Dietary Reference Intakes for Energy (2023) / Chapter Skim
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From page 297... ...
APPENDIX G 297 TABLE 6 Sample Sizes for Final Analysis Data Set, by Data Source and Age Group (Appendix P §2.1) CNRC IAEA IOM SOLNAS TOTAL Infants 0 378 177 0 555 Children 0 432 689 0 1121 Teenagers 0 425 279 0 704 Adults 0 4309 767 380 5456 Preg/Lac/NPNL19 220 173 371 0 764 TOTAL 220 5717 2283 380 8600 Detailed descriptive statistics for the 8,600 observations included are presented in Appendix P, Section (§)
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Bold numbers in Table 7 below were used to define the new age-dependent PAL categories as described above (Appendix Q §2.1)
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TABLE 7 PAL Percentiles from Imputed Data by Age Categories (Appendix Q §2.1.1) 0 –2.99 y 3–8.99 y 9–18.99 y 19–70 .99 y 71+ y n L ac tating Pregnant Percentile n = 750 n = 926 n = 704 n = 4299 = 1281 n = 203 n = 431 10% 1.00 1.20 1.34 1.39 1.31 1.34 1.30 25% 1.11 1.31 1.50 1.53 1.46 1.50 1.46 50% 1.27 1.44 1.66 1.68 1.62 1.69 1.60 75% 1.44 1.59 1.85 1.85 1.79 1.83 1.77 90% 1.61 1.75 2.04 2.03 1.95 2.05 1.97 0–6 mo 7–11 mo 1–3 y 4–8 y 9–13 y 14–18 y 19–30 y 31–50 y 51–70 y n 71 y Percentile n = 443 n = 112 n = 243 n = 878 n = 304 n = 403 n = 1,417 n = 1,994 = 1,519 n = 1,281 10% 1.00 1.08 1.06 1.20 1.29 1.40 1.35 1.39 1.39 1.31 25% 1.07 1.19 1.17 1.32 1.44 1.56 1.50 1.53 1.52 1.46 50% 1.23 1.31 1.33 1.44 1.59 1.73 1.67 1.69 1.67 1.62 75% 1.40 1.47 1.49 1.60 1.77 1.92 1.85 1.86 1.82 1.79 90% 1.58 1.65 1.64 1.76 1.92 2.11 2.05 2.03 1.99 1.95 299
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300 DIETARY REFERENCE INTAKES FOR ENERGY The distribution of PAL within age group is shown in Figure 3 (and Appendix Q §2.2)
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+ 14.10 Weight (kg) • Low Active: 581.47 – 10.83 Age (y)
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Table 9 shows the mean and standard deviation of the difference in observed TEE – predicted TEE (i.e., the error) from the primary models in each stratum (Appendix R §1.10)
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and Standard Deviation of the Difference in Observed TEE – Predicted TEE, by Stratum (Appendix R §1.10) Strata n Mean Std Dev.
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Tables 11A and 11B show the model fit from the predicted values after applying the TEE models to the study-level data extracted from the literature (Appendix R §4.2)
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Boy 21 0.92 0.96 61,755.86 248.51 7.72 Girl 20 0.87 0.97 35,342.89 188.00 8.01 Man 32 0.82 0.92 49,684.74 222.90 5.57 Woman 71 0.82 0.93 28,833.66 169.80 5.46 9. APPENDICES21 Supplemental online files Appendix Description Appendix N DLW Data Codebook Appendix O Data Preparation and Preliminary Descriptive Statistics Appendix P Clean Analysis Appendix Q Multiple Imputation GLM Results Appendix R Performance Report Appendix S List of IAEA Studies with Inclusion/Exclusion continued 21 All appendixes to this IU report are provided in Supplemental Appendixes N through W and are available at: https://nap.nationalacademies.org/catalog/26818.
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306 DIETARY REFERENCE INTAKES FOR ENERGY Appendix T IOM Data Extracted from 2002/2005 Report Appendix U External Validation Data Appendix V SAS Code for Importing, Harmonizing, and Merging Data Appendix W SAS Code for Multiple Imputation and Models
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+ error where PALCATi represents 3 indicator variables for PAL category (Active, Low Active, Inactive) that are coded as 0 or 1; ‘A', ‘B0', ‘C0', and ‘Di' are the model coefficients for the main effects of age, height, weight and the 3 PAL categories, respectively; and ‘IBDi' and ‘IBCi' are the model coefficients for the interaction of the 3 PAL categories with height and weight, respectively.
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The coefficients for Age, Height, and Weight may be thought of as slopes -- i.e., positive slopes represent increasing energy expenditure and negative slopes decreasing energy expenditure for a change in the corresponding variable holding the other values constant (e.g., for adult females, there is on average a decrease of 10.83 kcal/d for each 1-year increase in age, for women of the same weight, height, and physical activity level)
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By substitution of the four coefficients for PA, this prediction could also be written separately for each PAL category, as above. Also, similar to the TEE prediction equation above, the coefficient for Age remains constant for each PAL category.
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RQ source (will be labeled as indirect calorimetry for all) Lean body mass (DLWA35)
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Data Sets Requested: Physical Activity data sets: pa_derv_solnas_lad1.sas7bddat Variables requested: all the physical activity derived variables for those included in SOLNAS Data Sets Requested: Smoking variables from tbea_lad1.sas7bdat Variables requested: TBEA1-smoke at least 100 cigs in lifetime; TBEA3-present smoking status Data Sets Requested: Health status variables from mhea_lad1.sas7bdat Variables Requested: MHEA1-HBP/hypertension-self reported; MHEA16-diabe tes-self reported. SOURCE: Data from SOLNAS are publicly available on the National Heart, Lung, and Blood Institute's (NHLBI's)
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56.19] Body Mass Index N 5,010 2,897 7,907 Mean (SD)
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307 (12.8%) Total Energy Expenditure (kcal/d)
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39 (0.5%) Physical Activity Level Observed + Predicted (TEE/ BMR)
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57 (0.723%) NOTE: BMI = body mass index; BMR = basal metabolic rate; cm = centimeter; DLW = doubly labeled water; kcal/d = kilocalorie/day; kg = kilogram; m = meter; max = maximum; min = minimum; PAL = physical activity level; SD = standard deviation; TEE = total energy expenditure.
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14 (2.41%) Total Energy Expenditure (kcal/d)
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579.94] Physical Activity Level Observed + Predicted N 334 248 582 Mean (SD)
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8.50] Life Stage 1 –3 years 145 (22.7%)
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1,470.00] Physical Activity Level Observed N 300 194 494 Mean (SD)
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1,954.74] Physical Activity Level Observed + Predicted N 635 477 1,112 Mean (SD)
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18.90] Life Stage 9–13 years 184 (41.5%)
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3,010.00] Physical Activity Level Observed N 262 107 369 Mean (SD)
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4.03] Physical Activity Level Observed + Predicted PAL < 1 0 (0%)
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101.00] Life Stage 19–30 years 633 (17.5%)
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164 (2.98%) Total Energy Expenditure (kcal/d)
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41 (0.748%) NOTE: BMI = body mass index; BMR = basal metabolic rate; cm = centimeter; DLW = doubly labeled water; kcal/d = kilocalorie/day; kg = kilogram; m = meter; max = maximum; min = minimum; PAL = physical activity level; SD = standard deviation; TEE = total energy expenditure.
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TABLE H-6 Characteristics of Pregnant Women Included in Combined DLW Database 328 1st Trimester 2nd Trimester 3rd Trimester NPNL Overall (N = 31)
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Life Stage 19–30 years 19 (61.3%)
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54.82] Body Mass Index N 30 200 205 133 568 Mean (SD)
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2,392.59] Physical Activity Level Observed (TEE/BMR)
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51,034.18] Physical Activity Level Observed + Predicted N 31 201 206 133 571 Mean (SD)
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7 (1.23%) NOTE: BMI = body mass index; BMR = basal metabolic rate; cm = centimeter; DLW = doubly labeled water; kcal/d = kilocalorie/day; kg = kilogram; m = meter; max = maximum; min = minimum; NPNL = nonpregnant nonlactating; PAL = physical activity level; SD = standard deviation; TEE = total energy expenditure.
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41.00] Life Stage 19–30 years 54 (58.1%)
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9 (4.37%) Total Energy Expenditure (kcal/d)
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4 (1.93%) NOTE: BMI = body mass index; BMR = basal metabolic rate; cm = centimeter; DLW = doubly labeled water; kcal/d = kilocalorie/day; kg = kilogram; m = meter; max = maximum; min = minimum; mo = months; PAL = physical activity level; SD = standard deviation; TEE = total energy expenditure.
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Appendix I Characteristics of the DLW Validation Studies 337
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0 (0%) NOTE: BMI = body mass index; DLW = doubly labeled water; max = maximum; min = minimum; mo = months; PAL = physical activity level; PALCAT = PAL category; SD = standard deviation; TEE = total energy expenditure.
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APPENDIX I 339 Man Woman Overall (N = 32)
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Appendix J Summary of Data Extracted from Systematic Reviews and Other Reviewed Literature 341
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White surveys, and recall interviews Adamo et al., 13 110 males Indirect Mean 2009 1–18 y; White measures of physical difference European, activity included from DLW in U.S. African activity diaries boys American, or logs, U.S.
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From page 343... ...
typical week) ranging from –59.5% to 62.1%, self-reported PA energy expenditure for the previous month ranged from –13.3% to 11.4%, selfreported PA from the previous 12 months ranged from –77.6% to 112.5%.
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344 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-1 Continued Sample Predictor or Number Character- Intervention or Primary Author, Year of Studies istics Comparator Outcome Dowd et al., 2018 24 Males and Activity monitor DLW females ≥ determined energy 19 y; high- expenditure income countries Dowd et al., 2018 9 Males and Activity monitor Indirect females ≥ determined PA calorimetry 19 y; high- intensity and whole income room countries calorimetry PA intensity Dowd et al., 2018 31 Males and Activity monitor Indirect females ≥19 determined energy calorimetry EE y; high- expenditure income countries Dowd et al., 2018 3 Males and Pedometer DLW females ≥ determined EE 19y; high income countries Helmerhorst et 2 111 males Physical activity DLW al., 2012 and females questionnaires < 18 y; high-income countries
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of 11) Energy expenditure estimates from activity monitoring devices for total PA were compared against indirect calorimetry estimates, where MPD ranged from –41.4% to 115.7%.
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346 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-1 Continued Sample Predictor or Number Character- Intervention or Primary Author, Year of Studies istics Comparator Outcome Helmerhorst et 6 239 males Physical activity DLW al., 2012 and females questionnaires 18–65 y; high-income countries Helmerhorst et 2 86 males and Physical activity DLW al., 2012 females > questionnaires 65 y; high income countries Jeran et al., 2016 24 1,148 males Assess whether Crude R2 and females study or accelerometer ≥ 19 y; mix accelerometer device output vs. of general characteristics AEE or AEE population, influence the per kg soldiers, association between and patients accelerometer (COPD and derived physical cancer)
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APPENDIX J 347 Hetero- Overall geneity of AMSTAR2 Quantitative or Qualitative Finding(s) Risk of Bias Studies Rating For PA EE, Spearman r = 0.39 and MD -- -- Not well was −12.9 kJ/day from one study.
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348 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-1 Continued Sample Predictor or Number Character- Intervention or Primary Author, Year of Studies istics Comparator Outcome Pisanu et al., 2020 5 734 males REE estimated -- and females from wearable ≥ 19 y with accelerometer-based overweight devices and obesity; high-income countries Pisanu et al., 2020 9 339 males PA EE estimated -- and females from wearable ≥ 19 y with accelerometer–based overweight devices during and obesity; different structured high-income physical activities countries
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APPENDIX J 349 Hetero- Overall geneity of AMSTAR2 Quantitative or Qualitative Finding(s) Risk of Bias Studies Rating One study obtained an underestimation Risk of bias -- Well done/ of REE SWA, although the statistical was judged as reported significance was not specified.
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350 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-1 Continued Sample Predictor or Number Character- Intervention or Primary Author, Year of Studies istics Comparator Outcome Pisanu et al., 2020 5 185 males TEE or PA EE free- -- and females living from wearable ≥ 19 y with accelerometer-based overweight devices and obesity; high-income countries
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APPENDIX J 351 Hetero- Overall geneity of AMSTAR2 Quantitative or Qualitative Finding(s) Risk of Bias Studies Rating The accuracy of the Caltrac uniaxial Risk of bias -- Well done/ accelerometer in the measurement of was judged as reported TEE was evaluated: even if the accuracy low (or partially of the instrument was good at a group well done/ level, at the individual level, differences reported if were large.
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352 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-1 Continued Sample Predictor or Number Character- Intervention or Primary Author, Year of Studies istics Comparator Outcome Plasqui et al., 25 944 males Validity of wearable -- 2013 and females; PA monitor high-income estimates of EE countries Sharifzadeh et al., 30 3,877 males Physical activity -- 2021 and females; questionnaire TEE high-income (50 questionnaires) countries Sharifzadeh et al., 15 2,058 males Physical activity -- 2021 and females; questionnaire AEE high-income (35 questionnaires)
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Output from the 3dNX accelerometer significantly increased the prediction of TEE in addition to FFM. The Tracmor significantly contributed to the prediction of TEE after correcting for sleeping metabolic rate, body mass, or FFM.
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354 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-1 Continued Sample Predictor or Number Character- Intervention or Primary Author, Year of Studies istics Comparator Outcome Tudor-Locke et 8 Males and Pedometer versus -- al., 2002 females; energy expenditure high-income countries Tudor-Locke et 8 Males and Pedometer versus -- al., 2002 females; energy expenditure high-income countries NOTE: AEE = activity energy expenditure; COPD = chronic obstructive pulmonary disease; DLW = doubly labeled water; EE = energy expenditure; ES = effect size; FFM = fat-free mass; IDEEA = Intelligent Device for Energy Expenditure and physical Activity; kcal = kilocalories; kg = kilogram; kJ = kilojoule; LIPA = light-intensity physical activity; MD = mean difference; MET = metabolic equivalent of task; MPA = moderate-intensity physical activity; MPD = mean percentage difference; PA = physical activity; PAL = physical activity level; PAQ = physical activity questionnaire; REE = resting energy expenditure; SD = standard deviation; SWA = SenseWear Armband; TEE = total energy expenditure; VPA = vigorous-intensity physical activity; WMD = weighted mean difference; y = years.
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. Pedometers generally correlate with -- -- Not well indirect calorimetry from r = 0.49 to done/ 0.81 reported
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. Sensitivity analysis produced similar results Park et al., 15 Adults -- -- -- 2020 19–50 y with obesity or lean/ normal weight Quatela et 19 Male and Total energy DIT; RMR The effect of al., 2016 (related female intake energy intake on to adults 19 y DIT (coefficient, energy)
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The thermic effect of alcohol is similar to that of protein. Therefore, the main determinants of DIT are the energy content and protein fraction of the diet.
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NOTE: AEE = activity energy expenditure; BMI = body mass index; C = controls; CT = constitutional thinness; DLW = doubly labeled water; FFM = fat-free mass; PAL = physical activity level; REE = resting energy expenditure; RMR = resting metabolic rate; RQ = respiratory quotient; TEE = total energy expenditure; y = years.
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Bias Studies Rating See Table 9 in Bailly et al., 2021: CT -- -- Partially well individuals have a lower TEE, REE done/reported compared to normal weight; No diff in RQ, AEE, PAL between CT and normal weight; RMR/FFM trend of significant difference such that C < CT (p = .083)
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360 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-4 Evidenc e on the Effec t or Asso c iation of Weight Cyc ling with Metabolic Effic ienc y (Energy Usage/Expenditure) and Health Outc omes: System atic Reviews and Observ ational Studies Predictor or Number Intervention Author, of Sample or Primary Quantitative Year Studies Characteristics Comparator Outcome Finding(s)
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Although weight loss associated -- -- -- with reduced REE, there was no association between REE and weight cycling in adults with class I/II obesity In overweight and obese adults -- -- -- age 22–45, weight cycling shows a reduced REE when adjusted for organ and tissue mass. Behavioral interventions for weight -- I2, 75% Well done/ loss maintenance in obese adults reported reduces risk for weight regain/ cycling.
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Fothergill et -- 14 males and Diet and TEE and REE al., 2016 females 19–50 exercise REE reduced y with class III 704 ± 427 obesity kcal/d below baseline at 6 years after weight loss (p < .0001) Zhang et 4 92,063 females Weight Endometrial Odds ratio, al., 2019 19 y and older cycling cancer 1.23 to 2.33 NOTE: BMI = body mass index; CI = confidence interval; CVD = cardiovascular disease; N/A = not applicable; REE = resting energy expenditure; RR = relative risk; TEE = total energy expenditure; y = years.
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low risk of bias, 38 medium risk of bias Metabolic adaptation in morbid -- -- -- obesity is associated with the degree of weight loss; REE and TEE remain reduced for 6 years after weight loss even with weight regain or increased physical activity. Weight cycling is associated with -- -- Partially well 1.2- to 2.3-fold increased risk for done/reported endometrial cancer in females age ≥ 18y.
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364 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-5 Evidence on the Effect of Race or Ethnicity on Energy Expenditure Author, Year Populations Sex Life Stage Albu et al., 1997 B/W F Adults Foster et al., 1999 B/W F Adults Jakicic and Wing, 1998 B/W F Adults Mika Horie et al., 2009 B/W F Adults Reneau et al., 2019 B/W F/M Adults Shook et al., 2014 B/W F Adults Olivier et al., 2016 B/W F Adults Sharp et al., 2002 B/W F/M Adults Spaeth et al., 2015 B/W F/M Adults Vander Weg et al., 2004 B/W F Adults Wang et al., 2010 B/W F Adults Adzika Nsatimba et al., 2016 B/W F/M Adults Forman et al., 1998 B/W F Adults Santa-Clara et al., 2006 B/W F Adults Vander Weg et al., 2000 B/W F/M Adults Martin et al., 2004 B/W F/M Adults Most et al., 2018 B/W F Adults Manini et al., 2011 B/W F/M Adults Désilets et al., 2006 B/W F/M Adults Rush et al., 1997 Maori/W F Adults Wouters-Adriaens and Asian/W F/M Adults Westerterp, 2008 Byrne et al., 2003 B/W F Adults Hunter et al., 2000 B/W F Adults Deemer et al., 2010 Hispanic/W F Adults
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W REE difference, adjusted 119 Lower REE in Maori vs. W REE no difference, adjusted 0 Equal REE after adjusting for body composition REE no difference, adjusted 0 Equal REE after adjusting for detailed composition REE no difference, adjusted 0 Equal EE after adjusting for trunk lean body mass REE no difference, adjusted 0 Equal REE but unadjusted continued
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366 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-5 Continued Author, Year Populations Sex Life Stage Soares et al., 1998 Indian/W F/M Adults Weyer et al., 1999 Pima/W F/M Adults Javed et al., 2010 B/W F/M Adults Jones et al., 2004 B/W F Adults Gallagher et al., 2006 B/W F/M Adults Gallagher et al., 1997 B/W F/M Adults Song et al., 2016 Chinese/Indian/ M Adults Malay Tranah et al., 2011 B/W F/M Adults Glass et al., 2002 B/W F Adults DeLany et al., 2014 B/W F Adults Dugas et al., 2009 B/W F Adults Lam et al., 2014 B/W F/M Adults Weinsier et al., 2000 B/W F Adults Most et al., 2018 B/W F Adults Blanc et al., 2004 B/W F/M Adults Walsh et al., 2004 B/W F Adults Weyer et al., 1999 Pima/W F/M Adults Katzmaryk et al., 2018 B/W F/M Adults Hunter et al., 2000 B/W F Adults Kushner et al., 1995 B/W F Adults Lovejoy et al., 2001 B/W F Adults Saad et al., 1991 Pima/W M Adults Christin et al., 1993 Pima/W M Adults Fontvieille et al., 1994 Pima/W F/M Adults
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W, equal SMR REE no difference - HMRO 0 Equal after adjusting for organ metabolic rate REE no difference - HMRO 0 Equal after adjusting for skeletal muscle mass REE no difference - HMRO 0 Organ sizes/metabolic rates REE no difference - HMRO 0 Body composition differences REE no difference - HMRO 0 Lower EE in Asians, equal when adjusting for trunk lean body mass REE no difference - mtDNA 0 Equal EE after adjusting for mtDNA haplotypes; elderly REE no difference -unadjusted 0 Equal EE TEE difference - adjusted 233 Lower EE B vs. W TEE difference - adjusted 105 Lower EE in B vs.
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368 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-5 Continued Author, Year Populations Sex Life Stage Tershakovec et al., 2002 B/W F/M Children Wong et al., 1996 B/W F Children Bandini et al., 2002 B/W F Children Morrison et al., 1996 B/W F Children Yanovski et al., 1997 B/W F Children Wong et al., 1999 B/W F Children Sun et al., 2001 B/W F/M Children McDuffie et al., 2004 B/W F/M Children Pretorius et al., 2021 B/W F/M Children Sun et al., 1998 B/W F/M Children Broadney et al., 2018 B/W F/M Children Hanks et al., 2015 B/W M Children Rush et al., 2003 Maori/Pacific F/M Children Islander/W Spurr et al., 1992 Mestizo/B/ F/M Children Amerindian Goran et al., 1995 Mohawk/W F/M Children Fontvieille et al., 1992 Pima/W F/M Children Bandini et al., 2002 B/W F Children DeLany et al., 2002 B/W F/M Children Dugas et al., 2008 Hispanic/W F Children Sun et al., 1998 B/W F/M Children Goran et al., 1998 B/W/Mohawk/ F/M Children Guatemalan Goran et al., 1995 Mohawk/W F/M Children NOTE: AEE = activity energy expenditure; B = Black; BMD = bone mineral density; EE = energy expenditure; F = female; HMRO = high-metabolic-rate organs; kcal/d = kilocalorie per day; M = male; mtDNA = mitochondrial DNA; REE = resting energy expenditure; SMR = sleeping metabolic rate; TEE = total energy expenditure; W = White.
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W, attenuated with inclusion of trunk lean body mass REE difference - adjusted 52 Testing REE predictive equations; greater overestimation in B REE difference - adjusted 62 Lower REE,TEE, AEE in B vs. W REE difference - adjusted 120 Lower REE in B vs.
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370 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-6 Evidence on How Physical Activity and Energy Expenditure Change Across the Life Span: Systematic Reviews Predictor or Number Sample Intervention or Primary Author, Year of Studies Characteristics Comparator Outcome Craigie et al., 22 11,889 males and Association -- 2011 females, children between physical and adults from activity levels high-income at baseline and countries follow-up Craigie et al., 13 4,999 males and Maintenance of -- 2011 females, children relative position -- and adults from physical activity high-income countries Craigie et al., 10 17,654 males and The probability of -- 2011 females, children being physically and adults from active at follow high-income up according to countries activity at baseline
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However, a comparison of their findings is complicated by the variation in categories used in their analyses. The Amsterdam Growth and Health Longitudinal Study reported general daily physical activity: those in the lowest quartile for daily physical activity at 13 years old were 3.6 times more likely (95% CI, 2.4–5.4)
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372 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-6 Continued Predictor or Number Sample Intervention or Primary Author, Year of Studies Characteristics Comparator Outcome Foulds et al., 8 915 males and Average PALs -- PAL via 2013 females; Native adults DLW and American metabolic population in chamber Canada and United States Foulds et al., 2 408 males and Average PALs -- PAL via 2013 females; Native adults DLW and American metabolic population in chamber Canada and United States Foulds et al., 5 > 100,000 males Physical activity PAL via self2013 published and females; change over time report from 1980 Native American to 1989, population in 14 from Canada and 1990 to United States 1999, and 20 from 2000 to 2011
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Among children at age 5 years, Citations -- Partially well overall average total energy included in done/reported expenditure was found to be 5.93 the physical MJ, with 1.17 MJ of activity energy activity expenditure, resulting in a PAL ratio behavior of 1.42. Results among other ages of assessment children/youth are not available in consisted of the literature.
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on Energy Balance or Energy Expenditure: Systematic Reviews Number Predictor or of Sample Intervention or Primary Author, Year Studies Characteristics Comparator Outcome Ashtary-Larky 7 361 males and Gradual weight Weight change et al., 2020 females 19 y loss and older with overweight and obesity Cheng et al., 12 1,499 males and Pubertal REE 2016 females 9–18 y Nunes et al., 33 2,528 males and Weight loss REE or TEE 2022 females 19 y and older
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Bias Studies Rating Gradual weight Gradual weight loss 3/7 low -- Partially loss preserved produces less reduction well done/ REE by ~100 kcals in REE than rapid weight reported compared to rapid loss and a greater loss of weight loss fat mass and percent body fat. REE increases 12% Both REE and TEE are Medium -- Partially and TEE increases significantly higher during well done/ 16% during puberty.
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From page 376... ...
376 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-7 Continued Number Predictor or of Sample Intervention or Primary Author, Year Studies Characteristics Comparator Outcome Schwartz and 90 2,996 males and Diet or diet REE Doucet, 2010 females 19 y plus exercise and older with or diet plus overweight and pharmacological obesity intervention Dhurandar et 32 1,680 males Diet Compensation al., 2015 and females 19–50 y with normal weight, overweight, and obesity Kee et al., 2012 20 Males and BMI REE females 19–50 y with morbid obesity (BMI ≥ 40) Nunes et al., 94 males and Diet; calorie REE 2021 females 19 y restriction and older with averaged 270 overweight and kcal/d obesity Schwartz et al., 90 815 males and Diet or diet plus REE 2012 females 19 y exercise or diet and older with plus weight loss overweight and intervention obesity NOTE: BMI = body mass index; kcal = kilocalorie; kg = kilogram; REE = resting energy expenditure; TEE = total energy expenditure; y = years.
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Bias Studies Rating REE decreases 15 The 15-kcal/kg decrease -- -- Not well kcal/kg during in REE during weight done/ weight loss. loss does not differ by reported sex.
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From page 378... ...
TABLE J-9a Evidence on How the Increase in Tissue Deposition Associated with Pregnancy Influences, Effects, or Contributes to Energy Requirements: Nonsystematic Reviews Author, Year N Age (SD) BMI Status Ethnicity Catalano et al., 6 normal, 10 31.8 y (5.5)
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28.0 (9.1) Gestational Weight Gain Protein Gain FFM Gain FM Gain g/day (SD)
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380 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-9b Evidence on How the Increase in Tissue Deposition Associated with Pregnancy Influences, Effects, or Contributes to Energy Requirements: Systematic Reviews Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Savard et 32 Pregnant women, Pregnancy REE/TEE al., 2021 mostly White NOTE: kcal = kilocalorie; REE = resting energy expenditure; TEE = total energy expenditure.
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Risk of Bias Studies Rating Increases in REE ranged REE and TEE Huge -- Partially from 0.5% to 18.3% (8 to increase during variability. well done/ 239 kcal)
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From page 382... ...
25.0 (3.9) White 2011 30 with 26 EBF Nielsen et al., -- -- -- 2013 NOTE: BF = breast feeding; BMI = body mass index; DLW = doubly labeled water; EBF = exclusively breast feeding; FFM = fat-free mass; FM = fat mass; g = gram; kcal/d = kilocalories/day; kg = kilogram; kJ = kilojoule; ml = milliliter; pp = postpartum; REE = resting energy expenditure; SD = standard deviation; TEE = total energy expenditure; y = years.
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No difference by sex. Energy intakes male 2,582 (SD = 362)
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From page 384... ...
384 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-10b Evidence on How the Increase in Tissue Deposition Associated with Lactation Influences, Effects, or Contributes to Energy Requirements: Systematic Reviews Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Reilly et al., 3–4 months, 3–4 months, 1,041; Not applicable Milk transfer 2005 33; 5–6 5–6 months, 99; months, 6; at 6 months, 72 6 months, 5 mom–infant dyads; exclusively breast feeding NOTE: CI = confidence interval; d = day; g = gram; kcal = kilocalorie; kJ = kilojoule; SD = standard deviation; WHO = World Health Organization.
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From page 385... ...
Bias Studies Rating At 3–4 months: The Cross-sectional Risk of -- Partially weighted mean milk studies of milk bias was well done/ transfer was 779 g/d (SD transfer suggest provided reported = 40) , and the unweighted that it typically for mean was 796 g/d (SD varies between included = 48)
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From page 386... ...
, or Weight Gain (if Underweight) : Systematic Reviews Sample Predictor or Number of Character- Intervention or Primary Author, Year Studies istics Comparator Outcome Heymsfield et 10 150 obese Relationship between TEE-DLW al., 2007 subjects on measured and or indirect low-calorie predicted TEE among calorimeter diet and reduced obesity after patients with long-term ( 26 reduced weeks)
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From page 387... ...
Bias Studies Rating Mean difference Limited literature, but -- -- Not well between measured findings support that done/ and predicted TEE for low patient adherence reported all reduced obesity is the main basis for subjects 20.1 kcal/ modest weight loss day (–58, –155) % associated with LCD.
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From page 388... ...
388 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-12 Evidence on the Association Between Weight Change and Chronic Disease Outcomes: Systematic Reviews Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Alharbi et 2 715 community- Intentional All-cause al., 2021 dwelling males weight loss mortality risk and females 65 y and older; not all from high-income countries Alharbi et 23 1,210,116 Weight gain All-cause al., 2021 community- mortality risk dwelling males and females 65 y and older; not all from high-income countries
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From page 389... ...
losses were intentional p = .01; I2 = Weight gain had a 41% small, but significant association with all cause mortality. In community-dwelling older adults, weight gains are associated with an increased risk of all cause mortality relative to stable weight.
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From page 390... ...
390 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-12 Continued Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Alharbi et 4 6,901 community- Weight All-cause al., 2021 dwelling males fluctuation mortality risk and females 65 y and older; not all from high-income countries Capristo et 17 39,875 males and Weight loss All-cause al., 2021 females ≥ 18 y associated with mortality with overweight anti-obesity or obesity; not all medications from high-income countries
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From page 391... ...
losses were intentional p = .31; I2 = A 63% increased risk 14.6% of all-cause mortality with weight fluctuation compared to stable weight reference In community-dwelling older adults, weight fluctuations are associated with an increased risk of all cause mortality relative to stable weight. Weight fluctuation data were a mixture of measured and self reported.
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From page 392... ...
392 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-12 Continued Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Capristo et al., 2021 (continued) Capristo et 8 28,657 males and Weight loss Cardioal., 2021 females ≥ 18 y associated with vascular with overweight antiobesity mortality or obesity; not all medications from high-income countries Capristo et 7 30,404 males and Weight loss Myocardial al., 2021 females ≥ 18 y associated with infarction with overweight anti-obesity or obesity; not all medications from high-income countries
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From page 393... ...
Risk of Bias Studies Rating Although unable to demonstrate a superiority of anti obesity medications over placebo, meta regression showed that even a small weight reduction tends to reduce all-cause mortality in obesity. The health status of participants is not described.
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From page 394... ...
394 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-12 Continued Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Capristo et 4 21,584 males and Weight loss Stroke al., 2021 females ≥ 18 y associated with with overweight anti-obesity or obesity; not all medications from high-income countries Chan et al., 8 1,373 females ≥ 18 Adult weight Premenopausal 2019 y; underweight loss of unknown breast cancer women (BMI < intention 18.5) excluded; not all from high income countries Chan et al., 14 8,283 females ≥ 18 Adult weight Postmenopausal 2019 y; underweight loss of unknown breast cancer women (BMI < intention 18.5)
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From page 395... ...
Risk of Bias Studies Rating OR (95% CI) : Unable to demonstrate Suboptimal No Not well 0.93 (0.72– effect of weight loss quality heterogeneity done/ 1.20)
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From page 396... ...
not all from high income countries Chan et al., 16 Females ≥ 18 Adult weight Postmenopausal 2019 y; underweight gain per 5 kg breast cancer women (BMI < (of unknown 18.5) excluded; intention)
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From page 397... ...
Risk of Bias Studies Rating RR (95% CI) No association of Most studies I2 = 20.7%, p Not well = 1.00 (0.97– weight gain and considered = .265 done/ 1.03)
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From page 398... ...
398 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-12 Continued Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Hao et al., 19 862,177 females ≥ Highest adult Onset of breast 2021 19 y; American, weight gain since cancer or total European, early adulthood cancers Australia, Asian for both whole (Japanese, Chinese) adulthood and hormone-changed menopause stages
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From page 399... ...
lowest adult weight gain. For postmenopausal women, there was a significant effect of weight gain since menopause on breast cancer risk.
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From page 400... ...
400 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-12 Continued Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Jayedi et 5 134,247 males and Weight gain Hypertension al., 2018 females; general equal to a 1-unit incidence population > 18 y increment in with > 1 y follow- BMI (both up; high-income self-reported countries and measured weights)
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From page 401... ...
Risk of Bias Studies Rating There was There was a linear No data I2 = 77.8%. p Well done/ a linear association between heterogeneity reported association weight gain and risk of = 0.001 between hypertension (p nonweight gain linearity = 0.58)
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From page 402... ...
, Middle East (1) CVD Jayedi et 2 118,140 males Weight gain CVD incidence al., 2020 and females ≥ during adulthood 18 y reporting unintended weight gain during adulthood or before assessment; Europe (13)
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From page 403... ...
indicated that the risk score of 9, = < 0.001; p reported for a 5-kg of CVD mortality did 1/3 of the heterogeneity increment in not change materially studies were between body weight with weight gain of 0 to rated as 7 subgroups = 5 kg and then increased and 2/3 as 8. 0.15 sharply at weight gain of > 6 kg.
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From page 404... ...
404 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-12 Continued Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome Karahalios 18 Healthy adults Weight at All-cause et al., 2017 measured between baseline and mortality middle and older follow-up based age on measured weight (subgroup No data on number analysis) of participants
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From page 405... ...
Weight gain in middle aged to older adults is associated with muscle mass decreases and fat-mass increases, with the largest increase in visceral and abdominal fat. Weight gain from middle to older adulthood was associated with a slightly increased risk of all-cause mortality.
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From page 406... ...
Included both intentional and unintentional weight gain. Excluded studies that investigated weight gain from early adulthood to middle age; included studies of weight gain from middle age to older age.
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From page 407... ...
Studies Weight gain in midlife with > 10 is associated with y between increased risk of CVD weight mortality. measurements had higher HRs than studies with < 10 y HR = 1.44 Results from weight-loss No data No data Partially (95% CI = studies with measured well done/ 1.03, 2.00)
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From page 408... ...
408 DIETARY REFERENCE INTAKES FOR ENERGY TABLE J-12 Continued Predictor or Author, Number of Sample Intervention or Primary Year Studies Characteristics Comparator Outcome LeBlanc et 9 Males and females Behavior-based Diabetes al., 2018 ≥ 19 y; high- weight loss incidence in income countries prediabetic participants Included studies with ≥ 12 months follow-up and participants ≥ 18 y with above normal weight. Excluded studies with participants with chronic diseases or secondary causes of obesity.
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