Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Energy expenditure in chronic obstructive pulmonary disease—evaluation of simple measures

European Journal of Clinical Nutrition volume 65, pages 1309–1313 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

Almost 50% of all chronic obstructive pulmonary disease (COPD) patients become underweight. One possible reason for nutritional treatment to fail could be miscalculation of patients’ energy requirements. The aim of this study was, therefore, to evaluate simple measures that may be used to assess the energy requirement of COPD patients.

Subjects/Methods:

This cross-sectional evaluation study includes 68 COPD patients (42 women). Resting metabolic rate (RMR) was assessed by indirect calorimetry, while total energy expenditure (TEE) was assessed by a 7-day monitoring using the ActiReg. Simple measures to evaluate was body weight (kg) multiplied by 125 kJ (30 kcal), predicted RMR multiplied by 1.7 and two simple questionnaires.

Results:

Mean physical activity level (PAL) from the ActiReg was 1.46. Calculation of energy expenditure multiplying body weight with 125 kJ resulted in a TEE of 8614 kJ compared with ActiReg 8317 kJ (P=0.10). To multiply predicted RMR by 1.7 resulted in a statistically significant overestimation of 1335 kJ (P<0.01). Both questionnaires showed a clear ‘dose-response’ regarding PAL from ActiReg in the different activity categories.

Conclusions:

This study shows that simple measures of energy expenditure could, on group level, assess COPD patient's energy needs. However, for individual assessment of energy need, more thorough procedures are necessary.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  • Arvidsson D, Slinde F, Nordenson A, Larsson S, Hulthen L (2006). Validity of the ActiReg system in assessing energy requirement in chronic obstructive pulmonary disease patients. Clin Nutr 25, 68–74.

    Article  Google Scholar 

  • Baarends EM, Schols AM, Pannemans DL, Westerterp KR, Wouters EF (1997). Total free living energy expenditure in patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med 155, 549–554.

    Article  CAS  Google Scholar 

  • Bland JM, Altman DG (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1, 307–310.

    Article  CAS  Google Scholar 

  • Creutzberg EC, Wouters EF, Mostert R, Weling-Scheepers CA, Schols AM (2003). Efficacy of nutritional supplementation therapy in depleted patients with chronic obstructive pulmonary disease. Nutrition 19, 120–127.

    Article  Google Scholar 

  • FAO/WHO/UNU (1985). Energy and Protein Requirements. Technical Report Series 724. World Health Organization: Geneva.

  • Gray-Donald K, Gibbons L, Shapiro SH, Macklem PT, Martin JG (1996). Nutritional status and mortality in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 153, 961–966.

    Article  CAS  Google Scholar 

  • Hitzl AP, Jorres RA, Heinemann F, Pfeifer M, Budweiser S (2010). Nutritional status in patients with chronic respiratory failure receiving home mechanical ventilation: impact on survival. Clin Nutr 29, 65–71.

    Article  Google Scholar 

  • Hoyert DL, Heron MP, Murphy SL, Kung HC (2006). Deaths: final data for 2003. Natl Vital Stat Rep (CDC) 54, 1–120.

    Google Scholar 

  • Hustvedt BE, Christophersen A, Johnsen LR, Tomten H, McNeill G, Haggarty P et al. (2004). Description and validation of ActiReg®—a novel instrument to measure physical activity and energy expenditure. Br J Nutr 92, 1001–1008.

    Article  CAS  Google Scholar 

  • IAEA (2009). Assessment of Body Composition and Total Energy Expenditure in Humans Using Stable Isotope Techniques. IAEA: Vienna.

  • Nordenson A, Grönberg AM, Hulthén L, Larsson S, Slinde F (2010). A validated disease specific prediction equation for resting metabolic rate in underweight patients with COPD. Int J COPD 5, 271–276.

    Google Scholar 

  • Pitta F, Troosters T, Probst VS, Spruit MA, Decramer M, Gosselink R (2006). Quantifying physical activity in daily life with questionnaires and motion sensors in COPD. Eur Respir J 27, 1040–1055.

    Article  CAS  Google Scholar 

  • Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC (1993). Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J 16, 5–40.

    Article  CAS  Google Scholar 

  • Saltin B, Grimby G (1968). Physiological analysis of middle-aged and old former athletes. Comparison with still active athletes of the same ages. Circulation 38, 1104–1115.

    Article  CAS  Google Scholar 

  • Schols AM, Slangen J, Volovics L, Wouters EF (1998). Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 157, 1791–1797.

    Article  CAS  Google Scholar 

  • Slinde F, Arvidsson D, Sjoberg A, Rossander-Hulthen L (2003a). Minnesota leisure time activity questionnaire and doubly labeled water in adolescents. Med Sci Sports Exerc 35, 1923–1928.

    Article  Google Scholar 

  • Slinde F, Ellegård L, Grönberg AM, Larsson S, Rossander-Hulthén L (2003b). Total energy expenditure in underweight patients with severe chronic obstructive pulmonary disease living at home. Clin Nutr 22, 159–165.

    Article  CAS  Google Scholar 

  • Slinde F, Grönberg AM, Engström CP, Rossander-Hulthen L, Larsson S (2002). Individual dietary intervention in patients with COPD during multidisciplinary rehabilitation. Respir Med 96, 330–336.

    Article  CAS  Google Scholar 

  • Slinde F, Grönberg AM, Engström CP, Rossander-Hulthén L, Larsson S (2005). Body composition by bioelectrical impedance predicts mortality in chronic obstructive pulmonary disease patients. Respir Med 99, 1004–1009.

    Article  Google Scholar 

  • Slinde F, Kvarnhult K, Grönberg AM, Nordenson A, Larsson S, Hulthen L (2006). Energy expenditure in underweight chronic obstructive pulmonary disease patients before and during a physiotherapy programme. Eur J Clin Nutr 60, 870–876.

    Article  CAS  Google Scholar 

  • Socialstyrelsen (2010). ‘National statistics. Causes of death in Sweden 1997–2006.’. From http://www.socialstyrelsen.se/Statistik/statistikdatabas.

  • Sonn U, Matthiasson-Nilo I, Johannesson K, Gosman-Hedström G, Persson GB, Grimby G (1993). Är män mer fysiskt aktiva än kvinnor i 70-årsåldern? Socialmedicinsk tidskrift 70, 384–388.

    Google Scholar 

  • Sridhar MK, Galloway A, Lean ME, Banham SW (1994). An out-patient nutritional supplementation programme in COPD patients. Eur Respir J 7, 720–724.

    Article  CAS  Google Scholar 

  • Weekes CE, Emery PW, Elia M (2009). Dietary counselling and food fortification in stable COPD: a randomised trial. Thorax 64, 326–331.

    Article  CAS  Google Scholar 

  • WHO (2008). ‘World health statistics 2008.’. From http://www.who.int/whosis/whostat/2008/en/index.html.

Download references

Acknowledgements

This study was supported by The Swedish Research Council, The Swedish Heart and Lung Foundation and The Swedish Heart and Lung Association.

Author information

Authors and Affiliations

  1. Department of Clinical Nutrition, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    F Slinde, A M Grönberg & L Hulthén

  2. Department of Internal Medicine/Respiratory Medicine and Allergology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    A M Grönberg & S Larsson

  3. Department of Clinical Neuroscience and Rehabilitation, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

    U Svantesson

Authors
  1. F Slinde
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A M Grönberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U Svantesson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L Hulthén
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S Larsson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F Slinde.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Contributors: FS designed the study, conducted the research, analyzed the data and wrote the paper; AMG designed the study, conducted the research and wrote the paper; US wrote the paper; LH and SL designed the study and wrote the paper.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Slinde, F., Grönberg, A., Svantesson, U. et al. Energy expenditure in chronic obstructive pulmonary disease—evaluation of simple measures. Eur J Clin Nutr 65, 1309–1313 (2011). https://doi.org/10.1038/ejcn.2011.117

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2011.117

Keywords

This article is cited by

Search

Advanced search

Quick links