Lower daily energy expenditure as measured by a respiratory chamber in subjects with spinal cord injury compared with control subjects

Monroe, M. B.; Tataranni, P. Antonio; Pratley, Richard E.; Manore, Melinda M.; Skinner, James S.; Ravussin, Éric

doi:10.1093/ajcn/68.6.1223

Cited by 174 publications

(151 citation statements)

References 15 publications

Supporting

Mentioning

142

Contrasting

Order By: Relevance

“…15 Innervated muscle above the level of the neurological lesion may potentially become insulin resistant because daily energy expenditure is lower in those with SCI than in able-bodied individuals. 16 Thus, both denervation and deconditioning may contribute to IGT and insulin resistance in those with SCI.…”

Section: Discussionmentioning

confidence: 99%

Glucose tolerance and physical activity level in people with spinal cord injury

et al. 2010

View full text Add to dashboard Cite

Study design: Cross-sectional, observational study. Objectives: To evaluate the associations of physical activity and neurological lesion level with glucose tolerance in people with spinal cord injury (SCI). Setting: New South Wales, Australia. Methods: Twenty-five people (5 women, 20 men) with SCI (46 months post-injury) aged between 18 and 65 years were recruited. Exclusion criteria included known coronary heart disease, stroke or diabetes. Participants underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose concentrations were classified according to the World Health Organization categories of glycemia. Participants also completed the Physical Activity Scale for Individuals with Physical Disabilities and mean MET-hours day À1 was calculated. Associations with the 2-h plasma glucose concentration were calculated through multiple and stepwise regressions. Results: Participants presented with complete or incomplete tetraplegia (n ¼ 11 TETRA) or complete or incomplete paraplegia (n ¼ 14 PARA) with neurological lesion levels ranging from C3/4 to T12. Mean 2-h plasma glucose was 7.13 ± 2.32 mmol l À1 . Nine participants had disordered glycemia (n ¼ 6 TETRA; n ¼ 3 PARA) and the remaining participants had normal glucose tolerance. Those participants with normal glucose tolerance participated in more moderate-vigorous and strength exercise and undertook more non-exercise-related mobility than those with disordered glycemia. Physical activity and age, but not lesion level were independent determinants of 2-h plasma glucose concentration (r ¼ 0.683, P ¼ 0.001), explaining 47% of the variance. Conclusion: Physical activity level is independently associated with glucose tolerance in people with SCI. Non-exercise activity may also be important for maintaining normal glycemia.

show abstract

Section: Discussionmentioning

confidence: 99%

Glucose tolerance and physical activity level in people with spinal cord injury

et al. 2010

View full text Add to dashboard Cite

show abstract

“…2 Mean percent fat mass (measured by dual energy X-ray absorptiometry (DXA), isotope dilution or the threecompartment model) reported in cross-sectional studies of persons (mostly men) with chronic spinal cord injury (SCI) ranges from 23 to 35%. [4][5][6][7][8][9][10][11] The percentage of body weight as fat mass is 8-18% higher in SCI versus age-, height-and/or weight-matched able-bodied control subjects. These values are often consistent with the above definitions of obesity, and are summarized in Table 1.…”

Section: Body Mass Index (Bmi) As a Marker Of Obesity In Chronic Scimentioning

confidence: 99%

“…12 Mean BMI values in studies of persons with long-standing SCI range from 20 to 27, 5,6,10,[13][14][15][16][17][18] consistent with the classifications of normal and overweight, but inconsistent with classification based on measured percent fat mass. [4][5][6][7][8][9][10][11] One reason for the underestimation of obesity using BMI may be the potential measurement error associated with determination of weight and/or height in persons with SCI. While weight can be measured using a wheelchair scale, an accurate height is difficult to obtain in those who are wheelchair dependent.…”

Section: Body Mass Index (Bmi) As a Marker Of Obesity In Chronic Scimentioning

confidence: 99%

A review of body mass index and waist circumference as markers of obesity and coronary heart disease risk in persons with chronic spinal cord injury

2005

View full text Add to dashboard Cite

Study design: Literature review. Background: Increased fat mass and coronary heart disease (CHD) are secondary complications of chronic spinal cord injury (SCI). In able-bodied populations, body mass index (BMI, body weight (kg)/height (m 2 )) is a widely used surrogate marker of obesity and predictor of CHD risk. Waist circumference, an accurate and reproducible surrogate measure of abdominal visceral adipose tissue, is also associated with CHD risk (more so than BMI) in able-bodied populations. Objective: To review the literature on the accuracy of BMI and waist circumference as surrogate measures of obesity and CHD risk in persons with chronic SCI. Setting: Ontario, Canada. Methods: Literature review. Results: In the SCI population, BMI is an insensitive marker of obesity, explains less of the variance in measured percent fat mass than in the able-bodied, and is inconsistently related to CHD risk factors. This may be due to potential measurement error, and to the inability of BMI to distinguish between fat and fat-free mass and to measure body fat distribution. Waist circumference has not been validated as a surrogate measure of visceral adipose tissue, however preliminary evidence supports a relationship between waist circumference and CHD risk in the SCI population. Conclusions: We recommend that SCI-specific BMI classifications be determined. We also recommend that accuracy and reliability of waist circumference as a surrogate measure of visceral adipose tissue and CHD risk be determined in men and women with long-standing paraplegia and tetraplegia. Body mass index (BMI) as a marker of obesity in chronic SCIObesity is defined as an excess accumulation of fat mass. Able-bodied men and women p40 years are considered obese when fat mass exceeds 22-25 and 35% of body weight, respectively. 1,2 As individuals age, fat mass accrues at the expense of fat-free mass, so that at older ages percentage fat mass is higher, even in individuals who do not gain weight. 3 Thus, obesity in 41-60-yearold able-bodied men and women can be defined as a fat mass 425 and 438% of body weight, respectively. 2 Mean percent fat mass (measured by dual energy X-ray absorptiometry (DXA), isotope dilution or the threecompartment model) reported in cross-sectional studies of persons (mostly men) with chronic spinal cord injury (SCI) ranges from 23 to 35%. [4][5][6][7][8][9][10][11] The percentage of body weight as fat mass is 8-18% higher in SCI versus age-, height-and/or weight-matched able-bodied control subjects. These values are often consistent with the above definitions of obesity, and are summarized in Table 1. Accurate classification of an individual as normal weight, overweight or obese requires measurement of body composition. However, measuring fat mass can be difficult and expensive, and no accurate method is easily available for routine clinical use. Therefore, the body mass index (BMI) is widely used. Expressed as weight (kg) divided by height (m 2 ), BMI allows classification of able-bodied adults as underweight, normal we...

show abstract

“…There is also a decrease in sympathetic nervous system activity [12]. As a result of the decreased lean mass, decreased sympathetic nervous system activity, and decreased physical activity, persons with SCI have decreased energy expenditure compared to able-bodied individuals [13][14][15]. Subsequently, obesity, and particularly central adiposity, is common among persons with chronic SCI and is more prevalent than in able-bodied persons [16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Commentary on Comparison of Coronary Artery Calcification Scores, National Cholesterol Education Program Guidelines for Coronary Heart Disease Risk Assessment, Treatment Paradigms in Individuals with Chronic Traumatic Spinal Injury

Lieberman¹

2017

Int J Neurorehabilitation Eng

View full text Add to dashboard Cite

This commentary considers the implications of the findings related to the effect of a study related to coronary heart disease (CHD) risk assessment in individuals with a chronic spinal cord injury (SCI). The findings from the study suggest that there is poor agreement in CHD risk assessment between the previously used guidelines, the National Cholesterol Education Program (NCEP) Guidelines, and coronary artery calcium scores (CACS). Since this publication, a new atherosclerotic cardiovascular disease (ASCVD) risk estimator has been developed. This has not been used in any study with SCI participants. The study also showed that 18 (47.4%) of the participants had some element of CAC, indicating the presence of CHD. Many previous articles have discussed CHD risk factors and mortality in the SCI population. Despite this, there have been very few interventions to decrease the CHD risk in the chronic SCI population.

show abstract

Lower daily energy expenditure as measured by a respiratory chamber in subjects with spinal cord injury compared with control subjects

Abstract: The 24-h EE was significantly lower in SCI than in control subjects. This difference can be explained by the lower levels of physical activity, and lower RMR and TEF values, in SCI subjects.

Cited by 174 publications

References 15 publications

Glucose tolerance and physical activity level in people with spinal cord injury

Glucose tolerance and physical activity level in people with spinal cord injury

A review of body mass index and waist circumference as markers of obesity and coronary heart disease risk in persons with chronic spinal cord injury

Commentary on Comparison of Coronary Artery Calcification Scores, National Cholesterol Education Program Guidelines for Coronary Heart Disease Risk Assessment, Treatment Paradigms in Individuals with Chronic Traumatic Spinal Injury

Contact Info

Product

Resources

About