Total daily energy expenditure in wasted chronic obstructive pulmonary disease patients.
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.
Tang
N L S
NL
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
Chung
M L
ML
Elia
M
M
Hui
E
E
Lum
C M
CM
Luk
J K H
JK
Jones
M G
MG
Woo
J
J
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