Doubly labelled water assessment of energy expenditure: principle, practice, and promise

Klaas R. Westerterp*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

77 Citations (Web of Science)

Abstract

The doubly labelled water method for the assessment of energy expenditure was first published in 1955, application in humans started in 1982, and it has become the gold standard for human energy requirement under daily living conditions. The method involves enriching the body water of a subject with heavy hydrogen (H-2) and heavy oxygen (O-18), and then determining the difference in washout kinetics between both isotopes, being a function of carbon dioxide production. In practice, subjects get a measured amount of doubly labelled water ((H2O)-H-2-O-18) to increase background enrichment of body water for O-18 of 2000 ppm with at least 180 ppm and background enrichment of body water for H-2 of 150 ppm with 120 ppm. Subsequently, the difference between the apparent turnover rates of the hydrogen and oxygen of body water is assessed from blood-, saliva-, or urine samples, collected at the start and end of the observation interval of 1-3 weeks. Samples are analyzed for O-18 and H-2 with isotope ratio mass spectrometry. The doubly labelled water method is the indicated method to measure energy expenditure in any environment, especially with regard to activity energy expenditure, without interference with the behavior of the subjects. Applications include the assessment of energy requirement from total energy expenditure, validation of dietary assessment methods and validation of physical activity assessment methods with doubly labelled water measured energy expenditure as reference, and studies on body mass regulation with energy expenditure as a determinant of energy balance.

Original languageEnglish
Pages (from-to)1277-1285
Number of pages9
JournalEuropean Journal of Applied Physiology
Volume117
Issue number7
DOIs
Publication statusPublished - Jul 2017

Keywords

  • Doubly labelled water
  • Carbon dioxide production
  • Energy expenditure
  • Physical activity
  • Body composition
  • Energy requirement
  • Energy intake
  • Motion sensors
  • Body mass regulation
  • ISOTOPE RATIO MEASUREMENTS
  • HABITUAL FOOD-INTAKE
  • TOTAL-BODY WATER
  • PHYSICAL-ACTIVITY
  • AFFLUENT SOCIETIES
  • DEUTERIUM DILUTION
  • HUMANS
  • CHILDREN
  • ACCURACY
  • EXERCISE

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