Submitted to: Trade Journal Publication
Publication Type: Trade Journal
Publication Acceptance Date: 10/7/2008
Publication Date: 4/20/2009
Citation: Delikanaki-Skaribas, E., Trail, M., Wong, W.W., Lai, E.C. 2009. Daily energy expenditure, physical activity, and weight loss in Parkinson's disease patients. Movement Disorders. 24(5):667-671. Interpretive Summary: In order to find out if weight loss in patients with Parkinson's disease is due to an increase in energy usage, we compared the daily energy expenditure, resting energy expenditure, and physical energy expenditure between 10 weight-stable Parkinson's disease patients and 10 weight-loss Parkinson's disease patients. No difference in daily energy expenditure, resting energy expenditure, and energy intake were detected between the two groups. Higher physical activity energy expenditure was detected among the weight-loss patients only with the wrist activity monitors. Therefore, an increase in physical activity energy expenditure detected in the wrists alone cannot account for the weight loss commonly observed among Parkinson's disease patients.
Technical Abstract: Patients with Parkinson's disease (PD) commonly exhibit weight loss (WL) which investigators attribute to various factors, including elevated energy expenditure. We tested the hypothesis that daily energy expenditure (DEE) and its components, resting energy expenditure (REE) and physical activity (PA) energy expenditure (PAEE), are elevated in WL compared with weight stable (WS) PD patients. We measured DEE in 10 PD WL patients and 10 PD WS patients using doubly labeled water (DLW). PAEE was estimated with DLW, activity monitors, and activity questionnaires. REE was measured with indirect calorimetry. We evaluated energy intake (EI) with a patient's 3-day food diary. Data was assessed employing SPSS, Spearman correlation coefficients, and Bland and Altman plots. There was no difference in DEE between the WL and WS groups measured with DLW. There were no differences in REE and EI between groups. DEE (r = 0.548, P < 0.05) and PAEE (r = 0.563, P < 0.01) are related with caloric intake. The WL group had higher PA than the WS group (P < 0.042) only when measured with wrist activity monitors. Results suggest that WL in PD patients cannot be fully explained by an increase in DEE. Large longitudinal studies to examine multiple relationships between variables might provide us with a better understanding of WL among PD patients.