Resting energy expenditure is lower than predicted in people taking atypical antipsychotic medication

Resting energy expenditure (REE) is lower than predicted in persons taking atypical antipsychotic medication, and weight management is a significant clinical challenge for some of them. However, to date there have been no published guidelines to assist clinicians in choosing appropriate prediction equations to estimate energy expenditure in persons taking atypical antipsychotic medications. The objectives of this study were to measure REE in a group of men taking the atypical antipsychotic clozapine and to determine whether REE can be accurately predicted for this population using previously published regression equations. REE was measured using indirect calorimetry via a ventilated hood on eight men who had completed at least 6 months of treatment with clozapine. Comparisons between measured REE and predicted REE using five different equations were undertaken. The commonly-used Harris-Benedict and Schofield equations systematically overestimated REE. Predictions of REE from other equations were too variable for clinical use. When estimating energy requirements as part of a weight-management program in men who have been taking clozapine for 6 months, predictions of REE from the equations of Harris-Benedict and Schofield should be reduced by 280 kcal/day.

Physical activity cost in children following an acquired brain injury - a comparative study

Background: Alterations in energy expenditure during activity post head injury has not been investigated due primarily to the difficulty of measurement. Objective: The aim of this study was to compare energy expenditure during activity and body composition of children following acquired brain injury (ABI) with data from a group of normal. controls. Design: Energy expenditure was measured using the Cosmed K4b(2) in a group of 15 children with ABI and a group of 67 normal children during rest and when walking and running. Mean number of steps taken per 3 min run was also recorded and body composition was measured. Results: The energy expended during walking was not significantly different between both groups. A significant difference was found between the two groups in the energy expended during running and also for the number of steps taken as children with ABI took significantly less steps than the normal controls during a 3 min run. Conclusions: Children with ABI exert more energy per activity than healthy controls when controlled for velocity or distance. However, they expend less energy to walk and run when they are free to choose their own desirable, comfortable pace than normal controls. (C) 2003 Elsevier Ltd. All rights reserved.

Skeletal muscle and nuclear hormone receptors: Implications for cardiovascular and metabolic disease

Skeletal muscle is a major mass peripheral tissue that accounts for similar to 40% of the total body mass and a major player in energy balance. It accounts for > 30% of energy expenditure, is the primary tissue of insulin stimulated glucose uptake, disposal, and storage. Furthermore, it influences metabolism via modulation of circulating and stored lipid (and cholesterol) flux. Lipid catabolism supplies up to 70% of the energy requirements for resting muscle. However, initial aerobic exercise utilizes stored muscle glycogen but as exercise continues, glucose and stored muscle triglycerides become important energy substrates. Endurance exercise increasingly depends on fatty acid oxidation (and lipid mobilization from other tissues). This underscores the importance of lipid and glucose utilization as an energy source in muscle. Consequently skeletal muscle has a significant role in insulin sensitivity, the blood lipid profile, and obesity. Moreover, caloric excess, obesity and physical inactivity lead to skeletal muscle insulin resistance, a risk factor for the development of type II diabetes. In this context skeletal muscle is an important therapeutic target in the battle against cardiovascular disease, the worlds most serious public health threat. Major risk factors for cardiovascular disease include dyslipidemia, hypertension, obesity, sedentary lifestyle, and diabetes. These risk factors are directly influenced by diet, metabolism and physical activity. Metabolism is largely regulated by nuclear hormone receptors which function as hormone regulated transcription factors that bind DNA and mediate the pathophysiological regulation of gene expression. Metabolism and activity, which directly influence cardiovascular disease risk factors, are primarily driven by skeletal muscle. Recently, many nuclear receptors expressed in skeletal muscle have been shown to improve glucose tolerance, insulin resistance, and dyslipidernia. Skeletal muscle and nuclear receptors are rapidly emerging as critical targets in the battle against cardiovascular disease risk factors. Understanding the function of nuclear receptors in skeletal muscle has enormous pharmacological utility for the treatment of cardiovascular disease. This review focuses on the molecular regulation of metabolism by nuclear receptors in skeletal muscle in the context of dyslipidemia and cardiovascular disease. (c) 2005 Published by Elsevier Ltd.

Hydrogen production and utilisation opportunities for Australia

Worldwide, research and policy momentum is increasing in the move towards a hydrogen economy. Australia is one of the highest per capita users of energy, but relies heavily on fossil fuels to fulfil its energy requirements-thus making it one of the highest per capita polluters. It is also a country rich in natural resources, giving it the full range of options for a hydrogen economy. With the first Australian Hydrogen Study being completed by the end of 2003, there has as yet been little analysis of the options available to this country specifically. This paper reviews the resources, production and utilisation technology available for a hydrogen economy in Australia, and discusses some of the advantages and disadvantages of the different options. It points out that coal, natural gas, biomass and water are the most promising hydrogen sources at this stage, while solid oxide and molten carbonate fuel cells may hold the advantage in terms of current expertise for utilising hydrogen rich gases for stationary power in Australia. (c) 2004 International Association for Hydrogen Energy. Published by Elsevier Ltd. All rights reserved.

Eliminating non-renewable CO2 emissions from sewage treatment: An anaerobic migrating bed reactor pilot plant study

The aim of this work was to demonstrate at pilot scale a high level of energy recovery from sewage utilising a primary Anaerobic Migrating Bed Reactor (AMBR) operating at ambient temperature to convert COD to methane. The focus is the reduction in non-renewable CO2 emissions resulting from reduced energy requirements for sewage treatment. A pilot AMBR was operated on screened sewage over the period June 2003 to September 2004. The study was divided into two experimental phases. In Phase 1 the process operated at a feed rate of 10 L/h (HRT 50 h), SRT 63 days, average temperature 28 degrees C and mixing time fraction 0.05. In Phase 2 the operating parameters were 20 L/h, 26 days, 16 degrees C and 0.025. Methane production was 66% of total sewage COD in Phase 1 and 23% in Phase 2. Gas mixing of the reactor provided micro-aeration which suppressed sulphide production. Intermittent gas mixing at a useful power input of 6 W/m(3) provided satisfactory process performance in both phases. Energy consumption for mixing was about 1.5% of the energy conversion to methane in both operating phases. Comparative analysis with previously published data confirmed that methane supersaturation resulted in significant losses of methane in the effluent of anaerobic treatment systems. No cases have been reported where methane was considered to be supersaturated in the effluent. We have shown that methane supersaturation is likely to be significant and that methane losses in the effluent are likely to have been greater than previously predicted. Dissolved methane concentrations were measured at up to 2.2 times the saturation concentration relative to the mixing gas composition. However, this study has also demonstrated that despite methane supersaturation occurring, microaeration can result in significantly lower losses of methane in the effluent (< 11% in this study), and has demonstrated that anaerobic sewage treatment can genuinely provide energy recovery. The goal of demonstrating a high level of energy recovery in an ambient anaerobic bioreactor was achieved. An AMBR operating at ambient temperature can achieve up to 70% conversion of sewage COD to methane, depending on SRT and temperature. (c) 2006 Wiley Periodicals, Inc.

Feline obesity: causes, consequences and management

Regulation of food intake and body weight involves a complex balance between long-term control of fat mass involving insulin, adrenal steroids and leptin signals to the CNS and short-term, meal-related signals. Cats will normally limit their food intake to their energy requirements. However, in some instances cats appear unable to regulate energy balance. Our research has demonstrated that despite elevated circulating leptin levels in obese cats associated with increased fat mass, they continue to overeat and gain weight. This paradox of increased leptin concentrations in obesity has been observed in other species and is hypothesized to be a consequence of 'leptin resistance'.

Reducing the time period of steady state does not affect the accuracy of energy expenditure measurements by indirect calorimetry

Achievement of steady state during indirect calorimetry measurements of resting energy expenditure (REE) is necessary to reduce error and ensure accuracy in the measurement. Steady state is often defined as 5 consecutive min (5-min SS) during which oxygen consumption and carbon dioxide production vary by +/-10%. These criteria, however, are stringent and often difficult to satisfy. This study aimed to assess whether reducing the time period for steady state (4-min SS or 3-min SS) produced measurements of REE that were significantly different from 5-min SS. REE was measured with the use of open-circuit indirect calorimetry in 39 subjects, of whom only 21 (54%) met the 5-min SS criteria. In these 21 subjects, median biases in REE between 5-min SS and 4-min SS and between 5-min SS and 3-min SS were 0.1 and 0.01%, respectively. For individuals, 4-min SS measured REE within a clinically acceptable range of +/-2% of 5-min SS, whereas 3-min SS measured REE within a range of -2-3% of 5-min SS. Harris-Benedict prediction equations estimated REE for individuals within +/-20-30% of 5-min SS. Reducing the time period of steady state to 4 min produced measurements of REE for individuals that were within clinically acceptable, predetermined limits. The limits of agreement for 3-min SS fell outside the predefined limits of +/-2%; however, both 4-min SS and 3-min SS criteria greatly increased the proportion of subjects who satisfied steady state within smaller limits than would be achieved if relying on prediction equations.