Submitted to: European Journal of Clinical Nutrition
Publication Type: Peer reviewed journal
Publication Acceptance Date: 10/17/2001
Publication Date: 7/1/2002
Citation: YAO, M., MCCRORY, M.A., GUANSHENG, M., LI, Y., DONIKOWSKI, G.G., ROBERTS, S.B. ENERGY REQUIREMENTS OF CHINESE ADULTS WITH MANUAL OR SEDENTARY OCCUPATION, DETERMINED BY USING THE DOUBLY LABELED WATER METHOD. EUROPEAN JOURNAL OF CLINICAL NUTRITION. 2002;56(7):575-84. Interpretive Summary: Information on the dietary energy requirements of different population groups is needed for the planning of national nutrition programs and identification of at-risk groups. Currently, most developing and transitional countries use the 1985 FAO/WHO/UNU recommendations as a basis for their energy requirements. However, concerns have been raised about the accuracy of the WHO estimates because they are based on theoretical factorial calculations of energy needs rather than direct measurements of total energy expenditure (TEE) in individuals leading different lifestyles. The primary aim of this study was to examine energy requirements using the doubly labeled water method. In addition, we explored the relationship between TEE and both occupational and reported leisure activity. Using a cross-sectional study design in 73 weight- maintaining urban Chinese adults we determined TEE, body composition, and habitual physical activity. The principal findings of this study were that TEE values measured using the doubly-labeled water technique were similar to the WHO (FAO/WHO/UNU, 1985) estimates of energy needs, and that level of occupational activity was a significant predictor of TEE and hence energy requirements in this urban Chinese population.
Technical Abstract: The objective of this study is to examine total energy expenditure (TEE) to occupation and reported leisure time activities in free-living Chinese adults, and to determine whether measured TEE values differ from current international dietary energy recommendations. A cross-sectional study in which TEE was determined by doubly labeled water, body composition by deuterium oxide (2H2SO4) dilution, resting energy expenditure (pREE) by a prediction equation, and occupational and leisure time activities by questionnaire. for men and women respectively, TEE averaged 12.10+/-0.32 and 9.53+/-0.23 MJ/d (P0.001), and physical activity level (PAL=TEE/pREE) 1.77+/-0.04 and 1.66+/-0.02 (P<0.05). fat free mass (FFM) was the single best predictor of TEE (adjusted R**2=071, P<0.001). Occupational category (light, moderate and heavy) further predicted TEE, independent of FFM (adjusted multiple R**2=0.82, P<0.001). Both TEE adjusted for weight PAL increased with occupational category. Measured TEE was significantly higher than the 1985 FAO/WHO/UNU estimates for women with light occupations, but did not differ from estimates for men with light occupations, or for adults with moderate or heavy occupations. Levels of occupational activity, but not duration or type of leisure activity, significantly predicted TEE and hence energy requirements in free-living urban Chinese adults. Current energy requirement recommendations may underestimate energy needs of women with light occupations.