Energy and Protein requirements, Proceedings of an IDECG workshop, November 1994, London, UK, Supplement of the European Journal of Clinical Nutrition (International Dietary Energy Consultative Group - IDECG, 1994, 198 pages): Energy requirements: general principles: Summary of research needs

Energy and Protein requirements, Proceedings of an IDECG workshop, November 1994, London, UK, Supplement of the European Journal of Clinical Nutrition (International Dietary Energy Consultative Group - IDECG, 1994, 198 pages)

(introductory text...)

Foreword

Energy requirements: general principles

(introductory text...)

Energy expenditure as the basis for estimating energy requirements

Methodology

Importance of body composition

Points of uncertainty requiring further research

Summary of research needs

References

Discussion

References

Energy requirements of adults: an update on basal metabolic rates (BMRs) and physical activity levels (PALs)

(introductory text...)

Introduction

Variability in adult BMRs

Predictive equations to estimate bmrs of adults

Ethnic differences in BMR

Effects of migration from tropical to temperate climate on BMR

Adaptation and energy requirements

Total energy expenditure (TEE) and physical activity levels (PAL) in adults: doubly-labelled water data

References

Energy requirements of infants

(introductory text...)

Energy requirements of infants based on energy intake

Compilation of energy intakes published before and after 1980

Total energy expenditure of infants

Energy requirement for growth

Energy requirements of infants predicted from total energy expenditure and growth

Recommendations

References

Discussion

Energy requirements and dietary energy recommendations for children and adolescents 1 to 18 years old

(introductory text...)

Introduction

Total daily energy expenditure (TEE)

Estimates of basal metabolic rate to calculate total energy expenditure

Time allocation to different activities

Physical activity levels of children and adolescents

Dietary energy intake

General conclusions and recommendations

References

Discussion

Energy requirements of pregnant and lactating women

(introductory text...)

Introduction

Pregnancy

Recommendations for pregnancy

Lactation

Recommendations for lactation

References

Discussion

References

Energy requirements of older individuals

(introductory text...)

Introduction

Methodology for determination of total energy expenditure

Total energy expenditure of older individuals

Relationship between total energy expenditure and physical activity

Effects of energy balance on nitrogen balance

Summary of energy requirements in older individuals and recommendations for future research

References

Discussion

Protein requirements of infants and children

(introductory text...)

1. Introduction

2. Protein requirements of infants

3. Protein requirements of children and adolescents

4. Protein needs during catch-up growth

5. protein needs associated with infection

6. Assessment of protein quality of weaning diets

7. Future research needs

References

Discussion

References

The requirements of adult man for indispensable amino acids

(introductory text...)

1. Introduction

2. The problem in defining requirements

3. Protein quality

4. The maintenance requirement (MR)

5.Diurnal cycling: the Millward-Rivers model

6. Theoretical basis of the MIT tracer balance studies

7. Technical problems of tracer balance studies

8. Results of the MIT tracer balance studies

9. Relation between leucine oxidation and nitrogen excretion

10. Factors relating to the design of tracer balance experiments

11. Breakpoint analysis

12. Effect of protein/amino acid intake on protein synthesis and breakdown

13. The colon: losses or gains?

14. Conclusion

References

Discussion

References

Protein requirements of elderly people

(introductory text...)

Introduction: current dietary protein requirement recommendations

Protein requirement studies in elderly people: previously reviewed data

Protein requirement studies in elderly people: reassessment of previously reviewed data

Summary

References

Discussion

References

Report of the working group on general principles of assessing energy requirements

(introductory text...)

General recommendations

Research needs

Report of the working group on energy requirements of infants, children and adolescents

(introductory text...)

General principles

Infants

Children and adolescents

Methodological considerations

Report of the working group on energy requirements for pregnancy and lactation

(introductory text...)

Pregnancy

Lactation

Report of the working group on energy requirements of older individuals

(introductory text...)

General statement

Recommendations on requirements

Recommendations for future research

Report of the working group on protein and amino acid requirements

(introductory text...)

Infants

Infection and catch-up growth

Children and adolescents

Adults

Elderly

Research needs: Infants and children

Research needs: adults

Appendix Criteria for valid nitrogen balance measurement of protein requirements

(introductory text...)

Long-term studies

Analysis of multilevel short-term balance studies

References

Summary of research needs

Suggestions have been made, at different places in the text of this paper, for further analyses or studies on various aspects of energy requirements. The different items are as follows:

BMR: A critical re-assessment of all the data is highly desirable. Particular attention needs to be given to the extent of intra- and inter-individual variability.

Physical activities: There is a need for further analysis and for more investigation into the energy cost of different activities. The confusing effect of uncertainty with regard to whether or not rest-pauses have been taken into account in the estimate of the energy cost of the different activities is discussed.

Doubly-labelled water: Its role is discussed briefly and a specific proposal is made in relation to its potential use in the investigation of the 'maintenance' factor, specifically applied to BMR and the activity factor in physically inactive populations.

Maintenance factors: The validity of some of these to real life situations are discussed with specific examples of practical implications of the factors 1.4 (for 'maintenance') and 1.2 (for 'survival').

Body mass and composition: It is doubtful if, within a fairly wide range of 'fatness' (but excluding the grossly obese), there is any real benefit in field situations from taking body composition into account, bearing in mind the extent of the variability of both BMR and total daily energy expenditure. In this context, because total body mass clearly has a considerable influence on energy expenditure, further studies of the effect of actual or desirable body mass are needed.

Population sample size: Because of the considerable variability in many aspects of energy metabolism, it is critical to have a sample size which has an acceptable statistical power and is reasonably representative of the particular variables being analysed. It is not scientifically admissible to make other than highly qualified deductions from data obtained on only small sample sizes. It is particularly depressing to read statements with sweeping generalizations about energy expenditure, which contradict data obtained on very large numbers of individuals by many experienced investigators, when the statements are based on findings on nine individuals (Haggarty et al, 1994).