A255 INCREASED ENERGY EXPENDITURE AND REDUCED EXERCISE CAPACITY IN CELIAC DISEASE PATIENTS ON A GLUTEN-FREE DIET
Bibliographic record
Abstract
Abstract Background Celiac disease (CeD) patients often exhibit impaired nutritional status due to nutrient malabsorption and altered metabolism. Accurate clinical assessment of malnutrition, muscle function and energy requirements are thus essential to prevent and treat malnutrition. Indirect calorimetry (IC) is the most accurate method to measure energy needs, but it is underutilized in outpatient settings. Aims To assess the use of IC testing in estimating the resting energy expenditure and exercise-related energy utilization in treated CeD patients compared to patients with other gastrointestinal (GI) conditions. Methods Adult patients attending the Celiac and Nutrition Clinic at McMaster University that underwent rest and exercise testing as a part of their nutritional assessment were enrolled. CeD diagnosis was based on positive CeD serology and confirmed by biopsy, and all of them were on a GFD for at least 6 months. Patients with inflammatory bowel disease (IBD), functional gastrointestinal disorders (FGID) and undernutrition due to other causes (UN) were included as controls. Resting energy expenditure was assessed using 3 methods 1) predictive formula (25kcal/kg), 2) Harris Benedict and 3) estimation of VO2 by IC. Exercise capacity and energy expenditure (EE) during exercise was estimated at baseline, moderate and maximum exercise. Statistical analysis was performed using SPSS. ANOVA with Bonferroni corrections and Chi2 test were used to assess differences between continuous and categorical variables, respectively. Results A total of 66 patients (CeD n=24; IBD n=15; FGID n=17; UN n=10) were included in the analysis. The REE of GI patients measured using the HB equation and the predictive formula were significantly underestimated compared to IC [Mean Difference (MD)=229 kcal/day p=0.03 and MD=365 kcal/day p<0.001, respectively]. The EE during exercise increased with intensity of exercise. CeD patients had the highest EE during moderate and strenuous exercise (Mean EE = 286 kcal/h and 494 kcal/h respectively) compared to patients with other GI conditions (Moderate and Strenuous for IBD= 218kcal/h and 373kcal/h; for FGIDs 296kcal/hand 467kcal/h, for UN, Mean EE = 181kcal/h and 294kcal/h). Exercise capacity was reduced in CeD compared to predicted exercise capacity (Mean = 86% predicted work capacity, range 72.5–107%), but was significantly higher than IBD (86% vs 73%; p=0.65) and UN patients (86% vs 46%; p=0.004). Conclusions Increased energy consumption and reduced exercise capacity is suggestive of chronic impaired nutritional status in treated CeD patients. Future studies with larger sample sizes are needed to understand whether incorporating accurate estimations of energy expenditure in nutritional practices can improve CeD outcomes. Funding Agencies CAG
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".