Doubly labelled water assessment of energy expenditure: principle, practice, and promise

Abstract

The doubly labelled water method for the assessment of energy expenditure was first published in 1955, application in humans started in 1982, and it has become the gold standard for human energy requirement under daily living conditions. The method involves enriching the body water of a subject with heavy hydrogen (2H) and heavy oxygen (18O), and then determining the difference in washout kinetics between both isotopes, being a function of carbon dioxide production. In practice, subjects get a measured amount of doubly labelled water (2H218O) to increase background enrichment of body water for 18O of 2000 ppm with at least 180 ppm and background enrichment of body water for 2H of 150 ppm with 120 ppm. Subsequently, the difference between the apparent turnover rates of the hydrogen and oxygen of body water is assessed from blood-, saliva-, or urine samples, collected at the start and end of the observation interval of 1–3 weeks. Samples are analyzed for 18O and 2H with isotope ratio mass spectrometry. The doubly labelled water method is the indicated method to measure energy expenditure in any environment, especially with regard to activity energy expenditure, without interference with the behavior of the subjects. Applications include the assessment of energy requirement from total energy expenditure, validation of dietary assessment methods and validation of physical activity assessment methods with doubly labelled water measured energy expenditure as reference, and studies on body mass regulation with energy expenditure as a determinant of energy balance.

Nutrition for Female Soccer Players—Recommendations

“…Deuterium will be eliminated only in the form of water, while oxygen will be eliminated in the form of both water and CO2. The difference between removing H and O from the body gives a measurement of CO2 production [19,20]. Calorimetric methods can be divided into direct and indirect calorimetry.…”

Show cards of the Global Physical Activity Questionnaire (GPAQ) – do they impact validity? A crossover study

“…represents high validity in assessing total energy expenditure, it is a complex and expensive procedure that provides a total value of energy expenditure for a certain time frame but does not give information, e.g., on several individual periods of time or the context of energy expenditure [3,5,7]. Questionnaires, on the other side, are considered a more practicable tool to assess physical activity in large samples [2,5].…”

Agreement between the total energy expenditure calculated with accelerometry data and the BMR yielded by predictive equations v. the total energy expenditure obtained with doubly labelled water in low-income women with excess weight

“…There is a myriad of methods available to assess TEE, being the doubly labelled water (DLW) usually considered the 'gold standard' one (6) . Nonetheless, this method has a high operational cost, turning its use in large studies and clinical practice prohibitive (7) .…”