Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL 57072-900, Brazil.
Departamento de Agroindústria, Instituto Federal de Alagoas, Satuba, AL 57120-000, Brazil.
Br J Nutr. 2019 Dec 28;122(12):1398-1408. doi: 10.1017/S0007114519002460.
Low-income women are the group with the highest levels of obesity worldwide. In low-income settings, the use of predictive equations, which yield a measure of the individuals' BMR, is a feasible approach to estimate the individuals' total energy expenditure (TEE), using the factorial method (calculated-TEE = BMR × physical activity level), an important step of the obesity nutritional care. The present study aimed to identify the predictive equation that, in conjunction with metabolic equivalents of tasks (MET) data from accelerometers, yields the calculated-TEE with better agreement compared with the TEE measured by doubly labelled water (TEE-DLW). Forty-five women aged 19-45 years, with excess weight and mothers of undernourished children, were included. They received DLW to determine TEE (14 d); at the same time, they used triaxial accelerometers (7 d) to estimate their MET. The Bland-Altman method, paired-sample t tests, concordance correlation coefficient and root-mean-square error were used to assess the agreement. Maximum allowed differences were defined as 24 %, based on the within-variance coefficient of the energy intake of the sample. Eleven equations were studied. The calculated-TEE obtained by five equations showed non-significant bias: Dietary Reference Intake (Institute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids), FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series), Harris & Benedict ((1919) Proc Natl Acad Sci USA4, 370-373), Henry & Rees ((1991) Eur J Clin Nutr45, 177-185) and Schofield ((1985) Hum Nutr Clin Nutr39, 5-41). The mean percentage differences were -1·5, -0·8, 2·2, -2·2 and 2·0 %, respectively. Considering all parameters, FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series) equation performed slightly better than the others; nevertheless, no equation in conjunction with the estimated-MET showed a calculated-TEE with its CI for the Bland-Altman limits of agreement inside the pre-defined acceptable range.
低收入妇女是全球肥胖程度最高的群体。在低收入环境中，使用预测方程来衡量个体的基础代谢率（BMR），然后采用因素法（计算的总能量消耗（TEE）= BMR × 体力活动水平）来估算个体的总能量消耗（TEE），是估计个体总能量消耗的一种可行方法，这也是肥胖营养护理的重要步骤。本研究旨在确定预测方程，该方程与加速度计的代谢当量（MET）数据结合使用，与双标水（TEE-DLW）测量的 TEE 相比，计算的 TEE 具有更好的一致性。研究纳入了 45 名年龄在 19-45 岁之间、超重且子女营养不良的妇女。她们接受了双标水来确定 TEE（14 天）；同时，她们使用三轴加速度计（7 天）来估计其 MET。采用 Bland-Altman 法、配对样本 t 检验、一致性相关系数和均方根误差来评估一致性。基于样本能量摄入的方差系数，将最大允许差异定义为 24%。研究了 11 个方程。五个方程计算出的 TEE 显示出无显著偏差：膳食参考摄入量（医学研究所（2005 年）能量、碳水化合物、纤维、脂肪、脂肪酸、胆固醇、蛋白质和氨基酸的膳食参考摄入量）、粮农组织/世卫组织/联合国大学（2001 年）《食物和营养技术报告系列》）、哈里斯和本尼迪克特（1919 年）《美国国家科学院院刊》4,370-373）、亨利和里斯（1991 年）《欧洲临床营养杂志》45,177-185）和斯科菲尔德（1985 年）《人类营养与临床营养杂志》39,5-41）。平均百分比差异分别为-1.5%、-0.8%、2.2%、-2.2%和 2.0%。考虑到所有参数，粮农组织/世卫组织/联合国大学（2001 年）《食物和营养技术报告系列》方程的表现略优于其他方程；然而，没有一个方程与估计的 MET 结合使用，其计算的 TEE 及其置信区间在 Bland-Altman 一致性限内位于预先定义的可接受范围内。
