慢性脊髄損傷者における正および負のエネルギー過剰

Total energy expenditure (TEE) is estimated as the product of basal metabolic rate (BMR) and an SCI-specific factor. The agreement between TEE and total energy intake (TEI) was just established. The findings suggested the existence of positive and negative energy balance distributions. Forty-two males with chronic SCI underwent BMR followed by detailed metabolic profile after overnight fast. TEI and macronutrients of 3-day dietary logs were analyzed using the Nutrition Data System for Research software. Energy surplus was calculated as TEE minus TEI. Body composition assessment was conducted using dual energy x-ray absorptiometry. 57% of SCI participants were classified as negative energy surplus with an average TEI of 1284±422 compared to 2197±553 kcal/day in the positive energy group (P = 0.0002). Negative energy group had a higher BMR (9%; P =0.02), greater body weight (P =0.03), greater total body lean mass (P= 0.03) and consume greater percentage of protein compared to the positive energy group. Percentage macronutrients of protein explained 27% of the variance of energy surplus in a multivariate regression model (r² =0.27; P = 0.008). TEI adjusted to fat-free mass explained 87% of the variance in energy surplus and 34.7 kcal/kg/day was recommended to balance TEI with TEE. Persons with SCI are either classified into negative or positive energy surplus groups. Larger body weight and greater protein intakes are among the major characteristics of the negative energy group. Clinicians may need to consider the spectrum of energy balance before starting dietary regimen after SCI.