title: Total daily energy expenditure in wasted chronic obstructive pulmonary disease patients.
abstract: OBJECTIVE
  To investigate total daily energy expenditure in chronic obstructive pulmonary disease (COPD) patients during a rehabilitation programme.
  
  
  METHODS
  Observational study involving a case and a control group.
  
  
  METHODS
  Ten COPD patients (six with body mass index (BMI) <18.5 kg/m(2) and four with BMI >18.5 kg/m(2)) were evaluated for their energy expenditure profile. Four additional healthy age-matched volunteers were also included for methodology evaluation.
  
  
  METHODS
  Measurements of total daily energy expenditure (TEE), resting energy expenditure (REE) and diet-induced thermogenesis (DIT) and energy intake were undertaken by indirect calorimetry and bicarbonate-urea methods and dietary records.
  
  
  RESULTS
  REE in COPD patients was not significantly different from that predicted by the Harris-Benedict equation. Before the exercise day the mean TEE was 1508 kcal/day and physical activity level (PAL as calculated by TEE/REE) was 1.52. On the exercise day the TEE increased to 1568 kcal/day and PAL was 1.60, but neither of these changes were significant. The energy cost of increased physical activity during rehabilitation exercise was estimated to be 191 kcal/day. No significant change was found in DIT between the two patient groups. However, overall energy balances were found to be negative (-363 kcal/day).
  
  
  CONCLUSIONS
  The rehabilitation programme did not cause a significant energy demand in COPD patients. TEE in COPD patients was not greater than in free-living healthy subjects. Patients, who were underweight, did not have a higher TEE than patients with normal weight. This suggested that malnutrition in COPD patients was not due to an increased energy expenditure. On the other hand, a significant negative energy balance due to insufficient energy intake was found in seven out of 10 patients.
authors.affiliation: Department of Chemical Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, People's Republic of China. nelsontang@cuhk.edu.hk
authors.forename: N L S
authors.initials: NL
authors.lastname: Tang
authors.forename: M L
authors.initials: ML
authors.lastname: Chung
authors.forename: M
authors.initials: M
authors.lastname: Elia
authors.forename: E
authors.initials: E
authors.lastname: Hui
authors.forename: C M
authors.initials: CM
authors.lastname: Lum
authors.forename: J K H
authors.initials: JK
authors.lastname: Luk
authors.forename: M G
authors.initials: MG
authors.lastname: Jones
authors.forename: J
authors.initials: J
authors.lastname: Woo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015930:Diet Records; D002149:Energy Intake / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006723:Hong Kong; D006801:Humans; D009748:Nutrition Disorders / Q000378:metabolism*; D029424:Pulmonary Disease, Chronic Obstructive / Q000378:metabolism* / Q000534:rehabilitation; D022722:Thermogenesis / Q000502:physiology