Nightingale Tom E, Williams Sean, Thompson Dylan, Bilzon James L J
Department for Health, University of Bath, Bath, BA2 7AY, UK.
Int J Behav Nutr Phys Act. 2017 Sep 26;14(1):132. doi: 10.1186/s12966-017-0590-z.
Despite obesity being highly prevalent in persons with spinal cord injury (SCI), our current understanding of the interactions between energy balance components, which may contribute to this, is limited. The primary aim of this study is to identify the intra-individual variability of physical activity dimensions across days and suggest an appropriate monitoring time frame for these constructs in adults with SCI. The secondary aim is to examine these parameters with regard to energy intake and dietary macronutrient composition.
Participants [33 men and women with chronic (> 1 year post injury) paraplegia; age = 44 ± 9 years (mean ± S.D.] wore an Actiheart™ PA monitor and completed a weighed food diary for 7 consecutive days. Spearman-Brown Prophecy Formulae, based on Intraclass Correlations of .80 (acceptable reliability), were used to predict the number of days required to measure energy balance components. Linear mixed-effects analyses and magnitude-based inferences were performed for all energy intake, expenditure and physical activity dimensions. Adjustments were made for age, injury level, wear time, sex, day of the week and measurement order as fixed effects.
To reliably measure energy expenditure components; 1 day [total energy expenditure (TEE)], 2 days [physical activity energy expenditure (PAEE), light-intensity activity, moderate-to-vigorous PA (MVPA)], 3 days [physical activity level (PAL)] and 4 days (sedentary behaviour) are necessary. Device wear time (P < 0.02), injury level (P < 0.04) and sex (P < 0.001) were covariates for energy expenditure components. Four and ≤24 days are required to reliably measure total energy intake (kcal) and diet macronutrient composition (%), respectively. Measurement order (from day 1-7) was a covariate for total energy intake (P = 0.01).
This is the first study to demonstrate the variability of energy intake and expenditure components in free-living persons with chronic (> 1 year) paraplegia and propose suitable measurement durations to achieve acceptable reliability in outcome measures. Device wear time and measurement order play a role in the quality of energy expenditure and intake data, respectively, and should be considered when designing and analysing studies of energy balance components in persons with SCI.
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尽管肥胖在脊髓损伤（SCI）患者中非常普遍，但我们目前对可能导致肥胖的能量平衡各组成部分之间相互作用的理解有限。本研究的主要目的是确定成人脊髓损伤患者身体活动维度在不同日期的个体内变异性，并为这些指标建议合适的监测时间框架。次要目的是研究这些参数与能量摄入和膳食宏量营养素组成的关系。
参与者[33名患有慢性（受伤后>1年）截瘫的男性和女性；年龄=44±9岁（平均值±标准差）]佩戴Actiheart™身体活动监测仪，并连续7天完成称重食物日记。基于组内相关系数为0.80（可接受的可靠性）的斯皮尔曼-布朗预测公式，用于预测测量能量平衡各组成部分所需的天数。对所有能量摄入、支出和身体活动维度进行线性混合效应分析和基于量级的推断。将年龄、损伤水平、佩戴时间、性别、星期几和测量顺序作为固定效应进行调整。
为可靠测量能量消耗各组成部分，分别需要1天[总能量消耗（TEE）]、2天[身体活动能量消耗（PAEE）、轻度活动、中度至剧烈身体活动（MVPA）]、3天[身体活动水平（PAL）]和4天（久坐行为）。设备佩戴时间（P<0.02）、损伤水平（P<0.04）和性别（P<0.001）是能量消耗各组成部分的协变量。可靠测量总能量摄入（千卡）和饮食宏量营养素组成（%）分别需要4天和≤24天。测量顺序（从第1天到第7天）是总能量摄入的协变量（P=0.01）。
这是第一项证明慢性（>1年）截瘫自由生活患者能量摄入和消耗各组成部分变异性的研究，并提出了合适的测量持续时间，以在结果测量中获得可接受的可靠性。设备佩戴时间和测量顺序分别在能量消耗和摄入数据质量中起作用，在设计和分析脊髓损伤患者能量平衡各组成部分的研究时应予以考虑。
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