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Cited by 219Body Composition Measurement TechniquesMuscle metabolism and nutritionRegulation of Appetite and Obesity

The DOI matches its Crossref record; 69 of the 70 references it cites were found in a registry or an index.

Doubly labelled water assessment of energy expenditure: principle, practice, and promise.

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Westerterp, Klaas R.·2017·European Journal of Applied Physiology
DOI 10.1007/s00421-017-3641-xPMC PMC5486561
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Abstract

Abstract The doubly labelled water method for the assessment of energy expenditure was first published in 1955, application in humans started in 1982, and it has become the gold standard for human energy requirement under daily living conditions. The method involves enriching the body water of a subject with heavy hydrogen ( 2 H) and heavy oxygen ( 18 O), and then determining the difference in washout kinetics between both isotopes, being a function of carbon dioxide production. In practice, subjects get a measured amount of doubly labelled water ( 2 H 2 18 O) to increase background enrichment of body water for 18 O of 2000 ppm with at least 180 ppm and background enrichment of body water for 2 H of 150 ppm with 120 ppm. Subsequently, the difference between the apparent turnover rates of the hydrogen and oxygen of body water is assessed from blood-, saliva-, or urine samples, collected at the start and end of the observation interval of 1–3 weeks. Samples are analyzed for 18 O and 2 H with isotope ratio mass spectrometry. The doubly labelled water method is the indicated method to measure energy expenditure in any environment, especially with regard to activity energy expenditure, without interference with the behavior of the subjects. Applications include the assessment of energy requirement from total energy expenditure, validation of dietary assessment methods and validation of physical activity assessment methods with doubly labelled water measured energy expenditure as reference, and studies on body mass regulation with energy expenditure as a determinant of energy balance.

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Crossref · 10.1007/s00421-017-3641-x

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Fig. 1 Principle of measurement of carbon dioxide production with doubly labelled water (2H218O). After administration of water labelled with heavy oxygen (18O) and heavy hydrogen (2H), the two isotopes mix with the body water, where 18O exchanges with CO2 in the bicarbonate pools as well. Thus, the elimination rate of 2H (K 2) is a measure for water loss (rH2O) and the elimination rate of 18O (K 18) is a measure for rH2O plus carbon dioxide production (rCO2), and rCO2 = K 18 − K 2
Fig. 1 Principle of measurement of carbon dioxide production with doubly labelled water (2H218O). After administration of water labelled with heavy oxygen (18O) and heavy hydrogen (2H), the two isotopes mix with the body water, where 18O exchanges with CO2 in the bicarbonate pools as well. Thus, the elimination rate of 2H (K 2) is a measure for water loss (rH2O) and the elimination rate of 18O (K 18) is a measure for rH2O plus carbon dioxide production (rCO2), and rCO2 = K 18 − K 2CC BY · PubMed Central
Fig. 2 Preparation line for hydrogen gas samples at the Stable Isotope Geology Unit of the Scottish Universities Research and Reactor Centre in East Kilbride, Scotland 1977. The glass system is connected to a rotary pump (1) and a mercury diffusion pump (2) to create high vacuum. A blood-, saliva-, or urine sample in a sealed glass capillary is placed in a tube cracker (3), connected to the system and the system is pumped to vacuum. Then, the capillary is broken and water in the sample is frozen in a U-tube surrounded by liquid nitrogen in a dewar vessel (4). Subsequently, the frozen water is evaporated and passes a uranium furnace kept at 600 °C (5), where it is converted to hydrogen gas. The hydrogen gas is absorbed in a charcoal tube surrounded by liquid nitrogen in a dewar vessel (6). Finally, the charcoal tube with the sample is closed and transferred to an isotope ratio mass spectrometer for analysis
Fig. 2 Preparation line for hydrogen gas samples at the Stable Isotope Geology Unit of the Scottish Universities Research and Reactor Centre in East Kilbride, Scotland 1977. The glass system is connected to a rotary pump (1) and a mercury diffusion pump (2) to create high vacuum. A blood-, saliva-, or urine sample in a sealed glass capillary is placed in a tube cracker (3), connected to the system and the system is pumped to vacuum. Then, the capillary is broken and water in the sample is frozen in a U-tube surrounded by liquid nitrogen in a dewar vessel (4). Subsequently, the frozen water is evaporated and passes a uranium furnace kept at 600 °C (5), where it is converted to hydrogen gas. The hydrogen gas is absorbed in a charcoal tube surrounded by liquid nitrogen in a dewar vessel (6). Finally, the charcoal tube with the sample is closed and transferred to an isotope ratio mass spectrometer for analysisCC BY · PubMed Central
Fig. 3 Frequency distribution of the value of the physical activity level, total energy expenditure as a multiple of resting energy expenditure, including all adult subjects with doubly labelled water-assessed energy expenditure in Maastricht until 2016: women (N = 358, closed bars) and men (N = 490, open bars)
Fig. 3 Frequency distribution of the value of the physical activity level, total energy expenditure as a multiple of resting energy expenditure, including all adult subjects with doubly labelled water-assessed energy expenditure in Maastricht until 2016: women (N = 358, closed bars) and men (N = 490, open bars)CC BY · PubMed Central

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Research works printed but not linked: 2

  1. Speakman JR (1997) Doubly labelled water. Springer, Berlin
  2. Westerterp KR (2011) Body composition and its measurement. In: Sobotka L, Allison SP, Forbes A, Ljungqvist O, Meier RF, Pertkiewicz M, Soeters PB (eds) Basics in clinical nutrition, 4th edn. Espen, Galén, Czech Republic

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Metadata

Authors
Westerterp, K. R.
Affiliations
Maastricht University Medical Centre (NL)
Corresponding author
Westerterp, Klaas R.
ORCID
Westerterp, Klaas R.
Venue
European Journal of Applied Physiology
Publisher
Springer Science and Business Media LLC
Published
2017-05-15
Volume
117
Issue
7
Pages
1277-1285
ISSN
  • 0020-9376 (ISSN-L)
  • 1439-6319
  • 1439-6327
DOI
10.1007/s00421-017-3641-x
PMC
PMC5486561
OpenAlex
W2616634005
Cited by
219
References
70
Citations by year
2026: 25 · 2025: 30 · 2024: 22 · 2023: 32 · 2022: 28 · 2021: 28 · 2020: 20 · 2019: 21 · 2018: 12 · 2017: 1
FWCI
1.81
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Applied Physiology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, cc-by)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
  • Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords
doubly labeled water, energy expenditure, energy requirements, CO2 emissions, deuterium, physical activity energy expenditure, energy balance, body weight regulation
MeSH terms
Energy Metabolism, Humans, Oxygen Isotopes, Ergometry, Deuterium Oxide

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