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Monitoring of physical activity
Published in Claudio F. Donner, Nicolino Ambrosino, Roger S. Goldstein, Pulmonary Rehabilitation, 2020
Heleen Demeyer, Thierry Troosters, Henrik Watz
Using an objective measure is preferred both in research and clinical practice in order to quantify PA of an individual patient. Although the doubly labelled water technique is the most accurate method to measure the total energy expenditure (22), it is very expensive, requires a complex setup and does not quantify duration, frequency or intensity of PA but provides an estimate of CO2 production over several weeks. This can be converted into a measure of energy expenditure from which active energy expenditure can be obtained after correcting for resting energy expenditure. It is infrequently used.
Appetite-Stimulant Use in the Palliative Care of Cystic Fibrosis
Published in Victor R. Preedy, Handbook of Nutrition and Diet in Palliative Care, 2019
Samya Z. Nasr, Aarti Shakkottai
Cystic fibrosis (CF) is a chronic, life-shortening disease that affects approximately 30,000 patients in the United States (Table 32.1). The nutritional goal for CF is to achieve normal growth and development. Evidence has shown that lung function is associated with nutritional status in CF and that nutritional status is an independent predictor of survival (McColley et al. 2017). However, 10% of CF patients are ≤10th percentile for weight and ≤5th percentile for height (CF Foundation Patient Registry 2015). In a recent study, 40% of CF patients were not meeting the minimum energy requirements (Calvo-Lerma et al. 2017). Good nutritional status is dependent on the consumption of adequate nutrients, which is driven by complex, inter-related factors such as physical hunger, appetite, food-related behaviors, emotions, knowledge and beliefs (Table 32.2). Patients with CF have chronic respiratory infections which affect their appetite. They also have a high resting energy expenditure. Malabsorption from pancreatic insufficiency is also an issue for most CF patients. They consequently have higher than normal caloric requirements. Ultimately, achieving good nutritional status is dependent on the consumption of adequate nutrients, which is driven by complex, inter-related factors such as physical hunger, appetite, food-related behaviors, emotions, knowledge and beliefs (Table 32.2).
Type 2 Diabetes in Childhood
Published in Emmanuel C. Opara, Sam Dagogo-Jack, Nutrition and Diabetes, 2019
A sedentary lifestyle increases the risk of T2D, while exercise, in combination with caloric and fat restriction, reduces the rate of progression to diabetes in adults with IGT [29–32]. The mechanisms by which exercise improves insulin sensitivity and glucose tolerance are complex, involving metabolic adaptations in adipose tissue, liver, and skeletal muscle. Exercise has beneficial effects on fat storage and distribution, with losses of visceral fat depots exceeding those of subcutaneous fat stores. Lean body mass increases, thereby augmenting resting energy expenditure. A reduction in abdominal fat mass increases adipose tissue sensitivity to insulin; this explains in part the reductions in fasting and postprandial FFA, LDL and triglyceride concentrations, and the increase in plasma HDL levels in adults who adhere to a rigorous diet and exercise regimen. The effect of exercise on plasma triglyceride is mediated through induction of lipoprotein lipase and reduction in triglyceride production.
Metabolic and cardiopulmonary impact of aquatic exercise and nutritional guidance for four individuals with chronic motor incomplete spinal cord injury: a case series
Published in Physiotherapy Theory and Practice, 2023
Paula Richley Geigle, Anna Ogonowska-Slodownik, Joanne E Smith, Kylie James, William H. Scott
We collected all outcome data at the beginning and end of the program regime (exercise and diet intervention). Weight measurements and dietary intake logs were obtained weekly. We determined Resting Energy Expenditure (REE) using a calibrated COSMED metabolic cart. Each participant arrived in the early morning hours following at least a 10-hour fast and at least 24-hours after previous exercise. We measured REE in a quiet, thermal-neutral environment with subdued lighting for approximately 30 minutes. We positioned each participant in a supine position on an examination table and fitted with a Hans Rudolph mask and flow meter attachment. This configuration interfaced with a metabolic cart to collect air flow and gas concentrations during the assessment. This information was processed using software to determine energy expenditure. The REE calculation was based on average values for the last 20 minutes of the 30-minute sampling period. We asked each participant to stay awake, quiet, and limit movements throughout the procedure.
Reduced contextually induced muscle thermogenesis in rats with calorie restriction and lower aerobic fitness but not monogenic obesity
Published in Temperature, 2023
Ashley M. Shemery, Meredith Zendlo, Jesse Kowalski, Erin Gorrell, Scott Everett, Jacob G. Wagner, Ashley E. Davis, Lauren G. Koch, Steven L. Britton, Joram D. Mul, Colleen M. Novak
With the progression of the obesity epidemic [1], increasing interest has focused on methods that can decrease caloric intake as well as amplify caloric expenditure. Potential strategies being considered have widened beyond those involving direct manipulation of food intake and increasing physical activity, however, to include activating thermogenesis (reviewed by [2,3]). Strategies to combat obesity by engaging thermogenic mechanisms have focused on brown adipose tissue thermogenesis and “browning” of white adipose to induce or amplify caloric expenditure (both reviewed by [4]); less consideration is commonly given to the potential thermogenic role of skeletal muscle. Indeed, muscle comprises a large proportion of body mass in both men and women [5] and contributes 40% [6] to resting energy expenditure in humans. Evidence supports a sizable role of skeletal muscle glucose uptake in homeostatic acute cold-induced thermogenesis [7] as well as in thermogenic hypermetabolism to maintain temperature homeostasis in an aquatic mammal [8,9].
Correlation between serum trimethylamine-N-oxide concentration and protein energy wasting in patients on maintenance hemodialysis
Published in Renal Failure, 2022
Chun Hu, Yumei Zhang, Xiao Bi, Lu Yao, Yueling Zhou, Wei Ding
PEW is highly prevalent in ESRD patients, with a prevalence of 30–75% among patients on hemodialysis [20]. Several signaling pathways and humoral factors have been discovered to be involved in CKD-induced PEW, including the ubiquitin proteasome system (UPS), myostatin/activin pathway, endogenous glucocorticoids, insulin-like growth factor 1 (IGF-1) pathway, metabolic acidosis, and persistent inflammation [21–23]. In our previous study, we also showed that mitochondrial dysfunction/NLRP3 inflammasome axis may contribute to angiotensin II-induced skeletal muscle wasting, the use of siRNA or genetic depletion of NLRP3, mitochondria-targeted antioxidant, or PPAR-γ agonists significantly normalized muscle function and the protein energy balance [24,25]. The factors associated with these pathways lead to decreased anabolism and/or increased catabolism, which increases resting energy expenditure and causes hypermetabolism, eventually leading to progressive muscle wasting. Uremic toxins, which are organic solutes normally metabolized and excreted by the kidneys, often accumulated in the presence of impaired kidney function, causing body toxicity [26]. However, to date, there are few published reports on gut microbiota-dependent metabolite TMAO in patients with CKD, and the association between TMAO concentrations and PEW/muscle wasting has not been investigated.