Robin P. Shook

45-Year Trends in Women’s Use of Time and Household Management Energy Expenditure

Context Relationships between socio-environmental factors and obesity are poorly understood due to a dearth of longitudinal population-level research. The objective of this analysis was to examine 45-year trends in time-use, household management (HM) and energy expenditure in women. Design and Participants Using national time-use data from women 19–64 years of age, we quantified time allocation and household management energy expenditure (HMEE) from 1965 to 2010. HM was defined as the sum of time spent in food preparation, post-meal cleaning activities (e.g., dish-washing), clothing maintenance (e.g., laundry), and general housework. HMEE was calculated using body weights from national surveys and metabolic equivalents. Results The time allocated to HM by women (19–64 yrs) decreased from 25.7 hr/week in 1965 to 13.3 hr/week in 2010 (P<0.001), with non-employed women decreasing by 16.6 hr/week and employed women by 6.7 hr/week (P<0.001). HMEE for non-employed women decreased 42% from 25.1 Mj/week (6004 kilocalories per week) in 1965 to 14.6 Mj/week (3486 kcal/week) in 2010, a decrement of 10.5 Mj/week or 1.5 Mj/day (2518 kcal/week; 360 kcal/day) (P<0.001), whereas employed women demonstrated a 30% decrement of 3.9 Mj/week, 0.55 Mj/day (923 kcal/week, 132 kcal/day) (P<0.001). The time women spent in screen-based media use increased from 8.3 hr/week in 1965 to 16.5 hr/week in 2010 (P<0.001), with non-employed women increasing 9.6 hr/week and employed women 7.5 hr/week (P<0.001). Conclusions From 1965 to 2010, there was a large and significant decrease in the time allocated to HM. By 2010, women allocated 25% more time to screen-based media use than HM (i.e., cooking, cleaning, and laundry combined). The reallocation of time from active pursuits (i.e., housework) to sedentary pastimes (e.g., watching TV) has important health consequences. These results suggest that the decrement in HMEE may have contributed to the increasing prevalence of obesity in women during the last five decades.

The Energy Balance Study: The Design and Baseline Results for a Longitudinal Study of Energy Balance

Purpose: The Energy Balance Study (EBS) was a comprehensive study designed to determine over a period of 12 months the associations of caloric intake and energy expenditure on changes in body weight and composition in a population of healthy men and women. Method: EBS recruited men and women aged 21 to 35 years with a body mass index between 20 and 35 kg/m2. Measurements of energy intake and multiple objective measures of energy expenditure, as well as other physiological, anthropomorphic and psychosocial measurements, were made quarterly. Resting metabolic rate and blood chemistry were measured at baseline, 6 and 12 months. Results: Four hundred and thirty (218 women and 212 men) completed all baseline measurements. There were statistically significant differences by sex uncovered for most anthropomorphic, physiological and behavioral variables. Only percent of kcals from fat and alcohol intake, as well as energy expenditure in light activity and very vigorous activity were not different. Self-reported weight change (mean ± SD) over the previous year were 0.92 ± 5.24 kg for women and − 1.32 ± 6.1 kg for men. Resting metabolic rate averages by sex were 2.88 ± 0.35 ml/kg/min for women and 3.05 ± 0.33 ml/kg/min for men. Conclusion: Results from EBS will inform our understanding of the impact of energy balance components as they relate to changes in body weight and composition. Initial findings suggest a satisfactory distribution of weight change to allow for robust statistical analyses. Resting metabolic rates well below the standard estimate suggest that the evaluation of the components of total energy expenditure will be impactful for our understanding of the roles of energy intake and expenditure on changes in energy utilization and storage.

Low levels of physical activity are associated with dysregulation of energy intake and fat mass gain over 1 year

BACKGROUNDnPrevious studies suggest that appetite may be dysregulated at low levels of activity, creating an energy imbalance that results in weight gain.nnnOBJECTIVEnThe aim was to examine the relation between energy intake, physical activity, appetite, and weight gain during a 1-y follow-up period in a large sample of adults.nnnDESIGNnParticipants included 421 individuals (mean ± SD age: 27.6 ± 3.8 y). Measurements included the following: energy intake with the use of interviewer-administered dietary recalls and calculated by using changes in body composition and energy expenditure, moderate-to-vigorous physical activity (MVPA) with the use of an arm-based monitor, body composition with the use of dual-energy X-ray absorptiometry, and questionnaire-derived perceptions of dietary restraint, disinhibition, hunger, and control of eating. Participants were grouped at baseline into quintiles of MVPA (min/d) by sex. Measurements were repeated every 3 mo for 1 y.nnnRESULTSnAt baseline, an inverse relation existed between body weight and activity groups, with the least-active group (15.7 ± 9.9 min MVPA/d, 6062 ± 1778 steps/d) having the highest body weight (86.3 ± 13.2 kg) and the most-active group (174.5 ± 60.5 min MVPA/d, 10260 ± 3087 steps/d) having the lowest body weight (67.5 ± 11.0 kg). A positive relation was observed between calculated energy intake and activity group, except in the lowest quintile of activity. The lowest physical activity group reported higher levels of disinhibition (P = 0.07) and cravings for savory foods (P = 0.03) compared with the group with the highest level of physical activity. Over 1 y of follow-up, the lowest activity group gained the largest amount of fat mass (1.7 ± 0.3 kg) after adjustment for change in MVPA and baseline fat mass. The odds of gaining >3% of fat mass were between 1.8 and 3.8 times as high for individuals in the least-active group as for those in the middle activity group.nnnCONCLUSIONSnThese results suggest that low levels of physical activity are a risk factor for fat mass gain. In the current sample, a threshold for achieving energy balance occurred at an activity level corresponding to 7116 steps/d, an amount achievable by most adults. This trial was registered at clinicaltrials.gov as NCT01746186.

Anti-inflammatory Dietary Inflammatory Index scores are associated with healthier scores on other dietary indices

Dietary components are important determinants of systemic inflammation, a risk factor for most chronic diseases. The Dietary Inflammatory Index (DII) was developed to assess dietary inflammatory potential. It was hypothesized that anti-inflammatory DII scores would be associated with healthier scores on other dietary indices. The Energy Balance Study is an observational study focusing on energy intake and expenditure in young adults; only baseline data were used for this analysis (n=430). The DII, as well as the Healthy Eating Index-2010 (HEI-2010), the Alternative Healthy Eating Index (AHEI), and the Dietary Approaches to Stop Hypertension Index (DASH) were calculated based on one to three 24-hour dietary recalls. General linear models were used to estimate least square means of the AHEI, HEI-2010, and DASH according to DII quartiles. Those with higher (ie, more proinflammatory) DII scores were more likely to be males, have less than a completed college education, and be younger. In addition, those with higher scores for cognitive restraint for eating or drive for thinness had lower (ie, anti-inflammatory) DII scores. Linear regression analyses indicated that as the DII increased, the AHEI, HEI-2010, and DASH dietary indices decreased (ie, became more unhealthy, all P<.01). The DII is a novel tool that characterizes the inflammatory potential of diet and is grounded in the peer-reviewed literature on diet and inflammation. Findings from the Energy Balance Study indicate that the DII is associated with other dietary indices, but has the added advantage of specifically measuring dietary inflammatory potential, a risk factor for chronic disease.

Validation of a Novel Protocol for Calculating Estimated Energy Requirements and Average Daily Physical Activity Ratio for the US Population: 2005-2006

OBJECTIVEnTo validate the PAR protocol, a novel method for calculating population-level estimated energy requirements (EERs) and average physical activity ratio (APAR), in a nationally representative sample of US adults.nnnMETHODSnEstimates of EER and APAR values were calculated via a factorial equation from a nationally representative sample of 2597 adults aged 20 and 74 years (US National Health and Nutrition Examination Survey; data collected between January 1, 2005, and December 31, 2006). Validation of the PAR protocol-derived EER (EER(PAR)) values was performed via comparison with values from the Institute of Medicine EER equations (EER(IOM)).nnnRESULTSnThe correlation between EER(PAR) and EER(IOM) was high (0.98; P<.001). The difference between EER(PAR) and EER(IOM) values ranged from 40 kcal/d (1.2% higher than EER(IOM)) in obese (body mass index [BMI] ≥30) men to 148 kcal/d (5.7% higher) in obese women. The 2005-2006 EERs for the US population were 2940 kcal/d for men and 2275 kcal/d for women and ranged from 3230 kcal/d in obese (BMI ≥30) men to 2026 kcal/d in normal weight (BMI <25) women. There were significant inverse relationships between APAR and both obesity and age. For men and women, the APAR values were 1.53 and 1.52, respectively. Obese men and women had lower APAR values than normal weight individuals (P¼.023 and P¼.015, respectively) [corrected], and younger individuals had higher APAR values than older individuals (P<.001).nnnCONCLUSIONnThe PAR protocol is an accurate method for deriving nationally representative estimates of EER and APAR values. These descriptive data provide novel quantitative baseline values for future investigations into associations of physical activity and health.

Top 10 Research Questions Related to Energy Balance

Obesity is the result of a mismatch between the amount of calories consumed and the amount of calories expended during an extended period of time. This relationship is described by the energy balance equation, which states the rate of change in energy storage depots in the body are equal to the rate of energy intake minus the rate of energy expenditure. Although this relationship may appear easy to understand based on simple mathematics, in reality, a variety of known and unknown systems influence the components of energy balance (energy storage, energy intake, energy expenditure). Clearly, if a complete understanding of energy balance was apparent, worldwide levels of obesity would not have reached pandemic proportions due to effective prevention and treatment strategies. The aim of the present article is to provide a brief overview of the components of energy balance and to identify 10 key topics and unanswered questions that would move the research field forward if addressed. These topics are intentionally diverse and range from general themes (e.g., methodological issues) to specific areas (e.g., intensity of exercise required to alter energy intake). Although this list is not meant to be exhaustive, it does provide a research agenda for scientists involved in the study of energy balance and recommendations for public health professionals developing obesity interventions.

The independent association between diet quality and body composition.

Excess body weight is associated with an imbalance between energy expenditure and dietary intake but evidence on the association between diet quality and body composition remains equivocal. Rather than relying on differences in diet quality between overweight/obese and normal weight adults, this study examined the association between the Healthy Eating Index 2010 (HEI-2010) and body fatness on a continuous scale, independent of physical activity (PA). Further the association between components of the HEI-2010 and risk for overweight/obesity was explored. 407 adults (27.6 ± 3.7 years) provided at least two 24-hour diet recalls over a period of 14 days, which were used to calculate the HEI-2010. Percent body fat (BF) was assessed via dual X-ray absorptiometry and PA was determined via a multi-sensor device, worn over a period of 10 days. PA was a stronger contributor to the variability in BF than the HEI-2010 and the association between HEI-2010 and BF was significant only in men. Particularly a high consumption of protein, sodium and empty calories increased the risk for overweight/obesity. Adherence to dietary guidelines positively affects body fatness in men, independent of PA. In contrast to current dietary recommendations, the risk for overweight/obesity was increased with a higher protein intake.

High respiratory quotient is associated with increases in body weight and fat mass in young adults.

Background/Objectives:Metabolic disturbances, such as reduced rates of fat oxidation (high respiratory quotient (RQ)) or low energy expenditure (low resting metabolic rate (RMR)), may contribute to obesity. The objective was to determine the association between a high RQ or a low RMR and changes in body weight and body composition over 1 year.Subjects/Methods:We measured RQ and RMR in 341 adults using indirect calorimetry, along with body weight/body composition using dual-energy X-ray absorptiometery, energy expenditure using an arm-based activity monitor and energy intake using dietary recalls. Participants were classified into low, moderate or high RQ and RMR (adjusted for age, sex, race and body composition) groups according to tertiles by sex. Follow-up measurements were completed every 3 months.Results:Individuals with a high RQ had larger gains in body weight and fat mass compared with individuals with a low/moderate RQ at month 3, and increases in fat mass were more than double among individuals with a high RQ at 12 months (1.3±3.0 vs 0.6±3.7u2009kg, P=0.03). Individuals with a low RMR did not gain more body weight nor fat mass compared with individuals with a moderate/high RMR.Conclusion:The primary finding is a high RQ is predictive of gains in body weight and fat mass over a 12-month period among young adults, with changes occurring as soon as 3 months. In addition, a low RMR was not associated with gains in body weight or fat mass over the same period.

The Prospective Association between Different Types of Exercise and Body Composition.

PURPOSEnDespite the widely accepted benefits of exercise on chronic disease risk, controversy remains on the role of exercise in weight loss. This study examined the effect of different exercise types on measures of adiposity across different fat categories.nnnMETHODSnA total of 348 young adults (49% male; 28 ± 4 yr), participating in an ongoing observational study provided valid data over a period of 12 months. Fat mass (FM) and lean mass (LM) were measured via dual x-ray absorptiometry every 3 months. Percent body fat was calculated and used to differentiate between normal-fat, overfat, and obese participants. At each measurement time point, participants reported engagement (min·wk) in aerobic exercise, resistance exercise, and other forms of exercise.nnnRESULTSnMost participants (93%) reported some exercise participation during the observation period. Total exercise or specific exercise types did not significantly affect subsequent body mass index after adjusting for sex, ethnicity, age, and baseline values of adiposity and exercise. Resistance exercise affected LM (P < 0.01) and FM (P < 0.01), whereas aerobic exercise only affected FM (P < 0.01). Any exercise type positively affected LM in normal-fat participants (P < 0.04). In overfat and obese participants, FM was reduced with increasing resistance exercise (P ≤ 0.02) but not with aerobic exercise (P ≥ 0.09). Additionally adjusting for objectively assessed total physical activity level did not change these results.nnnCONCLUSIONSnDespite the limited effects on body mass index, exercise was associated with beneficial changes in body composition. Exercise increased LM in normal-fat participants and reduced FM in overfat and obese adults. Adults with excess body fat may benefit particularly from resistance exercise.

Low Fitness Partially Explains Resting Metabolic Rate Differences Between African American and White Women

BACKGROUNDnHigh levels of obesity among African American women have been hypothesized to be partially resultant from a lower resting metabolic rate compared with white women. The aim of the current study was to determine if differences in cardiorespiratory fitness and moderate-to-vigorous physical activity are associated with differences in resting metabolic rate among free-living young adult African American women and white women.nnnMETHODSnParticipants were 179 women (white women n = 141, African American women n = 38, mean age = 27.7 years). Resting metabolic rate was measured using indirect calorimetry, body composition using dual energy x-ray absorptiometry, cardiorespiratory fitness via maximal treadmill test, and moderate-to-vigorous physical activity using an activity monitor.nnnRESULTSnAfrican American women had higher body mass index, fat mass, and fat-free mass compared with white women but lower levels of cardiorespiratory fitness. No differences were observed between African American and white women in resting metabolic rate when expressed as kcal/day (1390.8 ± 197.5 vs 1375.7 ± 173.6 kcal/day, P = .64), but African American women had a lower resting metabolic rate when expressed relative to body weight (2.56 ± 0.30 vs 2.95 ± 0.33 mL/kg/min, P < .001). After statistical adjustment for differences in body composition between groups using linear regression models, African American women had a lower resting metabolic rate compared with white women (1299.4 ± 19.2 vs 1400.4 ± 9.2 kcal/day, P < .001). The addition of cardiorespiratory fitness reduced the differences among groups by 25%. The addition of moderate-to-vigorous physical activity did not improve the model.nnnCONCLUSIONSnThe present study confirms that African American women have a lower resting metabolic rate compared with their white peers, and low cardiorespiratory fitness explained 25% of this difference. Variables associated with resting metabolic rate, such as cardiorespiratory fitness, represent possible points of tailored interventions designed to address high levels of obesity seen in certain demographic groups.