There was not an apparent decline in GDR with age or time since menopause per se. However, E2 action on GDR was dependent on time since menopause, such that there was an apparent benefit early (≤ 6 years) compared to harm later (≥ 10 years) in menopause. E2-mediated effects on insulin action may be one mechanism by which HT reduces the incidence of T2D in early postmenopausal women.
Automatic recognition of activities of daily living (ADL) is an important component in understanding of energy balance, quality of life, and other areas of health and well-being. In our previous work, we had proposed an insole-based activity monitor-SmartStep, designed to be socially acceptable and comfortable. The goals of the current study were: first, validation of SmartStep in recognition of a broad set of ADL; second, comparison of the SmartStep to a wrist sensor and testing these in combination; third, evaluation of SmartStep's accuracy in measuring wear noncompliance and a novel activity class (driving); fourth, performing the validation in free living against a well-studied criterion measure (ActivPAL, PAL Technologies); and fifth, quantitative evaluation of the perceived comfort of SmartStep. The activity classification models were developed from a laboratory study consisting of 13 different activities under controlled conditions. Leave-one-out cross validation showed 89% accuracy for the combined SmartStep and wrist sensor, 81% for the SmartStep alone, and 69% for the wrist sensor alone. When household activities were grouped together as one class, SmartStep performed equally well compared to the combination of SmartStep and wrist-worn sensor (90% versus 94%), whereas the accuracy of the wrist sensor increased marginally (73% from 69%). SmartStep achieved 92% accuracy in recognition of nonwear and 82% in recognition of driving. Participants then were studied for a day under free-living conditions. The overall agreement with ActivPAL was 82.5% (compared to 97% for the laboratory study). The SmartStep scored the best on the perceived comfort reported at the end of the study. These results suggest that insole-based activity sensors may present a compelling alternative or companion to commonly used wrist devices.
When the doubly labeled water (DLW) method is used to measure total daily energy expenditure (TDEE), isotope measurements are typically performed using isotope ratio mass spectrometry (IRMS). New technologies, such as off-axis integrated cavity output spectroscopy (OA-ICOS) provide comparable isotopic measurements of standard waters and human urine samples, but the accuracy of carbon dioxide production (V̇co) determined with OA-ICOS has not been demonstrated. We compared simultaneous measurement V̇co obtained using whole-room indirect calorimetry (IC) with DLW-based measurements from IRMS and OA-ICOS. Seventeen subjects (10 female; 22 to 63 yr) were studied for 7 consecutive days in the IC. Subjects consumed a dose of 0.25 g HO (98% APE) and 0.14 g HO (99.8% APE) per kilogram of total body water, and urine samples were obtained on days 1 and 8 to measure average daily V̇co using OA-ICOS and IRMS. V̇co was calculated using both the plateau and intercept methods. There were no differences in V̇co measured by OA-ICOS or IRMS compared with IC when the plateau method was used. When the intercept method was used, V̇co using OA-ICOS did not differ from IC, but V̇co measured using IRMS was significantly lower than IC. Accuracy (~1-5%), precision (~8%), intraclass correlation coefficients ( R = 0.87-90), and root mean squared error (30-40 liters/day) of V̇co measured by OA-ICOS and IRMS were similar. Both OA-ICOS and IRMS produced measurements of V̇co with comparable accuracy and precision compared with IC.
Although neither specific timing of DLW water studies nor intraindividual comparisons were found to be avenues for reducing the impact of background isotope abundance fluctuations on DLW studies, strong inter-isotope correlations within an individual confirm that use of a dosing ratio of 8‰:1‰ (0.6 p.p.m.: p.p.m.) optimizes DLW precision. Theoretical implications for the possible use of (17)O measurements within a DLW study require further study.
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