Exercise, energy expenditure and energy balance, as measured with doubly labelled water

Klaas R. Westerterp*

*Corresponding author for this work

Research output: Contribution to journalConference article in journalAcademicpeer-review

123 Downloads (Pure)


The doubly labelled water method for the measurement of total daily energy expenditure (TDEE) over 1-3 weeks under daily living conditions is the indicated method to study effects of exercise and extreme environments on energy balance. Subjects consume a measured amount of doubly labelled water ((H2O)-H-2-O-18) to increase background enrichment of body water for O-18 and H-2, and the subsequent difference in elimination rate between O-18 and H-2, as measured in urine, saliva or blood samples, is a measure for carbon dioxide production and thus allows calculation of TDEE. The present review describes research showing that physical activity level (PAL), calculated as TDEE (assessed with doubly labelled water) divided by resting energy expenditure (REE, PAL = TDEE/REE), reaches a maximum value of 2.00-2.40 in subjects with a vigorously active lifestyle. Higher PAL values, while maintaining energy balance, are observed in professional athletes consuming additional energy dense foods to compete at top level. Exercise training can increase TDEE/REE in young adults to a value of 2.00-2.40, when energy intake is unrestricted. Furthermore, the review shows an exercise induced increase in activity energy expenditure can be compensated by a reduction in REE and by a reduction in non-exercise physical activity, especially at a negative energy balance. Additionally, in untrained subjects, an exercise-induced increase in activity energy expenditure is compensated by a training-induced increase in exercise efficiency.
Original languageEnglish
Pages (from-to)4-10
Number of pages7
JournalProceedings of the Nutrition Society
Issue number1
Publication statusPublished - 1 Feb 2018
EventSpring Conference of the Nutrition-Society on Nutrition and Exercise for Health and Performance - Stirling, SCOTLAND, Stirling
Duration: 1 Feb 2018 → …


  • Doubly labelled water
  • Physical activity level
  • Non-exercise activity
  • MEN

Cite this