Understanding energy expenditure in children with chronic disease is critical due to the impact on energy homeostasis and growth. This systematic review aimed to describe available literature of resting (REE) and total energy expenditure (TEE) in children with chronic disease measured by gold-standard methods of indirect calorimetry (IC) and doubly labeled water (DLW), respectively. A literature search was conducted using OVID Medline, Embase, CINAHL Plus, Cochrane, and Scopus until July 2023. Studies were included if the mean age of the participants was ≤18 y, participants had a chronic disease, and measurement of REE or TEE was conducted using IC or DLW, respectively. Studies investigating energy expenditure in premature infants, patients with acute illness, and intensive care patients were excluded. The primary outcomes were the type of data (REE, TEE) obtained and REE/TEE stratified by disease group. In total, 271 studies across 24 chronic conditions were identified. Over 60% of retrieved studies were published >10 y ago and conducted on relatively small population sizes (n range = 1-398). Most studies obtained REE samples (82%) rather than that of TEE (8%), with very few exploring both samples (10%). There was variability in the difference in energy expenditure in children with chronic disease compared with that of healthy control group across and within disease groups. Eighteen predictive energy equations were generated across the included studies. Quality assessment of the studies identified poor reporting of energy expenditure protocols, which may limit the validity of results. Current literature on energy expenditure in children with chronic disease, although extensive, reveals key future research opportunities. International collaboration and robust measurement of energy expenditure should be conducted to generate meaningful predictive energy equations to provide updated evidence that is reflective of emerging disease-modifying therapies. This study was registered in PROSPERO as CRD42020204690.

The purpose of this study was to critically review the existing literature on the effects of active video games (AVGs) on physical activity in overweight and obese college students to determine whether AVGs can promote and achieve recommended levels of physical activity. The results should provide constructive input for future research.
A total of five international databases including PubMed, SCOPUS, Web of Science, CINAHL Plus, and EBSCOhost were searched with keywords related to \"active video games,\" \"physical activity,\" and \"obese college students\" from July 2022. A systematic review was conducted using the PRISMA guidelines and randomised controlled trial (RCT) studies that met the inclusion criteria were included. Furthermore, the quality assessment of the studies was measured using the PEDro scale.
One thousand and twenty-three articles were retrieved, of which eight randomised controlled trial studies met the inclusion criteria. AVGs can reduce sedentary behaviour and positively affect physical activity, time spent on moderate-to-vigorous physical activity (MVPA), positive psychological factors, and game attendance rate. Combining AVGs with other assistive devices (such as mini-trampolines and stationary bikes) can enhance the effects of AVGs and provide greater physiological stimulation. Different types of AVGs and game modes can achieve different emotional responses, physiological stimulation, and physical activity levels.
The research findings prove that AVGs can be a viable intervention to increase physical activity in overweight or obese college students, ultimately reaching the recommended physical activity level(PAL). Physical activity can be further increased by incorporating assistive devices or using features supported by self-determination theory (SDT). As a new modality, AVGs could be a potential alternative to traditional physical activity.Systematic Review Registration:https://www.crd.york.ac.uk/prospero, identifier: CRD42022363993.

BACKGROUND: Since pregnancy is a decisive period for women and children in terms of future health, it is very important to determine changes in energy expenditure and requirements. However, there is no reference method to determine the energy expenditure as there are many factors that change maternal energy homeostasis during this period.
OBJECTIVE: This review aims to evaluate the changes in energy expenditure during pregnancy and the effects of these changes on maternal weight gain, as well as the methods used to determine energy expenditure.
METHODS: Google Scholar, PubMed, ScienceDirect, Cochrane Library, and Wiley Online Library databases were searched to determine studies on energy expenditure during pregnancy between 2010 and 2022.
METHODS: Of the 2095 articles initially identified, 20 met the inclusion criteria for this review. Two independent reviewers selected and extracted data from those articles.
METHODS: The articles reviewed show that prepregnancy body mass index, gestational weight gain, changes in fat mass, and lean body mass influence energy expenditure during pregnancy. Doubly-labeled water and indirect calorimetric methods are considered reference methods for determining energy expenditure in pregnancy. Indirect calorimetric methods, when used together with body weight and physical activity measurements, allow an accurate estimation of resting energy expenditure and energy requirements for pregnant women. Metabolic Holter or accelerometers are valid methods for determining activity energy expenditure in pregnant women and are suitable for use during activity.
CONCLUSIONS: Resting energy expenditure and activity energy expenditure should be carefully monitored and measured by valid methods to achieve the correct energy intake targets during pregnancy. The existing equations used in determining energy expenditure should be developed for a more accurate estimation of energy expenditure during pregnancy, or new pregnancy-specific equations should be derived.

BACKGROUND: Many equations to estimate the resting energy expenditure (REE) of patients with burns are currently available, but which of them provides the best guide to optimize nutrition support is controversial. This review examined the bias and precision of commonly used equations in patients with severe burns.
METHODS: A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases was undertaken on June 1, 2023, to identify studies comparing predicted REE (using equations) with measured REE (by indirect calorimetry [IC]) in adults with severe burns. Meta-analyses of bias and calculations of precisions were performed in each predictive equation, respectively.
RESULTS: Nine eligible studies and 12 eligible equations were included. Among the equations, the Toronto equation had the lowest bias (26.1 kcal/day; 95% CI, -417.0 to 469.2), followed by the Harris-Benedict equation × 1.5 (1.5HB) and the Milner equation. The Ireton-Jones equation (303.4 kcal/day; 95% CI, 224.5-382.3) acceptably overestimated the REE. The accuracy of all of the equations was <50%. The Ireton-Jones equation had the relatively highest precision (41.2%), followed by the 1.5HB equation (37.0%) and the Toronto equation (34.7%).
CONCLUSIONS: For adult patients with severe burns, all of the commonly used equations for the prediction of REE are inaccurate. It is recommended to use IC for accurate REE measurements and to use the Toronto equation, 1.5HB equation, or Ireton-Jones equation as a reference when IC is not available. Further studies are needed to propose more accurate REE predictive models.

Polycystic ovary syndrome (PCOS) occurs in 8%-13% of reproductive-aged women and is associated with reproductive, metabolic, and psychological dysfunction. Overweight and obesity are prevalent and exacerbate the features of PCOS. The aim of this review is to evaluate the extent of evidence examining the physiological factors affecting energy homeostasis, which may impact weight gain, weight loss, and weight maintenance in PCOS, and identify research gaps and recommendations for future research. Literature searches using MEDLINE, EMBASE, PsycInfo, AMED, CINAHL, and Cochrane Central Register of Controlled Trials were conducted up to June 22, 2022. Abstracts, non-English-language articles, and reviews were excluded. A total of n = 78 (n = 55 energy intake and n = 23 energy expenditure) primary research papers were included. Papers with multiple outcomes of interest were counted as separate studies. Energy-intake studies (n = 89) focussed on assessing food, nutrient, or supplements stimuli and were grouped into the outcomes of gastrointestinal appetite hormones (n = 43), adipokines (n = 34), subjective appetite (n = 9), functional brain imaging (n = 3), and neuropeptides (n = 0). Energy-expenditure studies (n = 29) were grouped into total energy expenditure (n = 1), resting energy expenditure (n = 15), meal-induced thermogenesis (n = 3), nutrient oxidation (n = 5), and metabolic flexibility (n = 5). Across both energy-intake and -expenditure papers, 60% of the studies compared outcome responses in women with PCOS with a control group. Results were inconsistent, with 57% reporting no differences and 43% reporting altered responses in PCOS compared with controls, including blunted appetite hormone responses, metabolic inflexibility, and reduced energy expenditure. The authors identified that there is inconsistent, yet preliminary, evidence of possible altered physiological factors, which may impact energy balance and weight management. Further work is needed to act on the identified clinical and research gaps to support women with PCOS and health professionals in informing and achieving realistic weight-management goals for women with PCOS. Systematic Review Registration: The protocol was prospectively registered on the Open Science Framework on February 16, 2021 (https://osf.io/9jnsm).

Over recent decades, wearable inertial sensors have become popular means to quantify physical activity and mobility. However, research assessing measurement accuracy and precision is required, especially before using device-based measures as outcomes in trials. The GT9X Link is a recent activity monitor available from ActiGraph, recognized as a \"gold standard\" and previously used as a criterion measure to assess the validity of various consumer-based activity monitors. However, the validity of the ActiGraph GT9X Link is not fully elucidated. A systematic review was undertaken to synthesize the current evidence for the criterion validity of the ActiGraph GT9X Link in measuring steps and energy expenditure. This review followed the PRISMA guidelines and eight studies were included with a combined sample size of 558 participants. We found that (1) the ActiGraph GT9X Link generally underestimates steps; (2) the validity and accuracy of the device in measuring steps seem to be influenced by gait speed, device placement, filtering process, and monitoring conditions; and (3) there is a lack of evidence regarding the accuracy of step counting in free-living conditions and regarding energy expenditure estimation. Given the limited number of included studies and their heterogeneity, the present review emphasizes the need for further validation studies of the ActiGraph GT9X Link in various populations and in both controlled and free-living settings.

OBJECTIVE: The objective of this systematic review and meta-analysis was to assess the validity of the Actigraph triaxial accelerometer device in measuring physical activity energy expenditure (PAEE) in healthy adults, with indirect calorimetry (IC) serving as the validity criterion.
METHODS: A comprehensive search was conducted using the PubMed, Web of Science, and sportdiscuss databases, in addition to manual searches for supplementary sources. Search strategies were employed that involved conducting single keyword searches using the terms \"gt3x\" and \"Actigraph gt3x\". The literature search encompassed the timeframe spanning from 1 January 2010 to 1 March 2023. The methodological quality of the studies included in the analysis was evaluated using both the Downs and Black checklist and the Consensus-Based Criteria for Selection of Measurement Instruments (COSMIN) checklist. The meta-analysis was conducted using the Review Manager 5.4 software. The standardized mean difference (SMD) was calculated and expressed as a 95% confidence interval (CI). The significance level was set at α = 0.05. A systematic assessment of the Actigraph\'s performance was conducted through the descriptive analysis of computed effect sizes.
RESULTS: A total of 4738 articles were retrieved from the initial search. After eliminating duplicate articles and excluding those deemed irrelevant, a comprehensive analysis was conducted on a total of 20 studies, encompassing a combined sample size of 1247 participants. The scores on the Downs and Black checklist ranged from 10 to 14, with a mean score of 11.35. The scores on the COSMIN checklist varied from 50% to 100%, with an average score of 65.83%. The meta-analysis findings revealed a small effect size (SMD = 0.01, 95% CI = 0.50-0.52, p = 0.97), indicating no statistically significant difference (p > 0.05).
CONCLUSIONS: The meta-analysis revealed a small effect size when comparing the Actigraph and IC, suggesting that the Actigraph can be utilized for assessing total PAEE. Descriptive analyses have indicated that the Actigraph device has limited validity in accurately measuring energy expenditure during specific physical activities, such as high-intensity and low-intensity activities. Therefore, caution should be exercised when utilizing this device for such purposes. Furthermore, there was a significant correlation between the activity counts measured by the Actigraph and the PAEE, indicating that activity counts can be utilized as a predictive variable for PAEE.

BACKGROUND: In critically ill pediatric patients, optimal energy and protein intakes are associated with a decreased risk of morbidity and mortality. However, the determination of energy and protein needs is complex. The objective of this scoping review was to understand the extent and type of evidence related to the methods used to determine energy and protein needs in critically ill pediatric patients.
METHODS: An international expert group composed of dietitians, pediatric intensivists, a nurse, and a methodologist conducted the review, based on the Johanna Briggs Institute methodology. Two researchers searched for studies published between 2008 and 2023 in two electronic databases, screened abstracts and relevant full texts for eligibility, and extracted data.
RESULTS: A total of 39 studies were included, mostly conducted in critically ill children undergoing ventilation, to assess the accuracy of predictive equations for estimating resting energy expenditure (REE) (n = 16, 41%) and the impact of clinical factors (n = 22, 56%). They confirmed the risk of underestimation or overestimation of REE when using predictive equations, of which the Schofield equation was the least inaccurate. Apart from weight and age, which were positively correlated with REE, the impact of other factors was not always consistent. No new indirect calorimeter method used to determine protein needs has been validated.
CONCLUSIONS: This scoping review highlights the need for scientific data on the methods used to measure energy expenditure and determine protein needs in critically ill children. Studies using a reference method are needed to validate an indirect calorimeter.

Malnutrition is prevalent in people with upper gastrointestinal (GI) cancers and is associated with shorter survival and poor quality of life. In order to effectively prevent or treat malnutrition, nutrition interventions must ensure appropriate energy provision to meet daily metabolic demands. In practice, the energy needs of people with cancer are frequently estimated from predictive equations which are not cancer-specific and are demonstrated to be inaccurate in this population. The purpose of this scoping review was to synthesize the existing evidence regarding energy expenditure in people with upper GI cancer. Three databases (Ovid MEDLINE, Embase via Ovid, CINAHL plus) were systematically searched to identify studies reporting on resting energy expenditure using indirect calorimetry and total energy expenditure using doubly labeled water (DLW) in adults with any stage of upper GI cancer at any point from diagnosis. A total of 57 original research studies involving 2,125 individuals with cancer of the esophagus, stomach, pancreas, biliary tract, or liver were eligible for inclusion. All studies used indirect calorimetry, and one study used DLW to measure energy expenditure, which was reported unadjusted in 42 studies, adjusted for body weight in 32 studies, and adjusted for fat-free mass in 13 studies. Energy expenditure in upper GI cancer was compared with noncancer controls in 19 studies and measured compared with predicted energy expenditure reported in 31 studies. There was heterogeneity in study design and in reporting of important clinical characteristics between studies. There was also substantial variation in energy expenditure between studies and within and between cancer types. Given this heterogeneity and known inaccuracies of predictive equations in patients with cancer, energy expenditure should be measured in practice wherever feasible. Additional research in cohorts defined by cancer type, stage, and treatment is needed to further characterize energy expenditure in upper GI cancer.

The use of non- and low-caloric sweetener(s) (NCS and LCS) as a means to prevent overweight and obesity is highly debated, as both NCS and LCS have been proposed to have a negative impact on energy homeostasis. This systematic review aimed to assess the impact of NCS and LCS on fasting and postprandial substrate oxidation, energy expenditure, and catecholamines, compared to caloric sweeteners or water, across different doses and types of NCS and LCS, acutely and in the longer-term. A total of 20 studies were eligible: 16 studies for substrate oxidation and energy expenditure and four studies for catecholamines. Most studies compared the acute effects of NCS or LCS with caloric sweeteners under non-isoenergetic conditions. These studies generally found higher fat oxidation and lower carbohydrate oxidation with NCS or LCS than with caloric sweeteners. Findings for energy expenditure were inconsistent. With the limited number of studies, no convincing pattern for the remaining outcomes and comparisons could be seen. In conclusion, drinks or meals with NCS or LCS resulted in higher fat and lower carbohydrate oxidation compared to caloric sweeteners. No other conclusions could be drawn due to insufficient or inconsistent results. Further studies in this research field are warranted.