Medical research has repeatedly documented that obese and overweight patients are at a higher risk of developing a number of chronic diseases including hypertension, coronary heart disease, type 2 diabetes and certain types of cancer. The link between obesity and incidence of chronic diseases was noted in a 2009 study by the Centers for Disease Control and Prevention that reported the U.S. economic health care costs related to obesity is currently as high as $147 billion annually, with medical care for obese patients averaging 42 percent higher than patients of normal weight.
In the absence of more effective obesity treatments, including patient-centered options for weight management and behavior modification, the economic cost of health care for the obese is likely to rise. According to the CDC, in the past decade 35.1 percent of U.S. adults between the age of 20 and 74 were categorized as obese as measured by their Body Mass Index or “BMI.” The percentage of children who are categorized as obese or overweight is rising, along with the costs of hospitalizations related to childhood obesity.
Even though the personal health toll and economic costs of obesity are well recognized, there are a number of gaps in the non-surgical treatments available to individuals who are motivated to monitor and re-balance their calorie intake and energy expenditure on a daily basis to attain and maintain a more healthy weight. For example, there has not been a cost-effective and scientifically validated portable device capable of accurate measurement and monitoring of the calories burned by an individual going about normal daily activities, including monitoring at work, at rest, and asleep as well as during exercise routines. The calorie burn numbers provided by pedometers, exercise machines, accelerometers in smart phones, and other consumer devices are indirect measures based on estimates and averages, which often result in significant inaccuracies. Unfortunately, those measurement techniques generally regarded as clinically validated are complex, expensive, invasive and are not well suited for daily use.
One of the gold standards for the accurate monitoring of calorie expenditure is “direct calorimetry” which tracks and measures the specific amount of heat energy given off by the body.Historically, the laboratory instrumentation and techniques that have been developed to carry out direct calorimetry studies are expensive and are not portable or comfortable enough to track individuals in their free-living, normal daily activities. The absence of accurate calorie expenditure data, however, increases the difficulty of balancing nutrition intake and calorie burn to promote the long-term weight loss required for obese patients. Lack of direct calorie expenditure measurements may also contribute to overestimates of daily physical activity by both patients and clinicians who are prescribing weight loss regimens.
Validation for a Mobile Direct Calorimetry Device
MetaLogics has addressed the gap in current options for direct calorie measurement by developing a mobile, connected Personal Calorie Monitor. MetaLogics has applied its innovative, patented DirectCAL sensing technology to enable direct calorie measurement and collection of calorie expenditure data in free-living environments in the form of a connected device that the individual wears as an armband.
According to a review of techniques to measure energy expenditure in humans by Kathryn Dannecker and Raymond Browning of Colorado State University, there is a clear need for portable direct calorimetry options,
Due to a lack of accurate and convenient devices capable of precise measures of energy expenditure, health care professionals and consumers alike are ill-equipped to effectively monitor energy balance on a day-to-day basis. Devices and methods with high precision are generally expensive, require special training to operate, are invasive and are not portable. Portable devices such as pedometers, heart rate monitors, accelerometers and GPS systems, on the other hand, have some limitations in their ability to accurately measure EE across all phases of daily activities. Clearly, better technologies are required in this area. One device that shows promise to overcome many existing limitations is a calorie monitor (MetaLogics) that is based upon direct calorimetry. This technique allows the device to measure physical calories as they are burned and does not have to rely on estimations and averages of resting or sleeping metabolic rate. Furthermore, it can directly measure calories in any physical state, whether resting or active. Such a device allows immediate adjustment to the users’ energy balance, and is well suited to fill the critical missing need to accurately measure free-living EE.
This review goes on to summarize the performance of various forms of currently available direct and indirect energy expenditure measurement techniques and concludes that,
The MetaLogics Personal Calorie Monitor is the first device for measuring EE that is based upon the principles of direct calorimetry. ..The PCM measures heat flux directly from the body and determines minute by minute and total 24-hour EE….The biggest limitation to commercially available heat flow sensors is that they cannot adequately measure evaporative heat loss and therefore will underestimate total heat flow. The PCM has overcome this limitation through a unique sensor design that has been validated to capture all for forms of heat exchange and thus, accurately report true EE.
Patient-Centered and Clinical Weight Management Applications for the MetaLogics Personal Calorie Monitor MetaLogics is currently expanding its field trials for the Personal Calorie Monitor and is planning to launch this device in early 2011. Applications for mobile direct calorimetry technology for weight management and obesity treatment include both patient –centered weight management programs such as those provided by nutritionists and personal trainers and integration of the Personal Calorie Monitor into clinically supervised nutrition intake and exercise programs in which specific calorie expenditure data can be used to guide nutritional recommendations for food intake and meal planning from week to week to create a dynamic and highly personalized option for balanced weight loss over time
The MetaLogics Personal Calorie Monitor will also have medical applications as a diagnostic tool for the healthcare provider to use in determining whether unexpected weight gain (or loss) is due to changes in physical activity and calorie expenditure levels and in support of patients who are on strictly controlled diets and medically monitored nutritional programs in which calorie intake and expenditure must be balanced.
An important feature of this device is a wireless communication system that allows the device to be interoperable with other data display, data aggregation and monitoring devices. The communication platform is based upon Dynastream’s ANT low-power protocol, which allows portability with battery operation. This system allows the device to provide data as necessary for user analysis and also for use by clinicians to monitor compliance and patterns. This feature provides an opportunity to enhance behavior changes and achieve better clinical outcomes.
Dr. Cronin is a Professor of Management in the Information Systems Department at Boston College. To read more of her articles, please visit her columnist page.Edited by
Michael Dinan