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  • Letter to the Editor
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Reply to Schoeller and Coward

International Journal of Obesity volume 31, page 1034 (2007)Cite this article

Schoeller and Coward have raised some interesting points for discussion with respect to our work on affordable measurement of human energy expenditure using reduced dose doubly labelled water.1 Although these authors have proposed a standard dose for the isotopes as a function of estimated total body water, they should be aware that many investigators have based these same dosages relative to body weight2, 3, 4 and for those schedules our proposal does indeed represent a 10-fold dosage reduction for the more expensive 18O isotope. We are familiar with the theoretical predictions for coefficient of variation based on propagation of error analysis. However, we must disagree with their comment that we have shown a precision of 9.3% since no replicated low-dose measurements were performed. This was a proof of concept study, with necessarily limited number of individuals using descriptive and comparative data supported by correlation analysis. We have acknowledged the need for additional work to confirm the precision and accuracy of our dosage and analytical proposals, which will allow a rational interpretation of the impact on sample size estimation (and cost implications) for future studies. The fundamental importance of stability of background isotope enrichment is not disputed, and was sufficient under the conditions of our study not to impair the quality of data acquisition.

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References

  1. Mann DV, Ho CS, Critchley L, Fok BS, Pang EW, Lam CW et al. Affordable measurement of human total energy expenditure and body composition using one-tenth dose doubly labelled water. Int J Obes (London) 2007; 31: 1004–1013.

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  2. Prentice AM, Coward WA, Davies HL, Murgatroyd PR, Black AE, Goldberg GR et al. Unexpectedly low levels of energy expenditure in healthy women. Lancet 1985; 1: 1419–1422.

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  3. Pullicano E, Coward A, Marinos E . Total energy expenditure in intravenously fed patients measured by the doubly labelled water technique. Metabolism 1993; 42: 58–64.

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  4. Seale JL, Rumpler WV, Conway JM, Miles CW . Comparison of doubly labelled water, intake-balance, and direct- and indirect-calorimetry methods for measuring energy expenditure in adult men. Am J Clin Nutr 1990; 52: 66–71.

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Authors and Affiliations

  1. Chinese University of Hong Kong, Hong Kong

    D V Mann, C S Ho & M Hjelm

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  1. D V Mann
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  2. C S Ho
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  3. M Hjelm
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Correspondence to D V Mann.

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Mann, D., Ho, C. & Hjelm, M. Reply to Schoeller and Coward. Int J Obes 31, 1034 (2007). https://doi.org/10.1038/sj.ijo.0803647

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