Obesity Research 2005; 13:A175

Total Energy Expenditure In Morbidly Obese Subjects: A New Device Validation

Paolo De Cristofaro¹, Angelo Pietrobelli^2,3, Beatrice Dragani1, Guido Malatesta1, Simona Arzeni1, Maria Luciani1, Marcella Malavolti³, and Nino C. Battistini³

Abstract

Introduction: Indirect calorimetry is the most frequently method used to estimate total energy expenditure (TEE) and, together with Harris-Benedict equations, are widely used in clinical settings to provide the basis for prescribing and individualizing energy intake to attain a desired level of energy deficit. Because resting energy expenditure (REE) is an important TEE determinant, measurement or prediction of REE is generally the first step to predict TEE. An advanced technique, the HealthWear™ Armband, designed to assess TEE in free-living adults, represents a new frontier for evaluating energy expenditure and physical activity.

Aim: To test the validity/accuracy of the SenseWear®/Armband for estimating daily energy expenditure in morbidly obese subjects.

Method. Among 288 morbidly obese subjects (BMI range 35.0 – 60.9) we randomly selected 37 subjects (29 females, and 9 males) (mean±SD, age 38.7±13.2 years; BMI 40.1±6.4 kg/m2). Estimated energy expenditure from the SenseWear®/Armband (The HealthWear™ Armband, BodyMedia, Roche Diagnostics, Indianapolis, IN, USA) was compared with energy expenditure determined using indirect open-circuit calorimetry (Sensor Medics Vmax 29N, Metabolic Cart, Yorbe Linda CA, USA) and Harris-Benedict equation which served as the criteria measurements. Waist circumference (WC, cm) was also measured.

Results: No significant difference was found in mean TEE between SenseWear®/Armband (2002±433 Kcal/day) and Harris-Benedict equation (1984±396) while significant differences were found between Sensor Medics Vmax (1742±403 Kcal/day) Vs. SenseWear®/Armband (p=0.009) and Vs. Harris-Benedict equation (p=0.01). Higher correlation was found between Sensewear and BMI (r=0.7, p>0.0001) as well as with WC (r=0.8, p>0.0001) than between TEE measured by Sensor Medics Vmax and BMI (r= 0.6, p>0.0001) and WC (r=0.7, p>0.0001).

Conclusion: Our results suggested that SenseWear® Armband could be an acceptable device to measure TEE in morbidly obese subjects during observational period. In conjunction with indirect calorimetry represents a useful method to estimate energy expenditure in order to personalize nutritional management. SenseWear® Armband could make the assessment of TEE accurate, portable and inexpensive, could define subjects’ life-style and could promote physical activity to prevent weight gain.

Publication: Obesity Research 2005; 13:A175