Lower daily energy expenditure as measured by a respiratory chamber in subjects with spinal cord injury compared with control subjects

Background: This study was designed to determine the effect of chronic spinal cord injury on daily energy expenditure. Objective: We hypothesized that both resting and total energy expenditure would be lower in spinal cord-injured (SCI) subjects than in control subjects because of lower sympathetic nervous system activity and reduced levels of physical activity in SCI subjects. Design: Twenty-four-hour energy expenditure (24-h EE), resting metabolic rate (RMR), sleeping metabolic rate, spontaneous physical activity, the thermic effect of food (TEF), and 24-h respiratory quotient were measured by using a respiratory chamber in 10 male SCI subjects (injury ranged from level C6 to L3) and 59 age-matched, noninjured, male control subjects. Results: The 24-h EE was lower in SCI than in control subjects (7824 =/- 305 compared with 9941 +/- 188 kJ, P < 0.01). After adjustment for fat-free mass, fat mass, and age, 24-h EE was still lower (-753 kJ/d, P < 0.01) in SCI than in control subjects. Spontaneous physical activity measured by a radar system was also significantly lower (4.6 +/- 0.6% compared with 6.5 +/- 0.3% of time, P < 0.01) in SCI than in control subjects. In absolute value (7347 +/- 268 compared with 9251 +/- 1326 kJ/d, P < 0.01) or after adjustment for fat-free mass, fat mass, and age (-678 kJ/d, P < 0.01), RMR was also lower in SCI than in control subjects. TEF was significantly lower in SCI than in control subjects (987 +/- 142 compared with 1544 +/- 213 kJ/d, representing 12.9% and 15.9% of total energy intake, respectively, P < 0.05). The sleeping metabolic rate and 24-h respiratory quotient did not differ significantly between groups. Conclusions: The 24-h EE was significantly lower in SCI than in control subjects. This difference can be explained by the lower levels of physical activity, and lower RMR and TEF values, in SCI subjects.