• Journal of Obesity & Metabolic Syndrome
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• v.27 no.4
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• pp.203-212
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• 2018

Dynamic energy balance can give clinicians important answers for why obesity is so resistant to control. When food intake is reduced for weight control, all components of energy expenditure change, including metabolic rate at rest (resting energy expenditure [REE]), metabolic rate of exercise, and adaptive thermogenesis. This means that a change in energy intake influences energy expenditure in a dynamic way. Mechanisms associated with reduction of total energy expenditure following weight loss are likely to be related to decreased body mass and enhanced metabolic efficiency. Reducing calorie intake results in a decrease in body weight, initially with a marked reduction in fat free mass and a decrease in REE, and this change is maintained for several years in a reduced state. Metabolic adaptation, which is not explained by changes in body composition, lasts for more than several years. These are powerful physiological adaptations that induce weight regain. To avoid a typically observed weight-loss and regain trajectory, realistic weight loss goals should be established and maintained for more than 1 year. Using a mathematical model can help clinicians formulate advice about diet control. It is important to emphasize steady efforts for several years to maintain reduced weight over efforts to lose weight. Because obesity is difficult to reverse, clinicians must prioritize obesity prevention. Obesity prevention strategies should have high feasibility, broad population reach, and relatively low cost, especially for young children who have the smallest energy gaps to change.

• Journal of the Korean Society of Food Science and Nutrition
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• v.34 no.2
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• pp.196-201
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• 2005

The aim of this study was to confirm the validity of predictive equations for the calculation of basal energy expenditure (BEE). One hundred twenty female college students were participated in this study. The resting energy expenditure (REE) was measured by indirect calorimetry for 30 minutes following an 12 hour overnight fasting. Among the available equations for predict BEE, Harris-Benedict, WHO/FAO/UNU and Cunningham methods were selected. Body composition was estimated by bioelectrical impedance analysis (BIA) for the equation of predicted BEE. The mean of measured REE was 1257.2$\pm$147.9 kcal/day, while the predicted value by Harris-Benedict, WHO/FAO/UNU and Cunningham were 1373.3$\pm$45.4 kcal/day, 1290.0$\pm$61.7 kcal/day and 1187.6$\pm$49.2 kcal/day, respectively. The Cunningham equation was more closed to measured values than Harris-Benedict and WHO/FAO/UNU equation by the correlation coefficient. Comparing Pearson's correlation coefficients, fat-free mass (FFM), body surface area (BSA) and body weight were higher than others such as height, body mass index (BMI), fat and fat%. The FFM's correlation coefficient was the highest as 0.74. Thus, the conclusion of this study suggested that the main determinant of BEE was FFM, and we derived a prediction equation as follows: BEE=-569.86+48.27 (FFM).

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.13-20
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• 2021

Purpose: Nutritional therapy in the intensive care unit is an essential factor for patient progress. The purpose of this study was to compare resting energy expenditure (REE) calculated by prediction equations (PEs) to the REE measured by indirect calorimetry (IC) in trauma patients. Methods: Patients admitted to the trauma intensive care unit who received mechanical ventilation between January and December 2015 were enrolled. REE was measured by IC (CCM Express, MGC Diagnostics) and calculated by the following PEs: Harris-Benedict, Fleisch, Robertson and Reid, Ireton-Jones, and the maximum value (25 kcal/kg/day) of the European Society for Clinical Nutrition and Metabolism (ESPEN). All patients were ventilated at a fraction of inspired oxygen (FiO2) below 60%. Results: Of the 31 patients included in this study, 24 (77.4%) were men and seven (22.6%) were women. The mean age of the patients was 49.7±13.2 years, their mean weight was 68.1±9.6 kg, and their mean Injury Severity Score was 26.1±11.3. The mean respiratory quotient on IC was 0.93±0.19, and their mean FiO2 was 38.72%±6.97%. The mean REE measured by IC was 2,146±444.36 kcal/day, and the mean REE values calculated by the PEs were 1,509.39±205.34 kcal/day by the Harris and Benedict equation, 1,509.39±154.33 kcal/day by the Fleisch equation, and 1,443.39±159.61 kcal/day by the Robertson and Reid equation. The Ireton-Jones equation yielded a higher value (2,278.90±202.35 kcal/day), which was not significantly different from the value measured using IC (p=0.53). The ESPEN maximum value (1,704.03±449.36 kcal/day) was lower, but this difference was likewise not significant (p=0.127). Conclusions: The REE measured by IC was somewhat higher than that calculated using PEs. Further studies are needed to determine the proper nutritional support for trauma patients.

• Journal of Nutrition and Health
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• v.38 no.10
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• pp.847-855
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• 2005

This study investigated and compared the daily activities and energy expenditure of normally-weighted and obese elementary school children. The participants were 115 boys and 115 girls (6th grade) at ten elementary schools in Busan. Time spent on each activity was evaluated using the twenty-four hour recall method. 1) The general characteristics of the normally-weighted and obese children did not differ, although the normally-weighted children exercised and used stairs more than the obese children.2) Among their classified activities, the children spent most of their time resting, study, leisure, physiology and hygiene, commuting, and housework in that decreasing order. Normally-weighted children spent less time tying down and in conversation with family and friends than obese ones. 3) The children's average activity factors were 1.47 - 1.50. The normally-weighted children's rest energy expenditure (REE) (1391.4 kcal,1264.7 kcal) was less than that of the obese children (1711.4 kcal. 1461.0 kcal) . The normally-weighted children's daily energy expenditure was less than that of the obese, but energy expenditure per body weight was less in obese children than in the normally-weighted. In conclusion, sedentary activities and energy expenditure per body weight was less in the obese compared to the normally-weighted children. Programs to help children perceive and practice desirable physical activities should be suggested for prevention of obesity in children. (Korean J Nutrition 38(10): 847$\sim$855,2005)

• Tuberculosis and Respiratory Diseases
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• v.46 no.6
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• pp.836-845
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• 1999

Background : Obesity is present in the majority of adult patients with obstructive sleep apnea(OSA) and is considered to be a major risk factor for its development. A reduction in body weight has been associated with substantial improvement in the severity of apnea. However, a variety of treatment strategies for obesity have yielded limited sucess. This study was done to determine resting energy expenditure(REE) in patients with obstructive sleep apnea and the correlation between the severity of sleep apnea and REE, and to investigate whether leptin influences REE and correlated with the severity of sleep apnea in 39 patients with OSA and 45 controls matched for obesity. Method : Overnight polysomnography was performed on all subjects using standard techniques. Measurements of REE were made using a Sensormedic Vmax 229 and a canopy system. Serum leptin concentration was measured by human leptin RIA kit of LINCO Research INC. Results : REE was greater in patients with OSA compared with controls, but there was no difference between the two groups on REE%. And also there was no significant correlation between anthropometric data, polysomnographic data and REE%. Serum leptin was linearly related to body mass index(BMI), apnea index, apnea hypopnea index and lowest arterial oxygen saturation($SaO_2$) but not related to REE%. Conclusion : This study suggests the followings. Firstly patients patients with sleep apnea have a pattern of obesity characterized by energy homeostasis at an elevated body weight set-point. In order to achieve a lower body weight in these patients, it may be necessary to increase energy expenditure by increasing physical activity. Secondly leptin level was not correlated with REE, suggesting that leptin may predominantly regulate body fat by altering eating behavior rather than calorigenesis. Lastly leptin level was significantly correlated with the severity of sleep apnea. These elevated level of leptin in patients of sleep apnea may be related to the obesity, however it needs further studies to determine the relationship between the severity of sleep apnea and serum leptin.

• Journal of Nutrition and Health
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• v.56 no.1
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• pp.35-53
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• 2023

Purpose: The purpose of the first part of this study was to evaluate the validity of the physical activity classification table for youth (Youth-PACT). The second part of this study was aimed at comparing the estimated energy requirement (EER) with the total energy expenditure (TEE) and evaluating the physical activity patterns of Korean children and adolescents. Methods: The subjects of the first part of the study were 17 children aged 10 to 12 years, and their total energy expenditure (TEE_DLW) was measured using the double labeled water (DLW) method. A total of 166 children and adolescents aged 6-18 years participated in the second part of this study. Their resting energy expenditure (REE) was measured using indirect calorimetry and the TEE_Youth-PACT and physical activity level were calculated by applying the Youth-PACT to the physical activity diary prepared by the subjects. Results: In the first part of this study, there were no significant differences between the TEE_DLW and the TEE_Youth-PACT. The TEE_Youth-PACT accurately predicted TEE_DLW in 37.5% of the subjects. In the second part of the study, the rates at which EER accurately predicted TEE _YouthPACT and overestimated TEE _Youth-PACT were 29.6% and 47.3%, respectively. The time spent based on intensity of physical activity and the physical activity categories which were obtained using Youth-PACT showed different patterns according to sex and age group. Age showed significant positive correlations with REE, TEE, and the time spent in sedentary behavior, but age was significantly negatively correlated with REE/body weight, TEE/body weight, and the time spent in low-intensity and high-intensity activities. Conclusion: The results of this study showed that the Youth-PACT can be used to evaluate the TEE and PAL of children and adolescents. However, further studies are needed to validate the TEE_Youth-PACT and to set the EER for children and adolescents.

• Korean Journal of Community Nutrition
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• v.17 no.2
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• pp.215-225
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• 2012

The purpose of this study was to measure and investigate the acute effects of two fatty meals (high-SFA & high-PUFA) on post-prandial thermic effect, substrate oxidation, and satiety. Eight healthy adults (four males and four females) aged 19-22 years were assigned to consume two isocaloric meals: high in saturated fatty acids from butter and high in polyunsaturated fatty acids from sesame oil. Indirect calorimetry was used to measure resting energy expenditure (REE), post-prandial energy expenditure for five hours, and substrate oxidation. Satiety of the subjects after meals was estimated by using visual analogue scales (VAS). Five hours thermic effect of food (TEF) was not significantly different between butter meal (6.5% of energy intake) and sesame oil meal (7.3% of energy intake), but, the TEF of butter meal reached the peak point at 150 min and decreased more rapidly arriving to REE in 270 min. On the other hand, TEF of sesame oil meal reached the peak at 90 min and decreased slower than butter meal (still higher than REE at 300 min). No significant differences in substrate oxidation rates were found between the two meals. Post-prandial fat oxidation rates increased significantly after the consumption of both butter and sesame oil meal than that of the pre-prandial state. Satiety values (hunger, fullness, and appetite) were similar among the meals, but recovery of hunger and fullness to the pre-prandial state was faster in butter meal than that of the sesame oil meal.

• Journal of Korean Home Economics Education Association
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• v.23 no.3
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• pp.121-138
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• 2011

This research examined the amounts and methods change of recommended energy intake(REI) from 1962's recommended dietary intakes for Korean to 2010's dietary reference intakes for Koreans. REI is composed of 3 factors, such basal metabolic rate(or Resting Energy Expenditure, REE), activity energy, and thermogenic effect of foods. The first 1962 calculation formula of REI was weight based formula, that of 95's was the weight based REE multiplied by activity coefficient, and the recent one of 2005's(Estimated Energy Requirement: EER) was age, height. weight, and the activity level applying formula derived from the energy expenditure data by doubly labeled water technique(DLW). During the 50 years or so, REIs were reduced in all age groups, according to the activity(labor) strength and hour were reduced. The individual REI calculation method was introduced in 1995, and individual REI calculation was recommended since to prevent obesity. For the better REI estimation for Koreans, REI calculation formula derived from our peoples' DLW energy expenditure data is required.

• Asian Oncology Nursing
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• v.11 no.1
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• pp.20-25
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• 2011

Purpose: The study was aimed to review and understand the meaning of cancer cachexia. Methods: Using the keywords "cachexia" and "cancer cachexia" 30 oncology research published from 1974 to 2009 were selected for the review. Results: The mechanism of cancer cachexia has not been fully understood, but various pathogenesis appears to be involved in the development cachexia including altered metabolism of carbohydrate, lipid, and protein associated with cytokines and hormone. As a result, muscle strength, food intake and resting energy expenditure (REE) are reduced. Most medications for the treatment of cachexia show debating results except some drugs such as megace. Supportive care including nutritional education, nursing care, and social support are found another effective treatment options. Conclusion: The results of this study would help oncology nurses to understand the mechanism of cancer cachexia and its management.

• Nutrition Research and Practice
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• v.10 no.2
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• pp.175-181
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• 2016

BACKGROUND/OBJECTIVES: The anti-obesity effect of quercetin-rich onion peel extract (OPE) was suggested in rats, but information from human studies is limited. This study aimed to investigate the effects of OPE on the body composition of overweight and obese subjects. MATERIALS/METHODS: In this 12-week, randomized, double-blind, placebo-controlled study, parallel clinical trials were performed in overweight and obese Korean subjects. Randomly assigned subjects were instructed to take daily either the placebo (male, 6 and female, 30) or OPE capsules containing 100 mg of quercetin (male, 5 and female, 31). Body composition was measured by using bioimpedance and dual-energy X-ray absorptiometry (DXA). Resting energy expenditure (REE) and respiratory quotient (RQ) were evaluated by using indirect calorie measurement methods. Fasting blood levels of glucose, insulin, lipids, and leptin were determined. RESULTS: Quercetin-rich OPE supplementation significantly reduced the weight and percentage of body fat as measured by DXA (P = 0.02). These effects were not shown in the control group. Levels of blood glucose (P = 0.04) and leptin (P = 0.001 for placebo, P = 0.002 for OPE) decreased in both groups. Significant increases in REE and RQ were observed in both groups (P = 0.003 for placebo, P = 0.006 for OPE) and in the OPE group alone (P = 0.02), respectively. CONCLUSIONS: Quercetin-rich OPE supplementation changed the body composition of the overweight and obese subjects. This result suggests a beneficial role of the anti-obesity effect of OPE human subjects.