Energy intake, expenditure and balance, and factors associated with energy balance of young adults (20–39 years): a retrospective cross-sectional community-based cohort study
Authors: Ayogu Rufina N. B. , Oshomegie Hannah , Udenta Elizabeth A. 
Published: December 2022

Abstract
Background
Obesity epidemic presents major challenge to chronic disease prevention. Young adults may be at higher risk due to consumption of energy dense foods/beverages and low physical activity. This study assessed the energy intake, expenditure and balance of 20–39 year-old adults and also evaluated factors associated with energy balance to provide basis for obesity prevention and control.

Methods
This retrospective cross-sectional cohort study involved 240 respondents selected through multistage random sampling. Data were collected through questionnaire, anthropometry and three 24-h dietary recall. Energy expenditure was assessed as the sum of resting energy expenditure (REE), energy expenditure of activity (EEA) and diet-induced energy expenditure of three days. Frequencies and percentages were employed in analysing general characteristics of the respondents. T-test and analysis of variance were used to assess relationships between and among numerical variables while relationships among categorical variables were evaluated through Chi-square test. Binary and multivariate logistic regression analyses were used to evaluate the factors associated with energy balance.

Results
Majority (53.2%) had normal body mass index and this decreased as age increased (P < 0.001); 23.8% had overweight, 21.7% had general obesity, 38.3% had abdominal obesity and 39.2% had high risk waist hip ratio. Total energy intake (TEI) of the respondents was 2416.0 ± 722.728 kcal/day. Males had lower energy intake (kcal/day) of 2398.8 ± 494.761 than females (2431.1 ± 876.664). Male intake contributed less (85.7%) than female intake (110.5%) to recommended energy intake. TEI (kcal/day) was lowest among 25–29 (2285.3 ± 497.793) but highest (2586.0 ± 467.587) among 35–39 year-olds (P < 0.05). Total energy expenditure (TEE) was 2195.5 ± 384.544 kcal/day; a value of 2274.3 ± 385.792 was found among males while the females had a lower value of 2126.6 ± 371.403. TEE (kcal/day) ranged from 2169.4 ± 411.625 in 20–24 to 2248.8 ± 273.534 in 30–34 year-olds. Those with general obesity had higher energy (kcal/day) intake (2733.7 ± 1171.073), expenditure (2431.7 ± 491.666) and balance (302.0 ± 1300.186) than those without obesity (P < 0.01). Energy intake (2573.0 ± 966.553) and expenditure (2226.4 ± 372.621) were significantly higher among those with abdominal obesity than those with normal waist circumference (P < 0.05). Overall positive energy balance of the adults was 220.5 ± 787.271. The females had higher positive energy balance (304.4 ± 921.041) than males (124.5 ± 588.637). Energy balance was lowest (102.5 ± 629.780) among 25–29 and highest (373.5 ± 494.546) in 35–39 year-olds. Most (68.8%) of the participants had positive energy balance. Age (AOR:2.89, 95% C.I.:1.27–6.56) and occupation (AOR:2.30, 95% C.I.:1.05–5.03) increased the likelihood of positive energy balance by 2.

Conclusions
The study showed lower energy intake among the respondents than the recommended value; females had a value higher than what was recommended, males had less. Majority had positive energy balance and this was mostly found among those with obesity. Age and occupation were factors associated with positive energy balance. Nutrition education, health education and dietary counselling are recommended strategies to control sustained weight gain.