EAL

EE: Body Positions (2014)

Citation:

Taguri E, Tanaka S, Ohkawara K, Ishikawa-Takata K, Hikihara Y, Miyake R, Yamamoto S, Tabata I. Validity of physical activity indices for adjusting energy expenditure for body size: Do the indices depend on body size? J Physiol Anthropol. 2010; 29(3): 109-117.

PubMed ID: 20558969

Study Design:

Diagnostic, Validity or Reliability Study

Class:

C - Click here for explanation of classification scheme.

Quality Rating:

NEUTRAL: See Quality Criteria Checklist below.

Research Purpose:

To evaluate the validity of energy expenditure from physical activity indices for daily activities and assess the impact of body size on the estimates.

Inclusion Criteria:

Japanese adults 20 to 69 years of age.

Exclusion Criteria:

A chronic disease that would influence metabolism of daily physical activity.

Description of Study Protocol:

Recruitment

Recruited from various occupations to represent total Japanese population.

Design

Validity study.

Blinding Used

Implied with measurements.

Statistical Analysis

Correlations computed for body weight and computed physical activity indices (PAI) using a general linear model (GLM) that examined the effects of:

Age
Sex
Sex–BW interaction.

Data Collection Summary:

Timing of Measurements

Data collected after a 12-hour fast and adequate sleep in the laboratory (8 am. to 9 am.).

Dependent Variables

Body weight (BW) using a digital scale
Fat free mass (FFM) using bioelectrical impedance technique
Energy expenditure (EE, kcal per minute) for each activity measured through gas analysis:
- The expired gasses were collected in a 100L Douglas bag (Fukuda Sangyo, Chiba, Japan)
- The volume measured using a dry gas meter (DC-5; Shinagawa, Tokyo, Japan)
- The O₂ and CO₂ concentrations were measured with a calibrated mass spectrometer (ARCO-1000; Arco System, Kashiwa, Japan).
Physical activity indices (PAI) = (EE per activity per BW) and (EE per activity per FFM).

Independent Variables

Activity (lying, sitting, lifestyle, ambulant):
- Lying- (L-RMR) and sitting-resting metabolic rate (S-RMR) were collected upon arrival. L-RMR (kcal per minute) was measured after lying for 30 minutes, using two 10-minute periods. S-RMR was measured for 10 minutes while sitting in a chair.
- Energy expenditure was also measured for the following activities conducted for three to six minutes to achieve steady state (ordered less intense to more intense):
  - Lifestyle activities:
    - Vacuuming
    - Hanging laundry
    - Washing dishes
    - Lifting and carrying a small load (loading, unloading, and carrying a 5kg package).
  - Ambulant activities:
    - Walking up stairs
    - Walking down stairs
    - Walking (55m per minute, 70m per minute, 100m per minute)
    - Walking at 70m per minute with a 3kg load
    - Jogging (140m per minute).

Control Variables

Sex
Age
Sex-age interaction.

Description of Actual Data Sample:

Initial N: 78 (41 males, 37 females)
Age: 43±13 years (range 21 to 66 years)
Ethnicity: Japanese.

Anthropometrics

Variable	Total	Male	Female	Significance by Gender
Height (cm)	163.7±8.1	169.6±6.1	158.2±5.5	<0.001
Body weight (kg)	60.0±10.5	65.3±9.6	55.2±9.0	<0.001
BMI (kg/m²)	22.3±3.0	22.6±2.4	22.1±3.4	0.450
Fat-free mass	45.2±8.5	51.9±6.3	38.9±4.7	<0.001
Body fat (%)	24.7±6.7	20.0±4.5	28.9±5.4	<0.001

Location: National Institute of Health and Nutrition, Japan.

Summary of Results:

Key Findings

EE/BW correlated significantly with all sedentary activities.
EE/L-RMR correlated significantly with BW for walking up stairs, walking at 70 m/min, and walking at 100 m/min.
EE/S-RMR correlated significantly with BW for vacuuming, lifting and carrying a small load, and for five of the ambulant activities
EE/FFM correlated significantly with BW for walking up stairs.

	EE/BW (kcal per minute per kg)	EE/L-RMR (kcal per minute / kcal per minute)	EE/S-RMR (kcal per minute / kcal per minute)	EE/FFM (kcal per minute per kg)
Sedentary activities
Lying quietly	0.0148±0.0016		0.91±0.06	0.0197±0.0018
Sitting quietly	0.0164±0.0017	1.11±0.07		0.0218±0.0019
Working at the computer	0.0181±0.0019	1.23±0.11	1.11±0.08	0.0242±0.0026
Lifestyle activities
Vacuuming	0.0481±0.0096	3.28±0.72	2.96±0.63	0.0643±0.0140
Hanging laundry	0.0367±0.0053	2.50±0.40	2.26±0.37	0.0491±0.0081
Washing dishes	0.0293±0.0046	2.00±0.35	1.80±0.32	0.0391±0.0071
Carrying a small load	0.0715±0.0108	4.85±0.79	4.39±0.69	0.0954±0.0153
Ambulant activities
Walking up stairs	0.1228±0.0093	8.40±0.82	7.60±0.74	0.1646±0.0161
Walking downstairs	0.0512±0.0082	3.46±0.50	3.13±0.47	0.0684±0.0118
Walking (55m/s)	0.0502±0.0064	3.40±0.46	3.08±0.43	0.0671±0.0100
Walking (70m/s)	0.0590±0.0071	4.00±0.54	3.62±0.50	0.0789±0.0116
Walking (100m/s)	0.0759±0.0115	5.15±0.82	4.66±0.76	0.1016±0.0180
Walking (70m/s) with a 3kg load	0.0689±0.0090	4.68±0.68	4.23±0.62	0.0923±0.0154
Jogging (140m/s)	0.1557±0.0188	10.51±1.26	9.50±1.10	0.2040±0.0223

Other Findings

Issues of missing data resulted from inability to reach steady state using the prescribed intensity for activities.

Author Conclusion:

Physical activity indices adjusted for body weight were inappropriate for sedentary activities. Adjustments for L-RMR, S-RMR and adjustments for FFM were inappropriate for estimating EE for ambulant activities.

Funding Source:

Government:

National Institute of Health and Nutrition

Reviewer Comments:

Little to no information was provided about the recruitment and locations of data collection. The measurements were well described, but the tables and conclusions about amount of overweight were not described in the methods or in the tables. The data presented did not accurately depict the described methods.

Quality Criteria Checklist: Primary Research
Relevance Questions
	1.	Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies)	Yes
	2.	Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about?	Yes
	3.	Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice?	Yes
	4.	Is the intervention or procedure feasible? (NA for some epidemiological studies)	Yes

Validity Questions
1.	Was the research question clearly stated?		Yes
	1.1.	Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified?	Yes
	1.2.	Was (were) the outcome(s) [dependent variable(s)] clearly indicated?	Yes
	1.3.	Were the target population and setting specified?	Yes
2.	Was the selection of study subjects/patients free from bias?		???
	2.1.	Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study?	???
	2.2.	Were criteria applied equally to all study groups?	???
	2.3.	Were health, demographics, and other characteristics of subjects described?	Yes
	2.4.	Were the subjects/patients a representative sample of the relevant population?	???
3.	Were study groups comparable?		N/A
	3.1.	Was the method of assigning subjects/patients to groups described and unbiased? (Method of randomization identified if RCT)	N/A
	3.2.	Were distribution of disease status, prognostic factors, and other factors (e.g., demographics) similar across study groups at baseline?	N/A
	3.3.	Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.)	N/A
	3.4.	If cohort study or cross-sectional study, were groups comparable on important confounding factors and/or were preexisting differences accounted for by using appropriate adjustments in statistical analysis?	N/A
	3.5.	If case control study, were potential confounding factors comparable for cases and controls? (If case series or trial with subjects serving as own control, this criterion is not applicable.)	N/A
	3.6.	If diagnostic test, was there an independent blind comparison with an appropriate reference standard (e.g., "gold standard")?	N/A
4.	Was method of handling withdrawals described?		Yes
	4.1.	Were follow-up methods described and the same for all groups?	Yes
	4.2.	Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.)	Yes
	4.3.	Were all enrolled subjects/patients (in the original sample) accounted for?	Yes
	4.4.	Were reasons for withdrawals similar across groups?	N/A
	4.5.	If diagnostic test, was decision to perform reference test not dependent on results of test under study?	N/A
5.	Was blinding used to prevent introduction of bias?		Yes
	5.1.	In intervention study, were subjects, clinicians/practitioners, and investigators blinded to treatment group, as appropriate?	N/A
	5.2.	Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.)	Yes
	5.3.	In cohort study or cross-sectional study, were measurements of outcomes and risk factors blinded?	N/A
	5.4.	In case control study, was case definition explicit and case ascertainment not influenced by exposure status?	N/A
	5.5.	In diagnostic study, were test results blinded to patient history and other test results?	Yes
6.	Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described?		Yes
	6.1.	In RCT or other intervention trial, were protocols described for all regimens studied?	N/A
	6.2.	In observational study, were interventions, study settings, and clinicians/provider described?	Yes
	6.3.	Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect?	Yes
	6.4.	Was the amount of exposure and, if relevant, subject/patient compliance measured?	Yes
	6.5.	Were co-interventions (e.g., ancillary treatments, other therapies) described?	???
	6.6.	Were extra or unplanned treatments described?	???
	6.7.	Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups?	Yes
	6.8.	In diagnostic study, were details of test administration and replication sufficient?	Yes
7.	Were outcomes clearly defined and the measurements valid and reliable?		???
	7.1.	Were primary and secondary endpoints described and relevant to the question?	Yes
	7.2.	Were nutrition measures appropriate to question and outcomes of concern?	Yes
	7.3.	Was the period of follow-up long enough for important outcome(s) to occur?	N/A
	7.4.	Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures?	Yes
	7.5.	Was the measurement of effect at an appropriate level of precision?	???
	7.6.	Were other factors accounted for (measured) that could affect outcomes?	No
	7.7.	Were the measurements conducted consistently across groups?	Yes
8.	Was the statistical analysis appropriate for the study design and type of outcome indicators?		Yes
	8.1.	Were statistical analyses adequately described and the results reported appropriately?	No
	8.2.	Were correct statistical tests used and assumptions of test not violated?	Yes
	8.3.	Were statistics reported with levels of significance and/or confidence intervals?	Yes
	8.4.	Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)?	N/A
	8.5.	Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)?	Yes
	8.6.	Was clinical significance as well as statistical significance reported?	No
	8.7.	If negative findings, was a power calculation reported to address type 2 error?	N/A
9.	Are conclusions supported by results with biases and limitations taken into consideration?		Yes
	9.1.	Is there a discussion of findings?	Yes
	9.2.	Are biases and study limitations identified and discussed?	Yes
10.	Is bias due to study's funding or sponsorship unlikely?		Yes
	10.1.	Were sources of funding and investigators' affiliations described?	Yes
	10.2.	Was the study free from apparent conflict of interest?	Yes