Increased resting energy expenditure in cystic fibrosis

Buchdahl, Roger; M, Cox; Fulleylove, C.; Marchant, J L; Tomkins, Andrew; Brueton, M. J.; Warner, J O

doi:10.1152/jappl.1988.64.5.1810

Cited by 94 publications

(54 citation statements)

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“…It has been con®rmed that REE is elevated in patients which is consistent with previous research (Vaisman et al, 1987a,b;Buchdahl et al, 1988;O'Rawe et al, 1992;Grunow et al, 1993;Horswill et al, 1994;Bell et al, 1995Bell et al, , 1999Stallings et al, 1998). There were also signi®cant increases in the ECA in patients with CF during walking, even when the contribution of REE was accounted for.…”

Section: Discussionsupporting

confidence: 89%

“…There was no relationship between REE and genotype, which is consistent with others (Fried et al, 1991;Tomezsko et al, 1994). Researchers have also suggested that the increase in REE is related to pulmonary function (Vaisman et al, 1987a,b;Buchdahl et al, 1988;Fried et al, 1991;Amin & Dozor, 1994), however this study did not ®nd any relationship between REE and FEV 1 or FVC. This may be due to the small sample size or the small range in pulmonary function scores observed in this study.…”

Section: Discussionsupporting

confidence: 88%

“…The main effects are on the respiratory system, the digestive system and the sweat glands. There are many complications associated with the disease process, including chronic lung disease, malabsorption and malnutrition, which cause an increase in energy requirements (Vaisman et al, 1987a,b;Buchdahl et al, 1988;Grunow et al, 1993;Horswill et al, 1994;Bell et al, 1995). Hence, measurement of resting energy expenditure (REE) and total energy expenditure (TEE) is crucial to aid in optimal therapeutic regimes.…”

Section: Introductionmentioning

confidence: 99%

“…REE in patients with CF is often reported to be 10 ± 20% greater than in healthy subjects (Vaisman et al, 1987a,b;Buchdahl et al, 1988;O'Rawe et al, 1992;Grunow et al, 1993;Horswill et al, 1994;Bell et al, 1995Bell et al, , 1999Stallings et al, 1998). Although the speci®c reasons for this increase are unclear, the rise has been attributed to a number of possible mechanisms.…”

Section: Introductionmentioning

confidence: 99%

“…Although the speci®c reasons for this increase are unclear, the rise has been attributed to a number of possible mechanisms. These include declining pulmonary mechanics (Vaisman et al, 1987a;Buchdahl et al, 1988;Fried et al, 1991;Amin & Dozor, 1994), malnutrition (Vaisman et al, 1987a,b;Naon et al, 1993;Zemel et al, 1996), in¯ammation of the infectious agents within the lungs (Buchdahl et al, 1988;Naon et al, 1993;Steinkamp et al, 1993;Bell et al, 2000), genetics (O'Rawe et al, 1990(O'Rawe et al, , 1992Thomson et al, 1996;Zemel et al, 1996) and cellular iron transport defects (Feigal & Shapiro, 1979;Stutts et al, 1986). …”

Section: Introductionmentioning

confidence: 99%

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Energy cost of physical activity in cystic fibrosis

Richards

Davies²,

Bell³

2001

Eur J Clin Nutr

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Objective: The purpose of this study was to compare the energy cost of standardized physical activity (ECA) between patients with cystic ®brosis (CF) and healthy control subjects. Design: Cross-sectional study using patients with CF and volunteers from the community. Setting: University laboratory. Subjects: Fifteen patients (age 24.6 AE 4.6 y) recruited with consent from their treating physician and 16 healthy control subjects (age 25.3 AE 3.2) recruited via local advertisement. Interventions: Patients and controls walked on a computerised treadmill at 1.5 kmah for 60 min followed by a 60 min recovery period and, on a second occasion, cycled at 0.5 kp (kilopond), 30 rpm followed by a 60 min recovery. The ECA was measured via indirect calorimetry. Resting energy expenditure (REE), nutritional status, pulmonary function and genotype were determined. Results: The REE in patients was signi®cantly greater than the REE measured in controls (P 0.03) and was not related to the severity of lung disease or genotype. There was a signi®cant difference between groups when comparing the ECA for walking kg p FFM (P 0.001) and cycling kg p FFM (P 0.04). The ECA for each activity was adjusted (ECA adj ) for the contribution of REE (ECA kJ kg p FFM 120 min 71 7 REE kJ kg p FFM 120 min 71 ). ECA adj revealed a signi®cant difference between groups for the walking protocol (P 0.001) but no difference for the cycling protocol (P 0.45). This ®nding may be related to the fact that the work rate during walking was more highly regulated than during cycling. Conclusions: ECA in CF is increased and is likely to be explained by an additional energy-requiring component related to the exercise itself and not an increased REE.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Energy cost of physical activity in cystic fibrosis

Richards

Davies²,

Bell³

2001

Eur J Clin Nutr

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Toward quantifying the usage costs of human immunity: Altered metabolic rates and hormone levels during acute immune activation in men

Muehlenbein

Hirschtick

Bonner

et al. 2010

American J Hum Biol

121

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There is a paucity of data on the energetic demands of human immune functions, despite the fact that both clinical medicine and evolutionary biology would benefit from further clarification of these costs. To better understand the energetic requirements of mounting a mild immune response, as well as some of the major hormonal changes underlying these metabolic changes, we examined changes in resting metabolic rate (RMR) and hormones during and after respiratory tract infection in young adult men. An epidemiologic passive detection design was used to recruit 25 nonfebrile subjects naturally infected with respiratory tract pathogens. Symptomology, percent body fat, RMR, salivary testosterone and cortisol, and other information were collected at a minimum of three time points during and after convalescence. Comparisons of the differences in RMR, testosterone, and cortisol between sampling days within individual cases were made using paired t-tests. Participants experienced 8% higher RMR during illness, and a subset of these men experienced a mean increase greater than 14%. The participants also experienced 10% lower testosterone levels during illness, and a subset of these participants experienced a mean decrease of 30%, although cortisol levels did not change significantly. These results document elevated RMR following natural pathogen exposure in adult humans, demonstrating that even mild immune reactions can elicit significant increases in energy expenditure. Understanding the costs of immunity and the immunomodulatory actions of hormones are central to understanding the role of immunity in human life history evolution.

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Energy and Respiratory Metabolism in Cystic Fibrosis

Kane,

Hobbs

1991

J. pediatr. gastroenterol. nutr.

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SummaryThe basal energy expenditure (BEE) in a group of adolescent and young adult patients with cystic fibrosis (CF) with mild lung disease was 97 ± 6% of that predicted by the Harris‐Benedict equation (which estimates BEE by age, sex, height, and weight). The BEE of a group with more severe lung disease was 117 ± 5% of that predicted by the Harris‐Benedict equation, due primarily to a 14% greater oxygen consumption (Vo2) and 24% greater CO2 production (Vco2) compared with milder lung disease (p < 0.05). The measured BEE in the patients with mild lung disease correlated well with the predicted BEE, but variably underestimated that of patients with more advanced lung disease. The influence of low carbohydrate (Pulmocare) and higher carbohydrate (Instant Breakfast) nutritional supplements on the energy and pulmonary metabolism was compared in 10 malnourished CF patients with moderate to severe lung disease. Their BEE before ingesting the supplements was 120% of that predicted by the Harris‐Benedict equation. Their Vco2 increased 9–19% for the 3 h after ingesting 500 kcal/M2 of Pulmocare, and 25–30% after ingesting Instant Breakfast (p < 0.05). The respiratory quotient (RQ) was significantly greater for Instant Breakfast than Pulmocare. The minute ventilation (VE) rose 10–13% for the 3 h after ingesting Pulmocare, versus 27–31% after ingesting Instant Breakfast, but the difference was not significant. The metabolic expenditure rose 13–16% for the 3 h after ingesting both formulas. We concluded that CF patients have increasing difficulty maintaining their nutrition as their pulmonary disease progresses, in part because of a 17–20% increase in their BEE. Pulmocare resulted in a lower Vco2 and RQ than Instant Breakfast, suggesting it is a reasonable nutritional supplement in CF patients with moderate to severe pulmonary disease.

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Increased resting energy expenditure in cystic fibrosis

Cited by 94 publications

References 0 publications

Energy cost of physical activity in cystic fibrosis

Energy cost of physical activity in cystic fibrosis

Toward quantifying the usage costs of human immunity: Altered metabolic rates and hormone levels during acute immune activation in men

Energy and Respiratory Metabolism in Cystic Fibrosis

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