Indirect calorimetry and

Non-calorimetric methods
INDIRECT CALORIMETRY NON-CALORIMETRIC METHODS
• Benedict’s oxy calorimeter • Doubly labelled water method
• Benedict’s roth respiration apparatus • Bioelectrical impedance analysis
• Heart rate monitoring
• Sensor of heat and movement
• Accelerometers
• Pedometers
Benedict’s oxy calorimeter

• Benedict’s oxy calorimeter is used for the determination of the energy value of foods
• This instrument was devised by Benedict and co-workers
• The benedict’s oxy calorimeter measures the volume of oxygen required to burn a known
weight of food
Principle

• The fundamental principle of this apparatus is the direct determination of the volume of
oxygen required to burn a known weight of a substance and the computation of the
potential energy of the substance
• This apparatus consists of the following parts:
• Combustion chamber- this is the place where a known amount of sample is burnt
• Spirometer- It is used for measuring the oxygen used
• Motor blower unit is used for circulating gas mixture
• Soda lime chamber is used for absorption of carbon-di-oxide
• SAMPLE PREPARATION-The sample must be dry to burn readily
• The sample is generally 1g air-dry material which is accurately weighed and ample for
combustion
Benedict’s oxy calorimetry
PROCEDURE

• 1g of the sample is placed in a nickel crucible which is then placed in a combustion

chamber
• The ignition wire is attached to the two upright nickel alloy rods for igniting the sample.
• The whole system is filled with oxygen and the substance is ignited
• Then the combustion gets complete at the end of 1-2 minutes
• After the combustion the decrease in volume of the gas inside of the system
represents the oxygen consumed.
• Using this instrument the amount of oxygen consumed in burning 1g of pure
carbohydrate, protein and fat can be determined
• 1g of carbohydrate requires 0.8 litres of oxygen for oxidation and yields 4.1 kcal
• 1g of protein requires 1.2 litres of oxygen for complete oxidation and yields 5.5 kcals
• 1g of fat requires 2.2 litres of oxygen for complete oxidation and yields 9.5 kcals
Benedict’s roth respiration apparatus

• It is used to measure the energy expenditure during work

• The benedict’s roth respiration apparatus is used to measure the basal metabolic rate.
• It is an indirect method of measurement of BMR
• It can also be used as a spirometer.
• It is the closed circuit method of determining metabolic rate.
Parts of the apparatus

• Outer and inner chamber

• Soda lime chamber
• Bell
• Pulley with beaded chain
• Kymograph with recording paper
• Stylus
• Rubber tubes with mouth piece
PROCEDURE

• The subject is allowed to lie down on a couch or bed

• Then subject wears a nose clip and breathes via a mouth piece which is connected to the
apparatus
• The subject breathes in oxygen through a respiratory valve and breathes out into a carbon-di-
oxide absorber and then through the expiratory valve into a spirometer bell.
• The sheet on the kymograph consists of the records
• In this apparatus the oxygen consumption is directly expressed in terms of calories per hour
• Since the subject is in the post absorptive state the RQ is 0.82 at which 1 litre of oxygen
liberates 4.285 calories
• From the above value of oxygen consumed per hour the number of calories liberated per
hour can also be calculated
• Since the BMR is Calories/Square meter body surface area per hour, the surface area of
the subject has also to be found out.
• The body surface area can be calculated using two methods
• By using Dubois’s formula – (Weight in kg)0.425*(Height in centimeter)0.725*71.84 ( a
constant)
• By using the nomogram- where the subject’s height and weight are marked on vertical
lines on the left and right
• The center line joining two points intersecting gives the surface area
• Finally the BMR is obtained by applying the values in the formula
Non-calorimetric methods

• Many methods have been developed to measure the energy expenditure

• The classic methods based on direct or indirect calorimetry are the most accurate.
• These methods have disadvantages like the subjects cannot perform all of their habitual
activities because of their confinement in a small chamber or the need to wear a
cumbersome apparatus
• To overcome this disadvantage the non-calorimetric methods have been developed.
• These non-calorimetric methods include doubly labelled water method , bioelectrical
impedance analysis, , heart rate monitors, sensor of heat and movement , accelerometry
and pedometry.
DOUBLY LABELED WATER (DLW) METHOD

• PRINCIPLE- The DLW method is based on isotopic dilution. It uses stable isotopes
oxygen 18 and hydrogen isotope-deuterium for the measurement of TEE
• The DLW is recognized as the gold standard for the measurement of TEE.
• This method is based on the principle that after the subject ingests a dose of deuterium
and oxygen 18 there is an equilibrium of the two isotopes with total body water
• To measure the total body water a pre-established volume and concentration of deuterium
and oxygen-18 is orally administered
• It diffuses throughout the body in 2-6 hours
• As the energy is spent by the body , Carbon- di-oxide and water are produced
• The deuterium and oxygen-18 disappearance rates is determined by measuring the
concentrations of saliva, urine or blood
• Deuterium is lost from the body via only water
• Oxygen 18 is lost both via water and carbon-di-oxide
• The rate of carbon-di-oxide production is calculated as the difference between the
elimination rates of oxygen-18 and deuterium.
• rCO2(mol/day) =0.4554* TBW (mol)*(1.007k0-1.041kh)
• The ko and kh are the elimination rates of deuterium and oxygen-18
• The TEE is calculated by the modified version of weir’s formula based on rC02 and food
quotient
• TEE(kcal/day)=22.4*(3.9*{rCo2/FQ}+1.1* rCO2)
ADVANTAGES

• This method is an accurate and precise method for measuring TEE of subjects
• It is a non-invasive method and the subjects do not require confinement and any change
in their routine
• It is considered as a safe method because deuterium and oxygen-18 are non-radioactive
elements which are naturally found in the human body
Dis-advantages

• This method is very expensive due to the high price of DLW isotopes
• High expertise is required for the analysis
• DLW provides a overall measure of average daily TEE over the measurement period
BIOELECTRICAL IMPEDANCE ANALYSIS

• BIA is a fast and non-invasive method that estimates body composition, including the
distribution of body fluids of intra and extracellular spaces
• It estimates RMR based on the lean body mass
• This method is performed by devices with 2,4 or 8 electrodes
• Lean tissues have a high conductivity of electric current and adipose tissue , bones and skin
have low conductivity.
• This method measures the level of resistance and reactance of a body to the electric current
• By doing so the analyzer evaluates the total body water, assuming a constant hydration and
predicts the amount of lean body mass and estimates REE based on the value
• REE is calculated using the lean body mass and creatinine levels
ADVANTAGES

• The REE estimation by BIA is valid for clinical practice when the right protocol for this
method is respected
• BIA is an non-invasive technique
• BIA is a less expensive technique when compared with indirect calorimetry
DIS-ADVANTAGES

• BIA has some limitations related to individuals hydration status

• In cases of hyperhydration and fluid retention both lean body mass and REE will be
overestimated
• Results of BIA is affected by factors like diet, physical activity, use of diuretics,
menstrual period, age, body shape and nutritional status
HEART RATE MONITORING

• Heart rate monitors are objective tools for measuring energy expenditure
• Their use is based on the assumed relationship among heart rate, activity intensity and
oxygen consumption since physical activity puts the heart under pressure to deliver more
oxygen
• Heart rate changes proportionally with activity intensity.
• To estimate energy expenditure from heart rate the individual’s heart rate/ oxygen uptake
curve should be known
• Advantages- This method is inexpensive and non-restrictive in subjects and can be used
in a large number of subjects and non-invasive
• Dis-advantages- The correlation between heart rate and oxygen consumption is affected
by factors like type of activity, physical fitness levels and exercise-related factors
• At lower rates of activity especially other factors confound the relationship so activity
patterns classified as light or very light the heart rate monitoring is less appropriate
• Electrical or magnetic interference with the heart rate measurements by computers,
microwaves leads to unstable reading and data loss
• To reduce this problem the heart rate monitors should be placed atleast metre away from
the electrical circuit
Sensor of heat and movement

• The heat and movement sensor-Sense Wear Pro 2 Armband (SWA) is a recently
developed device used to estimate energy expenditure through equations
• It is designed to be worn on the upper arm over the triceps
• Its internal sensors include an accelerometer, a thermal flow sensor, galvanic sensor
• This device considers parameters like heat flow, skin temperature, height, body weight,
right handed or left-handed and smoking habits
• The software created by the manufacturer calculates EE using a patented algorithm that
combines acceleration, heat flow and other parameters
• Advantage – Easy and practical device that estimates EE
• It quantifies EE during very low exercises and static exercises
• It is used for EE calculation in old people
• Disadvantage- Studies indicate the device needs adjusts especially in equations for obese
people
ACCELEROMETRY

• Recent advances in technology have permitted the development of accelerometers used

for energy expenditure measurement
• This method is based on measurement of body’s acceleration which is the change of
velocity over time which includes frequency, intensity and duration
• Accelerometers generate their output in form of “ counts “ per unit time.
• Some of the equations permit to calculate energy expenditure as metabolic equivalents or
kcal/min.
• Validation studies for these equations are being conducted and their findings indicate
there are many limitations when translating accelerometer counts to energy expenditure
• Accelerometers measure acceleration –rate of intensity of movement using piezoelectric
sensors in 1plane, 2 planes or 3 planes
• In the recent models energy expenditure is calculated by integration of counts from three
planes namely the vertical (Y), the horizontal right-left (X) and the horizontal front back
axis (Z)
• Here the energy expenditure is predicted as vector magnitude
ADVANTAGES

• Accelerometers are small in size and have the capacity to record data
• Accelerometers measure both physical activity and energy expenditure
• Accelerometers are accurate, non-invasive methods to quantify physical activity volume
and intensity with minimal discomfort
• Disadvantages- It has low sensitivity to sedentary activities
PEDOMETRY

• Pedometers are used in the measurement of walking, which is one of the most frequently
performed activities
• The basic output of pedometers is in form of step counts
• Pedometers are also used to estimate distance travelled by multiplying number of steps by
stride length
• Some pedometers display energy expenditure as kilocalorie
• Pedometers are the most accurate for measuring steps and less accurate for measuring
distance and even more less accurate for assessing kilocalories
• ADVANTAGES- Low cost
• Easy to use tools
• Dis-advantages- Low accuracy