{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:53:19Z","timestamp":1791363199441,"version":"4.3.1"},"reference-count":69,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Obesity and insulin resistance are characterized by substantial heterogeneity in energy expenditure and substrate utilization. Whole-room indirect calorimetry (WRIC) enables continuous assessment of oxygen consumption, carbon dioxide production, energy expenditure, respiratory exchange ratio (RER), and substrate oxidation under controlled conditions. This narrative review examines the physiological interpretation, methodological strengths, limitations, and applications of WRIC in obesity, insulin resistance, metabolic flexibility, and weight-loss interventions. By enabling prolonged observation during resting, postprandial, exercise, and sleep periods, WRIC complements short-term indirect calorimetry and free-living energy expenditure measurements obtained using doubly labeled water. Validation studies generally demonstrate high technical accuracy and reproducibility for respiratory gas exchange and 24 h energy expenditure measured using WRIC. In contrast, estimates of the thermic effect of food, short-term changes in RER, and substrate oxidation are more sensitive to protocol design, energy balance, physical activity, and analytical procedures. Available studies demonstrate substantial interindividual variability rather than a uniform metabolic pattern associated with obesity or insulin resistance. Direct WRIC evidence concerning contemporary anti-obesity pharmacotherapy and metabolic and bariatric surgery remains limited. Standardized protocols and complementary assessments of body composition, insulin sensitivity, and free-living energy expenditure are needed to improve the comparability and interpretation of findings across studies.<\/jats:p>","DOI":"10.3390\/nu18193287","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:28:57Z","timestamp":1791361737000},"page":"3287","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Whole-Room Indirect Calorimetry in the Study of Obesity, Insulin Resistance and Metabolic Flexibility: A Narrative Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6548-5446","authenticated-orcid":false,"given":"Andrii","family":"Zahorodnii","sequence":"first","affiliation":[{"name":"Second Department of General and Gastroenterological Surgery, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9833-9727","authenticated-orcid":false,"given":"Alicja","family":"Jelska","sequence":"additional","affiliation":[{"name":"Doctoral School, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3952-3154","authenticated-orcid":false,"given":"Paulina","family":"G\u0142uszy\u0144ska","sequence":"additional","affiliation":[{"name":"Second Department of General and Gastroenterological Surgery, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0726-0910","authenticated-orcid":false,"given":"Layth Majeed Mhayyal","family":"Almltashe","sequence":"additional","affiliation":[{"name":"Second Department of General and Gastroenterological Surgery, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hady Razak","family":"Hady","sequence":"additional","affiliation":[{"name":"Second Department of General and Gastroenterological Surgery, Medical University of Bialystok, 15-089 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1038\/s41574-024-01008-5","article-title":"Metabolically healthy obesity: From epidemiology and mechanisms to clinical implications","volume":"20","author":"Schulze","year":"2024","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S2213-8587(24)00316-4","article-title":"Definition and diagnostic criteria of clinical obesity","volume":"13","author":"Rubino","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1038\/s41591-024-03095-3","article-title":"A new framework for the diagnosis, staging and management of obesity in adults","volume":"30","author":"Busetto","year":"2024","journal-title":"Nat. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1161\/CIRCRESAHA.119.315896","article-title":"Metabolic Inflammation and Insulin Resistance in Obesity","volume":"126","author":"Wu","year":"2020","journal-title":"Circ. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"595","DOI":"10.4093\/dmj.2023.0011","article-title":"Adipose Tissue and Metabolic Health","volume":"47","author":"An","year":"2023","journal-title":"Diabetes Metab. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e13190","DOI":"10.1111\/obr.13190","article-title":"Diagnosis of obesity based on body composition-associated health risks-Time for a change in paradigm","volume":"22","year":"2021","journal-title":"Obes. Rev. Off. J. Int. Assoc. Study Obes."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s11154-023-09796-3","article-title":"Relevance of body composition in phenotyping the obesities","volume":"24","year":"2023","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Emamat, H., Jamshidi, A., Farhadi, A., Ghalandari, H., Ghasemi, M., and Tangestani, H. (2024). The association between the visceral to subcutaneous abdominal fat ratio and the risk of cardiovascular diseases: A systematic review. BMC Public Health, 24.","DOI":"10.1186\/s12889-024-19358-0"},{"key":"ref_9","first-page":"1","article-title":"Visceral Obesity with Excess Ectopic Fat: A Prevalent and High-Risk Condition Requiring Concerted Clinical and Public Health Actions","volume":"1","year":"2021","journal-title":"CardioMetabolic Syndr. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Shoemaker, M.E., Gillen, Z.M., Fukuda, D.H., and Cramer, J.T. (2023). Metabolic Flexibility and Inflexibility: Pathology Underlying Metabolism Dysfunction. J. Clin. Med., 12.","DOI":"10.3390\/jcm12134453"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.mayocp.2022.01.012","article-title":"Metabolic Flexibility and Its Impact on Health Outcomes","volume":"97","author":"Palmer","year":"2022","journal-title":"Mayo Clin. Proc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3284","DOI":"10.1093\/jn\/nxab263","article-title":"Measuring Postprandial Metabolic Flexibility to Assess Metabolic Health and Disease","volume":"151","author":"Yu","year":"2021","journal-title":"J. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s13679-021-00434-0","article-title":"The Role of Mitochondrial Adaptation and Metabolic Flexibility in the Pathophysiology of Obesity and Insulin Resistance: An Updated Overview","volume":"10","author":"Tsilingiris","year":"2021","journal-title":"Curr. Obes. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e70044","DOI":"10.1002\/edm2.70044","article-title":"Are Individuals With Type 2 Diabetes Metabolically Inflexible? A Systematic Review and Meta-Analysis","volume":"8","author":"Hansen","year":"2025","journal-title":"Endocrinol. Diabetes Metab."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Verdejo, R., Malo-Vintimilla, L., Guti\u00e9rrez-Pino, J., L\u00f3pez-Fuenzalida, A., Olmos, P., Irarrazaval, P., and Galgani, J.E. (2021). Similar Metabolic Health in Overweight\/Obese Individuals With Contrasting Metabolic Flexibility to an Oral Glucose Tolerance Test. Front. Nutr., 8.","DOI":"10.3389\/fnut.2021.745907"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1146\/annurev-nutr-062122-031443","article-title":"Energy Expenditure in Humans: Principles, Methods, and Changes Throughout the Life Course","volume":"44","author":"Ravussin","year":"2024","journal-title":"Annu. Rev. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1113\/jphysiol.1949.sp004363","article-title":"New methods for calculating metabolic rate with special reference to protein metabolism","volume":"109","author":"Weir","year":"1949","journal-title":"J. Physiol."},{"key":"ref_18","first-page":"628","article-title":"Calculation of substrate oxidation rates in vivo from gaseous exchange","volume":"55","author":"Frayn","year":"1983","journal-title":"J. Appl. Physiol. Respir. Environ. Exerc. Physiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1613","DOI":"10.1002\/oby.22928","article-title":"Room Indirect Calorimetry Operating and Reporting Standards (RICORS 1.0): A guide to conducting and reporting human whole-room calorimeter studies","volume":"28","author":"Chen","year":"2020","journal-title":"Obesity"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12937-023-00903-3","article-title":"Comparison of energy expenditure measurements by a new basic respiratory room vs. classical ventilated hood","volume":"22","author":"Tjalma","year":"2023","journal-title":"Nutr. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s43657-023-00127-9","article-title":"Measurement of Energy Expenditure by Indirect Calorimetry with a Whole-Room Calorimeter","volume":"4","author":"Zhou","year":"2024","journal-title":"Phenomics"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1017\/S0007114521001094","article-title":"Does adaptive thermogenesis occur after weight loss in adults? A systematic review","volume":"127","author":"Nunes","year":"2022","journal-title":"Br. J. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1053\/j.gastro.2017.01.052","article-title":"Obesity Energetics: Body Weight Regulation and the Effects of Diet Composition","volume":"152","author":"Hall","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1007\/s00421-017-3641-x","article-title":"Doubly labelled water assessment of energy expenditure: Principle, practice, and promise","volume":"117","author":"Westerterp","year":"2017","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_25","unstructured":"National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Food and Nutrition Board, and Committee on the Dietary Reference Intakes for Energy (2023). Dietary Reference Intakes for Energy, National Academies Press (US)."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1369","DOI":"10.3945\/ajcn.2010.29885","article-title":"Specific metabolic rates of major organs and tissues across adulthood: Evaluation by mechanistic model of resting energy expenditure","volume":"92","author":"Wang","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.1111\/obr.12718","article-title":"Human Energy Expenditure: Advances in Organ-Tissue Prediction Models","volume":"19","author":"Heymsfield","year":"2018","journal-title":"Obes. Rev. Off. J. Int. Assoc. Study Obes."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1093\/ajcn\/63.2.164","article-title":"Measuring the thermic effect of food","volume":"63","author":"Reed","year":"1996","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1126\/science.abe5017","article-title":"Daily energy expenditure through the human life course","volume":"373","author":"Pontzer","year":"2021","journal-title":"Science"},{"key":"ref_30","first-page":"312","article-title":"Assessment of energy expenditure: Are calories measured differently for different diets?","volume":"23","author":"Ravussin","year":"2020","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1002\/oby.22982","article-title":"A Novel Approach to Assess Metabolic Flexibility Overnight in a Whole-Body Room Calorimeter","volume":"28","author":"McDougal","year":"2020","journal-title":"Obesity"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1002\/oby.24245","article-title":"Validation of a novel approach to assess metabolic flexibility to a high-fat meal in a whole-body room calorimeter","volume":"33","author":"McDougal","year":"2025","journal-title":"Obesity"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e13131","DOI":"10.1111\/obr.13131","article-title":"Pathophysiological role of metabolic flexibility on metabolic health","volume":"22","author":"Galgani","year":"2021","journal-title":"Obes. Rev. Off. J. Int. Assoc. Study Obes."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1002\/oby.22783","article-title":"Direct Relationship Between Metabolic Flexibility Measured During Glucose Clamp and Prolonged Fast in Men","volume":"28","author":"Olmos","year":"2020","journal-title":"Obesity"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.1007\/s00125-021-05535-y","article-title":"Twenty-four hour assessments of substrate oxidation reveal differences in metabolic flexibility in type 2 diabetes that are improved with aerobic training","volume":"64","author":"Carnero","year":"2021","journal-title":"Diabetologia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1017\/S0029665121003669","article-title":"Dynamic changes in energy expenditure in response to underfeeding: A review","volume":"81","author":"Egan","year":"2022","journal-title":"Proc. Nutr. Soc."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Martelli, D., and Brooks, V.L. (2023). Leptin Increases: Physiological Roles in the Control of Sympathetic Nerve Activity, Energy Balance, and the Hypothalamic\u2013Pituitary\u2013Thyroid Axis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24032684"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Zekri, Y., Flamant, F., and Gauthier, K. (2021). Central vs. Peripheral Action of Thyroid Hormone in Adaptive Thermogenesis: A Burning Topic. Cells, 10.","DOI":"10.3390\/cells10061327"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1038\/s12276-022-00741-z","article-title":"Hypothalamic control of energy expenditure and thermogenesis","volume":"54","author":"Tran","year":"2022","journal-title":"Exp. Mol. Med."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Tabuchi, C., and Sul, H.S. (2021). Signaling Pathways Regulating Thermogenesis. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.595020"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"154303","DOI":"10.1016\/j.metabol.2020.154303","article-title":"Early Adaptive Thermogenesis Is a Determinant of Weight Loss after Six Weeks of Caloric Restriction in Overweight Subjects","volume":"110","author":"Heinitz","year":"2020","journal-title":"Metab. Clin. Exp."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1056\/NEJM198802253180802","article-title":"Reduced Rate of Energy Expenditure as a Risk Factor for Body-Weight Gain","volume":"318","author":"Ravussin","year":"1988","journal-title":"N. Engl. J. Med."},{"key":"ref_43","first-page":"E650","article-title":"Low ratio of fat to carbohydrate oxidation as predictor of weight gain: Study of 24-h RQ","volume":"259","author":"Zurlo","year":"1990","journal-title":"Am. J. Physiol. Metab."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2859","DOI":"10.2337\/db14-1881","article-title":"A Human Thrifty Phenotype Associated With Less Weight Loss During Caloric Restriction","volume":"64","author":"Reinhardt","year":"2015","journal-title":"Diabetes"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.cmet.2018.02.019","article-title":"Metabolic Slowing and Reduced Oxidative Damage with Sustained Caloric Restriction Support the Rate of Living and Oxidative Damage Theories of Aging","volume":"27","author":"Redman","year":"2018","journal-title":"Cell Metab."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1002\/oby.22518","article-title":"Early Time-Restricted Feeding Reduces Appetite and Increases Fat Oxidation But Does Not Affect Energy Expenditure in Humans","volume":"27","author":"Ravussin","year":"2019","journal-title":"Obesity"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"324","DOI":"10.3945\/ajcn.116.133561","article-title":"Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men","volume":"104","author":"Hall","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.cmet.2015.07.021","article-title":"Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity","volume":"22","author":"Hall","year":"2015","journal-title":"Cell Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"181","DOI":"10.2337\/db19-0719","article-title":"Impaired Metabolic Flexibility to High-Fat Overfeeding Predicts Future Weight Gain in Healthy Adults","volume":"69","author":"Begaye","year":"2020","journal-title":"Diabetes"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1002\/oby.24011","article-title":"Impaired Metabolic Flexibility to Fasting is Associated with Increased Ad Libitum Energy Intake in Healthy Adults","volume":"32","author":"Unlu","year":"2024","journal-title":"Obesity"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e184279","DOI":"10.1172\/jci.insight.184279","article-title":"Human metabolic chambers reveal a coordinated metabolic-physiologic response to nutrition","volume":"9","author":"Perry","year":"2024","journal-title":"JCI Insight"},{"key":"ref_52","first-page":"1077","article-title":"Effect of increasing protein content at the evening meal followed by exercise on overnight nocturnal total energy expenditure, fat and carbohydrate oxidation in healthy young Indian men","volume":"27","author":"Babu","year":"2018","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e70116","DOI":"10.1111\/obr.70116","article-title":"Effects of Glucagon-Like Peptide-1 Receptor Agonists (Mono and Combination Therapy) on Energy Expenditure: A Scoping Review","volume":"27","author":"Vieira","year":"2026","journal-title":"Obes. Rev. Off. J. Int. Assoc. Study Obes."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.metabol.2018.03.017","article-title":"Exenatide has a pronounced effect on energy intake but not energy expenditure in non-diabetic subjects with obesity: A randomized, double-blind, placebo-controlled trial","volume":"85","author":"Basolo","year":"2018","journal-title":"Metab. Clin. Exp."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1002\/oby.23633","article-title":"Glucagon-like peptide-1\/glucagon receptor agonism associates with reduced metabolic adaptation and higher fat oxidation: A randomized trial","volume":"31","author":"Corbin","year":"2023","journal-title":"Obesity"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1007\/s40618-025-02717-y","article-title":"Effects of 6-month treatment with the GLP-1 receptor agonist liraglutide on 24-hour energy metabolism and body composition in adults with obesity","volume":"48","author":"Basolo","year":"2025","journal-title":"J. Endocrinol. Investig."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1016\/j.cmet.2025.03.011","article-title":"Tirzepatide did not impact metabolic adaptation in people with obesity, but increased fat oxidation","volume":"37","author":"Ravussin","year":"2025","journal-title":"Cell Metab."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/dom.14255","article-title":"Effects of oral semaglutide on energy intake, food preference, appetite, control of eating and body weight in subjects with type 2 diabetes","volume":"23","author":"Gibbons","year":"2021","journal-title":"Diabetes Obes. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3755","DOI":"10.1210\/jc.2016-1814","article-title":"Energy Metabolic Adaptation and Cardiometabolic Improvements One Year After Gastric Bypass, Sleeve Gastrectomy, and Gastric Band","volume":"101","author":"Tam","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1002\/oby.24031","article-title":"Adaptive thermogenesis, at the level of resting energy expenditure, after diet alone or diet plus bariatric surgery","volume":"32","author":"Aukan","year":"2024","journal-title":"Obesity"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"4347","DOI":"10.1007\/s11695-021-05578-5","article-title":"Evaluation of Resting Energy Expenditure in Subjects with Severe Obesity and Its Evolution After Bariatric Surgery","volume":"31","author":"Fidilio","year":"2021","journal-title":"Obes. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"E287","DOI":"10.1152\/ajpendo.00185.2025","article-title":"Changes in body composition and resting energy expenditure during the first year after Roux-en-Y or one-anastomosis gastric bypass","volume":"330","author":"Karppinen","year":"2026","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1038\/s41430-024-01523-8","article-title":"Energy expenditure, metabolic adaptation, physical activity and energy intake following weight loss: Comparison between bariatric surgery and low-calorie diet","volume":"79","author":"Falkenhain","year":"2024","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e15658","DOI":"10.14814\/phy2.15658","article-title":"Validity and reproducibility of a whole-room indirect calorimeter for the estimation of VO2, VCO2, and resting metabolic rate","volume":"11","author":"Henriksen","year":"2023","journal-title":"Physiol. Rep."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1002\/oby.23226","article-title":"Reliability of measurements of energy expenditure and substrate oxidation using whole-room indirect calorimetry","volume":"29","author":"Allerton","year":"2021","journal-title":"Obesity"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1002\/oby.23527","article-title":"Validation of energy expenditure and macronutrient oxidation measured by two new whole-room indirect calorimeters","volume":"30","author":"Koop","year":"2022","journal-title":"Obesity"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Baugh, M.E., Ahrens, M.L., Hutelin, Z., Stylianos, C., Wohlers-Kariesch, E., Oster, M.E., Dotson, J., Moon, J., Hanlon, A.L., and DiFeliceantonio, A.G. (2024). Validity and reliability of a new whole room indirect calorimeter to assess metabolic response to small calorie loads. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0304030"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"14343","DOI":"10.1038\/s41598-020-71001-1","article-title":"An appraisal of whole-room indirect calorimeters and a metabolic cart for measuring resting and active metabolic rates","volume":"10","author":"Chen","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s13679-024-00558-z","article-title":"Adjuvant and Neo-Adjuvant Anti-Obesity Medications and Bariatric Surgery: A Scoping Review","volume":"13","author":"Sher","year":"2024","journal-title":"Curr. Obes. Rep."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/19\/3287\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:35:42Z","timestamp":1791362142000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/19\/3287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":69,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["nu18193287"],"URL":"https:\/\/doi.org\/10.3390\/nu18193287","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]}}}