Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements.

OBJECTIVES: To describe average levels of free-living energy expenditure in people from affluent societies and to determine the influence of body weight, height, age and sex. DESIGN: Analysis of 574 measurements of total energy expenditure (TEE, assessed by the doubly-labelled water method); basal metabolic rate (BMR, directly measured or derived from similar directly measured proxy measures such as during sleep); activity energy expenditure (AEE, derived as TEE-BMR); and physical activity level (PAL, derived as TEE/BMR) from people aged 2-95 years. The dataset was extracted from 1614 published and unpublished measurements in 1156 subjects after exclusion of repeat estimates and subjects in special physiological or behavioural states (eg pregnancy, athletic or military training etc). RESULTS: A separate analysis of data from non-ambulant subjects, and from elite endurance athletes (all excluded from the main dataset) established the limits of human daily energy expenditure at around 1.2 x BMR and 4.5 x BMR. In the main analysis, the validity of PAL as an index of TEE adjusted for BMR was tested and confirmed. Regression equations were then derived to describe TEE, BMR, AEE and PAL in terms of body weight, height, age and sex. As anticipated, TEE, BMR and AEE were all positively related to weight and height, while age was a negative predictor, especially of activity. The influence of weight disappeared when TEE was expressed as PAL, but height and age remained as highly significant predictors. For all three components, females expended 11% less energy on average than males after adjustment for weight, height and age. Average levels of energy expenditure in different age and sex groups are tabulated. CONCLUSIONS: There now exists a large and robust database of energy expenditure measurements obtained by the doubly-labelled water method. Analysis of the data from affluent societies shows that, in general, levels of energy expenditure are similar to the recommendations for energy requirements adopted by FAO/WHO/UNU (1985) and UK Department of Health (1991). PAL values for active subjects tend to be higher than is currently assumed. The current analysis provides a substantial body of normal data against which other estimates can be compared.