Purpose: This study evaluated the validity of a physical activity classification table (PACT) based on total energy expenditure (TEE) and physical activity level (PAL) measured using the doubly labeled water (DLW) method in Korean adults and the elderly. Methods: A total of 141 (male 70, female 71) adults and elderly were included. The reference standards TEEDLW , PALDLW were measured over a 14-day period using DLW. A 24-hour physical activity diary was kept for three days (two days during the week and one day on the weekend). PALPACT was calculated by classifying the activity type and intensity using the PACT. PALPACT was multiplied by resting energy expenditure measured by indirect calorimetry to estimate TEEPACT . Results: The mean age of the study participants was 50.5 ± 18.8 years, and the mean body mass index was 23.4 ± 3.3 kg/m2 . A comparison of TEEDLW and TEEPACT by sex and age showed no significant differences. The bias, the difference between TEEDLW and TEEPACT , was male 17.3 kcal/day and female −4.5 kcal/day. The percentage of accurate predictions (values within ± 10% of the TEEDLW ) of TEEPACT was 58.6% in males and 54.9% in females, with the highest prediction values in the age group 40–64 years (70.9%) in males and over 65 years (73.9%) in females. The spearman correlation coefficient (r) between TEEPACT and TEEDLW was 0.769, indicating a significant positive correlation (p < 0.001). Conclusion In this study, the use of a new PACT for calculating TEE and PAL was evaluated as valid. A web version of the software program and a smartphone application need to be developed using PACT to make it easier to apply for research purposes.

Purpose: The purpose of the first part of this study was to evaluate the validity of the physical activity classification table for youth (Youth-PACT). The second part of this study was aimed at comparing the estimated energy requirement (EER) with the total energy expenditure (TEE) and evaluating the physical activity patterns of Korean children and adolescents. Methods: The subjects of the first part of the study were 17 children aged 10 to 12 years, and their total energy expenditure (TEE DLW ) was measured using the double labeled water (DLW) method. A total of 166 children and adolescents aged 6-18 years participated in the second part of this study. Their resting energy expenditure (REE) was measured using indirect calorimetry and the TEE Youth-PACT and physical activity level were calculated by applying the Youth-PACT to the physical activity diary prepared by the subjects. Results: In the first part of this study, there were no significant differences between theTEE DLW and the TEE Youth-PACT. The TEE Youth-PACT accurately predicted TEE DLW in 37.5% of the subjects. In the second part of the study, the rates at which EER accurately predicted TEE Youth-PACT and overestimated TEE Youth-PACT were 29.6% and 47.3%, respectively. The time spent based on intensity of physical activity and the physical activity categories which were obtained using Youth-PACT showed different patterns according to sex and age group. Age showed significant positive correlations with REE, TEE, and the time spent in sedentary behavior, but age was significantly negatively correlated with REE/body weight, TEE/body weight, and the time spent in low-intensity and high-intensity activities. Conclusion The results of this study showed that the Youth-PACT can be used to evaluate the TEE and PAL of children and adolescents. However, further studies are needed to validate the TEE Youth-PACT and to set the EER for children and adolescents.

BACKGROUND/OBJECTIVES: The doubly labeled water (DLW) method is the gold standard for estimating total energy expenditure (TEE) and is also useful for verifying the validities of dietary evaluation tools. In this study, we compared the accuracy of total energy intakes (TEI) estimated by the 24-h diet recall method with TEE obtained using the doubly labeled water method. SUBJECTS/METHODS: This study involved 71 subjects aged 20–49 yrs. Over a 14-day period, three 24-h diet recalls per subject (2 weekdays and 1 weekend day) were used to estimate energy intakes, while TEE was measured using the DLW method. The paired t-test was used to determine the significance of differences between TEI and TEE results, and the accuracy of the 24-h recall method was determined by accuracy predictions percentage, root mean square error, and bias. RESULTS: Average study subject age was 33.4 ± 8.6 yrs. The association between TEI and TEE was positive and significant (r = 0.463, P < 0.001), and the difference between TEI (2,084.3 ± 684.2 kcal/day) and TEE (2,401.7 ± 480.3 kcal/day) was also significant (P < 0.001). In all study subjects, mean TEI was 12.0% (307.5 ± 629.3 kcal/day) less than mean TEE, and 12.2% (349.4 ± 632.5 kcal/day) less in men and 11.8% (266.7 ± 632.5 kcal/day) less in women. Rates of TEI underprediction for all study subjects, men, and women, were 60.5%, 51.4%, and 66.7%, respectively. CONCLUSIONS This study shows that 24-h diet recall underreports energy intakes. More research is needed to corroborate our findings and evaluate the accuracy of 24-h recall with respect to additional demographics.

Purpose: This study evaluated the accuracy of the 24-hour diet recall method for estimating energy intakes in elderly women using the doubly labeled water (DLW) method. Methods: The subjects were 23 elderly women with a mean age of 70.3 ± 3.3 years and body mass index (BMI) of 23.9 ± 2.8 kg/m 2 . The total energy expenditure (TEEDLW ) was determined by using the DLW and used to validate the 24-hour diet recall method. The total energy intake (TEI) was calculated from the 24-hour diet recall method for three days. Results: TEI (1,489.6 ± 211.1 kcal/day) was significantly lower than TEEDLW (2,023.5 ± 234.9 kcal/day) and was largely under-reported by −533.9 ± 228.0 kcal/day (−25.9%). The accurate prediction rate of elderly women in this study was 8.7%. The Bland-Altman plot, which was used to evaluate the TEI and the TEEDLW , showed that the agreement between them was negatively skewed, ranging from −980.8 kcal/day to −86.9 kcal/day. Conclusion This study showed that the energy intake of elderly women was underreported.Strategies to increase the accuracy of the 24-hour diet recall methods in the elderly women should be studied through analysis of factors that affect underreporting rate. Further studies will be needed to assess the validity of the 24-hour diet recall method in other population groups.

BACKGROUND/OBJECTIVES: The objectives of this study were to evaluate the accuracy of the Dietary Reference Intakes (DRI) for estimating the energy requirements of older adults, and to develop and validate new equations for predicting the energy requirements of this population group. MATERIALS/METHODS: The study subjects were 25 men and 23 women with a mean age of 72.2 ± 3.9 years and 70.0 ± 3.3 years, and mean BMI of 24.0 ± 2.1 and 23.9 ± 2.7, respectively. The total energy expenditure (TEE) was measured by using the doubly labeled water (DLW) method, and used to validate the DRI predictive equations for estimated energy requirements (EER) and to develop new EER predictive equations. These developed equations were cross-validated by using the leave-one-out technique. RESULTS: In men, the DRI equation had a −7.2% bias and accurately predicted the EER (meaning EER values within ±10% of the measured TEE) for 64% of the subjects, whereas our developed equation had a bias of −0.1% and an accuracy rate of 84%. In women, the bias was −6.6% for the DRI equation and 0.2% for our developed equation, and the accuracy rate was 74% and 83%, respectively. The predicted EER was strongly correlated with the measured TEE, for both the DRI equations and our developed equations (Pearson's r = 0.915 and 0.908, respectively). CONCLUSIONS: The DRI equations provided an acceptable prediction of EER in older adults and these study results therefore support the use of these equations in this population group. Our developed equations had a better predictive accuracy than the DRI equations, but more studies need to be performed to assess the performance of these new equations when applied to an independent sample of older adults.
Adult ; Aged ; Bias (Epidemiology) ; Energy Metabolism ; Female ; Humans ; Male ; Methods ; Nutritional Requirements ; Population Groups ; Recommended Dietary Allowances ; Water

BACKGROUND/OBJECTIVES: Dietary Reference Intakes (DRI) for energy are derived from total energy expenditure (TEE) measured using the doubly labelled water (DLW) method. The objective of this study was to assess the validity of DRI for predicting the energy requirements of elementary school-age children. SUBJECTS/METHODS: The present study involved 25 elementary school-age children aged between 9 and 11 years. TEE was assessed by the DLW method, and the results were compared with the TEE predicted by the DRI equations in order to evaluate accuracy. RESULTS: The subjects' TEE measured by the DLW method was 1,925.2 ± 380.9 kcal/day in boys and 1,930.0 ± 279.4 kcal/day in girls, whereas resting energy expenditure was 1,220.2 ± 176.9 kcal/day in boys and 1,245.9 ± 171.3 kcal/day for girls. The physical activity level was 1.58 ± 0.20 in boys and 1.55 ± 0.13 in girls. The mean bias between the predicted and measured TEE was 12.6% in boys and −1.6% in girls, and the percentage of accurate predictions was 28.6% and 63.6%, respectively. In boys, the equation resulted in underprediction of TEE among the subjects having low TEE values, whereas there was overprediction among subjects having high TEE values as shown by the Bland-Altman plot. On the contrary, this proportional bias was not observed in girls. CONCLUSIONS: The findings of this study suggest that the DRI equation for energy could result in the overestimation of energy requirements in elementary school-age boys. In the case of girls, the equations could be accurate at the group level. However, the DRI appears to be invalid for individual girls, as more than one third of girls had their TEE inaccurately predicted. We recommend more studies for confirmation of these results.
Bias (Epidemiology) ; Child* ; Energy Metabolism ; Female ; Humans ; Methods ; Motor Activity ; Nutritional Requirements ; Recommended Dietary Allowances* ; Water

No abstract available.

BACKGROUND/OBJECTIVES: The purpose of this study was to assess the accuracy of a dietary reference intake (DRI) predictive equation for estimated energy requirements (EER) in female college tennis athletes and non-athlete students using doubly labeled water (DLW) as a reference method. MATERIALS/METHODS: Fifteen female college students, including eight tennis athletes and seven non-athlete subjects (aged between 19 to 24 years), were involved in the study. Subjects' total energy expenditure (TEE) was measured by the DLW method, and EER were calculated using the DRI predictive equation. The accuracy of this equation was assessed by comparing the EER calculated using the DRI predictive equation (EER(DRI)) and TEE measured by the DLW method (TEE(DLW)) based on calculation of percentage difference mean and percentage of accurate prediction. The agreement between the two methods was assessed by the Bland-Altman method. RESULTS: The percentage difference mean between the methods was -1.1% in athletes and 1.8% in non-athlete subjects, whereas the percentage of accurate prediction was 37.5% and 85.7%, respectively. In the case of athletic subjects, the DRI predictive equation showed a clear bias negatively proportional to the subjects' TEE. CONCLUSIONS: The results from this study suggest that the DRI predictive equation could be used to obtain EER in non-athlete female college students at a group level. However, this equation would be difficult to use in the case of athletes at the group and individual levels. The development of a new and more appropriate equation for the prediction of energy expenditure in athletes is proposed.
Athletes* ; Bias (Epidemiology) ; Energy Metabolism ; Female* ; Humans ; Methods* ; Motor Activity ; Recommended Dietary Allowances* ; Sports ; Tennis* ; Water*

BACKGROUND/OBJECTIVES: The doubly labeled water (DLW) method is considered the gold standard for the measurement of total energy expenditure (TEE), which serves to estimate energy requirements. This study evaluated the accuracy of predictive dietary reference intake (DRI) equations for determining the estimated energy requirements (EER) of Korean adults by using the DLW as a reference method. SUBJECTS/METHODS: Seventy-one participants (35 men and 36 women) aged between 20 and 49 years were included in the study. The subjects' EER, calculated by using the DRI equation (EER(DRI)), was compared with their TEE measured by the DLW method (TEE(DLW)). RESULTS: The DRI equations for EER underestimated TEE by -36.3 kcal/day (-1.3%) in men and -104.5 kcal/day (-4.9%) in women. The percentages of accurate predictions among subjects were 77.1% in men and 62.9% in women. There was a strong linear correlation between EER(DRI) and TEE(DLW) (r=0.783, P<0.001 in men and r=0.810, P<0.001 in women). CONCLUSIONS: The present study supports the use of DRI prediction equations to determine EER in Korean adults. More studies are needed to confirm our results and to assess the validity of these equations in other population groups, including children, adolescents, and older adults.
Adolescent ; Adult* ; Child ; Energy Metabolism ; Female ; Humans ; Male ; Methods* ; Nutritional Requirements ; Population Groups ; Recommended Dietary Allowances* ; Water*

While the session-RPE (rating of perceived exertion) method can quantify training volume in athletes, this method is not able to evaluate energy expenditure (EE) during a training session. We developed an RPE-based activity record for assessing EE during athletic training, and we compared its results to those obtained using the flex-heart rate (flex-HR) method. The EE of nine female collegiate endurance runners was assessed by the RPE-based activity record and flex-HR methods during eight days in the normal training season. Subjects were asked to record their RPE in the record at 5-minute intervals, and to wear a HR monitor during training. All subjects also participated in an incremental treadmill exercise test, which was used to determine their RPE-EE and HR-EE regression equations. Although the RPE-based activity record significantly overestimated EE (RPE-activity record, 572 kcal/session; flex-HR method, 499 kcal/session; p = 0.031), it had high validity relative to the flex-HR method (intra-class correlation coefficient, 0.891; 95% confidence interval, 0.845–0.923) and there were no systematic errors in EE estimation between the two methods. Therefore, the RPE-based activity record can be used to assess EE during training in female runners. However, RPE-based activity record might overestimate EE for athletes who have more intermittent activities during training than endurance runners, because RPE takes more time for returning to the resting level than HR when the intensity of activity declines. Further research is needed to verify the validity of the RPE-based activity record for assessing EE during other sporting activities or measurement conditions, and to identify the factors affecting the degree of estimation error associated with this method.