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OBJECTIVE: This report aimed to describe the results of total daily energy expenditure (TDEE) assessed by doubly labeled water (DLW TDEE) and the adequacy of the dietary reference intakes (DRI) equations to estimate energy requirements (DRI ER). METHODS: A cross-sectional and observational study in a convenience sample of 40 healthy Brazilian adults (≥20 years; 21 women) living in a tropical urban region. Basal metabolic rate (BMR) was measured by indirect calorimetry, DLW TDEE was compared with DRI ER using individual calculated physical activity level (PAL = DLW TDEE/BMR) in its estimation. RESULTS: BMR (5043 ± 548 kJ/day in women and 6213 ± 656 kJ/day in men), DLW TDEE (8372 ± 1324 kJ/day and 11 453 ± 1834 kJ/day), and PAL (1.66 ± 0.17 and 1.85 ± 0.30, respectively) were significantly higher in men. The DRI ER significantly overestimated DLW TDEE by 13.7 ± 8.3% and 12.7 ± 10.7% in women and men, respectively. CONCLUSION: In the present sample of relatively active urban Brazilian subjects, the DRI ER yielded inaccurate estimation of DLW TDEE. More data from low- and moderate-income countries are necessary to develop accurate estimates of TDEE.

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OBJECTIVES: This study aimed to evaluate bone mineral density (BMD) in the presence or absence of dynapenia or obesity in Brazilian adults. METHODS: This is a cross-sectional study conducted in 502 adults (age: 33-81 y; 51% women) participating in the Pró-Saúde study, a cohort of civil servants at the university campuses in Rio de Janeiro, Brazil. Body composition and BMD were determined by dual energy x-ray absorptiometry. Handgrip strength was measured using a dynamometer. According to measures of handgrip strength (≤19 kg for women; ≤32 kg for men) and fat mass (>30% for men; >40% for women), participants were classified into four groups: non-obese non-dynapenic, obese non-dynapenic, non-obese dynapenic, and obese dynapenic. The association between BMD at each specific bone site and obesity, dynapenia, and their interaction was evaluated using a general linear model. RESULTS: The prevalence of dynapenic obesity was 14% in men and 15.2% in women. Dynapenia alone was not associated with BMD at any site in either men nor women. Obesity and dynapenia interacted to influence BMD in women (P < 0.05). Total body, lumbar spine, and femoral neck BMD were higher by 6.3%, 9.3%, and 10.4%, respectively, in dynapenic obese women compared with their non-obese counterparts (P < 0.05). In men, obesity, dynapenia, and their combination were not associated with BMD at any site. CONCLUSIONS: Our results suggest that dynapenia, obesity, and their combination may affect BMD in a sex-dependent manner. In the presence of dynapenia, fat mass appears to exert a protective effect on BMD in women, but not in men.

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OBJECTIVES: To measure basal metabolic rate (BMR) and to compare it with the values obtained from predictive equations in a sample of elderly (≥60 y) women. DESIGN: Cross-sectional study. PARTICIPANTS AND SETTING: Seventy-nine women living in Niterói, Rio de Janeiro, Brazil enrolled in physical activity programs open to the community. MEASUREMENTS: Anthropometric measures were obtained using standard procedures. Percent body fat (PBF) was assessed by DXA. BMR was measured (BMRm) by indirect calorimetry under standardized conditions and compared with BMR estimated by 14 predictive equations that included elderly individuals in their development. RESULTS: Mean (±SD) age, BMI and PBF were 69.7 ± 6.5 y, 27.2 ± 4.6 kg/m2 and 42.1 ± 5.9%. BMRm (4188.3 ± 707.2 kJ/day) was significantly lower than estimated BMR by all predictive equations, including the equation developed for the Niteroian adult population (4565.6 ± 607.9 kJ/day). This population-specific equation provided the largest number of results within ±10% of BMRm and the lowest overestimation (10.6 ± 15.4%), much lower than the results from the internationally recommended Schofield equation (27.2 ± 17.6%). Regression of calf circumference (CC), age and body mass on BMRm provided similar estimates in comparison to models with fat-free mass (FFM). CONCLUSIONS: All predictive equations provided biased, inaccurate estimates of BMR values in comparison to BMRm. Anthropometry and body composition explained only approximately 50% of the variability of BMRm. New equations should account for the variability of organ-metabolic rates and underlying undetected health conditions in older individuals living in tropical regions.

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ABSTRACT Objective: To assess the physical activity level (PAL) and the total daily energy expenditure (EE-TDEE) in a sample of ≥60y subjects from Niterói, Rio de Janeiro, Brazil. Methods: A convenience sample of 88 subjects recruited from recreational physical activity programs wore an accelerometer around the waist for seven consecutive days for at least 10h/day. Minute-by-minute EE was estimated from the counts per minute (CPM) data, and the daily sum yielded the TDEE. PAL (TDEE/BMR) with BMR calculated with the FAO/WHO predictive equation and a population-specific equation. Body composition was assessed by DXA. Results: Mean age (SD) was 69.2 (5.8) years, the prevalence of overweight and obesity was 36.4 and 25.0%, respectively, and excess body fat was 39.8%. The subjects spent 600min/day engaged in sedentary activities (CPM<100). Men engaged in 30min of moderate-to-vigorous physical activity (CPM≥1,952) daily, on average. The subjects were active on 34.5 and 18.0% of the weekdays and weekend days with a 1,400 steps/day difference between these days. TDEE was 1,731.5 (348.7) and 1,356.3 (223.7) kcal/day depending on the BMR prediction equation used. Mean PAL was lower than the maintenance level. Conclusions: The high prevalence of sedentary activities and the low percentage of subjects who met the physical activity recommendations indicate that physical activity programs must be adjusted so that the enrolled subjects can meet the physical activity recommendations, preferably with the activities objectively monitored. Population-specific equations improve the final estimation of TDEE and PAL. Level of Evidence I; Diagnostic studies - Investigating a diagnostic test.

RESUMO Objetivo: Avaliar o nível de atividade física (NAF) e o gasto energético total diário (GETD) em uma amostra de idosos (≥ 60 anos) residentes no município de Niterói, Rio de Janeiro, Brasil. Métodos: Uma amostra de conveniência de 88 indivíduos recrutados em programas de atividade física usou acelerômetro na cintura durante sete dias consecutivos, por pelo menos 10 horas por dia. O GE por minuto foi estimado a partir de dados de contagem por minuto (CPM), cujo somatório diário forneceu o GETD. O NAF (GETD/TMB) foi calculado com a TMB estimada pela equação preditiva da FAO/WHO e por equação especifica para a população estudada. A composição corporal foi avaliada por DXA. Resultados: A média de idade (DP) foi de 69,2 (5,8) anos, a prevalência de sobrepeso e obesidade foi de 36,4 e 25,0%, respectivamente, e o de excesso de gordura corporal foi 39,8%. Os indivíduos passaram 600 min./dia em atividades sedentárias (CPM < 100). Os homens realizaram, em média, 30 minutos de atividade física vigorosa a moderada (CPM ≥ 1.952) diariamente. Os indivíduos foram ativos em 34,5% e 18% dos dias da semana e nos fins de semana, respectivamente, com uma diferença de 1.400 passos/dia entre esses dias. O GETD foi de 1.731,5 (348,7) e 1.356,3 (223,7) kcal/dia, dependendo da equação preditiva da TMB usada. O NAF médio foi inferior ao nível de atividade de manutenção. Conclusão: A alta prevalência de atividades sedentárias e o baixo percentual de indivíduos que atenderam às recomendações de atividade física indicam que esses programas devem ser ajustados para que os indivíduos inscritos possam atender às recomendações, preferencialmente, com monitoramento objetivo. As equações populacionais específicas melhoram a estimativa final do GETD e NAF. Nível de Evidência I; Estudos diagnósticos - Investigação de um exame para diagnóstico.

RESUMEN Objetivo: Evaluar el nivel de actividad física (NAF) y el gasto energético total diario (GETD) en una muestra de ancianos (≥ 60 años) residentes en el municipio de Niterói, Rio de Janeiro, Brasil. Métodos: Una muestra de conveniencia de 88 individuos reclutados en programas de actividad física usó acelerómetro en la cintura durante siete días consecutivos, durante por lo menos 10 horas por día. El GE por minuto fue estimado a partir de datos de conteo por minuto (CPM), cuya sumatoria diaria suministró el GETD. El NAF (GETD/TMB) fue calculado con la ecuación predictiva de FAO/WHO y por ecuación específica para la población estudiada. La composición corporal fue evaluada por DXA. Resultados: El promedio de edad (SD) fue de 69,2 (5,8) años, la prevalencia de sobrepeso y obesidad fue de 36,4 y 25,0%, respectivamente, y el de exceso de grasa corporal fue de 39,8%. Los individuos pasaron 600 min/día en actividades sedentarias (CPM < 100). Los hombres realizaron, como promedio, 30 minutos de actividad física vigorosa a moderada (CPM ≥ 1.952) diariamente. Los individuos fueron activos en 34,5% y 18% de los días de la semana y en los fines de semana, respectivamente, con una diferencia de 1.400 pasos/día entre esos días. El GETD fue de 1.731,5 (348,7) y 1.356,3 (223,7) kcal/día, dependiendo de la ecuación predictiva de la TMB usada. El NAF promedio fue inferior al nivel de actividad de mantenimiento. Conclusión: La alta prevalencia de actividades sedentarias y el bajo porcentual de individuos que atendieron las recomendaciones de actividad física indican que esos programas deben ser ajustados para que los individuos inscriptos puedan atender las recomendaciones, preferentemente, con monitorización objetiva. Las ecuaciones poblacionales específicas mejoran la estimativa final del GETD y NAF. Nivel de Evidencia I; Estudios diagnósticos - Investigación de un examen para diagnóstico.

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OBJECTIVE: to evaluate the adequacy of dietary intake and the anthropometric nutritional status of pregnant adolescents in the city of Niterói, Rio de Janeiro, Brazil. METERIALS AND METHODS: forty-two adolescents (13-19 years of age), with single-fetus gestation, assisted in the public prenatal health care units between 2008-2014, participated in the study. Body mass index (BMI) was used to assess the nutritional status. Dietary intake was assessed by 24h dietary recalls on two days during a week and one during weekend. Basal metabolic rate was measured by indirect calorimetry and used to determine the energy requirements. Mixed effects models were used to assess dietary intake over the gestational weeks (random effect) and BMI. RESULTS: mean age (SD) of the pregnant women was 16.5 (1.5) years and the majority received allowance from a cash transfer federal program. Overall, 30.3% were overweight/obese pre-pregnancy and 16.7%, during pregnancy. Energy and protein intake adequacies decreased with increasing BMI and gestational week. There was adequate dietary intake of energy, protein, vitamin A and zinc and insufficient intakes of iron and calcium. There was excessive intake of sodium. CONCLUSION: pregnant adolescents living in underprivileged socio-economic environments assisted for prenatal care in primary health care units have adequate intakes of energy, protein, vitamin A and zinc. Pre-pregnancy overweight and high sodium intake are causes of concern due to the future implications for their health. The official Brazilian recommended criterion for anthropometric assessment in pregnancy of adolescents proved to be inadequate.

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BACKGROUND & AIMS: Basal metabolic rate (BMR) is an important physiologic measure in nutrition research. In many instances it is not measured but estimated by predictive equations. The purpose of this study was to compare measured BMR (BMRm) with estimated BMR (BMRe) obtained by different equations. METHODS: A convenient sample of 148 (89 women) 20-60 year-old subjects from the metropolitan area of Rio de Janeiro, Brazil participated in the study. BMRm values were measured by an indirect calorimeter and predicted by different equations (Schofield, Henry and Rees, Mifflin-St. Jeor and Anjos. All subjects had their body composition and anthropometric variables also measured. Accuracy of the estimations was established by the percentage of BMRe falling within ±10% of BMRm and bias when the 95% CI of the difference of BMRe and BMRm means did not include zero. RESULTS: Mean BMRm values were 4833.5 (SD 583.3) and 6278.8 (SD 724.0) kJ*day-1 for women and men, respectively. BMRe values were both biased and inaccurate except for values predicted by the Anjos equation. BMR overestimation was approximately 20% for the Schofield equation which was higher comparatively to the Henry and Rees (14.5% and 9.6% for women and men, respectively) and the Mifflin-St. Jeor (approximately 14.0%) equations. BMR estimated by the Anjos equation was unbiased (95% CI = -78.1; 96.3 kJ day-1 for women and -282.6; 30.7 kJ*day-1 for men). CONCLUSIONS: Population-specific BMR predictive equations yield unbiased and accurate BMR values in adults from an urban tropical setting.

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Studies have revealed complex interactions between bone and fat, however there are few studies about this crosstalk in patients with chronic kidney disease. This study investigated possible relationship between bone mineral density (BMD) and body composition in patients who underwent hemodialysis. Twenty patients were enrolled in a cross-sectional study (47.0 [42.3-56.8] years, body mass index 26.0 ± 4.2 kg/m, dialysis vintage of 48.5 [26.7-95.7] months). Body composition and BMD were assessed by dual-energy X-ray absorptiometry. Leptin and parathormone levels were analyzed using Multiplex kits (R&D System Inc). Low bone mass in the femoral neck was reported in 54.8% of patients. Total BMD and total T-score were positively correlated with lean mass (r = 0.46, P = 0.04; r = 0.47, P = 0.04, respectively), but not with leptin or body fat mass. In conclusion, lean body mass is probably important to maintain bone health in male patients who underwent hemodialysis.

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OBJETIVO: Descrever o perímetro da cintura e apresentar estimativas de pontos críticos para classificação de risco e alto risco de excesso de gordura abdominal segundo sexo e faixa etária. MÉTODOS: Foi estudada uma amostra probabilística de adolescentes (n=3 . 175) da rede pública de ensino do Rio de Janeiro. O perímetro da cintura foi aferido no ponto médio entre a borda inferior da costela e a crista ilíaca. Os percentis de perímetro da cintura estudados foram estimados segundo método LMS (Lambda, Mu, Sigma) proposto por Cole em 1990. Os pontos de corte adotados para definição de risco e alto risco de excesso de gordura abdominal foram os propostos por Jolliffe & Janssen em 2007. RESULTADOS: Comparando os valores estimados, meninas apresentaram valores de perímetro da cintura maiores que os de meninos para todos os percentis (exceto para o P90) em todas as idades. Os valores críticos estimados foram menores entre as meninas e aumentaram com a idade em ambos os sexos. Em geral, para ambos os sexos, os valores estimados foram menores do que os propostos pela referência adotada. CONCLUSÃO: Os achados ratificam a importância da aferição dessa medida em adolescentes, sendo apresentados pontos críticos de perímetro da cintura para classificação antropométrica desse grupo populacional segundo essa medida, o que até o momento não havia sido proposto com base em dados de adolescentes brasileiros. .

OBJECTIVE: To determine waist circumference and present waist circumference critical values to classify the risk and high risk posed by excessive abdominal fat according to age and gender. METHODS: A probabilistic sample of adolescent students (n=3,175) from public schools in Rio de Janeiro was analyzed. Waist circumference measurements were performed at midpoint between the last rib and the top of the iliac crest. Waist circumference percentiles were estimated using the LMS (Lambda, Mu, Sigma) method proposed by Cole (1990). The cut-points used to determine the risk and high-risk posed by excessive abdominal fat were proposed by Jolliffe & Janssen (2007). RESULTS: Comparing the values estimated, it was observed that the girls had higher waist circumference than the boys at all percentiles (except for P90) and ages. The estimated percentiles were lower in girls and increased with age in both sexes. At all ages, (except for 17 year old boys) and both genders, the estimated values were lower than the reference values used. CONCLUSION: The results obtained confirm the importance of measuring waist circumference in adolescents. This study presents waist circumference critical values for the anthropometric classification of the group studied, which has not yet been reported in the literature with data of Brazilian adolescents. .

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