Energy intake and energy expenditure in prepubertal males with asthma

Abstract

aaEnergy requirements should be assessed by measuring total daily energy expenditure (TEE) [1]. However, because of the difficulty in measuring TEE in free-living conditions, the energy requirements of children are usually estimated from energy intake (EI) [1]. Several studies exploring the relationship between nutrition and health in children have adopted the tacit assumption that the dietary assessment methods used provided valid measures of habitual food intake. At present, scanty data are available on the food intake of asthmatic children [2]; these data have shown that there is no significant difference in the energy intake between asthmatic and nonasthmatic children [2]. Therefore, on the basis of these results, the energy requirements of asthmatic children should be comparable to those of nonasthmatic children. The validity of this conclusion may be questioned because the use of energy intake measurement to assess energy requirements may lead to over-or underestimation, especially in children suffering from chronic disease, such as obesity, cystic fibrosis, chronic obstructive pulmonary disease, cerebral palsy, heart diseases, as well as in asthmatic patients requiring regular treatment to obtain asthma control [3][4][5][6][7][8][9]. The simultaneous measurement of EI and TEE in free-living conditions has shown that the measure of energy intake is a valid method of assessing energy requirements in normal children [9]. Two methods have recently been used to measure TEE: the doubly labelled water ( 2 H 2 18 O) method [10] and the heart rate (HR) monitoring method [11]. The HR monitoring method allows one to differentiate between energy expenditure due to different activities, sedentary and nonsedentary for instance, during the HR recording interval.At present no data are available on the energy intake and total daily energy expenditure in prepubertal children suffering from asthma. The purpose of the present study was to measure energy intake and energy expenditure in a group of prepubertal asthmatic males and to validate energy intake assessed by diet history as a method of estimating energy requirements of these subjects. Material and methods Study subjectsForth nine prepubertal males participated in the study. Twenty three males had asthma as defined by the American Thoracic Society, and a positive response to a standard questionnaire [12,13]. Twenty six healthy males were enrolled as controls. The control children were recruited from the nonobese children who voluntarily enrolled in a study designed to assess the relationship between energy expenditure, physical activity and adiposity, which was in progress at the same time in the Department of Paediatrics of the University of Verona [14]. Obesity was defined as weight >20% in excess of ideal body weight for height, age and sex. Medical history, a physical examination, and a negative response to a standard questionnaire allowed us Energy intake and energy expenditure in prepubertal males with asthma. C. Maffeis, E. Chiocca, M. Zaffanello, M. Golinelli,...

Gasto energético em adolescentes asmáticos com excesso de peso: calorimetria indireta e equações de predição

“…Os asmá-ticos deveriam suspender os agonistas β2-adrenér-gicos por 12 horas antecedentes ao exame 18 . A calorimetria indireta foi realizada em ambiente silencioso, com temperatura estável (21 a 23°C) e duração de 25 minutos, sendo os cinco primeiros desconsiderados para estabilização dos gases 19 .…”

“…Esses achados foram semelhantes a estudos em não asmáticos com excesso de peso 21 , mas diferentes do relatado por Van Mil et al 7 , que identificaram maior Gasto Energético Basal (GEB) nos obesos, mesmo quando ajustada para massa livre de gordura 7 . Por outro lado, estudos com crianças asmáticas sem excesso de peso sugerem que elas têm uma atividade metabólica mais elevada por unidade de massa magra, quando comparadas a não asmáticos 5,18 .…”

Balanço energético em crianças e adolescentes com bronquiolite obliterante pós-infecciosa

“…Ashley et al 23 corroboram, em seu estudo, o importante papel da MM como preditora do gasto energético, pois afirmam que cerca de 70% a 80% das variações do GER podem ser atribuídas à MM. Os presentes achados assemelham-se a estudos em meninos pré-púberes com asma 16 , em meninos chineses obesos e não obesos 24 , em crianças com fibrose cística 23 e em adolescentes com excesso de peso, asmáticos eutróficos e não asmáticos com excesso de peso 25 , os quais também não encontraram diferenças estatisticamente significantes no que se refere ao GER.…”

“…, detectaram diferenças significativas no que se refere ao GER; Van Mil et al 26 , identificaram maior Gasto Energético Basal (GEB) em obesos, mesmo quando ajustada para MM; Zeitlin et al 27 , e Maffeis et al 16 , sugerem uma atividade metabólica mais elevada por unidade de MM em crianças asmáticas sem excesso de peso quando comparadas a não asmáticas.…”

“…Sujeitos que sofrem de doenças crônicas podem ter necessidades energéticas diferentes daqueles da população saudável pareada por gênero e idade 16 . Ao comparamos os eutróficos do grupo bronquiolite obliterante e do grupo--controle, não se encontraram diferenças (p=0,223) no que tange ao GET.…”