Assessing energy expenditure during eating in vulnerable older adults
Goldberg, Lynette R.
Heiss, Cynthia J.
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Goldberg, Lynette R.; Heiss, Cynthia J. 2012. Assessing energy expenditure during eating in vulnerable older adults. Gerontologist, v.52 no.1 p.630
Reflecting the conference theme, Charting New Frontiers in Aging, this paper presents data on an innovative way to measure energy expenditure during eating in older adults with swallowing disorders (dysphagia). These older adults appear to fatigue during meals. This fatigue is thought to reflect their increased level of effort (energy expenditure) during eating. Optimal measurement of energy expenditure is documented through body heat output in an enclosed metabolic chamber, or indirect calorimetry in which the nose and mouth are masked and oxygen consumption is measured. Metabolic chambers are not readily available to healthcare providers and indirect calorimetry is not possible during eating. A portable computerized device, SenseWear, has been shown to have concurrent validity, when compared to indirect calorimetry, in measuring energy expenditure during activities such as running. A feasibility study of SenseWear and indirect calorimetry during simulated chewing in college students documented a statistically significant correlation (r = 0.49, p < 0.05) between the two measurement methods. SenseWear then was used to measure the energy expended by 20 selfreported healthy older adults who were residents of a Continuing Care Retirement Community as they ate a regular lunch. The mean energy expenditure was 61.90 (±6.90) kcal. This value was significantly greater than the expected 48 kcal for age- and weight-matched older adults documented through eating in a metabolic chamber. Although continued refinement of the protocol is needed, results suggest that the use of SenseWear may be a clinically useful way to assess energy expenditure during eating in vulnerable older adults.
Presented at the Gerontological Society of America 65th Annual Scientific Meeting, San Diego, CA, November 14–18, 2012