Methoden der Energieverbrauchsmessung: Von den Grundlagen zur klinischen Anwendung und personalisierten Adipositastherapie

Zusammenfassung

Ziel der Studie

Der Artikel gibt einen Überblick über Methoden zur Energieverbrauchsmessung als Basis für eine personalisierte Adipositastherapie, da pauschale Empfehlungen aufgrund der hohen individuellen Stoffwechselvariabilität oft scheitern.

Methodik

Es werden die Komponenten des Energieverbrauchs (Ruheenergieverbrauch (REE), nahrungsinduzierte Thermogenese (DIT), Aktivitätsenergieverbrauch (AEE)) sowie verschiedene Messmethoden kritisch verglichen: von Forschungs-Goldstandards (Stoffwechselkammer, doppeltmarkiertes Wasser (DLW)) bis hin zu klinischen Verfahren (Haubenkalorimetrie, Formeln, Bioelektrische Impedanzanalyse (BIA)). Zudem wird die Identifizierung von Stoffwechseltypen („sparsam“ vs. „verschwenderisch“) mittels funktioneller Tests erläutert.

Ergebnisse

Die indirekte Haubenkalorimetrie ist der klinische Goldstandard zur REE-Messung und Schätzformeln oder BIA weit überlegen. Die Existenz „sparsamer“ Stoffwechseltypen mit starker metabolischer Anpassung ist klinisch relevant und kann durch funktionelle Tests prädiktiv für den Abnehmerfolg identifiziert werden. Aktuelle Wearables sind für den klinischen Einsatz noch zu ungenau.

Schlussfolgerung

Die präzise Messung des Ruheenergieverbrauchs ist der Schätzung durch Formeln oder Wearables noch fundamental überlegen. Die Anerkennung individueller metabolischer Unterschiede ist entscheidend, um Therapieziele zu personalisieren und den Weg zu einer wirksamen, datengestützten Adipositasbehandlung zu ebnen.

Abstract

Study goals

This article reviews methods for measuring energy expenditure as a foundation for personalized obesity therapy, since one-size-fits-all recommendations often fail due to high individual metabolic variability.

Method

The components of energy expenditure (resting energy expenditure [REE], diet-induced thermogenesis [DIT], activity-related energy expenditure [AEE]) are critically compared across measurement techniques: from research gold standards (metabolic chamber, doubly labeled water [DLW]) to clinical approaches (indirect calorimetry, predictive equations, bioelectrical impedance analysis [BIA]). The identification of metabolic phenotypes (“thrifty” vs. “spendthrift”) via functional tests is also described.

Results

Indirect calorimetry is the clinical gold standard for REE measurement and is shown to vastly outperform predictive equations or BIA. The presence of “thrifty” phenotypes, characterized by strong metabolic adaptation, is deemed clinically relevant and can be predicted by functional testing for weight-loss success. Current wearable devices are found to be insufficiently precise for clinical application.

Conclusion

Precise measurement of resting energy expenditure is fundamentally superior to estimation via predictive equations or wearable devices. Recognition of individual metabolic differences is essential for personalizing therapeutic targets and paving the way to effective, data-driven obesity treatment.

Schlüsselwörter

Energieverbrauch - Stoffwechselkammer - Stoffwechseltypen - Adipositas

Key words

energy consumption - metabolic chamber - metabolic types - obesity

Publikationsverlauf

Artikel online veröffentlicht:
02. Dezember 2025

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