Diminution in energy expenditure during lactation.

Illingworth, Peter; Jung, R. T.; Howie, P. W.; Leslie, Peter; Isles, T. E.

doi:10.1136/bmj.292.6518.437

Cited by 80 publications

(27 citation statements)

References 22 publications

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“…Alternatively, the differences observed were small enough that sample sizes of n ¼ 229 for both LACT and NPNL women would be required to show a significance at 80% power. This finding of a non-significant tendency for BMR to be higher in lactating women is in agreement with the majority of studies in both developing (Schutz et al, 1980;Singh et al, 1989;Guillermo-Tuazon et al, 1992;Madhavapeddi & Rao, 1992), and developed countries (Goldberg et al, 1991;Illingworth et al, 1986).…”

Section: Discussionsupporting

confidence: 92%

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting

2002

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Objectives:To examine the components of energy balance during lactation in a population of economically disadvantaged women in an urban developing country setting in order to better understand the metabolic response to lactation. Design. Cross-sectional comparison of lactating (LACT) and non-pregnant non-lactating (NPNL) women. Body size and composition were assessed via anthropometry, energy intake was measured using estimated diet records and energy expenditure using indirect calorimetry and the Flex-Heart Rate method. Setting: Low-income neighborhoods of Cali, Colombia. Subjects: Lactating women (n ¼ 15) studied at 2.4 AE 0.8, 5.5 AE 0.8 and 8.9 AE 1.2 months postpartum, and NPNL women (n ¼ 48) studied in three measurement rounds at 0, 3.5 AE 0.6 and 7.1 AE 1.0 months. Results: There were no significant differences between LACT and NPNL women in anthropometric dimensions, but LACT women showed decreases in waist -hip ratio, lean body mass and increases in mid-arm circumference and percentage body fat with time. Energy intake was higher in LACT women (P ¼ 0.04), but there were no significant between-group differences in energy expenditure variables. Conclusion: This group of women met the cost of lactation principally via increased energy intake.

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Section: Discussionsupporting

confidence: 92%

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting

2002

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“…Declines in basal metabolic rate (BMR) and in the energy costs of exercise may indicate energy conservation or augmented metabolic efficiency in some pregnant women (3,4). Conflicting data have been reported on BMR and resting metabolic rate (RMR) in lactating women, with some authors reporting that it increased (7,8) and others finding that it remained unchanged (9)(10)(11).…”

Section: Introductionmentioning

confidence: 82%

Adjustments in energy expenditure and substrate utilization during late pregnancy and lactation

Butte

Hopkinson

Mehta

et al. 1999

The American Journal of Clinical Nutrition

209

167

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Background: Metabolic adjustments occur during pregnancy and lactation to support fetal growth and milk synthesis; however, the effect of body composition and hormonal milieu on these changes is poorly understood. Objective: We hypothesized that energy metabolism changes during pregnancy and lactation to support fetal growth and milk synthesis, and that body composition and hormonal milieu influence these alterations. Design: We measured energy expenditure, body composition, and hormone, metabolite, and catecholamine concentrations in 76 women (40 lactating, 36 nonlactating) at 37 wk gestation and 3 and 6 mo postpartum. Total energy expenditure (TEE), basal metabolic rate (BMR), sleeping metabolic rate (SMR), and minimal SMR (MSMR) were measured with room calorimetry. Fatfree mass (FFM) and fat mass were estimated with a 4-component model. Results: TEE, BMR, SMR, and MSMR were 15-26% higher during pregnancy than postpartum after being adjusted for FFM, fat mass, and energy balance. TEE, SMR, and MSMR were higher in lactating than in nonlactating women. Fasting serum insulin, insulin-like growth factor I, fatty acids, and leptin, and 24-h urinary free norepinephrine, epinephrine, and dopamine correlated positively with TEE, BMR, SMR, and MSMR. In nonlactating women, the respiratory quotient decreased over time, carbohydrate oxidation decreased, and fat oxidation increased. Substrate utilization was not influenced by body composition, fasting serum hormones, or 24-h urinary catecholamines. Conclusions: These results indicate increased energy expenditure and preferential use of carbohydrates during pregnancy and lactation. Elevated respiratory quotient and carbohydrate utilization during pregnancy continue during lactation, consistent with preferential use of glucose by the fetus and mammary gland. Am J Clin Nutr 1999;69:299-307.

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“…However, others have reported similar REE in lactating women compared to the non-lactating state (Frigerio et al, 1991;Goldberg et al, 1991;Illingworth et al, 1986;Motil et al, 1990;Piers et al, 1995;van Raaij et al, 1991). Thus, during lactation there seem to be no significant changes in REE compared with non-pregnant, non-lactating women; furthermore, there also seem to be no significant changes in the efficiency of work perfomance or TEE (FAO/WHO/UNU, 2004;IoM, 2005).…”

Section: Lactationmentioning

confidence: 99%

Scientific Opinion on Dietary Reference Values for energy

Products¹

2013

EFSA Journal

167

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Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived dietary reference values for energy, which are provided as average requirements (ARs) of specified age and sex groups. For children and adults, total energy expenditure (TEE) was determined factorially from estimates of resting energy expenditure (REE) plus the energy needed for various levels of physical activity (PAL) associated with sustainable lifestyles in healthy individuals. To account for uncertainties inherent in the prediction of energy expenditure, ranges of the AR for energy were calculated with several equations for predicting REE in children (1-17 years) and adults. For practical reasons, only the REE estimated by the equations of Henry (2005) was used in the setting of the AR and multiplied with PAL values of 1.4, 1.6, 1.8 and 2.0, which approximately reflect low active (sedentary), moderately active, active and very active lifestyles. For estimating REE in adults, body heights measured in representative national surveys in 13 EU Member States and body masses calculated from heights assuming a body mass index of 22 kg/m 2 were used. For children, median body masses and heights from the WHO Growth Standards or from harmonised growth curves of children in the EU were used. Energy expenditure for growth was accounted for by a 1 % increase of PAL values for each age group. For infants (7-11 months), the AR was derived from TEE estimated by regression equation based on doubly labelled water (DLW) data, plus the energy needs for growth. For pregnant and lactating women, the additional energy for the deposition of newly formed tissue, and for milk output, was derived from data obtained by the DLW method and from factorial estimates, respectively. The proposed ARs for energy may need to be adapted depending on specific objectives and target populations. The DRVs for food energy provide a best estimate of the food energy needs of population groups within Europe. They are given as average requirements (ARs) of specified age and sex groups and are of limited use for individuals. The reference values need to be adapted to specific objectives, such as dietary assessment, dietary planning, labelling dietary reference values, or development of food-based dietary guidelines. In addition, there is a need to define and characterise the target population. © EuropeanIn this Opinion, total energy expenditure (TEE) in the steady state of a healthy body mass was chosen as the criterion on which to base the AR for energy. In practice, the adequacy of usual energy intakes is best monitored by measuring body mass. In terms of regulation of body mass, the overall energy balance over a prolonged period of time needs to be considered. TEE expended over 24 hours is the sum of basal energy expenditure, the energy expenditure of physical activity and the thermic effect of food. In this Opinion, resting energy expenditure (REE) was used as a proxy for the slightly lower basal energy expenditure, as most ...

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Diminution in energy expenditure during lactation.

Cited by 80 publications

References 22 publications

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting

Adjustments in energy expenditure and substrate utilization during late pregnancy and lactation

Scientific Opinion on Dietary Reference Values for energy

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