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Energy expenditure studies

Studies of the energy cost of standardized activities carried out in healthy adult Malaysians [5, 13] have revealed a lower resting metabolic rate (RMR) and energy intakes below the RDI and FAO/WHO/UNU [1] figures. Comparison of the results obtained from one of these studies [13] with several earlier ones [16-18] (table 7) indicates that the RMRs of Malaysians and Singaporeans are comparable to those of undernourished Indians, whereas higher values were recorded for European and African subjects than for Asians. In a more recent study of BMRs among three ethnic groups in Malaysia [19] (tables 8 and 9), the differences in BMRs among the groups were not statistically significant, but it is of interest that the values were about 20% lower than predicted [1]. Consequently, if the measured BMR is multiplied by the physical activity level (PAL), classified as light, moderate, or heavy [1], the energy requirement is inevitably overestimated.

TABLE 6. Intake of nutrients among various age groups in Malaysia as percentage of recommended daily intakes (RDls)

a. Based on RDls for Malaysia |10].
b. Ref.12.

TABLE 7. Resting metabolic rates (RMRs) in males in various population groups

Subjects were all students except as otherwise indicated.

a. Laboratory assistants and clerks.
b. Students and staff.
c. Labourers.

With the emphasis on energy expenditure in estimating the energy requirement for a given population, and with BMR being the major determinant, the lower BMR values reported in many developing countries must be reviewed critically, especially when minimum energy requirements expressed as a multiple of BMR are used as cut-off points for undernutrition (table 10). One may question the validity of such an argument; however, these findings lend support to the notion that each country should assess the energy requirement of its own population.

TABLE 8. Physical characteristics of Malaysian adult men, by ethnic group

source: Ref 19.

Principal data are means ± SD; figures in parentheses are ranges.

TABLE 9. Basal metabolic rates of Malaysian adult men

see table 8 for the physical characteristics of these subjects.

a. Mean + SD.
b. Based on body weights as reported in table 8.

TABLE 10. Energy requirements for an adult Malaysian male

Calculation for 2s-year-old male, weighing 62 kg, height 1 65 m (BMI 22.8), with moderate activity.

a. PAL X BMR.
b. 1.4 BMR.

National energy (calorie) needs

The FAO manual [2] provides a simple approach to estimate a country's energy needs. Using locally available data wherever possible, as well as those reported in the manual, the per capita requirement for Malaysia is 2,030 kcal. PALs of 1.76 for adult males and 1.64 for adult females were used, instead of 1.82 (for less-developed countries) or 1.66 (for developed countries) suggested in the manual. These values are considered appropriate to reflect Malaysians' lifestyle, for which mean activity levels of 50% light and 50% moderate were adopted for urban and 75% moderate and 25% heavy for rural residents [1, 2].

According to the FAO manual [2], average body weights of specific age groups and BMR values in adolescents and adults appear to be critical. As body weights increase, so do the individual and total age-group energy needs. A recent FAO report [20] recommends that, for planning purposes, human energy requirements should be based on desirable body weights and desirable growth patterns of children rather than the actual body weights of adults and the growth of children at a particular time. It also recommends that, in order to reflect the local situation accurately, actual measurements of BMR for adults within countries should be used in the calculation of human energy requirements.

As emphasized in the 1985 FAO/WHO/UNU report, all countries need to determine the calorie requirements for the pattern of work and of discretionary activities that they consider appropriate to their populations. Different segments of a country's population have different mean energy requirements, and these may vary seasonally or over time [21].

References

1. FAO/WHO/UNU. Energy and protein requirements. Geneva: WHO, 1985.

2. James WPT, Schofield EC. Human energy requirements: a manual for planners and nutritionists. Oxford: Oxford University Press, 1990.

3. Survey Research Malaysia. Population map of Malaysia. In: Seng YK, ed. SRM Publication, 1989.

4. Wadsworth G. Lee TS. Height, weight and skinfold thickness of Muar children. J Trop Pediatr 1960;6:4854.

5. Universiti Kebangsasn Malaysia. Assessment of nutritional status amongst urban and rural populations: a compilation of data from BSc theses, 1985-1989. Bangi, Malaysia: Universiti Kebangsaan Malaysia, 1989.

6. Chong YH, Tee ES, Ng TKW et al. Status of community nutrition in poverty kampongs. IMR Bulletin no.22. Kuala Lumpur: Institute for Medical Research, 1984.

7. Gopalan C. Nutrition and development: some lessons from Asian experience. Proc Nutr Soc Mal 1989;4:1-18.

8. FAO. Food production for nutntional adequacy in Asia-Pacific region: the 19th regional conference. Bangkok, Thailand: FAO, 1988.

9. Khor GL, Tee ES, Kandiah M. Pattern of food production and consumption in the ASEAN region. World Rev Nutr Diet 1988;68:1-34.

10. Teoh ST. Recommended daily dietary intake for peninsular Malaysia. Med J Mal 1975;30:38-42.

11. Ismail MN. Survey of nutritional status and dietary lifestyle in Malaysia. In: Young KW, Cha LY, Yull LK, Soon JJ, He KS, eds. Proceedings of the 14th International Congress of Nutrition. Seoul, Korea, 1989:643-46.

12. Zawiah H. Influence of maternal nutrition during pregnancy on development of infants. PhD thesis, Universiti Kebangsaan Malaysia, Bangi. 1989.

13. Ismail MN, Zawiah H. Energy requirements of Malaysian students. Proc Nutr Soc Mal 1988;3:63-72.

14. Zanariah J. Yunus J. Norihan A. Studies of the food intake trend of the population in urban and rural areas in four selected districts in West Malaysia. Report no. 106. Serdang: Malaysian Agriculture Research Development Institute, 1986.

15. Zawiah H. Norlida MD, Ismail MN. Prevalence of malnutrition amongst preschool children in the FELDA scheme. J Mal Soc Health 1988;5(1):85-88.

16. Geissler CA, Aldouri MSH. Racial differences in energy cost of standardized activities. Ann Nutr Metab 1985 ;29:40-47.

17. Shetty PS. Adaptive changes in BMR and LBM in chronic undernutrition. Hum Nutr 1984;380:443-51.

18. Saha N. Tan PY, Banerjee B. Energy balance study in Singapore medical students. Ann Nutr Metab 1985;29:216-22.

19. Ismail MN. Studies with doubly-labelled water of adaptation in human energy needs in Malaysia. Report of the 2nd Coordinated Research Programme, International Atomic Energy Agency, Bangalore, India, November 1990. Annex 8. Vienna: IAEA, 1992.

20. FAO. Summary report of the regional expert consultation of the Asian Network for Food and Nutrition. Bangkok, Thailand: FAO, 1990.

21. Scrimshaw NS. Problems in the assessment of human nutritional needs. In: Nygaard DF, Pellett PL, eds. Dry area agriculture, food science and human nutrition. Oxford, UK: Pergamon Press, 1986:34-54.

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