RESEARCH

Research and Professional Briefs

Reading and Listening to Music Increase Resting Energy
Expenditure during an Indirect Calorimetry Test
Blaire Snell, MS, RDN; Susan Fullmer, PhD, RDN; Dennis L. Eggett, PhD
ARTICLE INFORMATION
Article history:
Accepted 12 March 2014
Keywords:
Resting energy expenditure (REE)
Resting activities
Music
Reading
Indirect calorimetry
Copyright 2014 by the Academy of Nutrition
and Dietetics.
2212-2672/$36.00
http://dx.doi.org/10.1016/j.jand.2014.03.013
ABSTRACT
Indirect calorimetry is often done early in the morning in a fasting state, with the
subject unshowered and abstained from caffeine or other stimulants. Subjects often
fall asleep, resulting in measurement of a sleeping metabolic rate rather than a resting
metabolic rate. The objective of this study was to determine whether listening to self-
selected relaxing music or reading an electronic device or magazine affects resting
energy expenditure (REE) during measurement in healthy adults. A randomized trial
comparing three different conditions (ie, resting, reading, and listening to music)
was performed. Sixty-ve subjects (36 female and 29 male) were used in nal
data analysis. Inclusion criteria included healthy subjects between the ages of 18 and
50 years with a stable weight. Exclusion criteria included pregnant or lactating women
or use of medications known to affect metabolism. Results showed that reading either
a magazine or an electronic device signicantly increased REE by 102.7 kcal/day when
compared with resting (P<0.0001); however, there was no difference in REE between
the electronic device and magazine. Listening to self-selected relaxing music increased
REE by 27.6 kcal/day compared with rest (P0.0072). Based on our results, we
recommend subjects refrain from reading a magazine or electronic device during an
indirect calorimetry test. Whether or not the smaller difference found while listening
to music is practically signicant would be a decision for the indirect calorimetry test
administrator.
J Acad Nutr Diet. 2014;-:---.
I
NDIRECT CALORIMETRY (IC) IS THE MOST COMMON
technique for measuring resting energy expenditure
(REE) in both clinical and research settings.
1
IC analyzes
pulmonary gases, namely oxygen consumption and car-
bon dioxide expiration, to obtain a more accurate REE than
can be predicted through equations.
1-4
The current protocol
to conduct an IC test includes performing the test early in
the morning after an overnight fast, being in a thermoneutral
room with low lighting and minimal sounds or distractions,
and the subject remaining awake but still.
1-4
Given these cir-
cumstances, subjects often fall asleep. Sleeping metabolic
rate has been shown to be at least 5% lower than REE; there-
fore, one of the challenges in conducting an IC study is to
keep the subject still, but awake.
5
Several studies have shown that REE can be affected by
activities such as playing active video games, music, our
physical environment, and laughter
5-20
; however, the ma-
jority of these studies were designed to explore how different
activities might increase REE in otherwise sedentary activ-
ities, they were not designed to standardize a measurement
protocol.
The purpose of this study was to determine whether sim-
ple activities such as reading a magazine or electronic device
or listening to relaxing music are acceptable activities that
would help subjects stay awake and pass the time but would
not signicantly increase REE during an IC test. Although
some studies have evaluated the effects of music on stress or
REE, few have been done to standardize a measurement
protocol and, to the best of our knowledge, there have been
no studies done testing the effect of reading on REE.
METHODS
Study Design
A randomized trial was conducted with IC under three
different conditions (ie, resting, reading, and listening to
music). All three conditions were measured during one
continuous IC test; subjects were randomly exposed to each
condition. Music and reading material were self-selected.
Description of Study Subjects
A convenience sample of 68 male and female subjects was
recruited from the faculty, staff, and the student body at
Brigham Young University and the surrounding community.
Recruitment efforts involved yers sent to all faculty and staff
at Brigham Young University and displayed throughout
campus, announcements made in specic classes, and by
word of mouth. Inclusion criteria included healthy subjects
between the ages of 18 and 50 years with a stable weight,
dened as no weight loss or gain exceeding 2.3 kg (5 lb) in
the past 6 months. Exclusion criteria included pregnant or
lactating women and subjects taking medications known to
2014 by the Academy of Nutrition and Dietetics. JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS 1
affect metabolism. The Brigham Young University Institu-
tional Review Board approved the study protocol and all
participants provided written informed consent.
Procedures
After recruitment, subjects were screened through e-mail to
determine inclusion/exclusion criteria. If inclusion criteria
were met, a short initial visit was scheduled at the subjects
convenience. During this visit, height and weight were ob-
tained, study procedures were explained, informed consent
was read and signed, and music and reading preferences
were determined. IC was performed within 1 week of the
initial visit. Researchers performed the randomization to rest,
music, or reading at this initial visit. Randomization was
achieved with three different colored marbles chosen from a
concealed container.
Music was chosen from a variety of Pandora stations played
on a provided iPad 2 (Apple Inc). Subjects were given the
choice to read on the provided iPad 2 or they could choose
from a wide variety of print magazines; books were not
allowed. Subjects also had the option of bringing in their
own music, magazine, and/or electronic tablet. If subjects
brought in their own device, they were instructed to have
them fully charged. With the exception of turning pages,
subjects were instructed to remain as still as possible during
the reading portion of the test. These options were chosen
because they reect realistic options that might be used in a
practice or research setting.
Anthropometrics
Height was measured using a professional-grade stadiometer
(model PE-WM-60-76-BRG2, Perspective Enterprises). Sub-
jects were measured while standing, without shoes, and with
weight evenly distributed. Height was measured to the
nearest 0.5 inch. Weight was assessed with a Tanita 310
electronic scale. Subjects were weighed only once, before IC
measurement, with light clothing and without shoes. Weight
was recorded to the nearest 0.5 lb.
IC Measurements
The information obtained during the initial visit was used
to have the music and reading preferences ready for each
subject before having measurements taken. IC measurements
were conducted as follows: tests were begun between
5:00 AM and 8:30 AM after an overnight fast, no shower the
morning of the test, and subjects were asked to abstain from
caffeine and exercise for at least 12 hours before the test. On
the morning of the test, subjects parked close to the building.
Upon arrival, subjects rested for 30 minutes in a supine po-
sition. A light blanket was provided. All measurements were
taken in a quiet, thermoneutral room with dimmed lights to
avoid any environmental inuences on REE.
AVMAX 29N indirect calorimeter (SensorMedics) was used
to take all measurements. Calibrations on the mass ow
sensor and gas analyzers were performed before each study.
Gas analyzers were calibrated using the following known
gases: 20% O
2
/ 0.75% CO
2
and 26% O
2
/0% CO
2
. A clear canopy
was placed over the subjects head to collect gas samples.
Each condition was randomly assigned before the test and
was measured for 25 minutes, for a total of 75 minutes; data
collected in the rst 5 minutes of each segment were
discarded.
21
Sol Tracks V8 headphones (Sol Republic) were provided for
all subjects. Headphones were worn for the duration of all
conditions to avoid unnecessary movement and to minimize
noise. To control for volume, subjects were given a decibel
scale with acceptable ranges highlighted. The maximum
decibel was dened as normal conversation. Transitions from
one condition to the next were done through written signs,
communicating with the subject to start or pause music and/
or to stop or start reading.
Data Analysis
A power analysis based on a practical change in REE of 75 kcal
determined a sample size of 50 subjects (a.2; b.05). The
differences between treatments were determined with
mixed-model repeated measures of analysis of variance using
Statistical Analysis Software (version 9.3, 2012, SAS Institute,
Inc). Results are reported as least squares meanstandard
error. Demographic information was analyzed using Micro-
soft Excel 2010. Results are reported means, standard de-
viations, and ranges.
RESULTS AND DISCUSSION
A total of 65 subjects (36 female and 29 male) were included
in the nal data analysis. Sixty-eight subjects were recruited
matching the inclusion criteria and completed the initial
visit; however, three subjects did not come in to have mea-
surements taken due to scheduling conicts. Subject char-
acteristics are described in Table 1.
Reading either a magazine or an electronic device resulted
in a signicant increase of 102.7 kcal/day or a 6.5% increase
(Table 2) when compared with resting (P<0.0001). There was
no difference in REE between reading a magazine or an
electronic device (data not shown). Listening to self-selected
relaxing music increased REE by 27.6 kcal/day or 1.8%
compared with rest (P0.0072). The order in which subjects
received the three tests (ie, rest, music, and reading) was
considered in the rst statistical model (included order),
but was not found to be signicantly related to the results, so
it was excluded from the nal analyses.
The primary ndings of this study suggest that both
listening to self-selected relaxing music and reading either a
magazine or an electronic device signicantly increase REE
during an IC test. The magnitude of increase in REE (>100
Table 1. Characteristics of participants in a study
comparing resting energy expenditure while at rest,
listening to music, or reading a magazine or electronic
tablet (n65)
Characteristics
Female, n (%) 36 (55.4)
Age (y), meanSD
a
(range) 279 (18-50)
Body weight (kg), meanSD (range) 7115 (46-120)
Height (cm), meanSD (range) 1729 (150-193)
Body mass index, meanSD (range) 244 (18-37)
a
SDstandard deviation.
RESEARCH
2 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS -- 2014 Volume - Number -
kcal) while reading a magazine or an iPad was surprising.
Cooper and colleagues
11
tested several different activities on
REE in adolescent girls. One activity was listening to a story
being read out loud. They found no difference in REE when
adolescent girls listened to a story (1,320 kcal/day) compared
with rest (1,346 kcal/day) (P0.066).
11
The signicant in-
crease we found while reading (102.7 kcal/day) in our study
could be a result of physically holding an object, whether
it be a magazine or electronic device, as opposed to just
listening to a story being read. A likely explanation for an
increased REE while reading is the energy required to hold
the magazine or iPad. However, we are not aware of any other
studies that have evaluated the effect of holding a magazine
on REE.
Studies have looked at the effects of music on stress and
have shown that different genres of music can affect the
stress response. For example, classical music generally has a
relaxing effect on stress, while genres such as hip hop, techno
music, and heavy metal are commonly associated with
physiologic arousal.
20
Research has also suggested that per-
sonal music preferences increase the ability of the music to
diminish an individuals stress levels.
20
Labbe and colleagues
13
found that healthy volunteers
who listened to self-selected or classical music after exposure
to a stressor showed signicant decreases in self-rated
anxiety, and those exposed to heavy metal or silence did
not.
13
However, markers of physiological stress were not
measured in the current study.
Lubetzky and colleagues
15
used classical music (Mozart) in
healthy preterm infants to see whether it would lower REE,
allowing more rapid weight gain, and shorten hospital stay.
REE decreased 13% when the infants were exposed to Mozart
for 30 minutes compared with no music exposure. Based on
the results of these studies and the known physiological ef-
fects of relaxing music, it might have been expected to see a
decrease in REE while subjects listened to self-selected
relaxing music. However, we did see a modest but signi-
cant increase in REE while listening to self-selected relaxing
music. One explanation might be that the denition of
relaxing can vary greatly from person to person. This vari-
ability could have played a role in the increase we saw in REE
during the music portion of the IC test. Subjects were allowed
to choose their own relaxing music; however, researchers did
preview all music selections to be sure they were appro-
priate. On the other hand, the auditory stimulus of music
might have raised REE.
One study performed by Carlsson and colleagues
8
exam-
ined the effects of calming music vs stressful music on REE.
This study was designed to determine whether listening
to stressful music could increase REE as a possible treat-
ment for obesity. Results showed no signicant difference
(P0.57) in REE when subjects listened to calm music (1,364
kcal/day) vs silence (1,366 kcal/day). There was also no
signicant difference (P0.43) between silence (1,366 kcal/
day) and stressful music (1,371 kcal/day).
8
Although this
study was similar to ours in protocol, subjects were only
exposed to the music selections for 10 minutes each, as
opposed to 25 minutes in our study. This short exposure
might not have been long enough to see the full effects of
the music on REE.
Limitations
A potential limitation of the current study is a lack of stan-
dardization in the music and reading material provided for
the tests. Subjects could choose any type of music they
deemed relaxing, although the researchers did approve all
music before it was used in the study. Any reading material
was also acceptable, as long as it was a magazine or on an
electronic device. However, this self-selection could also
be considered a strength, as self-selection would be more
applicable to practice settings. Additional research comparing
the effects of the standardized quiet music would be appro-
priate (ie, everyone listens to the same music). It is also
possible that a smaller handheld device (ie, a smart phone)
would be found to be acceptable during an IC study; however,
it is highly likely that the activity being performed
(answering texts or surng the web) might affect mood and,
therefore, REE.
CONCLUSIONS
We found that reading and listening to relaxing music under
a controlled environment have a signicant increase on REE
during an IC test. Based on our results, we recommend sub-
jects refrain from reading a magazine or electronic device
during a test. Whether or not the smaller difference found
Table 2. Least squares means of resting energy expediture, respiratory quotient, oxygen consumption, and carbon dioxide
production for subjects during measurement of resting energy expediture during rest, while listening to self-selected relaxing
music, and reading a magazine or electronic tablet
Resting (n[65) Music (n[65) Reading (n[65)
least squares meansstandard error!
REE
a
(kcal/day) 1,577.240.03
x
1,606.340.03
y
1,680.440.03
z
RQ
b
(VCO
2
c
/VO
2
d
) 0.800.005 0.820.005 0.820.005
VO
2
(L/min) 0.2770.006
x
0.2310.006
xy
0.2400.006
z
VCO
2
(L/min) 0.1820.005
x
0.1900.005
xy
0.2000.005
z
a
REEresting energy expediture.
b
RQrespiratory quotient.
c
VCO
2
carbon dioxide production.
d
VO
2
oxygen consumption.
xyz
Means not sharing the same superscript are signicantly different (P<0.001).
RESEARCH
-- 2014 Volume - Number - JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS 3
while listening to music is practically signicant would be a
decision for IC the test administrator.
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AUTHOR INFORMATION
B. Snell is a dietitian, Anytime Fitness, Salem, UT, and a dietary consultant, Grover C. Dils Medical Center, Caliente, NV; at the time of the study, she
was a graduate student, Nutrition Sciences, Brigham Young University, Provo, UT. S. Fullmer is a teaching professor, Department of Nutrition,
Dietetics and Food Science, and D. L. Eggett is an associate professor, Department of Statistics, Brigham Young University, Provo, UT.
Address correspondence to: Susan Fullmer, PhD, RDN, Department of Nutrition, Dietetics and Food Science, Brigham Young University, S227 ESC,
Provo, UT 84602. E-mail: susan_fullmer@byu.edu
STATEMENT OF POTENTIAL CONFLICT OF INTEREST
No potential conict of interest was reported by the authors.
FUNDING/SUPPORT
There is no funding to disclose.
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