• Nutrition Research and Practice
• /
• v.8 no.3
• /
• pp.241-248
• /
• 2014

The accuracy and noninvasive nature of the doubly labeled water (DLW) method makes it ideal for the study of human energy metabolism in free-living conditions. However, the DLW method is not always practical in many developing and Asian countries because of the high costs of isotopes and equipment for isotope analysis as well as the expertise required for analysis. This review provides information about the theoretical background and practical aspects of the DLW method, including optimal dose, basic protocols of two-and multiple-point approaches, experimental procedures, and isotopic analysis. We also introduce applications of DLW data, such as determining the equations of estimated energy requirement and validation studies of energy intake.

• Korean Journal of Community Nutrition
• /
• v.23 no.6
• /
• pp.516-524
• /
• 2018

Objectives: This study assessed the accuracy of the 24-hour diet recall method for estimating the energy intake of elderly men using the doubly labeled water as a reference method. Methods: Seventeen subjects (mean age $72.5{\pm}3.9years$), who maintained the same body weight during the two weeks study period, were included in this study. Three 24-hour diet recalls (two weekdays and one weekend) were obtained over a 14 day period to estimate the mean energy intake. The total energy expenditure was measured over the same 14 days using the doubly labeled water method. The total energy intake and total energy expenditure were compared by paired t-test. Results: The total energy intake from the 24-hour diet recalls method was $2536.7{\pm}350.6kcal/day$, and the total energy expenditure from the doubly labeled water method was $2659.8{\pm}306.8kcal/day$. The total energy intake was slightly under-reported by $-123.2{\pm}260.8kcal/day$ (-4.4%). On the other hand, no significant difference was observed between the total energy intake and total energy expenditure of the subjects (p=0.069). The percentage of accurate predictions was 64.7%. The correlation between the total energy intake and total energy expenditure was statistically significant (r=0.697, p<0.005). Conclusions: The present study supports the use of the 24-hour diet recall method to estimate the mean energy intake in elderly men group. More studies are needed to assess the validity of 24-hour diet recall method in other population groups, including elderly women, adults and children.

• Proceedings of the Korean Nutrition Society Conference
• /
• 2003.05a
• /
• pp.174.1-174.1
• /
• 2003

• Nutrition Research and Practice
• /
• v.16 no.sup1
• /
• pp.11-20
• /
• 2022

Research articles were reviewed to validate the estimated energy requirements (EERs) equations developed by the Institute of Medicine of the National Academies (IOM). These equations are based on total energy expenditure (TEE) measured by the doubly labeled water (DLW) method. We subsequently aimed to provide the basis for the suitability to apply the IOM equations as EER equations for Koreans, and develop relevant equations for EER in the Dietary Reference Intake for Koreans (KDRI). Additionally, besides the EER(IOM) equations, other equations were examined for EER estimation. Research papers demonstrating the validation of the EER(IOM) equations based on TEE(DLW) were searched through PubMed (up to September 2019). Of the 637 potentially relevant articles identified, duplicates and unsuitable titles and abstracts were excluded. Furthermore, papers with irrelevant subject and inappropriate study design were also excluded. Finally, 11 papers were included in the review. Among the reviewed papers, 8 papers validated the application of the EER(IOM) equations for EER based on TEE(DLW). These included 3 studies for children (USA 1, Korea 2), 1 for adolescents (Portugal), 2 for adults (Korean), and 2 for the elderly (Korea, USA). EER(IOM) equations were found to be generally acceptable for determining EER by using the DLW method, except for Korean boys at 9-11 yrs (overestimated) and female athletes at 19-24 yrs (underestimated). Additionally, 5 papers include the validation of other EER equations, beside EER(IOM) for EER based on TEE(DLW). In Japanese dietary reference intake and recommended dietary allowance, EER equations are acceptable for determining EER based on TEE(DLW). The EER(IOM) equations is generally acceptable for determining EER using the DLW method in Koreans as well as several populations, although certain defined groups were found to be unfit for the estimation. Additionally, the concept of healthy body mass index of Koreans and physical activity levels need to be considered, thereby providing the basis for developing relevant equations of EER in KDRI.

• Korean Journal of Exercise Nutrition
• /
• v.23 no.4
• /
• pp.1-5
• /
• 2019

[Purpose] The goal of this study was to review data on physical activity level (PAL), a crucial index for determining estimated energy requirement (EER), calculated as total energy expenditure (TEE, assessed with doubly labeled water [DLW]) divided by resting metabolic rate (RMR, PAL = TEE/RMR) in female athletes and to understand the methods of assessing athletes' EERs in the field. [Methods] For the PAL data review among female athletes, we conducted a PubMed search of the available literature related to the DLW method. DLW studies measuring TEE and RMR were included for the present review. [Results] Briefly, the mean PAL was 1.71 for collegiate swimmers with moderate training, which was relatively low, but the mean PAL was 3.0 for elite swimmers during summer training camp. This shows that PAL can largely vary even within the same sport depending on the amount of training, and the differences in PAL were remarkable depending on the sport. Aside from the DLW method, there is currently no research tool related to athletes' EERs that can be used in the field. [Conclusion] Briefly, the mean PAL was 1.71 for collegiate swimmers with moderate training, which was relatively low, but the mean PAL was 3.0 for elite swimmers during summer training camp. This shows that PAL can largely vary even within the same sport depending on the amount of training, and the differences in PAL were remarkable depending on the sport. Aside from the DLW method, there is currently no research tool related to athletes' EERs that can be used in the field.

• Journal of Nutrition and Health
• /
• v.54 no.6
• /
• pp.573-583
• /
• 2021

Energy requirement is defined as energy expenditure in an energy equilibrium state. The doubly labeled water (DLW) method is considered the gold standard for measuring total energy expenditure (TEE). In 2002, the Institute of Medicine (IOM) of the National Academies established dietary reference intakes (DRIs) for Americans and Canadians, and the equations for estimated energy requirement (EER) were developed by using pooled data from studies that had applied the DLW method. Since 2005, these equations have been used for establishing EER in the DRI for Koreans. These equations based on age group include the physical activity (PA) coefficient determined by the PA level (PAL; sedentary, low active, active and very active) as well as body weight and height. The PAL values of Koreans calculated using the DLW method and PA diaries were determined to fall in the low active category (1.40~1.59). Therefore, the PA coefficient corresponding to 'low active' was applied to the EER equations. In recent years, with increasing number of people regularly engaging in various physical activities in Korea, EER is now separately presented for people with 'active' and 'very active' PALs. In the future, like the United States and Japan, Korea needs to expand the DLW research for developing EER predictive equations for Koreans. In addition, standardized guidelines should be prepared to accurately evaluate the PAL using the physical activity diary and the new PA classification table for Koreans.

• Nutrition Research and Practice
• /
• v.16 no.5
• /
• pp.646-657
• /
• 2022

BACKGROUND/OBJECTIVES: The doubly labeled water (DLW) method is the gold standard for estimating total energy expenditure (TEE) and is also useful for verifying the validities of dietary evaluation tools. In this study, we compared the accuracy of total energy intakes (TEI) estimated by the 24-h diet recall method with TEE obtained using the doubly labeled water method. SUBJECTS/METHODS: This study involved 71 subjects aged 20-49 yrs. Over a 14-day period, three 24-h diet recalls per subject (2 weekdays and 1 weekend day) were used to estimate energy intakes, while TEE was measured using the DLW method. The paired t-test was used to determine the significance of differences between TEI and TEE results, and the accuracy of the 24-h recall method was determined by accuracy predictions percentage, root mean square error, and bias. RESULTS: Average study subject age was 33.4 ± 8.6 yrs. The association between TEI and TEE was positive and significant (r = 0.463, P < 0.001), and the difference between TEI (2,084.3 ± 684.2 kcal/day) and TEE (2,401.7 ± 480.3 kcal/day) was also significant (P < 0.001). In all study subjects, mean TEI was 12.0% (307.5 ± 629.3 kcal/day) less than mean TEE, and 12.2% (349.4 ± 632.5 kcal/day) less in men and 11.8% (266.7 ± 632.5 kcal/day) less in women. Rates of TEI underprediction for all study subjects, men, and women, were 60.5%, 51.4%, and 66.7%, respectively. CONCLUSIONS: This study shows that 24-h diet recall underreports energy intakes. More research is needed to corroborate our findings and evaluate the accuracy of 24-h recall with respect to additional demographics.

• Nutrition Research and Practice
• /
• v.11 no.1
• /
• pp.51-56
• /
• 2017

BACKGROUND/OBJECTIVES: The purpose of this study was to assess the accuracy of a dietary reference intake (DRI) predictive equation for estimated energy requirements (EER) in female college tennis athletes and non-athlete students using doubly labeled water (DLW) as a reference method. MATERIALS/METHODS: Fifteen female college students, including eight tennis athletes and seven non-athlete subjects (aged between 19 to 24 years), were involved in the study. Subjects' total energy expenditure (TEE) was measured by the DLW method, and EER were calculated using the DRI predictive equation. The accuracy of this equation was assessed by comparing the EER calculated using the DRI predictive equation ($EER_{DRI}$) and TEE measured by the DLW method ($TEE_{DLW}$) based on calculation of percentage difference mean and percentage of accurate prediction. The agreement between the two methods was assessed by the Bland-Altman method. RESULTS: The percentage difference mean between the methods was -1.1% in athletes and 1.8% in non-athlete subjects, whereas the percentage of accurate prediction was 37.5% and 85.7%, respectively. In the case of athletic subjects, the DRI predictive equation showed a clear bias negatively proportional to the subjects' TEE. CONCLUSIONS: The results from this study suggest that the DRI predictive equation could be used to obtain EER in non-athlete female college students at a group level. However, this equation would be difficult to use in the case of athletes at the group and individual levels. The development of a new and more appropriate equation for the prediction of energy expenditure in athletes is proposed.

• Nutrition Research and Practice
• /
• v.11 no.4
• /
• pp.300-306
• /
• 2017

BACKGROUND/OBJECTIVES: The doubly labeled water (DLW) method is considered the gold standard for the measurement of total energy expenditure (TEE), which serves to estimate energy requirements. This study evaluated the accuracy of predictive dietary reference intake (DRI) equations for determining the estimated energy requirements (EER) of Korean adults by using the DLW as a reference method. SUBJECTS/METHODS: Seventy-one participants (35 men and 36 women) aged between 20 and 49 years were included in the study. The subjects' EER, calculated by using the DRI equation ($EER_{DRI}$), was compared with their TEE measured by the DLW method ($TEE_{DLW}$). RESULTS: The DRI equations for EER underestimated TEE by -36.3 kcal/day (-1.3%) in men and -104.5 kcal/day (-4.9%) in women. The percentages of accurate predictions among subjects were 77.1% in men and 62.9% in women. There was a strong linear correlation between $EER_{DRI}$ and $TEE_{DLW}$ (r = 0.783, P < 0.001 in men and r = 0.810, P < 0.001 in women). CONCLUSIONS: The present study supports the use of DRI prediction equations to determine EER in Korean adults. More studies are needed to confirm our results and to assess the validity of these equations in other population groups, including children, adolescents, and older adults.

• Nutritional Sciences
• /
• v.7 no.4
• /
• pp.235-240
• /
• 2004

The Institute of Medicine of the National Academies Food and Nutrition Board in conjunction with Health Canada recently released the sixth in a series of reports on dietary reference values for the intake of energy and macronutrients. This paper discusses the Dietary Reference Intakes (DRIs) for energy and physical activity. Several new approaches were used with the DRIs for the macronutrients. Those discussed in this paper include: $.$Estimated Energy Requirements (EER) at four levels of energy expenditure based on doubly labeled water measurements of total energy expenditure (TEE). $.$Recommendations for levels of physical activity to decrease the risk of chronic disease.