Research Paper
Profile of energy expenditure in people with rheumatoid arthritis

https://doi.org/10.1016/j.dhjo.2015.03.008Get rights and content

Abstract

Background

No definitive conclusions have been made on the levels of physical activity in the rheumatoid arthritis (RA) population. Similarly no clear consensus has been reached on the correlates and predictors of physical activity in the population.

Objective

To profile total energy expenditure (TEE), resting energy expenditure (REE) and physical activity related energy expenditure (PAEE) levels using a validated objective measurement tool and to determine demographic and health related factors which influence and predict TEE and PAEE levels in individuals with RA.

Methods

Fifty nine (41 female, 18 male) individuals with RA were recruited to this cross sectional study. Energy expenditure was measured over seven days using SenseWear Armband. Correlational analysis and logistic regression were used to examine the relationship between demographic and health related factors and TEE, REE and PAEE.

Results

A profile of energy expenditure in RA individuals was developed in terms of levels, differences between genders and differences between weekdays and weekend days. Median TEE, PAEE and REE were 2204.0, 409.5 and 1506.2 kcal/day respectively. Energy expenditure was associated with factors such as gender, age, body mass index, employment status, disease severity and smoking.

Conclusion

The findings add to the growing research assessing energy expenditure in the RA population and strengthen the position due to the use of an objective validated tool. Some recommendations on what factors are associated with energy expenditure in the RA population are made, thus unveiling ways to tailor physical activity type interventions in this group.

Section snippets

Participants

Fifty-nine individuals (18 male, 41 female) with RA fulfilling the 1987 American College of Rheumatology (ACR) classification criteria for RA24 were recruited from the rheumatology outpatient clinics in the University Hospital Limerick, Ireland. Participants were excluded if they were under 18 years, were pregnant or were using any assistive walking devices. Ethical approval to undertake the study was granted by HSE Mid-West Ethics Committee. Participants gave written informed consent and were

Results

The demographic profile of the participants is outlined in Table 1.

Discussion

This study investigated energy expenditure over an extended period in people with RA using a validated, objective measure of energy expenditure. Total energy expenditure levels for people with RA of 2204.0 kcal/day in this study and 1981.5 kcal/day for the female subsample were similar to those reported in other studies. Roubenoff et al36 measured energy expenditure in its constructs using doubly labeled water (DLW) in the female RA population with TEE of 2181.39 kcal/day. Almeida et al,28

Conclusions

The findings of this study add to the growing research assessing energy expenditure in the RA population. Values for TEE, PAEE and REE were similar to those previously found in the RA population previously, although were somewhat lower, particularly for TEE and PAEE. This may be related to a lowering of energy expenditure in the RA population or may be related to the Irish context of this study. This study has used a tool validated for this population and so provides strengthened knowledge to

References (52)

  • P.D. Thompson et al.

    Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity)

    Circulation

    (June 24, 2003)
  • C. Caspersen et al.

    Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research

    Public Health Rep

    (1985)
  • J. Thomas et al.

    Research Methods in Physical Activity

    (2005)
  • M. Tierney et al.

    Physical activity in rheumatoid arthritis: a systematic review

    J Phys Act Health

    (2012)
  • Y.T. Lagerros et al.

    Measures of physical activity and their correlates: the Swedish National March Cohort

    Eur J Epidemiol

    (2009)
  • A.K. Gulsvik et al.

    Ageing, physical activity and mortality—a 42-year follow-up study

    Int J Epidemiol

    (2011)
  • R.K. Dishman et al.

    The determinants of physical activity and exercise

    Public Health Rep

    (1985)
  • A.A. Eyler

    Correlates of physical activity: who's active and who's not?

    Arthritis Care Res

    (2003)
  • A.E. Eyler et al.

    Correlates of physical activity among women from diverse racial/ethnic groups

    J Womens Health Gend Based Med

    (2002)
  • S. Zizzi et al.

    Correlates of physical activity in a community sample of older adults in Appalachia

    J Aging Phys Act

    (2006)
  • T. Bungum et al.

    Correlates of physical activity among Hispanic adults

    J Phys Act Health

    (2011)
  • P. Semanik et al.

    Physical activity behavior in older women with rheumatoid arthritis

    Arthritis Rheum

    (2004)
  • B.L. Greene et al.

    Factors affecting physical activity behavior in urban adults with arthritis who are predominantly African-American and female

    Phys Ther

    (2006)
  • S. Wilcox et al.

    Correlates of physical activity in persons with arthritis: review and recommendations

    J Phys Act Health

    (2005)
  • L. Larkin et al.

    Correlates of physical activity in adults with rheumatoid arthritis: a systematic review

    J Phys Act Health

    (2014)
  • F.C. Arnett et al.

    The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis

    Arthritis Rheum

    (1988)

    • Some of the data presented in this manuscript has been published in abstract form in: Tierney M. Fraser A. and Kennedy N. “Comparison of Energy Expenditure levels between RA subjects and controls” British Society of Rheumatology Annual Meeting, Birmingham (2013). Rheumatology, 2013: 52 (Suppl 1): i105.

    This work was supported by scholarships provided by the Irish Research Council, Intel Ireland and the Central Remedial Clinic to Marie Tierney to support her in her postgraduate studies. These organizations have no involvement in the study design, data collection, analysis or interpretation, the writing of this manuscript or the decision to submit the article for publication.

    1

    Marie Tierney is now affiliated with School of Medicine, National University of Ireland, Galway, Ireland.

    View full text
    Copyright © 2015 Elsevier Inc. All rights reserved.