Article
Estimating daily energy expenditure in elderly with Type 2 Diabetes Mellitus
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Published: | December 18, 2006 |
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Outline
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Background
In the past years there has been a concerning increase in the prevalence of type 2 diabetes mellitus and the metabolic syndrome. This increase is due to a sedentary lifestyle. The positive association between physical activity and glycemic control is long known and well documented.
Objective
The aim of this study was to highlight the relations between Daily Energy Expenditure (DEE) and glycemic control in diabetic subjects aged 65 – 75. Furthermore, we sought to examine the influence that an increase in DEE would have on glycemic control in these subjects.
Methods
We obtained a written consent form and performed anthropometric measurements: Weight (kg), Height (cm), Hip and Pelvic circumferences (cm). Step Length (cm) was measured by counting the number of steps paced at a 5 meter walk and then dividing 500 cm by the number of steps paced. BMI (kg/m2) was also calculated. Resting Metabolic Rate (RMR, kcal/24hr) was measured by respiratory analysis with a portable hand-held device (BodyGem, Health Tech Inc., Golden, CO). Blood tests results were retrieved from Health Care database: LDL, HDL, TG (mg/dl), HbA1c (%). Average Daily Steps were measured daily for a week using a step counting device, a pedometer (HJ-113-E, Omron).
Results
10 subjects (6 males, 4 females), age 70.5 ± 1 years (mean±SEM) have been studied thus far. The average weight was 73.3 ± 3.3 kg and the mean BMI was 27.1±1.6 kg/m2. In our preliminary findings we have found some evidence of a possible inverse correlation between Diabetes control outcome measures and daily energy expenditure. This trend was observed in HbA1c values and LDL values. We will continue to investigate these relations as our sample size increases. The average HbA1C was 8.8± 0.34%. The average daily steps was 5273 ± 863 steps per day, the average step length was 57.1 ± 1.06 cm. The subjects paced on average approximately 3 km per day. Given this distance and the average weight, we estimated that the subjects expended some 165 kcal per day. Thus, by adding the energy expenditure estimated from the pedometry to the average RMR measurement (1820± 52 kcal/24hr), it is acceptable to assume that these subjects expend 1985 kcal/24hr on average (2205 kcal/24hr when considering the thermal effect of food).
Discussion
We experienced a large amount of variability within the subjects. The average daily steps per subject varied from 1686 to 9280 stps/day. Thus was the Non Exercise Activity Thermogenesis (NEAT) which varied from 42 to 237 kcal/day. Our research is in progress and we continue to increase our sample size. The next phase would be to examine the influence of Exercise Activity Thermogenesis (EAT) in the form of 3 weekly walking sessions, for 12 weeks, on the above mentioned variables.