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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #304953
Title: The doubly labeled water method produces highly reproducible longitudinal results in nutrition studies

Author
item WONG, WILLIAM - Children'S Nutrition Research Center (CNRC)
item ROBERTS, SUSAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item RACETTE, SUSAN - Washington University School Of Medicine
item DAS, SAI - Pennington Biomedical Research Center
item REDMAN, LEANNE - Pennington Biomedical Research Center
item ROCHON, JAMES - Duke Clinical Research Institute
item BHAPKAR, MANJUSHRI - Duke Clinical Research Institute
item CLARKE, LUCINDA - Children'S Nutrition Research Center (CNRC)
item KRAUS, WILLIAM - Duke Clinical Research Institute

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/15/2014
Publication Date: 5/1/2014
Citation: Wong, W.W., Roberts, S.B., Racette, S.B., Das, S.K., Redman, L.M., Rochon, J., Bhapkar, M.V., Clarke, L.L., Kraus, W.E. 2014. The doubly labeled water method produces highly reproducible longitudinal results in nutrition studies. Journal of Nutrition. 144:777-783.

Interpretive Summary: The doubly labeled water method is the gold standard method for measuring energy expenditure, caloric intake and body composition in humans at a single point in time under free-living conditions. The method is based on the fact that the difference in how fast the stable oxygen and hydrogen isotopes are being removed from the body gives an accurate measure of energy expenditure or caloric intake. However, if the method is going to be used to document dietary energy intake compliance or changes in caloric intake and body composition at a later point in time, the doubly labeled water method must be reproducible in follow-up studies. Although the doubly labeled water method has been shown to be very accurate at a single point in time, the long-term reproducibility of the method has never been tested. In a multi-site caloric restriction clinical trial, we developed two simple studies to test the long-term reproducibility of the doubly labeled water method. One study involved the repeated analysis of two water solutions containing different amounts of the stable isotopes of hydrogen and oxygen once a month for 4.4 years. Another study involved repeated analysis of urine samples generated from the caloric restriction study. Both studies showed that the doubly labeled water method is highly reproducible. Therefore, the doubly labeled water method can be used to measure energy expenditure, energy intake, caloric intake adherence, and changes in body composition in long-term nutrition studies.

Technical Abstract: The doubly labeled water (DLW) method is considered the reference method for the measurement of energy expenditure under free-living conditions. However, the reproducibility of the DLW method in longitudinal studies is not well documented. This study was designed to evaluate the longitudinal reproducibility of the DLW method using 2 protocols developed and implemented in a multicenter clinical trial-the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE). To document the longitudinal reproducibility of the DLW method, 2 protocols, 1 based on repeated analysis of dose dilutions over the course of the clinical trial (dose-dilution protocol) and 1 based on repeated but blinded analysis of randomly selected DLW studies (test-retest protocol), were carried out. The dose-dilution protocol showed that the theoretical fractional turnover rates for 2H and 18O and the difference between the 2 fractional turnover rates were reproducible to within 1% and 5%, respectively, over 4.5 y. The Bland-Altman pair-wise comparisons of the results generated from 50 test-retest DLW studies showed that the fractional turnover rates and isotope dilution spaces for 2H and 18O, and total energy expenditure, were highly reproducible over 2.4 y. Our results show that the DLW method is reproducible in longitudinal studies and confirm the validity of this method to measure energy expenditure, define energy intake prescriptions, and monitor adherence and body composition changes over the period of 2.5-4.4 y. The 2 protocols can be adopted by other laboratories to document the longitudinal reproducibility of their measurements to ensure the long-term outcomes of interest are meaningful biologically.