Elsevier

Clinical Nutrition

Volume 22, Issue 2, April 2003, Pages 159-165
Clinical Nutrition

Original Article
Total energy expenditure in underweight patients with severe chronic obstructive pulmonary disease living at home

https://doi.org/10.1054/clnu.2002.0618Get rights and content

Abstract

Aim: The aim of the study was to assess total daily energy expenditure (TDE), as measured by doubly labelled water (DLW), and describe its components in home-living underweight patients with severe chronic obstructive pulmonary disease (COPD).

Methods: Basal metabolic rate (BMR) was measured prior to the study. Ten patients received DLW, followed by urine analysis by isotope ratio mass spectrometry from 10 standardised occasions during 15 days. Dietary intake was registered by each patient the first 7 days of the study. The patients were also interviewed about their physical activity pattern.

Results: Measured BMR was higher than predicted in five of the 10 patients using equations from WHO. Using disease-specific equations, estimated BMR was higher for male, but not for female COPD patients. The best estimation of BMR resulted from prediction including fat-free mass. TDE varied considerably between 5200 and 11,100 kJ. Physical activity level (PAL) ranged from 1.15 to 1.80. Energy intake varied between 4500 and 9100 kJ. In underweight patients with severe COPD, TDE is highly variable, ranging from 110 to 200 kJ/kg body weight.

Conclusions: This is the first study assessing and describing total energy expenditure in underweight patients with severe COPD living at home. Energy requirement in the patient group cannot solely be calculated from prediction equations. BMR should be measured and physical activity level assessed.

References (23)

  • JA Moore et al.

    Equations for the prediction of resting energy expenditure in chronic obstructive lung disease

    Chest

    (1988)
  • DO Wilson et al.

    Nutrition and chronic lung disease

    Am Rev Respir Dis

    (1985)
  • MF Muers et al.

    Energy balance and intermediate metabolism in chronic lung disease

    Monaldi Arch Chest Dis

    (1998)
  • NS Arora et al.

    Respiratory muscle strength and maximal voluntary ventilation in undernourished patients

    Am Rev Respir Dis

    (1982)
  • K Gray–Donald et al.

    Nutritional status and mortality in chronic obstructive pulmonary disease

    Am J Respir Crit Care Med

    (1996)
  • AM Schols et al.

    Energy balance in chronic obstructive pulmonary disease

    Am Rev Respir Dis

    (1991)
  • O Hugli et al.

    The daily energy expenditure in stable chronic obstructive pulmonary disease

    Am J Respir Crit Care Med

    (1996)
  • EM Baarends et al.

    Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease

    Am J Respir Crit Care Med

    (1997)
  • EM Baarends et al.

    Total daily energy expenditure relative to resting energy expenditure in clinically stable patients with COPD

    Thorax

    (1997)
  • NM Siafakas et al.

    Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force

    Eur Respir J

    (1995)
  • KR Westerterp et al.

    Energy intake, physical activity and body weight: a simulation model

    Br J Nutr

    (1995)
  • Cited by (55)

    • Energy expenditure in women and men with COPD

      2018, Clinical Nutrition ESPEN
      Citation Excerpt :

      For the clinical purpose, it is important to know the TEE per kg BW or fat-free mass (FFM) in COPD patients so that the given nutritional treatment can be more individualized. To our knowledge, till date, only one study in COPD patients has shown TEE/kg BW/day or TEE/kg FFM/day measured by DLW [15]. A compilation of data from complementary studies is an attractive approach to increase the understanding of TEE and energy requirement in patients with COPD.

    View all citing articles on Scopus
    f1

    (Correspondence to: FS, Department of Clinical Nutrition, Sahlgrenska Academy at Göteborg University, P.O Box 459, 405 30 Göteborg Sweden. E-mail: [email protected])

    View full text