DIRECT VS.

INDIRECT CALORIMETRY

Direct calorimetry measures heat production and indirect calorimetry measures

gas exchange: oxygen consumption and carbon dioxide production.

-Direct calorimetry measures the heat output by the subject, through direct
observation inside a calorimeter. Indirect calorimetry measure heat by using the
variable of O2 consumption and manufactured CO2. Indirect calorimetry gives a
more feasible and accurate measure of heat or energy, compared to direct
calorimetry.

Energy metabolism studied simultaneously using direct and indirect calorimetry

provides convincing evidence for the validity of the indirect method. At the turn
of the century, the two calorimetric methods were compared by Atwater and
Rosa for 40 days with threemen who lived in calorimeters. Their daily energy
outputs averaged2723 kCal when measured directly by heat production and
2717kCal when computed indirectly using closed-circuit measures ofoxygen
uptake.

DOUBLY LABELED WATER TECHNIQUE

The doubly labelled water (DLW) method is an isotope-based technique for the
assessment of energy expenditure. The method is based on the difference
between the turnover rates of the hydrogen and oxygen of body water as a
function of carbon dioxide (CO 2) production.
-The doubly labeled water technique provides an ideal way to assess total energy
expenditure of individuals over prolonged periods, including bed rest and extreme
activities such as climbing Mt. Everest, cycling the Tour de France, trekking across
Antarctica, military activities, extravehicular activities in space, and endurance
running and swimming.

The subject consumes a quantity of water with a known concentration of the

heavy, non-radioactive forms of the stable isotopes of hydrogen (2H or
deuterium) and oxygen (18O or oxygen- 18)—hence the term doubly labeled
water. The isotopes distribute throughout all bodily fluids. Labeled hydrogen
leaves the body as water in sweat, urine, and pulmonary water vapor ( 2H2O),
and labeled oxygen leaves as both water (H218O) and carbon dioxide (C18O2)
produced during macronutrient oxidation in energy metabolism.

Differences between elimination rates of the two isotopes determined by an

isotope ratio mass spectrometer relative to the body’s normal background levels
estimate total CO2 production during the measurement period. Oxygen
consumption is estimated on the basis of CO2 production and an assumed (or
measured) respiratory quotient (RQ) value of 0.85

Caloric Transformation for Oxygen

Bomb calorimeter studies show that approximately 4.82 kCal release when a
blend of carbohydrate, lipid, and protein burns in 1 L of oxygen. Even with large
variations in the metabolic mixture, this caloric value for oxygen varies within ±2%
to 4%.

An energy–oxygen equivalent of 5.0 kCal per liter provides a convenient yardstick

to transpose any aerobic physical activity to a caloric (energy) frame of reference.
Indirect calorimetry through oxygen uptake measurement provides the basis for
quantifying the caloric cost of most physical activities.

RESPIRATORY QUOTIENT

The respiratory quotient, also known as the respiratory ratio (RQ), is defined as
the volume of carbon dioxide released over the volume of oxygen absorbed
during respiration.
-The RQ is helpful in guiding the planning of nutritional therapy. The respiratory
quotient value indicates which macronutrients are being metabolized, as different
energy pathways are used for fats, carbohydrates, and proteins. If metabolism
consists solely of lipids, the respiratory quotient is approximately 0.7, for proteins
it is approximately 0.8, and for carbohydrates it is 1.0.
- The respiratory quotient (RQ)refers to the following ratio of metabolic gas
exchange:

RQ = (Carbon dioxide) produced ÷ (Oxygen) consumed

Respiratory Quotient for Carbohydrate

When carbohydrates are metabolized with oxygen, exactly one carbon dioxide
molecule is formed for each molecule of oxygen consumed. This ratio of carbon
dioxide output to oxygen usage is called therespiratory quotient, so the
respiratory quotient for carbohydrates is 1.0.
In the metabolism of glucose, for example, 6 O2 molecules are used up and 6 CO2
molecules are generated. The metabolic equation of glucose looks like this:

C6 H12 O6 + 6O2 → 6 CO2 + 6 H2 O

To determine the RQ of glucose, the ratio of CO2 to O2 is calculated.

In this case, RQ = 6 CO2 / 6 O2 = 1.0

Glucose is metabolized in a 1-to-1 ratio of CO2 and O2.

All of the oxygen consumed in carbohydrate combustion oxidizes carbon in the

carbohydrate molecule to carbon dioxide. This occurs because the ratio of
hydrogen to oxygen atoms in carbohydrates always exists in the same 2:1 ratio as
in water. The complete oxidation of one glucose molecule requires six oxygen
molecules and produces six molecules of carbon dioxide and water as follows:
Gas exchange during glucose oxidation produces an equal number of CO2
molecules to O2 molecules consumed; therefore, RQ for carbohydrate equals
1.00:

Respiratory Quotient for Lipid

The chemical composition of lipids differs from carbohydrates because lipids
contain considerably fewer oxygen atoms in proportion to hydrogen atoms and
carbon.

-Lipids are fatty, waxy, or oily compounds that are soluble in organic solvents and
insoluble in polar solvents such as water. Lipids include: Fats and oils
(triglycerides)

-Consequently, lipid catabolism for energy requires considerably more oxygen in

relation to carbon dioxide production.

-Palmitic acid, a typical fatty acid, oxidizes to carbon dioxide and water to produce
16 carbon dioxide molecules for every 23 oxygen molecules consumed. The
following equation summarizes this exchange to compute RQ:

Respiratory Quotient for Protein

The respiratory quotient of the protein albumin can be calculated using the
chemical formula for albumin metabolism. The chemical equation is:
C72 H112 N18 O22 S + 77 O2 → 63 CO2 + 38 H2 O + SO3 + 9 CO (NH2)2

The respiratory quotient of albumin is calculated therefore as:

RQ = 63 CO2 / 77 O2 = 0.81

Proteins do not oxidize to carbon dioxide and water during energy metabolism.
Rather, the liver first deaminates or removes nitrogen from the amino acid
molecule; then the body excretes the nitrogen and sulfur fragments in the urine,
sweat, and feces. The remaining “keto acid” fragment oxidizes to carbon dioxide
and water to provide energy for biologic work. To achieve complete combustion,
short-chain keto acids require more oxygen than carbon dioxide produced. For
example, the protein albumin oxidizes as follows:

In general, the respiratory quotient of carbohydrates is about 1.0, for fats about
0.70, and for proteins about 0.80.

Respiratory Quotient for a Mixed Diet

The approximate respiratory quotient of a mixed diet is 0.8. Some of the other
factors that may affect the respiratory quotient are energy balance, circulating
insulin, and insulin sensitivity. It can be used in the alveolar gas equation.

For most purposes, we assume an RQ of 0.82 from the metabolism of a mixture of

40% carbohydrate and 60% fat

-During activities that range from complete bed rest to mild aerobic walking or
slow jogging, the RQ seldom reflects the oxidation of pure carbohydrate or pure
fat. Instead, metabolizing a mixture of nutrients occurs with an RQ intermediate
between 0.70 and 1.00. For most purposes, we assume an RQ of 0.82 from the
metabolism of a mixture of 40% carbohydrate and 60% fat by applying the caloric
equivalent of 4.825 kCal per liter of oxygen for the energy transformation. Using
4.825 kCal, the maximum error possible in estimating energy metabolism from
steady-rate oxygen uptake equals about ±4%.

RESPIRATORY EXCHANGE RATIO

Application of the RQ requires the assumption that the O2 and CO2 exchange
measured at the lungs reflects cellular level gas exchange from nutrient
metabolism.

-Respiratory Exchange Ratio (RER) is the ratio between the volume of CO2 being
produced by the body and the amount of O2 being consumed. This value of this
ratio gives us an indication as to whether the body is operating aerobically or
anaerobically.

-RER values between 0.7 and 1 indicate a mix of carbohydrate and fat as an
energy source. If the value is greater than 1, it indicates anaerobic respiration,
which occurs when more carbon dioxide is produced than oxygen is consumed.

-This assumption is reasonably valid for rest and during steady-rate mild to
moderate aerobic exercise conditions without lactate accumulation.

-Aerobic means 'with air' and refers to the body producing energy with the use of
oxygen. This typically involves any exercise that lasts longer than two minutes in
duration. Continuous 'steady state' exercise is performed aerobically. Anaerobic
means 'without air' and refers to the body producing energy without oxygen.

-Aerobic - brisk walking, jump rope. Anaerobic - weightlifting, sprints,