A Re-examination of the Metabolic Equivalent Concept in Individuals With Coronary Heart Disease.
Savage, Patrick D. MS; Toth, Michael J. PhD; Ades, Philip A. MD
Journal of Cardiopulmonary Rehabilitation & Prevention.
27(3):143-148, May/June 2007.
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OBJECTIVE: The metabolic equivalent (MET) is a commonly used method of quantifying the energy cost and intensity of physical activity. Recent studies have questioned the accuracy of the well-accepted value of a MET of 3.5 mL O2 [middle dot] kg-1 [middle dot] min-1. The goal of the present study was to compare the traditionally accepted value for 1 MET to direct measures of resting metabolic rate in a group of stable individuals with coronary heart disease (CHD).
METHODS: The primary cohort consisted of 109 (60 men and 49 women) subjects with documented coronary heart disease and a body mass index >=25 kg/m2. Measurements included indirect calorimetry, body composition, and exercise capacity (peak oxygen uptake [VO2]). In a substudy of 17 (10 men, 7 women) normal weight subjects (body mass index <25 kg/m2), metabolic rate in the seated position was also measured.
RESULTS: Mean resting value for 1 MET was a VO2 value of 2.58 /- 0.4 mL O2 [middle dot] kg-1 [middle dot] min-1 for overweight subjects measured in the supine position and 2.84 /- 0.59 mL O2 [middle dot] kg-1 [middle dot] min-1 for normal weight individuals measured in the seated position. Caloric expenditure value was 0.74 /- 0.12 kcal [middle dot] kg-1 [middle dot] h-1 rather than the expected value of 1 kcal [middle dot] kg-1 [middle dot] h-1. Values were similar between men and women. Women on beta-blockers had a lower resting metabolic rate (2.47 /- 0.27 vs. 2.71 /- 0.38 mL O2 [middle dot] kg-1 [middle dot] min-1) (P < .05) than women not on beta-blocker therapy, whereas there was no effect of beta-blockers in men.
CONCLUSIONS: Findings confirm recent studies of otherwise healthy individuals and indicate that the average resting metabolic rate in subjects with coronary heart disease is 23% to 36% lower than the widely accepted value of 3.5 mL O2 [middle dot] kg-1 [middle dot] min-1. Results demonstrate the limitation of the convention of expressing energy expenditure in multiples of an assumed constant.
(C) 2007 Lippincott Williams & Wilkins, Inc.