Previous - Next
Abraham S. Johnson CL & Najjar ME (1979): Weight and height of adults 18-74 years of age: United States 1971-74. Vital Hlth Stat. 11, 1-49.
Bray GA (1979): Definition, measurement and classification of the syndrome of obesity. Int. J. Obes. 2, 99-112.
Casey VA, Dwyer IT, Coleman KA & Valadian I (1992): Body mass index from childhood to middle age. A 50 year follow-up. Am. J. Clin. Nutr. 56, 14-18.
Davidson S & Passmore R (1966): Human nutrition and dietetics, 3rd edn. Edinburgh & London: Livingstone.
FAO (1985): The fifth world food survey Rome: FAO.
FAO/WHO/UNU (1985): Energy and protein requirements. Technical Report Series No. 724. Geneva: WHO.
Ferro-Luzzi A, Sette S. Franklin M & James WPT (1992): A simplified approach to assessing adult chronic energy deficiency. Eur J. Clin. Nutr 46, 173-186.
François PJ (1981): The relationship between basal metabolism, height, body weight and sex of individuals. FAO Report EPR/87/5a. Rome: FAO.
Garrow JS, Blaza SA, Warwick PM & Ashwell MA (1988): Predisposition to obesity. Lancet i, 1103-1104.
Henry CJK & Rees DG (1988): A preliminary analysis of basal metabolic rate and race. In Comparative nutrition, eds K Blaxter & I MacDonald, pp. 149-162. London: John Libbey.
Henry CJK & Rees DG (1991): New prediction equations for the estimation of basal metabolic rate of tropical peoples. Eur J. Clin. Nutr 45, 177-185.
Henry CJK, Piggott S & Emery E} (1987): Basal metabolic rate and diet-induced thermogenesis in Asians living in Britain. Hum. Nutr.: Clin. Nutr 41C, 397.
ICMR Expert Group (1990): Nutrient requirements and recommended dietary allowances for Indians. New Delhi: Indian Council of Medical Research.
James WPT & Schofield EC (1990): Human energy requirements. A manual for planners and nutritionists. FAO & Oxford Medical Publications.
James WPT, Ferro-Luzzi A & Waterlow JC (1988): Definition of chronic energy deficiency in adults. Report of Working Party of IDECG. Eur J. Clin. Nutr 42, 969-981.
Khosla T & Lowe CR (1967): Indices of obesity derived from body weight and height. Br. J. Prev. Soc. Med. 21, 122-136.
Kurpad AV, Kulkarni RN, Sheela ML & Shetty PS (1989): Thermogenic responses to graded doses of nor-adrenaline in undernourished Indian male subjects. Br. J. Nutr. 61, 201-208.
McGregor RGS & Loh GL (1941): The influence of tropical environment upon basal metabolism, pulse rate and blood pressure in Europeans. J. Physiol 99, 496-501.
McNeill G. Rivers JPW, Payne PR, De Britto JJ & Abel R (1987): BMR of Indian men: no evidence of metabolic adaptation to a low plane of nutrition. Hum. Nutr: Clin. Nutr 41C, 473-484.
Mahadeva K (1954): The energy expenditure at rest of Southern Asiatics in Britain. Ind J. Med. Res. 42, 181-190.
Mason ED (1934): The metabolism of European women in South India and the effect of change of climate on European and South Indian women. J. Nutr 8, 695-709.
Mason ED & Benedict FG (1931): The basal metabolism of South Indian women. Ind. J. Med. Res. 19, 75 98.
Munro AF (1950): Basal metabolic rates and physical fitness scores of British and Indian males in the Tropics. J. Physiol. 110, 356-362.
Niyogi SP, Patwardhan UN & Modecai J (1939): Studies on basal metabolism in Bombay. Ind J. Med. Res. 27, 99-103.
Piers SP, Soares MJ & Shetty PS (1991): Thermic effect of a meal. 2. Responses in chronically undernourished subjects. Br. J. Nutr. 67, 177-185.
Quenouille MH, Boyce AW, Fisher WB & Leitch I (1957): Statistical analysis of recorded energy expenditure of men. Part 1. Basal metabolism related to sex, stature, age, climate and race. Commonwealth Bureau of Animal Nutrition. Technical Communication No. 17.
Rand WM (1982): The estimation of BMR. Background document for Joint FAO/WHO/UNU Report. Rome: FAO
Ravussin E & Bogardus C (1989): Relationship of genetics, age and physical activity on daily energy expenditure and fuel utilization. Am. J. Clin. Nutr 49, 968-975.
Roza AM & Shizgal HM (1984): The Harns-Benedict equation re-evaluated: resting energy requirements and the body cell mass. Am. J. Clin. Nutr 40, 164-171.
Schofield WN, Schofield C & James WPT (1985): Basal metabolic rate - review and prediction together with annotated bibliography of source material. Hum. Nutr: Clin. Nutr 39C, Suppl. 1, 5-96.
Shetty PS (1993): Chronic undernutrition and metabolic adaptation. Proc. Nutr Soc. 52, 267-284.
Shetty PS & James WPT (1994): Body mass index: a measure of chronic energy deficiency in adults. FAO Food and Nutrition Paper 56, pp. 1-57. Rome: FAO.
Soares MJ & Shetty PS (1988): Validity of Schofield's predictive equations for basal metabolic rates of Indians. Ind. J. Med. Res. S%, 253-260.
Soares MJ & Shetty PS (1991): Basal metabolic rates and metabolic economy in chronic undernutrition. Eur. J. Clin. Nutr 45, 363-373.
Soares MJ, Francis DJ & Shetty PS (1993): Predictive equations for basal metabolic rate of Indian males. Eur. J. Clin. Nutr 47, 389-394.
Sokhey SS & Malandkar MA (1939): Basal metabolism of Indians. A study based on the examination of sixty normal Indian men. Ind J. Med. Res. 27, 501-529.
Spurr GB & Reina JC (1988): Basal metabolic rates of normal and marginally malnourished mestizo children in Colombia. KU,: J. Clin. Nutr 42, 753-764.
Spurr GB, Reina JC & Barac-Neito (1986): Marginal malnutrition in school aged Colombian children: metabolic rates and estimation of daily energy expenditure. Am. J. Clin. Nutr 44, 113-126.
Srikantia SG (1985): Nutritional adaptation in man (Eighth Gopalan Oration). Proc. Nutr Soc. Ind 31, 1-16.
James: You are in the unusual position of judging undernutrition on two grounds: one is height, but you do not specify a cut-off point. The other is socio-economic, which could be a problem. Can you distinguish between these? Is the height criterion to be included in a graded way into Grades I-III CED? What is the prevalence of these height or socio-economic categories in your society?
Shetty: Stature is distinctly different in those individuals classified as underweight and those with CED, both having BMI <18.5. The so-called underweights have a normal stature of 1.70-1.74 m, while the undernourished are <1.6m, a clear difference of about 10 cm. We have data from the literature on over 1000 studies over 50 years of normal healthy adults in India. The mean BMI is 19-20 but there are still individuals of <18.5 in these groups of healthy individuals. Many of them have been monitored in a variety of physiological studies and have been assessed as fit, healthy and normal. This may be an effect of age and our cut-off point of 18 years may be too early. Norgan showed that there are correlations in the 30-39 year age group that are very different from the 18-30 year group. The profile of distribution of healthy individuals may change if you eliminate those <20 years of age. Perhaps the inclusion of those <18 years as fully grown is part of the problem.
Waterlow: You indicated that BMR is mostly correlated with weight and BMI adds very little. If you have two people of the same weight, but one is short and stocky and the other is tall and thin and they have different BMIs, will they have the same BMRs? Schofield added height to his weight equations and found that on average it made little difference. But if you compute from his equations individual cases, they are rather different. What is your experience as you seem to think that stature does make a difference to BMR?
Shetty: Their predicted BMRs would be the same, and their measured BMRs would be similar, i.e. within accepted levels of variation. So the shape and the surface area don't seem to make much difference.
James: If you discard height and are left with your socio-economic index you then define these people as healthy because you know they have access to enough food. If that is your method for identifying people with a low BMR, then I am becoming worried. Shetty: The well-fed thin group is small. We need to know what percentage of the population are in this category, and by subtracting them from the calculations we can obtain a better idea of the true numbers in CED. Waterlow: Even in John Durnin's healthy British soldiers there were some <18.5.