A standard calculation methodology for human doubly labeled water studies

International Atomic Energy Agency Doubly Labeled Water database group, Carlijn V.C. Bouten

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61 Citations (Scopus)


The doubly labeled water (DLW) method measures total energy expenditure (TEE) in free-living subjects. Several equations are used to convert isotopic data into TEE. Using the International Atomic Energy Agency (IAEA) DLW database (5,756 measurements of adults and children), we show considerable variability is introduced by different equations. The estimated rCO2 is sensitive to the dilution space ratio (DSR) of the two isotopes. Based on performance in validation studies, we propose a new equation based on a new estimate of the mean DSR. The DSR is lower at low body masses (<10 kg). Using data for 1,021 babies and infants, we show that the DSR varies non-linearly with body mass between 0 and 10 kg. Using this relationship to predict DSR from weight provides an equation for rCO2 over this size range that agrees well with indirect calorimetry (average difference 0.64%; SD = 12.2%). We propose adoption of these equations in future studies.
Original languageEnglish
Article number100203
Number of pages14
JournalCell Reports. Medicine
Issue number2
Publication statusPublished - 16 Feb 2021


The DLW database, which can be found at https://www.dlwdatabase.org/ , is generously supported by the IAEA (Vienna, Austria) , Taiyo Nippon Sanso , and SERCON . We are grateful to these companies for their support and especially to Takashi Oono for his tremendous efforts at fund raising on our behalf. The authors also gratefully acknowledge funding from the US National Science Foundation ( BCS-1824466 ) awarded to Herman Pontzer. The funders played no role in the content of this manuscript.

FundersFunder number
National Science FoundationBCS-1824466
National Institute of Diabetes and Digestive and Kidney DiseasesP30DK048520
National Institute of Child Health and Human DevelopmentZIAHD000641
National Center for Advancing Translational SciencesUL1TR001863


    • doubly labeled water
    • free-living
    • total energy expenditure
    • validation


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