Doubly Labeled Water Method and Accelerometer for the Measurement of Energy Expenditure in Human Immunodeficiency Virus-Infected Patients

Abstract

Background: Several studies have reported increased resting energy expenditure (REE) in human immunodeficiency virus (HIV)-infected patients with HIV-associated lipodystrophy syndrome (HALS). However, limited data exist on the total energy expenditure (TEE). This study was aimed at evaluating the REE and TEE of HIV-infected patients with and without HALS by using the doubly labeled water (DLW) technique and the activity monitor based on accelerometry system (AM), and comparing the results obtained using both methods. Methods: Evaluated total of 45 HIV+ men undergoing antiretroviral therapy, including 18 LIPO^- (without lipodystrophy) and 27 LIPO⁺ (with lipodystrophy) individuals were evaluated. Habitual physical activity patterns were measured by using the ActivPAL™ AM system, REE by indirect calorimetry, and TEE by DLW and AM. Results: No significant differences were found between LIPO^- and LIPO⁺ in REE (1,433 ± 196 vs. 1,510 ± 203 kcal), TEE-DLW (2,691 ± 856 vs. 2,618 ± 415 kcal) and TEE-AM (2,560 ± 458 vs. 2,594 ± 456 kcal), respectively. RQ was a predictor of REE in LIPO⁺. TEE estimated by the AM had a moderate correlation with DLW, but there was a wide variance in the intra-subject results. Conclusions: TEE is not increased in HIV-infected patients with HALS. AM should be used with caution for TEE evaluation during clinical practice.

Physical activity among women of low socioeconomic status living with HIV in two major cities of Brazil and Mozambique: A cross-sectional comparative study

“…These values were greater than our data obtained in patients from Rio de Janeiro and Maputo (1,976 kcal and 1,933 kcal, respectively). However, the energy expenditure at rest in our samples was similar to results reported by Guimarães et al ( 25 ) (1,520 kcal in Rio; 1,436 kcal in Maputo), which suggests differences across studies due to poorer PA levels in our patients.…”

“…Actually, we could not locate cross-sectional or cohort studies quantifying PA levels in PLHIV from South America by means of objective measurements. The possible exception was not designed to describe their PA, but to compare the energy expenditure assessed by doubly labeled water and ACL in individuals from Ribeirao Preto (SP, Brazil) ( 25 ). Patients with and without lipodystrophy exhibited similar energy expenditure at rest (1,433±196 vs. 1,510±203 kcal, respectively).…”

“…Actigraph ACL quantify the amount of movements performed over a given period with a dynamic range of +/- 8 G-force, and is widely used to measure sedentary time, PA, energy expenditure, and sleep behavior ( 23 ). Good relationships of energy expenditure quantified with ACL vs. doubly labeled water have been reported ( 24 ), including in HIV-infected patients aged 18- to 60 years ( 25 ).…”

“…Total daily energy expenditure (kcal/day) was calculated by means of an equation previously used in studies with HIV-infected patients ( 25 ) as [average MET x (0.0035 x body mass (kg) x 1440) x 5]. In addition, a value of 1 MET was assigned during non-wear time and when the vertical axis or triaxial counts were below the threshold for sedentary behavior (100 counts/min and 200 counts/min, respectively) ( 28 ).…”

“…Kcal Activity corresponds to energy expenditure within movements performed in the three axes. Total kcal/day was estimated by means of the equation: average MET obtained during the day x (0.0035 x body mass (kg) x 1440) x 5 [Guimarães et al ( 25 )]. Immobility corresponds to periods during which the accelerometers did not record movements in any of the three axes.…”