Send to

Choose Destination
Proc Nutr Soc. 2018 Feb;77(1):4-10. doi: 10.1017/S0029665117001148. Epub 2017 Jul 20.

Exercise, energy expenditure and energy balance, as measured with doubly labelled water.

Author information

Department of Human biology,Maastricht University Medical Centre,Maastricht,The Netherlands.


The doubly labelled water method for the measurement of total daily energy expenditure (TDEE) over 1-3 weeks under daily living conditions is the indicated method to study effects of exercise and extreme environments on energy balance. Subjects consume a measured amount of doubly labelled water (2H2 18O) to increase background enrichment of body water for 18O and 2H, and the subsequent difference in elimination rate between 18O and 2H, as measured in urine, saliva or blood samples, is a measure for carbon dioxide production and thus allows calculation of TDEE. The present review describes research showing that physical activity level (PAL), calculated as TDEE (assessed with doubly labelled water) divided by resting energy expenditure (REE, PAL = TDEE/REE), reaches a maximum value of 2·00-2·40 in subjects with a vigorously active lifestyle. Higher PAL values, while maintaining energy balance, are observed in professional athletes consuming additional energy dense foods to compete at top level. Exercise training can increase TDEE/REE in young adults to a value of 2·00-2·40, when energy intake is unrestricted. Furthermore, the review shows an exercise induced increase in activity energy expenditure can be compensated by a reduction in REE and by a reduction in non-exercise physical activity, especially at a negative energy balance. Additionally, in untrained subjects, an exercise-induced increase in activity energy expenditure is compensated by a training-induced increase in exercise efficiency.


AEE activity-induced energy expenditure; PAL physical activity level; REE resting energy expenditure; TDEE total daily energy expenditure; Doubly labelled water; Non-exercise activity; Physical activity level


Supplemental Content

Full text links

Icon for Cambridge University Press
Loading ...
Support Center