title: The measurement and estimation of total energy expenditure in Japanese patients with ALS: a doubly labelled water method study.
abstract: Appropriate nutritional therapy has not been established for patients with amyotrophic lateral sclerosis (ALS). Our objective was to measure the total energy expenditure (TEE) and determine an equation to estimate the energy requirements for Japanese patients with ALS. Twenty-six Japanese patients with ALS participated in the study. The TEE was measured using the doubly labelled water (DLW) method for a 14-day period. Using a range of clinical parameters and multiple regression analyses, we determined an adequate equation to calculate TEE. Results showed that the median value of total energy intake (TEI) was 1581 (interquartile 1278-1782) kcal/d. TEE and TEE/body weight were 1628 kcal/d (1352-1865) and 31.3 kcal/kg (29.2-34.4), respectively. The ratio of TEE/estimated TEE by the Harris-Benedict equation was 1.14 (1.09-1.26). The difference between TEI and TEE was -63 kcal (-221 - 122), and 15 patients (57.7%) showed a negative balance. From regression analyses, we determined an equation to estimate TEE using the resting metabolic rate estimated by the Harris-Benedict equation (RMR-HB) and scores of the revised ALS Functional Rating Scale (ALSFRS-R): TEE = (1.67 × RMR-HB) + (11.8 × ALSFRS-R) - 680 (p < 0.0001). In conclusion, energy expenditure of Japanese patients with ALS was higher than expected, and we proposed a preliminary equation to estimate TEE for future nutritional intervention.
authors.affiliation: a Department of Neurology , Tokyo Metropolitan Neurological Hospital , Tokyo , Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: b Department of Nutritional Education , National Institutes of Biomedical Innovation, Health and Nutrition , Tokyo , Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Ishikawa-Takata
authors.affiliation: b Department of Nutritional Education , National Institutes of Biomedical Innovation, Health and Nutrition , Tokyo , Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sakata
authors.affiliation: a Department of Neurology , Tokyo Metropolitan Neurological Hospital , Tokyo , Japan.
authors.forename: Utako
authors.initials: U
authors.lastname: Nagaoka
authors.affiliation: c Department of Neurology , National Hospital Organisation Takamatsu Medical Centre , Takamatsu , Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Ichihara
authors.affiliation: d Department of Neurology , National Hospital Organisation Iou Hospital , Kanazawa , Japan.
authors.forename: Chiho
authors.initials: C
authors.lastname: Ishida
authors.affiliation: e Laboratory of Nursing Research for Intractable Disease , Tokyo Metropolitan Institute of Medical Science , Tokyo , Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakayama
authors.affiliation: f Department of Neurology , National Hospital Organisation Hakone Hospital , Odawara , Japan , and.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Komori
authors.affiliation: g Department of Neurology , Brain Research Institute, Niigata University , Niigata , Japan.
authors.forename: Masatoyo
authors.initials: M
authors.lastname: Nishizawa
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology / Q000503:physiopathology*; D002149:Energy Intake / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D009751:Nutritional Requirements / Q000502:physiology*; D012720:Severity of Illness Index; D012737:Sex Factors; D014797:Vital Capacity; D014867:Water
chemical_list: D014867:Water
keywords: Amyotrophic lateral sclerosis; doubly labelled water; nutritional requirements; regression analysis; total energy expenditure