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Copyright 2006, The Johns Hopkins University and Benjamin Caballero. All rights reserved. Use of these materials
permitted only in accordance with license rights granted. Materials provided AS IS; no representations or
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Energy Homeostasis in Humans

Benjamin Caballero, MD, PhD

Johns Hopkins University
Section A

General Concepts of Energy Metabolism

Types of Energy
Solar
Chemical
Mechanical
Thermal
Electrical

4
Units of Energy
Calorie
Defined as the amount of heat required to rise the
temperature of
one kg of water from 14.5 to 15.5 C
Also defined based on the heat of combustion of benzoic
acid (thermochemical calorie)
Standardized in 1956one cal = 4.1868 Joules

5
Units of Energy
Joule
Defined as the energy expended when one kg is moved
one meter by a force of one Newton
Watt
Expresses rate of energy expenditure per unit time, i.e.,
work (J/sec)

6
Bioenergetics
1 L of O2 of Gas Exchange
= 4.825 kcal
1 g/atom of O2 = 3 mol of ATP

7
 Bomb Calorimeter

Diagram created by JHSPH CTLT 8

 Energy Combustion

O2 CO2 Energy
RQ
(ml) (ml) (kcal)
Starch 828 828 1.00 4.183
Fat 2019 1427 0.70 9.461
Protein 966 781 0.81 4.442

9
Energy in Foods

Heat of
Kcal/g Availabilit y Loss Net
Comb ustion
Meat 5.35 92% 1.25 4.0
Butter 9.12 95% 9.0
Starch 4.12 99% 4.0
Ethanol 7.1 100% tr. 7.0

10
Section B

Energy Balance and Measurement of Energy Expenditure

Energy Balance

Energy IN = Energy OUT

12
Measurement of Energy Balance

24 hrs
Energy Intake Energy Expenditure

13
Measurement of Energy Balance

24 hrs
Energy Intake Energy Expenditure

Food freq. quest.

24-hr recall
Food records
Food weighing
Direct observation

14
Measurement of Energy Balance

24 hrs
Energy Intake Energy Expenditure

Food freq. quest. Gas exchange calorimetry

24-hr recall Heart rate monitoring
Food records Estimated from activity
Food weighing Motion sensors
Direct observation Activity diary
Direct observation
Doubly labeled water (D218O)

15
Components of EE

Basal Metabolic Rate

(BMR, REE)

16
Components of EE

Thermic Effects of Food

(TEF, FIT)

Basal Metabolic Rate

(BMR, REE)

17
Components of EE

Physical Activity (PA)

Thermic Effects of Food

(TEF, FIT)

Basal Metabolic Rate

(BMR, REE)

18
 Daily Energy Balance

(>650,000 kcal)

Stores
Intake Range Oxidation
As total kcal Fat 125,000 kcal As % stores
1000 kcal 0.8%
500 kcal Protein 40,000 kcal 1.3%
1000 kcal 50%
Carbohydrate 2000 kcal

19
The Doubly-Labeled Water Method

H loss:

H2 O
Water

2
H2 18O Body Water

O loss:
H218O
Water

Normal water:1H2 16O

C18 O2
Carbon Dioxide
20
Disappearance Rates of DLW Tracers

21
Section C

Energy Requirements
 Dietary Reference Intakes

Frequency Distribution
of Individual Requirements

EAR 2 s.d. RDA

Increasing Intake 193-01

23
Determination of Dietary Energy Requirements: Factorial Method

TEE

Physical Activity Allowance

Food-Induced Thermogenesis (ignored)

BMR (measured/predicted)

24
Limitations of Previous Approach
BMR not constant throughout the day
Unreliable data on energy cost of physical activities, and only
estimated for selected activities
EPOC, fidgeting, other involuntary activities not accounted for

25
Selection of Approach for Current Revision
Use energy expenditure to estimate dietary energy
requirements
Use total daily energy expenditure (TEE) measured by the
doubly-labeled water technique

26
Adequacy Indicator
BMI
Strengths
Recognized link to health outcomes
Reflects relationship of weight and height
Good population data in U.S. and other countries

27
Adequacy Indicator
BMI
Limitations
Not best indicator of body adiposity
Cutoffs may not be valid across populations
Some difficulty in defining cutoff points in children and
across populations/countries

28
Estimated Energy Requirement (EER)
A level of dietary energy intake sufficient to maintain a stable
healthy body weight and an adequate level of physical
activity
Differs from EAR in that it is not a distribution of intakes
reflecting physiological variability

29
 Normative DLW Database TEE by Age

z
z Female
z
4000 z Male
zz zz
z zz z z z z
z zz zz z z
z zzzzz z
z z zzz z zz zz zz z
zz zzz z z z zz z z z z
z zzz z zz
zzz z
zz z z z
z
TEE (kcal/d)

3000 zz
z zzz
zz z zzz z z z zz zzzz z z
z
z
zz z zz zzz z z zzz
z
z
zzz z z z z
z z z z
zz zz z z zzz z
zzzzzz
zz z zzz
zz
zz z z z z
z
z zz zzz z zzz z z z
z z z zz zz
z zz
zz zz zz z
zzz z z
z z zz z z z zz z z z zzzzzz
z zzzz
z zz
zz z zz
zzzz
z z
zzz zzz
z
zz
zzz
z
zz zz z
z zz
z zz z z
zz
z
z
zz zz
zz zz z z zzzz z
z zz z z zz
z zz z z z zz z
zz
z z zzz z zz zzz zzz
z zz zzzz
z zz z z zzz z z
2000
zz
z z z
z
zz z z z zzz z z zzz z z zzz zzz zz
z zz z
z z
zzz z
zz zz
zz
z
z
zz
zzzzz z zzzz z z z zz z zz z z
z zzzzzz z
zz z
zzz
z
zz
zzz
z zz zz
z z zz z
z zz
zz
zz
z
zzzz zz z zz zzzzzz
z z
zzz
zzzzzzz z z z zz zz
z
zzzz
z z zz
z
z
zz
z
zz
zzz
z
zzzzz zz
z
zz z z z zz
z
zzz
zzz zz z z
zz
z
1000 z
z
z z z
z

0
0 20 40 60 80 100
Age (y)

30
Measures of Physical Activity
PALTEE / BEE
MET O2 consumption of 3.5 mL/kg/min
(= 0.0175 kcal/kg/min)
PAL equivalents of METs
0.0175 x 1.15 / 0.9

31
 PAL Levels

Mean
PA Category Range F M
Sedentary 1.01.39 1.23 1.29
Low Active 1.41.59 1.52 1.51
Active 1.61.89 1.74 1.74
Very Active 1.92.5 2.09 2.06

Data from Institute of Medicine/National Academy of Sciences 32

DLW Database: Distribution of PAL Levels

100
90
80
70
60
Females
n 50
Males
40
30
20
10
0
Sedentary Low Active Active Very Active
PAL Level

33
Equation for Prediction of TEE: General Models
02 Years of Age
TEE = 89 x Weight 100
Ages 3 Years and Over
TEE = A + B x Age + PA x (D x Weight + E x Height)
AConstant term
BAge coefficient
PAPhysical activity coefficient
DWeight coefficient
EHeight coefficient

34
 Energy Allowances +

Desirable activity
Catch-up growth
Infection
PA

TEF

BMR

Adapted by CTLT from Institute of Medicine/National Academy of Sciences 35

 Factors Affecting Energy Requirements
Food
Security
Impact of
Structural Food Aid
Adjustments

Energy Commodity
Agricultural Requirements Projections
Development

Land Use Impact of

Analysis Urbanization

Farming Food Demand

Systems Household Analysis
Economy
Copyright 2005, Benjamin Caballero and The Johns Hopkins University. All rights reserved. Use of these materials permitted
only in accordance with license rights granted. Materials provided AS IS; no representations or warranties provided. User
assumes all responsibility for use, and all liability related thereto, and must independently review all materials for accuracy
and efficacy. May contain materials owned by others. User is responsible for obtaining permissions for use from third parties
as needed. 36