Abstract
This review includes an historical overview of the techniques for measuring energy expenditure (EE). Following this overview, the ‘gold standard’ method of measuring EE, the doubly labelled water (DLW) method, is emphasised. Other methods, such as direct calorimetry, indirect calorimetry systems, heart rate and EE relationships, questionnaires and activity recall, motion sensors, combined heart rate and motion sensors for the estimation of EE are then highlighted in relation to their validation against the DLW method. The major advantages and disadvantages for each method are then considered. The preferred method to determine EE is likely to depend principally on factors such as the number of study participants to be monitored, the time period of measurements and the finances available. Small study participant numbers over a short period may be measured accurately by means of indirect calorimetric methods (stationary and portable systems). For periods over 3–4 days, EE should ideally be measured using the DLW method. However, the use of motion sensors is very promising in the measurement of EE, and has a number of advantages over the DLW method. Furthermore, if used correctly, both heart rate and questionnaire methods may provide valuable estimates of EE. Additional studies are needed to examine the possibility of improving the accuracy of measurement by combining two or more techniques. Such information, if confirmed by scientific rigour, may lead to an improvement in the estimation of EE and population-based physical activity levels. The accurate measurement of physical activity and EE is critical from both a research and health prospective. A consideration of the relevant techniques used for the estimation of EE may also help improve the quality of these frequently reported measurements.
Similar content being viewed by others
Notes
The use of tradenames is for product identification purposes only and does not imply endorsement.
References
Caspersen CJ. Physical activity epidemiology: concepts, methods, and applications to exercise science. In: Pandolf K, editor. Exercise and sport sciences review. Vol. 17. Baltimore (MD): Williams and Wilkins, 1989: 423–73
Elia M, Livesey G. Energy expenditure and fuel selections in biological systems: the theory and practice of calculations based on indirect calorimetry and tracer methods. In: Simopoulos AP, editor. Metabolic control of eating, energy expenditure and the bioenergetics of obesity: world review of nutrition and dietetics. Vol. 70. Basel: Karger, 1992: 68–131
Montoye HJ, Kemper HCG, Saris WHM, et al. Measuring physical activity and energy expenditure. Champaign (IL): Human Kinetics, 1996: 72–9
Macfarlane DJ. Automated metabolic gas analysis systems: a review. Sports Med 2001; 31: 841–61
West JB. High life: a history of high-altitude physiology and medicine. Oxford: Oxford University Press, 1998
Speakman JR. The history and theory of the doubly labeled water technique. Am J Clin Nutr 2001; 68: 932S–8S
Westerterp KR. Assessment of physical activity level in relation to obesity: current evidence and research issues. Med Sci Sports Exerc 1999; 31: S522–5
Prentice AM, editor. International Dietary Energy Consultancy Group (IDECG): the doubly-labelled water method for measuring energy expenditure, technical recommendations for use in humans. Vienna: NAHRES-4, International Atomic Energy Agency (IAEA), 1990
Schoeller DA, Delany JP. Human energy balance: what have be learned from the doubly labeled water method? Am J Clin Nutr 1998; 68: 927S–79S
Jequier E. Direct and indirect calorimetry in man. In: Garrow JS, Halliday D, editors. Substrate and energy metabolism. London: Libbey, 1985: 82–91
Schoeller DA, van Santen E. Measurement of energy expenditure in humans by doubly labelled water method. J Appl Physiol 1982; 53: 955–9
Speakman JR, Roberts SB. Recent advances in the doubly labeled water technique. Obes Res 1995; 3: 1S–74S
Westerterp KR. Body composition, water turnover and energy turnover assessment with labelled water. Proc Nutr Soc 1999; 58: 945–51
Black AE, Prentice AM, Coward WA. Use of food quotients to predict respiratory quotients for the doubly-labeled water method of measuring energy expenditure. Hum Nutr Clin Nutr 1986; 40: 381–91
Frayn KN. Metabolic regulation: a human perspective. London: Portland Press Ltd, 1996
Schoeller DA, Hnilicka JM. Reliability of the doubly labeled water method for the measurement of total daily energy expenditure in free-living subjects. J Nutr 1996; 126: 348S–54S
Zuntz N, Leowy A. Lehrbuch der physiologie bes menschem. Leipzig: Vogel, 1909
Kofranyi E, Michaelis HF. A portable apparatus to determine metabolism [in German]. Arbeitsphyiololgie 1940; 11: 148–50
Wolff HS. The integrating pneumotacograph: a new instrument for the measurement of energy expenditure by indirect calorimetry. Q J Exerc Physiol 1958; 43: 270–83
Humphrey SJE, Wolff HS. The oxylog [abstract]. J Appl Physiol 1977; 267: 120
Harrison MH, Brown GA, Belyasin AJ. The oxylog: an evaluation. Ergonomics 1982; 25: 809–20
McNeill G, Cox MD, Rivers JPW. The oxylog oxygen consumption meter: a portable device for measurement of energy expenditure. Am J Clin Nutr 1987; 45: 1415–9
Schulz H, Helle S, Heck H. The validity of the telemetric system CORTEX X1 in the ventilatory and gas exchange measurement during exercise. Int J Sports Med 1997; 18: 454–7
Meyer T, Georg T, Becker C, et al. Reliability of gas exchange measurements from two different spiroergometry systems. Int J Sports Med 2001; 22: 593–7
Christensen CC, Frey HM, Foenstelie E, et al. A critical evaluation of energy expenditure estimates based on individual O2 consumption, heart rate curves and average daily heart rates. Am J Clin Nutr 1983; 37: 469–72
Davidson L, McNeill G, Haggart P, et al. Free-living energy expenditure of adult men assessed by continuous heart rate monitoring and doubly labelled water. Br J Nutr 1997; 78: 696–708
Livingstone MB. Heart-rate monitoring: the answer for assessing energy expenditure and physical activity in population studies? Br J Nutr 1997; 78: 869–71
Melanson EL, Freedson PS. Physical activity assessment: a review of the methods. Crit Rev Food Sci Nutr 1996; 36: 385–96
Spurr GB, Prentice AM, Murgatroyd PR, et al. Energy expenditure from minute-by-minute heart-rate recording: comparison with indirect calorimetry. Am J Clin Nutr 1988; 48: 522–59
Secher NH, Ruberg-Larsen N, Binkhorst RA, et al. Maximal oxygen uptake during arm cranking and combined arm plus leg exercise. J Appl Physiol 1974; 36: 515–8
Rowlands AV, Eston RG, Ingledew DK. Measurements of physical activity in children with particular reference to the use of heart rate and pedometry. Sports Med 1997; 24: 258–72
Livingstone MB, Coward WA, Prentice AM, et al. Daily energy expenditure in free-living children: comparison of heart-rate monitoring with the doubly labeled water method. Am J Clin Nutr 1992; 56: 343–52
Bratteby LE, Sandhagen B, Fan H, et al. A 7-day activity diary for the assessment of daily energy expenditure validated by the doubly labelled water methods in adolescents. Eur J Clin Nutr 1997; 51: 585–91
Schulz S, Westerterp KR, Bruck K. Comparison of energy expenditure by the doubly labeled water technique with energy intake, heart rate and activity recording in man. Am J Clin Nutr 1989; 49: 1146–54
Racette SB, Schoeller DA, Kushner RF. Comparison of heart rate and physical activity recall with doubly labeled water in obese women. Med Sci Sports Exerc 1995; 27: 126–33
Bonnefoy M, Normand S, Pachiaudi C, et al. Simultaneous validation of ten physical activity questionnaires in older men: a doubly labeled water study. J Am Geriatr Soc 2001; 49: 28–35
Schuit AJ, Schouten EG, Westerterp KR, et al. Validity of the physical activity scale (PASE) for the elderly according to energy expenditure assessed by the doubly labeled water method. J Clin Epidemiol 1997; 50: 541–6
Philippaerts RM, Westerterp KR, Lefevre J. Doubly labeled water validation of three physical activity questionnaires. Int J Sports Med 1999; 20: 284–9
Dipietro L, Caspersen CJ, Ostfeld AM, et al. A survery for assessing physical activity among older adults. Med Sci Sports Exerc 1993; 25: 628–42
Bouchard CA, Tremblay A, Leblanc C, et al. A method to assess energy expenditure in children and adults. Am J Clin Nutr 1983; 37: 461–7
Ainsworth BE, Haskell WL, Leaon AS, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 1993; 25: 71–80
Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000; 32(9): S498–504
Reilly T, Thomas V. Estimated daily energy expenditures of professional association footballers. Ergonomics 1979; 22: 541–8
Ebine N, Rafamantanantsoa HH, Nayuki Y, et al. Measurement of total energy expenditure by the doubly labelled water method in professional soccer players. J Sports Sci 2002; 20: 391–7
Washburn RA, Cook TC, LaPorte RE. The objective assessment of physical activity in an occupationally active group. J Sports Med Phys Fitness 1989; 29: 279–84
Baecke JA, Burema HJ, Frijters JER. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 1982; 36: 936–42
Reiff GG, Montoye HJ, Remmington RD, et al. Assessment of physical activity by questionnaire and interview. J Sports Med Phys Fitness 1967; 7: 135–42
Taylor HL, Jacobs DR, Schucker B, et al. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis 1978; 31: 741–55
Richardson MT, Leon AS, Jacobs DR, et al. Comprehensive evaluation of the Minnesota Leisure Time Physical Activity questionnaire. J Clin Epidemol 1994; 47: 271–81
Conway JM, Irwin ML, Ainsworth BE. Estimating energy expenditure from the Minnesota Leisure Time Physical Activity and Tecumseh Occupational Activity questionnaires: a doubly labeled water validation. J Clin Epidemol 2002; 55: 392–9
Conway JM, Seale JL, Jacobs Jr DR, et al. Comparison of energy expenditure estimates from doubly labeled water, a physical activity questionnaire, and physical activity records. Am J Clin Nutr 2002; 75: 519–25
Starling RD, Matthews DE, Ades PA, et al. Assessment of physical activity in older individuals: a doubly labeled study. J Appl Physiol 1999; 86: 2090–6
Leenders NY, Sherman WM, Nagaraja NH, et al. Evaluation of methods to assess physical activity in free living condition. Med Sci Sports Exerc 2001; 33: 1233–40
Seale JL, Klein G, Friedmann J, et al. Energy requirements measurement by doubly labeled water, activity recall, and diet records in the rural elderly. Nutrition 2002; 18: 568–73
Goran MI, Poehlman ET. Total energy expenditure and energy requirements in healthy elderly persons. Metabolism 1992; 7: 744–53
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical comparison. Lancet 1986; I: 307–10
Atkinson G, Nevill AM. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med 1998; 26: 217–38
Atkinson G, Nevill AM. Typical error versus limits of agreement. Sports Med 2000; 30: 375–81
Basset DR, Ainsworth BE, Swartz AM, et al. Validity of four motion sensors in measuring moderate intensity physical activity. Med Sci Sports Exerc 2000; 32: S471–80
Freedson PS, Miller J. Objective monitoring of physical activity using motion sensors and heart rate. Res Q Exerc Sport 2000; 71(2): 21–9
Kemper HCG, Verschuur R. Validity and reliability of pedometers in habitual physical activity research. Eur J Appl Physiol 1977; 37: 71–82
Schutz Y, Froideraux F, Jequier E. Estimation of 25h energy expenditure by a portable accelerometer [abstract]. Proc Nutr Soc 1988; 47A: 23
Pambianco G, Wing RR, Robertson R. Accuracy and reliability of the caltrac accelerometer for estimated energy expenditure. Med Sci Sports Exerc 1990; 22: 858–62
Haymes EM, Byrnes WC. Walking and running energy expenditure estimated by Caltrac and indirect calorimetry. Med Sci Sports Exerc 1993; 25: 1365–9
Washburn RA, LaPorte RE. Assessment of walking behaviour: effect of speed and monitor position on two objective physical activity monitors. Res Q Exerc Sport 1988; 59: 83–5
Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications Inc. accelerometer. Med Sci Sports Exerc 1998; 30: 777–81
Welk GJ, Blair SN, Wood K, et al. A comparative evaluation of three accelerometry-based physical activity monitors. Med Sci Sports Exerc 2000; 32: S489–97
Campbell KL, Crocker PR, Mckenzie DC. Field evaluation of energy expenditure in women using Tritrac accelerometers. Med Sci Sports Exerc 2002; 34: 1667–74
Rodriguez G, Beghin L, Michaud L, et al. Comparison of the TriTrac-R3D accelerometer and a self-report activity diary with heart-rate monitoring for the assessment of energy expenditure in children. Br J Nutr 2002; 87: 623–31
Pannemans DL, Bouten CV, Westerterp KR. 24h energy expenditure during a standardised activity protocol in young and elderly men. Eur J Clin Nutr 1995; 49: 49–56
Bouten CV, Verboeket-Van De Venne P, Westerterp KR, et al. Daily physical activity assessment: comparison between movement registration and doubly labeled water. J Appl Physiol 1996; 81: 1019–26
Levine JA, Baukol PA, Westerterp KR. Validation of the Tracmor triaxial accelerometer system for walking. Med Sci Sports Exerc 2001; 33: 1593–7
Basset Jr DR. Validity and reliability issues in objective monitoring of physical activity. Res Q Exerc Sport 2000; 71(2): S30–6
Atwater WO, Benedict FG. Experiments of the metabolism of matter and energy in the human body. US Dept Agr Off Exp Sta Bull 1903; 136: 1–357
Atwater WO, Rosa EB. Descriptions of new respiration calorimeter and experiments on the conservation in the human body. US Dept Agr Off Exp Sta Bull 1899; 63
Ferrannini E. The theoretical bases of indirect calorimetry: a review. Metabolism 1988; 37: 287–301
Webb P. Human calorimeters. New York: Praeger, 1980
Carter J, Jeukendrup AE. Validity and reliability of three commercially available breath-by-breath respiratory systems. Eur J Appl Physiol 2002; 86: 435–41
McLaughlin JE, King GA, Howley ET, et al. Validation of the COSMED K4 b2 portable metabolic system. Int J Sports Med 2001; 22: 280–4
Bratteby LE, Sandhagen B, Fan H, et al. Total energy expenditure and physical activity as assessed by the doubly labeled water method in Swedish adolescents in whom energy intake was underestimated by 7-d diet records. Am J Clin Nutr 1998; 67: 905–11
American College of Sports Medicine. A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc 1997; 29 Suppl.: 5–9
Jacobs Jr DR, Ainsworth BE, Hartman TJ, et al. A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 1993; 25: 81–91
Bouten CV, Koekkoek KT, Verduin M, et al. A triaxial accelerometer and portable data processing unit for the assessment of daily physical activity. IEEE Trans Biomed Eng 1997; 44: 136–47
Washburn R, Chin MK, Montoye HJ. Accuracy of pedometer in walking and running. Res Q Exerc Sport 1980; 31: 693–702
Washburn RA, Smith KW, Jettee AM, et al. The physical activity scale for the elderly (PASE): development and evaluation. J Clin Epidemiol 1993; 46: 163–72
Basset DR, Ainsworth BE, Leggett SR, et al. Accuracy of five electronic pedometers for measuring distance walked. Med Sci Sports Exerc 1996; 28: 1071–7
Bouten CV, Westerterp KR, Verduin M, et al. Assessment of energy expenditure for physical activity using a triaxial accelerometer. Med Sci Sports Exerc 1994; 26: 1516–23
Rennie K, Rowsell T, Jebb SA, et al. A combined heart rate and movement sensor: proof of concept and preliminary testing study. Eur J Clin Nutr 2000; 54: 409–14
Sallis JF, Buono MJ, Roby JJ, et al. The Caltrac accelerometer as a physical activity monitor for school age children. Med Sci Sports Exerc 1990; 22: 698–703
Maliszewski AF, Freedson PS, Ebbeling CJ, et al. Validity of the Caltrac accelerometer in estimating energy expenditure and activity in children and adults. Pediatr Exerc Sci 1991; 3: 141–51
Eston RE, Rowlands AV, Ingledew DK. Validity of heart rate, pedometry, and accelerometry for predicting energy cost of children’s activities. J Appl Physiol 1998; 84: 362–71
Trost G, Ward DS, Moorehead SM, et al. Validity of the Computer Science and Applications (CSA) monitor in children. Med Sci Sports Exerc 1998; 30: 629–33
Hendelman D, Miller KM, Baggett C, et al. Validity of accelerometry in assessing moderate intensity physical activity. Med Sci Sports Exerc 2000; 32: S442–9
Fogelholm M, Hiilloskorpi H, Laukkanen R, et al. Assessment of energy expenditure in overweight women. Med Sci Sports Exerc 1998; 30: 1191–7
Ekelund U, Sjostrom M, Yngve A, et al. Physical activity assessed by activity monitor and doubly labeled water in children. Med Sci Sports Exerc 2001; 33: 275–81
Swan PD, Byrnes WC, Haymes EM. Energy expenditure estimates for the Caltrac accelerometer for running, race walking, and stepping. Br J Sports Med 1997; 31: 235–9
Westerterp KR, Bouten CV. Physical activity assessment: comparison between movement registration and doubly labeled water method. Z Ernahrungswiss 1997; 36: 263–7
Terrier P, Aminian K, Schutz Y. Can accelerometry accurately predict the energy cost of uphill/downhill walking? Ergonomics 2001; 44: 48–62
Meijer GA, Westerterp KR, Verhoeven MH, et al. Methods to assess physical activity with special reference to motion sensors and accelerometers. IEEE Trans Biomed Eng 1991; 38: 221–8
Chen KY, Sun M. Improving energy expenditure estimation by using triaxial accelerometer. J Appl Physiol 1997; 83: 2112–22
Jakicic JM, Winters C, Lagally K, et al. The accuracy of the TriTrac-R3D accelerometer to estimate energy expenditure. Med Sci Sports Exerc 1999; 31: 747–54
Nichols JF, Morgan CG, Sarkin JA, et al. Validity, reliability, and calibration of the Tritrac accelerometer as a measure of physical activity. Med Sci Sports Exerc 1999; 31: 908–12
Sherman WM, Morris DM, Kirby TE, et al. Evaluation of the commercial accelerometer (Tritrac-R3D) to measure energy expenditure during ambulation. Int J Sports Med 1998; 19: 43–7
Welk GJ, Corbin CB. The validity of the Tritrac-R3D activity monitor for the assessment of physical activity in children. Res Q Exerc Sport 1995; 66: 202–9
Aminian K, Robert P, Jequier E, et al. Estimation of speed and incline of walking speed using Neural Network. IEEE Trans Instr Meas 1995; 44: 743–6
Herren R, Sparti A, Aminian K, et al. The prediction of speed and incline in outdoor running in humans using accelerometry. Med Sci Sports Exerc 1999; 25: 1365–9
Terrier P, Ladetto Q, Merminod B, et al. Measurement of the mechanical power of walking by satellite positioning system (GPS). Med Sci Sports Exerc 2001; 33: 1912–8
Perrin O, Terrier P, Ladetto Q, et al. Improvement of walking speed prediction by accelerometry and altimetry, validated by DGPS. Med Biol Eng Comput 2000; 38: 164–8
Meijer G, Westerterp K, Koper H, et al. Assessment of energy expenditure by recording heart rate and body acceleration. Med Sci Sports Exerc 1989; 21: 343–7
Haskell WL, Yee MC, Evans A, et al. Simultaneous measurements of heart rate and body motion to quantify physical activity. Med Sci Sports Exerc 1993; 25: 109–15
Moon JK, Butte NF. Combined heart rate and activity improve estimates of oxygen consumption and carbon dioxide production rates. J Appl Physiol 1996; 81: 1754–61
Strath SJ, Bassett DR, Thompson DL, et al. Validity of the simultaneous heart rate-motion sensor technique for measuring energy expenditure. Med Sci Sports Exerc 2002; 34: 888–94
Acknowledgements
Philip N. Ainslie was supported by a grant from Masterfood Inc. The authors have no conflicts of interest directly relevant to the content of this review.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ainslie, P.N., Reilly, T. & Westerterp, K.R. Estimating Human Energy Expenditure. Sports Med 33, 683–698 (2003). https://doi.org/10.2165/00007256-200333090-00004
Published:
Issue Date:
DOI: https://doi.org/10.2165/00007256-200333090-00004