• Energy Research
• health sciences close

Weight loss and worsening of nutritional state is a frequent downfall of acute hospitalization in older people. It is usually accepted that acute inflammation is responsible for hypercatabolism. However, several studies suggest, on the contrary, a reduction in resting energy expenditure (REE). This study aimed to obtain a reliable measure of REE and total energy expenditure (TEE) in older patients hospitalized for an acute episode in order to better assess patients’ energy requirements and help understand the mechanisms of weight loss in this situation. Nineteen hospitalized older patients (mean age 83 years) with C-reactive protein (CRP) level >20mg/L were recruited. REE and TEE were measured using gold standard methods of indirect calorimetry and doubly labeled water (DLW), respectively. REE was then compared to data from a previous study on aged volunteers from nursing homes who were free of an acute stressor event. Energy requirements measured by DLW were confirmed at 1.3 × REE. Energy intake covered the needs but did not prevent weight loss in these patients. TEE was not increased in hospitalized patients and was not influenced by inflammation, while the relationship between REE and inflammation was uncertain. Our results suggest that lean mass remains the major determinant of REE in hospitalized older people and that weight loss may not be explained solely by a state of hypercatabolism.

Exercise has been shown to decrease subsequent energy intake, without modification of appetite, in adolescents who are obese. This study compared the impact of acute exercise with imposed sedentary behaviors on the daily nutritional adaptations and energy balance of youths with obesity.Body composition and maximal oxygen uptake were assessed in 10 12- to 15-year-old adolescents with obesity. Energy consumption, appetite, and energy expenditure were assessed during 3 experimental sessions: (1) exercise session (EX), (2) bed rest session (BR), and (3) control session (CON).Total and morning energy expenditures were significantly higher during EX compared to CON and BR sessions (p < .001), and no differences were found during the afternoon energy expenditure between conditions (BR: 1056.5 ± 121.5; CON: 1185.7 ± 173; EX: 996.1 ± 153.4 Kcal). Total energy intake was significantly reduced on EX (p < .001). Dinner energy intake was significantly reduced during EX (491.65 ± 75.74 Kcal) and CON (666.55 ± 152.09 Kcal) compared with BR (818.87 ± 122.97 Kcal) (p < .001). Appetite was not affected.Whereas intense exercise reduces daily energy balance in adolescents with obesity by mainly affecting ad libitum dinner energy consumption, imposed sedentary behaviors lead to increased energy intake and then positive energy balance. The impact of exercise or imposed sedentary behaviors on the energy balance of adolescents with obesity is not only related to the exercise-induced energy expenditure, but also to their energy intake.

International audience

Acute intensive exercise has been shown to induce a decreased subsequent daily energy intake in obese adolescents without altering the subjective appetite feelings. It is however unclear whether or not those nutritional adaptations to acute exercise are affected by the adolescents' weight status. The aim of this study was to compare the energy intake and macronutrient preferences, appetite feeling and energy expenditure response to acute exercise between lean and obese adolescents.Ten obese and nine normal weight 12-15year old adolescents randomly completed a session with a 30minute cycling exercise at 75% VO2max and a sedentary session. During both sessions energy expenditure was assessed using Armband, ad libitum energy intake measured by weighing at both lunch and dinner time and appetite feelings assessed using visual analog scales.Daily, morning and afternoon energy expenditure were significantly higher in obese than in normal weight adolescents (p0.05) but not in lean adolescents. No group or condition effects were observed on subjective appetite feelings.Post exercise spontaneous energy intake and energy expenditure are reduced in obese but not in normal weight adolescents, without appetite feeling changes. Acute exercise may have a greater impact on energy balance through the induced decreased energy intake in the absence of significant change in energy expenditure in obese youth.