Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-18T10:59:29.264Z Has data issue: false hasContentIssue false
  • English
  • Français

Understanding chronic malnutrition in childhood and old age: role of energy balance research

Published online by Cambridge University Press:  05 March 2007

John J. Reilly
John J. Reilly*
Affiliation:
University of Glasgow Department of Human Nutrition, Royal Hospital for Sick Children, Dalnair Street, Glasgow G3 8SJ, UK
*
*Corresponding author: Dr John J. Reilly, fax +44 141 201 9275, email jjr2y@clinmed.gla.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Undernutrition is commonly associated with chronic disease in children and the elderly. Overnutrition is also, but less commonly, associated with chronic illness. In most diseases malnutrition arises because energy intake does not match energy output. Traditionally, the focus of research has been on abnormalities in energy expenditure, in the belief that these factors were the main determinants of energy imbalance. Recent studies using the doubly-labelled-water method to measure total energy expenditure, combined with more complex study design, have suggested an alternative conclusion. In many chronic diseases patient behaviour, and particularly energy intake, is responsible for energy imbalance and malnutrition. Energy balance studies have therefore provided a useful foundation for the design of strategies aimed at preventing or managing chronic malnutrition. However, modifying patient behaviour is an ambitious undertaking which may not be within the scope of existing clinical nutrition services. A number of non-traditional models of managing chronic malnutrition in children and the elderly are promising. Increasing recognition of the value of systematic review will also provide improved strategies for prevention and management of chronic malnutrition.

Keywords

Chronic illnessCritical illnessEnergy requirementsEnergy expenditureNutritional supportDoubly-labelled-water method
Type
Sir David Cuthbertson Medal Lecture
Information
Proceedings of the Nutrition Society , Volume 61 , Issue 3 , August 2002 , pp. 321 - 327
Copyright
Copyright © The Nutrition Society 2002

References

Barber, MD, Ross, JA, Preston, T, Shenkin, A & Fearon, KCH (1999) Fish oil enriched nutritional supplement attenuates progression of the acute phase response in weight losing patients withadvanced pancreatic cancer. Journal of Nutrition 129, 1120–1125.CrossRefGoogle Scholar
Barden, EM, Zemel, BS, Kawchack, DA, Goran, MI, Ohere-Frempony, K & Stallings, VA (2000) Total and resting energy expenditure in children with sickle cell disease. Journal of Pediatrics 136, 73–79.CrossRefGoogle ScholarPubMed
Bland, RM, Bulgarelli, S, Ventham, JC, Jackson, D, Reilly, JJ & Paton, JY (2001) Total energy expenditure in children with obstructive sleep apnoea syndrome. European Respiratory Journal 18, 164–169.CrossRefGoogle ScholarPubMed
Bronstein, MN, Davies, PSW, Hambridge, KM & Accurso, FJ (1995) Normal energy expenditure in the infant with presymptomatic cystic fibrosis. Journal of Pediatrics 126, 28–33.CrossRefGoogle ScholarPubMed
Didi, M, Didcock, E, Davies, HA, Ogilvy-Stuart, AL, Wales, JKH & Shalet, SM (1995) High incidence of obesity in young adults after treatment of acute lymphoblastic leukaemia in childhood. Journal of Pediatrics 127, 163–167.CrossRefGoogle ScholarPubMed
Epstein, LH, Paluch, RA, Gordy, CC & Dorn, J (2000) Decreasing sedentary behaviours in treating pediatric obesity. Archives of Pediatrics and Adolescent Medicine 154, 220–226.CrossRefGoogle ScholarPubMed
Gibney, ER (2000) Energy expenditure in disease: time to revisit? Proceedings of the Nutrition Society 59, 199–247.CrossRefGoogle ScholarPubMed
Jebb, SA (1997) Energy metabolism in cancer and human immunodeficiency virus infection. Proceedings of the Nutrition Society 56, 763–775.CrossRefGoogle ScholarPubMed
Jeffery, RW, Drewnowski, A, Epstein, LH, Stunkard, AJ, Wilson, GT, Wing, RR & Hill, DR (2000) Long term maintenance of weight loss: current status. Health Psychology 19, 5–16.CrossRefGoogle ScholarPubMed
Jelalian, E, Stark, LJ, Reynolds, L & Seifer, R (1998) Nutrition intervention for weight gain in CF: a meta-analysis. Journal of Pediatrics 132, 486–492.CrossRefGoogle ScholarPubMed
Klipstein, K, Reilly, JJ, Potter, J, Edwards, CA & Roberts, MA (1995) Energy intake and expenditure in elderly patients admitted tohospital with acute illness. British Journal of Nutrition 73, 323–334.CrossRefGoogle Scholar
Lowdon, JL, Goodchild, MC, Ryley, HC & Doull, IJM (1998) Maintenance of growth in CF despite reduction in pancreatic enzyme supplementation. Archives of Disease in Childhood 78, 377–378.CrossRefGoogle Scholar
Macallan, DC, Noble, C, Baldwin, C, Jebb, SA, Prentice, AM, Coward, WA, Sawyer, MB, Mcmanuys, TJ & Griffin, GE (1995) Energy expenditure and wasting in HIV infection. New England Journal of Medicine 333, 83–88.CrossRefGoogle Scholar
Mackner, LM, Mcgrath, AM & Stark, LJ (2001) Dietary recommendations to prevent and manage chronic pediatric healthconditions: adherence, intervention, and future directions. Journal of Developmental and Behavioural Pediatrics 22, 130–143.CrossRefGoogle Scholar
Morgan, DB, Newton, HM, Schorah, CJ, Jewitt, MA, Hancock, MR & Hullin, RP (1986) Abnormal indices of nutrition in the elderly: a study of different clinical groups. Age and Ageing 15, 65–76.CrossRefGoogle ScholarPubMed
Morison, S, Dodge, JA, Cole, TJ, Lewis, PA, Coles, EC, Geddes, D, Russell, G, Littlewood, JM & Scott, MT (1997) Height and weight in CF: cross sectional study. Archives of Disease in Childhood 77, 497–500.CrossRefGoogle Scholar
Motil, KJ, Schultz, RJ, Wong, WW & Glaze, DG (1998) Increased energy expenditure associated with repetitive involuntary movement does not contribute to growth failure in girls with Rett Syndrome. Journal of Pediatrics 132, 228–233.CrossRefGoogle Scholar
Murphy, JL, Wootton, SA, Bond, SA & Jackson, AA (1991) Energy content of stools in normal healthy controls and patients with CF. Archives of Disease in Childhood 66, 495–500.CrossRefGoogle Scholar
Odame, I, Reilly, JJ, Donaldson, M & Gibson, BES (1994) Patterns of obesity in boys and girls following therapy for acute lymphoblastic leukaemia. Archives of Disease in Childhood 71, 147–149.CrossRefGoogle Scholar
Potter, J, Klipstein-Grobusch, K, Reilly, JJ & Roberts, MA (1995) The nutritional status and clinical course of acute admissions to a geriatric unit. Age and Ageing 24, 131–136.CrossRefGoogle ScholarPubMed
Potter, J, Langhorne, P & Roberts, M (1998) Routine protein energy supplementation in adults: systematic review. British Medical Journal 317, 495–501.CrossRefGoogle ScholarPubMed
Potter, JM, Roberts, MA, Mccoll, JH & Reilly, JJ (2001) Protein-energy supplements in unwell elderly patients: a randomised controlled trial. Journal of Parenteral and Enteral Nutrition 25, 323–329.CrossRefGoogle Scholar
Poustie, VJ, Smyth, RL & Watling, RM (2002) Oral protein calorie supplementation for children with chronic disease. The Cochrane Library 1, 2002. Oxford: The Cochrane Library.Google Scholar
Prentice, AM, Leavesley, K, Murgatroyd, PR, Coward, WA, Schorah, CJ, Bladon, PT & Hullin, RP (1989) Is severe wasting in elderly mental patients caused by an excessive energy requirement? Age and Ageing 18, 158–167.CrossRefGoogle ScholarPubMed
Reilly, JJ, Blacklock, CJ, Dale, E, Donaldson, M & Gibson, BE (1996) Resting metabolic rate and obesity in childhood acute lymphoblastic leukaemia. International Journal of Obesity 20, 1130–1132.Google ScholarPubMed
Reilly, JJ, Brougham, M, Montgomery, C, Richardson, F & Gibson, BES (2001) Effect of glucocorticoid therapy on energy intake in children treated for acute lymphoblastic leukemia. Journal of Clinical Endocrinology and Metabolism 86, 3742–3745.CrossRefGoogle Scholar
Reilly, JJ, Edwards, CA & Weaver, LT (1997) Malnutrition in cystic fibrosis: the energy balance equation. Journal of Pediatric Gastroenterology and Nutrition 25, 127–136.Google ScholarPubMed
Reilly, JJ, Kelly, A, Ness, P, Dorosty, AR, Wallace, WHB, Gibson, BES & Emmett, PM (2001) Premature adiposity rebound in children treated for acute lymphoblastic leukemia. Journal of Clinical Endocrinology and Metabolism 86, 2775–2778.Google ScholarPubMed
Reilly, JJ, Lord, A, Bunker, VW, Prentice, AM, Coward, WA & Briggs, RS (1992) Energy balance and physical activity in healthy women and women with chronic illness. Age and Nutrition 3, 121–122.Google Scholar
Reilly, JJ, Lord, A, Bunker, VW, Prentice, AM, Thomas, A, Briggs, RS & Coward, WA (1993) Energy balance in healthy elderly women. British Journal of Nutrition 69, 21–27.CrossRefGoogle ScholarPubMed
Reilly, JJ, Lord, A, Bunker, VW, Prentice, AM, Thomas, A, Coward, WA & Briggs, RS (1995) Total energy expenditure as measured by doubly-labelled water in two groups of elderly female inpatients. Age and Nutrition 6, 10–15.Google Scholar
Reilly, JJ, Montgomery, C, Jackson, D, Macritchie, J & Armstrong, J (2001) Energy intake by multiple pass 24 hour recall and total energy expenditure: a comparison in a representative sample of 3–4-year-olds. British Journal of Nutrition 86, 601–605.CrossRefGoogle Scholar
Reilly, JJ, Odame, I, Mccoll, J & Gibson, BS (1994) Does weight for height have prognostic significance in children with acute lymphoblastic leukemia? American Journal of Pediatric Hematology and Oncology 16, 225–230.CrossRefGoogle ScholarPubMed
Reilly, JJ, Ralston, JM, Paton, JY, Edwards, CA, Weaver, LT, Wilkinson, J & Evans, TJ (1999) Energy balance during acute respiratory exacerbations in children with cystic fibrosis. European Respiratory Journal 13, 804–809.CrossRefGoogle ScholarPubMed
Reilly, JJ, Ventham, JC, Newell, J, Aitchison, T, Wallace, WHB & Gibson, BES (2000) Risk factors for excess weight gain in children treated for acute lymphoblastic leukaemia. International Journal of Obesity 24, 1537–1541.CrossRefGoogle ScholarPubMed
Reilly, JJ, Ventham, J, Ralston, JM, Donaldson, M & Gibson, BES (1998) Reduced energy expenditure in pre-obese children treated for acute lymphoblastic leukemia. Pediatric Research 44, 557–562.CrossRefGoogle Scholar
Reilly, JJ, Weir, J, Mccoll, JH & Gibson, BES (1999) Prevalence ofprotein-energy malnutrition at diagnosis in children treated for acute lymphoblastic leukemia. Journal of Pediatric Gastroenterology and Nutrition 29, 194–197.Google ScholarPubMed
Reilly, JJ, Wilkinson, J, Evans, TJ & Paton, JY (1999) Adequacy of clinical formulae for estimation of energy requirements in children with cystic fibrosis. Archives of Disease in Childhood 81, 120–124.CrossRefGoogle ScholarPubMed
Reilly, JJ, Wilson, M, Summerbell, CD & Wilson, D (2002) Childhood obesity: evidence based answers to common clinical questions. Archives of Disease in Childhood (In the Press).Google Scholar
Roberts, SB, Fuss, P, Heyman, MB, Evans, WJ, Tsay, R, Rasmussen, H, Fiatarone, M, Cortella, J, Dallal, GE & Young, VR (1994) Control of food intake in older men. Journal of the American Medical Association 272, 1601–1606.CrossRefGoogle ScholarPubMed
Schechter, MS & Margolis, PA (1998) Relationship between socioeconomic status and disease severity in CF. Journal of Pediatrics 132, 260–264.CrossRefGoogle Scholar
Scott, RB, O'Laughlin, EV & Gall, DG (1985) Gastro-oesophageal reflux in CF. Journal of Pediatrics 108, 223–227.CrossRefGoogle Scholar
Shepherd, RW, Vasques-Velasquez, L, Prentice, AM, Holt, TL, Coward, WA & Lucas, A (1988) Increased energy expenditure in young children with CF. Lancet i, 1300–1303.CrossRefGoogle Scholar
Smyth, RL (2001) Research with children: paediatric practice needs better evidence – gained in collaboration with parents and children. British Medical Journal 322, 1377–1378.CrossRefGoogle ScholarPubMed
Speakman, JR (1998) The history and theory of the doubly labelled water technique. American Journal of Clinical Nutrition 68, 932s–938s.Google Scholar
Sridhar, MK, Galloway, A, Lean, MEJ & Barham, SW (1994) Study of an outpatient nutritional supplementation programme in malnourished patients with emphysematous chronic obstructive pulmonary disease. European Respiratory Journal 7, 720–724.CrossRefGoogle Scholar
Stallings, VA, Zemel, BS, Davies, JC, Cronk, CE & Charney, EB (1996) Energy expenditure of children and adolescents with severe disabilities: a cerebral palsy model. American Journal of Clinical Nutrition 64, 627–634.CrossRefGoogle ScholarPubMed
Stark, LJ, Jelalian, E, Maluihill, MM, Powers, SW, Bowmen, AM & Speith, LE (1995) Eating in pre-school children with CF and healthy controls: a behavioural analysis. Pediatrics 95, 210–216.CrossRefGoogle Scholar
Tomeszko, JL, Stallings, VA, Kawchak, DA, Going, JE, Diamond, G & Scanlin, TF (1994) Energy expenditure and genotype of children with CF. Pediatric Research 35, 451–460.CrossRefGoogle Scholar
Toth, MJ, Fishman, PS & Poehlman, ET (1997) Free living daily energy expenditure in patients with Parkinsons Disease. Neurology 48, 88–91.CrossRefGoogle Scholar
Toth, MJ & Poehlman, ET (2000) Energetic adaptation to chronic disease in the elderly. Nutrition Reviews 58, 61–66.CrossRefGoogle ScholarPubMed
Ventham, JC & Reilly, JJ (1999) Childhood leukaemia: a model of pre-obesity. Proceedings of the Nutrition Society 58, 277–281.CrossRefGoogle Scholar
Weir, J, Reilly, JJ, Mccoll, J & Gibson, BES (1998) No evidence for an effect of nutritional status on clinical outcome in childhood acute lymphoblastic leukemia. Journal of Pediatric Hematology and Oncology 20, 534–538.CrossRefGoogle Scholar
Wigmore, SJ, Fearon, KCH, Maingay, JP & Ross, JA (1997) Downregulation of the acute phase response in patients with pancreatic cancer cachexia receiving oral eicosapentanoic acid is mediated via suppression of interleukin-6. Clinical Science 92, 215–222.CrossRefGoogle ScholarPubMed
Wright, CM, Callum, J, Birks, E & Jarvis, S (1998) Effect of community based management of failure to thrive: a randomised controlled trial. British Medical Journal 317, 571–574.CrossRefGoogle ScholarPubMed