Total Energy Expenditure Across the Life Course in Low-and Middle-Income Countries -- Chinese Children

Condition(s) studied

Study summary

By 2050, there will be 9 billion people on earth. It will be necessary to feed them to avoid the population catastrophe predicted by Malthus 150 years ago. Yet a major issue facing governments is that the current method by which food demands are estimated is widely acknowledged as completely inaccurate. An accurate method is available. It is based on measurements of isotope elimination, called the doubly labelled water (DLW) method. In 2018, the International Atomic Energy Agency (IAEA) hosted and compiled a database of measurements using this technique. It showed that the use of the DLW method has been mostly restricted to the USA and Western Europe. It has rarely been applied across Africa and Asia. The database also focused on adults, leaving much unknown about the energy balance in children and adolescents. There is a clear need to fill this gap in knowledge, providing information that governments across Low- and Middle-Income countries can use to forecast future food demands. In China, the prevalence of overweight and obesity among children and adolescents is increasing. In 2009, 22.1% of Chinese youth aged 7-17 years were either overweight or obese, according to the China Health and Nutrition Survey. The obesity rate has increased fourfold since 1995. One of the most concerning problems is the persistence of childhood obesity into adulthood. The causes of this obesity epidemic are strongly disputed, with some suggesting it is due to increasingly sedentary lifestyles (computers, cars, phones, etc.), while others suggest it is mostly due to changing food patterns (junk food and sugar-sweetened beverages). Measuring energy expenditure in children and adolescents in China will address whether declining expenditure due to reduced physical activity is a key cause of the epidemic. Most measurements come from urban populations, leaving rural populations greatly underrepresented.

Eligibility

Primary outcome measure(s)

• Height — About 3 minutes.
  Height in centimetres will be measured by Leicester stadiometer(Seca 217, Germany).
• Weight — About 5 minutes.
  Weight in kilograms will be measured by TANITA.
• BMI — About 10 minutes (calculated).
  BMI values in kg/m2 were calculated from weight measured by TANITA and height measured by Leicester stadiometer (Seca 217, Germany).
• Fat mass — About 3 minutes.
  Fat mass in kilograms will be measured by TANITA.
• Fat percentage — About 3 minutes.
  Fat percentage will be measured by TANITA.
• Fat-free mass — About 3 minutes.
  Fat-free mass in kilograms will be measured by TANITA.
• Muscle mass — About 3 minutes.
  Muscle mass in kilograms will be measured by TANITA.
• Total body water — About 3 minutes.
  Total body water in kilograms will be measured by TANITA.
• Anthropometric measurements — About 10 minutes.
  Anthropometric measurements, including waist circumference (measured in centimeters), will be obtained using a flexible tape measure following standardized protocols.
• Anthropometric measurements — About 10 minutes.
  Anthropometric measurements, including hip circumference (measured in centimeters), will be obtained using a flexible tape measure following standardized protocols.
• Anthropometric measurements — About 10 minutes.
  Anthropometric measurements, including mid-upper arm circumference (measured in centimeters), will be obtained using a flexible tape measure following standardized protocols.
• Family socioeconomic status — About 5 minutes.
  Family socioeconomic status will be assessed by the Family Socioeconomic Status Questionnaire (SES).
• Secondary sexual characteristics — About 5 minutes.
  The Tanner stages are used to assess the development of secondary sexual characteristics and are divided into five stages. For boys, the evaluation includes pubic hair development and genital development (including testicular and penile growth). For girls, the evaluation includes pubic hair development and breast development (thelarche).
• Dietary intake — About 10 minutes (three times).
  The 24-hour dietary recall questionnaire is used to investigate the dietray intake level of the subjects. Three daily meals will be collected to calculate the dietary intake in kcal or MJ.
• Basal metabolic rate — About 30 minutes.
  The basal metabolic rate in kcal or MJ will be measured by respiratory indirect calorimetry (Cosmed).
• Total energy expenditure — About 14 days.
  Total energy expenditure in kcal or MJ will be measured using the DLW method. TEE will then be calculated using mean CO2 production using the Weir equation.
• Environmental temperature — About 14 days.
  The iButton (DS1921G) monitors will be provided for the assessment of both indoor and outdoor temperature of their living environment, measured in degrees Celsius (°C).
• Physical activity — About 14 days.
  Physical activity of the participants will be recorded using a GT3X accelerometer worn at the waist for a consecutive period of 14 days. Outcomes measured by the GT3X included physical activity energy expenditure in kcal or MJ, Total MVPA in minutes per day , and Vector Magnitude Counts expressed as counts per minute.

Trial sites (1)

More Shenzhen Institutes of Advanced Technology ,Chinese Academy of Sciences trials in China

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