk of type 2 diabetes mellitus in people with impaired glucose tolerance.

Adult↗

PubMedDate not supplied

Dietary habits and eating related symptoms in out-patients following total gastrectomy and Roux-en-Y reconstruction for carcinoma of the stomach.

Dietary habits and eating related symptoms were studied by one week recording method in thirteen successive out-patients attending the routine control following total gastrectomy and Roux-en-Y reconstruction for carcinoma of the stomach. All the patients except one had daily eating related symptoms such as difficulties in swallowing or/and rapid filling of the stomach, or/and discomfort, meteorism and pain, or/and nausea, faintness, sweating and rapid pulse. The number of daily meals was high (eight to fifteen) and the amounts of food eaten small, consisting of one sandwich, or one fruit, or one glass of milk, especially in those patients with most symptoms and most frequent meals. The daily intake of energy (7.4 +/- 2.0 and 6.8 +/- 1.5 MJ in the males and females, respectively) and nutrients was low, and there were no differences between the daily energy intakes by the patients with eight or fifteen daily meals. Thus, it is concluded that in the out-patients following total gastrectomy and Roux-en-Y reconstruction for carcinoma of the stomach, the symptoms related to eating are common and frequent, what causes the high number of daily meals and decreases the quality of life of the patients. The meals of the patients are simple and the patients are prone to a reduced nutritional state due to the low intake of energy and nutrients.

Aged↗

PubMed1995

Pharmacological aspects of obesity treatment: towards the 21st century.

Obesity: a bio-behavioural-environmental phenomenon: Obesity is on the increase all over the world in technologically advanced countries, developing countries and rural communities. What is causing this upward drift in body weight? Can drugs do anything to ameliorate the situation? It is generally agreed that obesity results from genetic vulnerability combined with a provocative environmental situation. This provides the basis for a psychobiological interaction in which behaviour plays a key role. This is the case since it is behaviour which translates biological propensities into action on the environment, and it is behaviour which mediates (in part) the effect of the environment upon biology. Two particularly important behavioural aspects of the genes-environment interaction are low levels of physical activity (high sedentariness) and dietary habits which favour overconsumption (high intake of energy, particularly as fat). One continuing theme of research is the development of drugs to allow people to gain control over appetite by modifying eating patterns (dietary habits) through a number of possible mechanisms. The use of drugs to make people more willing or more able to engage in physical activity is not widely discussed although the use of drugs to increase total energy expenditure (via a variety of mechanisms) is actively researched. More than a decade ago Sullivan defined the framework for the development of anti-obesity drugs by specifying that drugs could act on energy intake, energy output or on those mechanisms involved in the assimilation and storage of lipids in the body.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Weight↗

PubMed1988

Response surface analyses of the effects of dietary protein on feeding and growth patterns in mice from weaning to maturity.

Responses of food intake, protein intake, gross energy intake and body weight of mice from weaning to maturity to dietary protein level were studied. Thirteen groups of ddY male mice were fed purified diets covering the entire range (0-100%) of protein concentration on a gross energy basis for 68 d. The food intake and body weight data in each group were analyzed by nonlinear regression to obtain values of the six parameters in Parks' feeding and growth equations. These parameters, found as a function of the protein content of diet, were then used to construct the response surfaces of food intake and body weight over the dietary protein versus age space. At every protein level the daily energy intake rose rapidly with age to a plateau at about 7-14 d after weaning and was maintained throughout the experiment. Daily energy intake was independent of the dietary protein content except at very low dietary protein contents. Consequently, from 21 to 89 d of age daily protein intake was directly proportional to dietary protein level. These results imply that mice ate for energy rather than protein when fed diets varying in protein content in the range of 10-80%. Body weight as a function of time after weaning increased to a plateau at every dietary protein level, but the details of the pattern of growth were affected by the dietary protein level. Further, the response surface of body weight versus dietary protein level and age was analyzed to find the protein requirement of mice for maximal growth during a given interval from weaning.

Aging↗

PubMed1987

Effects of a moderate dietary fibre supplement on hunger rating, energy input and faecal energy output in young, healthy volunteers. A randomized, double-blind, cross-over trial.

The effects of moderate dietary-fibre supplementation on satiety, energy intake and faecal energy excretion were studied in 20 young healthy volunteers of normal body weight, mean body mass index 20.9, receiving a dietary fibre supplement of 7.3 g per day in a randomized, double-blind, cross-over study. Hunger feeling, energy intake, and defaecation pattern, were recorded daily during a 2-week control period and then, during two 4-week treatment periods. Furthermore, faecal energy output was determined during the last week of each treatment period. The fibre treatment, as compared to placebo, resulted in a significantly higher faecal energy excretion: 173 kcal/d (163-183 kcal/d) vs 153 kcal/d (135-171 kcal/d), respectively (P less than 0.05); a decrease in hunger rating (using a visual analogue scale) (P less than 0.05); an increase in number of bowel movements (P less than 0.05), and a softer consistency of the stools (P less than 0.05). There was no significant difference in mean energy intake between the two treatment periods. This study demonstrated that moderate dietary fibre supplementation in normal man increases faecal energy excretion with simultaneously decreased hunger feeling. These beneficial effects may have therapeutic value in the management of obesity.

Adult↗

PubMed1995

Alterations of energy and substrate metabolism in rats with large and sustained changes in daily food intake.

Energy expenditure was measured in one-way crossed-intestine rats by use of indirect calorimetry to examine the role of energy metabolism in body weight control. The intestinal surgery was done according to Koopmans (Brain Res. Bull. 14: 595-603, 1985). The food-losing rats increased daily food intake from 70.8 to 126.3 g/day, whereas their partners decreased intake from 67.1 to 38.7 g/day (P < 0.001). Compared with levels before surgery, the food-losing rats showed slightly increased O2 consumption (1.31 vs. 1.28 1.h-1.kg-1) and metabolic rate (6.62 vs. 6.39 kcal.h-1.kg-1) and largely increased CO2 production (1.31 vs. 1.22 l.h-1.kg-1, P < 0.01), whereas in their food-gaining partners O2 consumption (1.12 vs. 1.25 l.h-1.kg-1, P < 0.01) and metabolic rate (5.76 vs. 6.26 kcal.h-1.kg-1) were significantly decreased. Respiratory quotients were higher in the food-gaining rats than in their partners (1.076 vs. 0.999, P < 0.01), indicating more fatty acid synthesis. These results suggest that daily food intake and energy expenditure increase and decrease together, despite the fact that about the same amount of food has been absorbed from the intestines of each rat.

Animals↗

PubMed1996

Dietary intakes of energy and water-soluble vitamins in different categories of aging.

The dietary intakes of energy and the vitamins thiamin, riboflavin, B6, and C were assessed in four groups of elderly people, using the same modified dietary history method. The groups consisted of female nursing home residents (n = 40), people at admission to a nursing home (n = 21), free-living elderly people with a sedentary life style (n = 120), and physically active free-living elderly people (n = 66). Mean energy intake varied from 6.5 +/- 1.2 Megajoule (MJ)/day (nursing home residents) to 8.8 +/- 2.2 MJ/day (physically very active persons) in females and from 8.8 +/- 2.5 MJ/day (admission to nursing home) to 10.1 +/- 2.3 MJ/day (physically very active persons) in males. Dietary intakes of the selected vitamins were below the minimum requirements in almost half of the nursing home residents. However, the relative contribution of the various food groups to the dietary intake of these vitamins was similar in the four groups of elderly people. Stimulation of physical activity to increase energy requirements and use of foods with a high nutrient density may result in an improvement of dietary adequacy.

Aged↗

PubMed1997

Nutritional status of children with acute lymphoblastic leukemia: a longitudinal study.

To evaluate the nutritional consequences of acute lymphoblastic leukemia and its treatment, 15 children with leukemia were studied. Anthropometric data, fat-free mass by impedance, energy intake, and resting energy expenditure (REE) were determined at diagnosis and on days 22, 36, and 71 of the treatment. Interleukin (IL)-1 beta, IL-6, interferon-gamma, and tumor necrosis factor were also measured. Fifteen healthy control subjects were matched for age and sex. Body weight and height and body composition were comparable at all times of the study, although three children were underweight at diagnosis (weight-for-height < 85% of French standards). Although two different methods were used for dietary recall in the two groups, energy intake expressed as a percentage of normal recommended values for age and sex was lower in patients than in control subjects (104 +/- 19%) on day 1 (47 +/- 32.1%) and day 22 (58 +/- 24%), but was comparable on day 36 (85 +/- 71%) and day 71 (85 +/- 48%). This low energy intake involved both carbohydrates and fats. Energy and carbohydrate intakes improved significantly during the study in patients. The nonprotein respiratory quotient (RQ) in patients was significantly lower than in control subjects (0.84 +/- 0.04) on day 1 (0.79 +/- 0.02) but was comparable on day 71. The REE of the patients on day 1 (5057.8 +/- 1588.4 kJ/24 h) and day 71 (4844.7 +/- 116.1 kJ/24 h) and of the control subjects (4313.8 +/- 823.5 kJ/24 h) was not significantly different. Cytokines remained undetectable on days 1, 36, and 71. The results showed that at the time of diagnosis and during this period of chemotherapy there was no evidence of raised REE. The poor intakes during the first month of chemotherapy were recent as shown by the parents' questionnaire responses and the absence of consequences in body composition. The transient decrease in RQ seemed to be an adaptative mechanism to the poor carbohydrate intake. No indication of undernutrition in the patients as a group was evident during the first 71 d of treatment although further long-term nutritional assessment is needed.

Anthropometry↗

PubMed2004

The electrophysiology of feeding circuits.

Obesity is quickly becoming one of the most common and debilitating disorders of the developed world. More than 60% of American adults are now overweight or obese, predisposing them to a host of chronic diseases. To understand the etiology of obesity, and to discover new therapies for obesity, we must understand the components of energy balance. In simple terms, energy intake (feeding) must equal energy expenditure (physical activity, basal metabolism and adaptive thermogenesis) for body weight homeostasis. To maintain homeostasis, neurocircuitry must sense both immediate nutritional status and the amount of energy stored in adipose tissue, and must be able to provide appropriate output to balance energy intake and energy expenditure. The brain receives various signals that carry information about nutritional and metabolic status including neuropeptide PYY(3-36), ghrelin, cholecystokinin, leptin, glucose and insulin. Circulating satiety signals access the brain either by "leakage" across circumventricular organs or transport across the blood-brain barrier. Signals can also activate sensory vagal terminals that innervate the whole gastrointestinal tract.

Brain↗

PubMedDate not supplied

Increased resting energy expenditure in patients with end-stage renal disease.

BACKGROUND: Protein-calorie malnutrition is a significant problem for patients with end-stage renal disease. Increased resting energy expenditure may be an important contributing factor. We postulate that resting energy expen diture in the different stages of renal disease and treatments may be different. METHODS: Resting energy expenditure was measured using a whole-room indirect calorimeter (metabolic chamber) along with nutritional parameters and body composition after 12-hour fasting in 15 patients with advanced chronic renal failure patients, 15 patients on chronic hemodialysis, and 10 patients on peritoneal dialysis. Patients on hemodialysis were assessed on a non-dialysis day. A 2-day dietary recall was used to assess energy intake. RESULTS: Resting energy expenditure, adjusted for fat-free mass, was similar in patients on hemodialysis and peritoneal dialysis but significantly higher than in patients with chronic renal failure (p < .05). Resting energy expenditure in all patients were generally higher (10% to 20%) than predicted values using standard equations derived in normal and obese populations, whereas daily energy intake was less (26% to 34%) than energy expenditure for all groups, adjusted for light daily activity. CONCLUSIONS: End-stage renal disease patients displayed increases in resting energy expenditure over the predicted values derived using normal populations. Resting energy expenditure was significantly higher in patients receiving dialysis, regardless of the modality, than patients with chronic renal failure. Daily energy intake was substantially less than required in all patient groups studied, suggesting that patients with renal failure could develop protein-calorie malnutrition because of increased resting energy expenditure, which is exacerbated by dialysis.

Blood Proteins↗

PubMed1996

Effects of energy imbalance on energy expenditure and respiratory quotient in young and older men: a summary of data from two metabolic studies.

The roles of energy expenditure and substrate oxidation in energy regulation, and the effects of factors such as aging on these parameters, remain uncertain. A re-analysis of data from two studies involving overfeeding or underfeeding in young men (22.7 +/- 0.6 [SEM] years) and older men (68.0 +/- 1.50 years) was conducted to further evaluate the adaptive capacity of energy expenditure and respiratory quotient to an increase or a decrease in energy intake. Changes in total energy expenditure (TEE) and resting energy expenditure (REE) and respiratory quotient (RQ) in response to energy imbalance were compared between subjects undergoing overfeeding by 4.1 MJ/day for 21 days, or underfeeding by 3.2 MJ/day for 21 days. Comparing responses to overfeeding or underfeeding, there was a significant TEE response to energy imbalance averaging 1.39 MJ/day and equivalent to 19% of the alteration in energy intake (p < 0.05). There was also a significant REE response to energy imbalance averaging 0.45 MJ/day (p < 0.001), and a significant RQ response in both fasting and fed states (p < 0.01). There was no significant difference between young and older men in their TEE, energy deposition or RQ responses to energy imbalance, but older men did have significantly diminished REE response to energy imbalance (p < 0.05) and a significantly delayed thermic response to a standard meal (p < 0.05). These data indicate that energy expenditure plays a significant role in attenuating the effects of alterations in energy intake on body energy stores and that, based on some measures of energy expenditure, aging is associated with a reduction in the adaptive capacity of energy expenditure to participate in energy regulation.

Adult↗

PubMed2004

Dose-dependent effects of alcohol on appetite and food intake.

To examine the potential dose-response effect of alcohol on appetite and food intake, 12 males attended the laboratory on three occasions. On each occasion, they were given a standard breakfast, then lunch 3 h later, and dinner, 4 h after that. Thirty minutes before lunch, Ss received 330 ml of no-alcohol lager (263 kJ: no-alcohol condition), the same amount of lager spiked with 1 unit (1 UA: 8 g ethyl alcohol, 498.2 kJ) or 4 units of alcohol (4 UA: 32 g ethyl alcohol, 1203.8 kJ). Visual analogue scale (VAS) ratings of appetite and mood were recorded before and after preloads and lunch, then hourly across the day. Intake at lunch (excluding energy from the preload) was significantly higher following 4 UA (5786+/-991 kJ) compared to 1 UA (4928+/-1245 kJ). Participants consumed more high-fat salty food items at lunch following 4 UA compared to the other preloads. Hunger was rated higher following 4 UA across the day in comparison to the other preloads, but fullness ratings failed to reflect any difference by condition. Energy intake at dinner was similar in all conditions and total energy intake across the day was significantly higher after 4 UA (14,615+/-1540 kJ) than after 1 UA (13,204+/-2156 kJ). In conclusion, above a certain threshold, alcohol appears to stimulate appetite in part, due to elevated levels of subjective hunger. When this occurs, energy intake is not reduced at subsequent meals. Thus, alcohol may contribute to positive energy balance via its additive effects to total energy intake and by short-term appetite stimulation.

Adolescent↗

PubMed2004

Hyperphagia contributes to the normal body composition and protein-energy balance in HIV-infected asymptomatic men.

Wasting can occur at an early stage of HIV infection. Both reduced energy intake and increased resting energy expenditure (REE) have been considered as factors in wasting with predominant lean body mass loss, suggesting disturbances of protein metabolism. Our aim was to study protein-energy metabolism in relation to body composition and oral energy intake in asymptomatic patients with HIV infection but receiving no active antiretroviral therapy. Stable-weight asymptomatic male patients (n = 8) at stage A of HIV infection with a detectable viral load were compared with 9 healthy control men. Protein metabolism was studied in the postabsorptive state using a primed constant infusion of l-[1-(13)C]leucine and l-[2-(15)N]glutamine. REE was studied by indirect calorimetry, body composition by bioelectrical impedance, and energy intake by dietary records. BMI and lean body mass did not differ between patients and controls. In HIV-infected subjects, energy intake, protein breakdown, protein synthesis, and REE were 57% (P < 0.05), 18% (P < 0.05), 22% (P < 0.05) and 14% (P < 0.05) greater than in controls, respectively. REE and protein breakdown were correlated (r = 0.73, P < 0.05). The hormonal profile was normal in HIV-infected subjects with the exception of low urinary C-peptide and plasma reverse triiodothyronine. Plasma interleukin-6 and tumor necrosis factor-alpha were greater than in controls, but energy intake was 1.53 times the REE in the HIV-infected men. Thus, at the asymptomatic stage of HIV infection, increased protein turnover contributes to the increase in the REE. Moderate hyperphagia, which occurred despite increased levels of cytokines, in conjunction with increased protein synthesis maintains a normal body composition, without significant loss of lean body mass.

Adult↗

PubMed2006

How much might achievement of diabetes prevention behaviour goals reduce the incidence of diabetes if implemented at the population level?

AIMS/HYPOTHESIS: Randomised trials targeting high-risk people with impaired glucose tolerance have halved progression to diabetes using behavioural interventions aimed at achieving five goals related to weight, diet and physical activity. The number of people currently meeting these goals in the general population is unknown. The potential impact on the incidence of diabetes of increasing the proportion of people who meet these goals is also unclear. We quantified the association between the achievement of behavioural goals for the prevention of diabetes and the incidence of diabetes in a population-based cohort study. SUBJECTS AND METHODS: European Prospective Investigation into Cancer (EPIC)-Norfolk is a prospective cohort of 24,155 participants aged 40-79 years who attended a baseline health check and completed validated diet and activity questionnaires. We assessed the association between achievement of five diabetes healthy behaviour prevention goals (BMI <25 kg/m(2), fat intake <30% of energy intake, saturated fat intake <10% of energy intake, fibre intake > or =15 g/4,184 kJ, physical activity >4 h/week) and risk of developing diabetes at follow-up (mean 4.6 years). RESULTS: Only 20% of EPIC participants met three or more diabetes prevention goals. Diabetes incidence was inversely related to the number of goals achieved (p<0.001). None of the participants who met all five goals developed diabetes, whereas diabetes incidence was highest in those who did not meet any goals. If the entire population were able to meet one more goal, the total incidence of diabetes would be predicted to fall by 20%. CONCLUSIONS/INTERPRETATION: In this population-based study, the risk of diabetes was inversely associated with the number of behaviour goals for diabetes prevention that were met. Interventions that promote achievement of these goals in the general population could significantly reduce the growing burden of diabetes-related morbidity and mortality.

Adult↗

PubMed1984

Diet, smoking, social class, and body mass index in the Caerphilly Heart Disease Study.

Associations between smoking habit, social class, body mass index, and diet were examined in 493 men aged 45 to 59 yr, selected from the general population and who had completed a 7-day weighed dietary record. Smokers were lighter than nonsmokers and had a lower body mass index. There was no difference in energy intake, but in general, smokers had lower intakes of vitamins, minerals, and dietary fiber. Exsmokers had similar intakes to nonsmokers. Manual workers tended to be shorter, had a higher body mass index, higher intakes of energy and carbohydrates, and lower intakes of vitamins and minerals than nonmanual workers. Social class had a greater effect than smoking habit on intakes of energy and carbohydrates, whereas smoking habit had the greater effect on intakes of minerals and vitamins. Body mass index was associated negatively with sucrose intake and positively with protein intake, smoking habit, and social class being less important determinants.

Alcohol Drinking↗

PubMed2000

Plasma leptin in female athletes: relationship with body fat, reproductive, nutritional, and endocrine factors.

The relationship of leptin to thyroid and sex hormones, insulin, energy intake, exercise energy expenditure, and reproductive function was assessed in 39 female athletes. They comprised elite athletes who were either amenorrheic (EAA; n = 5) or cyclic (ECA; n = 8) and recreationally active women who were either cyclic (RCA; n = 13) or taking oral contraceptives (ROC; n = 13). Leptin was significantly lower in EAA (1.7 +/- 0.2 ng/ml) than in ECA (2.9 +/- 0.3 ng/ml), RCA (5.8 +/- 0.9 ng/ml), and ROC (7.4 +/- 1.3 ng/ml). Hypoleptinemia in EAA was paralleled by reductions (P < 0.05) in caloric intake, insulin, estradiol, and thyroid hormones. Leptin increased by 40-46% (P < 0.05) in the luteal phase of the menstrual cycle in RCA and ECA. Plasma leptin was similar in the placebo and active pill phases in ROC despite a significant increase in ethinylestradiol. Leptin correlated (P < 0.05) with triiodothyronine and insulin but not with estrogen, energy intake, or exercise energy expenditure. These data suggest that in female athletes 1) leptin may be a metabolic signal that provides a link between adipose tissue, energy availability, and the reproductive axis and 2) sex hormones do not directly regulate leptin secretion.

Adipose Tissue↗

PubMed1996

Energy balance in asymptomatic HIV infection.

OBJECTIVES: Body weight is regulated by the balance between energy intake and energy expenditure, but the influence of HIV infection on energy balance has not been fully examined. The main objectives of this study were (1) to assess the effect of HIV on energy balance, (2) to examine the relationship of parameters of immunodeficiency to energy balance, and (3) to examine the interrelationship of different components of energy balance in asymptomatic HIV-seropositive men. DESIGN: A cross-sectional study of nutrition and metabolism in asymptomatic HIV-seropositive men METHODS: Components of energy balance were examined in 104 asymptomatic HIV-seropositive men (CD4 count 4-482 x 10(6)/l) and 57 age-matched HIV-seronegative male controls. Energy and protein intake were measured using 5-day diaries, and small bowel absorption and permeability was assessed using four sugar probes. Resting energy expenditure was calculated from indirect calorimetry and nitrogen loss estimated from 24 h urine collection. Four methods were used to assess the effect of HIV infection on body composition (anthropometry, dual energy X-ray absorptiometry, bioelectrical impedance and 24 h urine creatinine). RESULTS: Resting energy expenditure per kilogram of fat-free mass was raised (P < 0.0001), fat mass was decreased (P = 0.001), fat-free mass was increased (P = 0.05), energy intake was higher (P = 0.05), absorption of L-rhamnose (P = 0.01) and 3-O-methyl-D-glucose was decreased (P = 0.003), and small bowel permeability was increased (P < 0.0001) in HIV-seropositive men compared with HIV-seronegative controls. HIV-seropositive subjects with a CD4 count less than 100 x 10(6)/l had decreased absorption of L-rhamnose (P < 0.05), D-xylose (P < 0.05) and 3-O-methyl-D glucose (P < 0.05) compared with HIV-seropositive subjects at higher CD4 counts, and had a similar resting energy expenditure to HIV-seronegative controls. Protein intake, carbohydrate, fat and protein oxidation. 24 h nitrogen excretion and appendicular muscle mass were similar in HIV-seropositive men and controls. CONCLUSION: HIV infection exerts a direct effect on parameters of energy balance that varies with the severity of immunosuppression.

Adult↗

PubMedDate not supplied

Reduction in energy expenditure after liver transplantation.

After successful liver transplantation (LTx), excessive weight gain is common among recipients. This rapid change in body morphology has been attributed to immunosuppressive regimens. The liver's role as a metabolic sensor and its autonomic innervation are pivotal in relaying humoral and neural information to the hypothalamus, where ingestive behavior is determined and has largely been ignored. We examined and assessed the contribution of drugs, energy intake, and energy expenditure on weight gain after LTx. Twenty-three patients were followed up at 3-mo intervals after LTx. Energy expenditure was measured by indirect calorimetry and dietary intake by diet diaries, and body composition was assessed with anthropometry and multifrequency bioelectrical impedance analysis. Cumulative drug doses were calculated, and associations between body composition and immunosuppressive regimens and energy expenditure were examined. Nine months after LTx, 20 of 23 (87%) recipients were overweight or obese, despite three-fourths of this cohort being on weight-reduction regimens. After LTx, a decrease in measured energy expenditure was observed (60.3 +/- 1.6 kJ/kg of body cell mass pre-LTx versus 53.7 +/- 2.2 kJ/kg of body cell mass after 9 mo; P < 0.05). Multiple stepwise regression analysis showed that, when adjusted for body weight, the strongest predictor of fat mass at 9 mo after LTx was resting energy expenditure. Weight gain after LTx is not predicted by immunosuppressive drug dosage. The strong association between weight gain and energy economy might be a consequence of the loss of hepatic metabolic integration and accelerated further by increased energy intake. Effective management of weight gain will not be achieved until the mechanisms involved in altered energy homeostasis are elucidated.

Basal Metabolism↗