Parental history of type 2 diabetes is associated with lower resting energy expenditure in normoglycemic subjects
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  • Published on:
    The 3500 Kcal Rule is Invalid for Projections of Weight Change
    • Andrew W Brown, Assistant Professor Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
    • Other Contributors:
      • Kevin Hall, Section Chief, Integrative Physiology Section, Laboratory of Biological Modeling
      • Steven B Heymsfield, Professor
      • David B Allison, Dean, Distinguished Professor, & Provost Professor

    Nyenwe et al. (1) address an interesting and important topic of the effects or associations of parental diabetes with offspring outcomes. However, the paper contains an important error that renders one of their conclusions markedly incorrect.

    Specifically, having estimated a difference in energy expenditure among offspring of parents with diabetes (which the authors refer to as ‘parental diabetes’) versus offspring of parents without diabetes, the authors project that persons with parental diabetes will, as a result of this difference, steadily gain substantial weight indefinitely. They state:

    “According to the data published by Wishnofsky (2), one pound has a caloric value of 3500 kcal or (1 kg=7700 kcal). We derived the estimated weight gain in kg by dividing the projected energy accrual by 7700. When normalized REE is used for this estimation, subjects with parental diabetes had a daily energy surplus of 125 kcal which would translate to ~6 kg weight gain per year.”

    This type of estimation is commonly referred to as the 3500 kcal rule or 3500 kcal per pound rule.

    This reasoning and calculation is erroneous because it fails to account for the dynamic changes of energy expenditure that occur with weight gain and loss. Wishnofsky himself noted the complexity of estimating energetic equivalents of gaining or losing body weight, specifically addressing the importance of time, nitrogen balance, tissue type, and water loss, among other factors, on...

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    Conflict of Interest:
    KH receive a patent on a method of personalized dynamic feedback control of body weight, assigned to the National Institutes of Health. AWB and DBA are supported in part by NIH grants R25DK099080 and R25HL124208. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any other organization.