title: Basal metabolism of weight-stable chronically undernourished men and women: lack of metabolic adaptation and ethnic differences.
abstract: The purpose of this study was to investigate whether weight-stable chronically energy-deficient subjects exhibit evidence of metabolic adaptation and to establish whether international predictive equations overestimate the basal metabolic rate (BMR) of tropical populations. BMR, body weight, height, and fat-free mass (FFM) by underwater weighing were measured in healthy, physically active urban dwellers of low socioeconomic status (178 men and women aged 22-38 y) in Bangalore, Southern India. Subjects were selected on the basis of body mass index (BMI; in kg/m2) and classified in three groups: severely undernourished (BMI < 17.0; n = 30 men, n = 25 women), marginally undernourished (BMI = 17.0-18.5; n = 31 men, n = 30 women), and well nourished (BMI > 18.5; n = 27 men, n = 35 women). The BMR of the well-nourished group, expressed in absolute terms (6.20 and 5.18 MJ/d for men and women, respectively), was significantly higher (P < 0.000) than that of the severely undernourished group (5.72 and 4.64 MJ/d for men and women, respectively). Normalizing BMR for either body weight or FFM by analysis of covariance abolished all differences. The mean BMR of the low-BMI study group was substantially higher (11-14%) than reported previously for undernourished Indian adults. The BMR of both men and women, regardless of their nutritional status, was accurately estimated by age- and sex-specific FAO/WHO/UNU equations. These findings suggest the absence of an enhanced metabolic response in weight-stable chronically undernourished adults. This is in contrast with earlier reports, and supports more recent views. The study also provides evidence of the absence of ethnic-specific energy turnover in Indians.
authors.affiliation: Unit of Human Nutrition, National Institute of Nutrition, Rome, Italy. afl.@inn.ingrm.it
authors.forename: A
authors.initials: A
authors.lastname: Ferro-Luzzi
authors.forename: C
authors.initials: C
authors.lastname: Petracchi
authors.forename: R
authors.initials: R
authors.lastname: Kuriyan
authors.forename: A V
authors.initials: AV
authors.lastname: Kurpad
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001481:Basal Metabolism; D015992:Body Mass Index; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D009748:Nutrition Disorders / Q000145:classification / Q000208:ethnology / Q000378:metabolism*; D009752:Nutritional Status; D012923:Social Class; D014329:Tropical Climate; D014505:Urban Population