Technologies and Systems for Assessing Human Energy Metabolism and Nutritional Rehabilitation

Primary outcomes

1. Height

   Time frame: Height will be measured on the first day after volunteers are enrolled.

   Measured by seca 217 stable stadiometer. Subjects wearing no shoes.

2. Resting Energy Expenditure (REE)

   Time frame: The measurement of REE will be completed within fifteen days after the volunteers are enrolled.

   REE will be measured via indirect calorimetry using a respiratory hood system (Cosmed). Participants will report to the laboratory after an overnight fast, lie supine on a flat bed, and have the hood placed over their head. Oxygen consumption and carbon dioxide production will be recorded for 40 minutes, with the final 10 minutes used for analysis. The system will be quality-checked regularly using a turbine test, and monthly validation will be conducted via an alcohol combustion test.

3. Total Energy Expenditure (TEE)

   Time frame: The measurement of TEE will be completed within fifteen days after the volunteers are enrolled.

   TEE will be assessed using two complementary methods:

   Doubly Labeled Water (DLW) Method: Urine samples from the DLW subset will be stored at -20 °C and shipped on dry ice to Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences. Isotope ratios will be analyzed using a Liquid Water Isotope Analyzer (ABB). CO₂ production will be calculated using the latest equation from Speakman et al. (2021, Cell Reports Medicine), and TEE will be estimated using the Weir equation.

   Metabolic Chamber: TEE will also be measured using a whole-body metabolic chamber (Maastricht Instruments, Netherlands), which continuously tracks oxygen consumption and carbon dioxide production. Participants will remain in the chamber for 48 hours, engaging in routine daily activities. Data from the second day will be analyzed to estimate TEE.

4. Physical Activity Level

   Time frame: GT3X will be worn by the volunteers on the first day of enrollment and continue for fifteen days.

   During the measurement period, all participants will be required to wear a three-axis accelerometer (Actigraph GT3XP-BTLE, USA) for 15 days, covering 24 hours a day, including sleep. Participants can remove the accelerometer only when showering, bathing, swimming, or engaging in other water activities. This device will provide multiple parameters of physical activity levels, including raw acceleration data, activity counts, and vector magnitudes. Raw acceleration data captures subtle changes in individual movements, activity counts measure the intensity of physical activity over specific time periods, and vector magnitudes integrate acceleration information from all directions. These three indicators were used to comprehensively evaluate participants' physical activity levels.

5. Fat mass

   Time frame: Fat mass will be completed within fifteen days after the volunteers are enrolled.

   Fat mass will be measured by Magnetic Resonance Imaging (Philips Multiva 1.5T ).

6. Mental Health Assessment

   Time frame: Mental health assessment will be completed within fifteen days after the volunteers are enrolled.

   The Symptom Checklist-90 (SCL-90) will be used to evaluate psychological well-being. This tool measures ten dimensions: somatization, obsessive-compulsive traits, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoid ideation, psychosis, and additional symptoms. Scores for each dimension and overall symptom severity will be calculated.

7. Cognitive Function Assessment

   Time frame: Cognitive function assessment will be completed within fifteen days after the volunteers are enrolled.

   Cognitive performance will be evaluated using:

   Mini-Mental State Examination (MMSE): Assesses orientation, memory, attention, language, and visuospatial function. Scores of 25-30 indicate normal function; 20-24 mild, 10-19 moderate, and <10 severe cognitive impairment.

8. Fat free mass

   Time frame: Fat free mass will be completed within fifteen days after the volunteers are enrolled.

   Fat free mass will be measured by Bioimpedance Analysis (Tanita, Philips Multiva 1.5T).

9. Body weight

   Time frame: Body weight will be measured on the first day after volunteers are enrolled.

   Subjects will be asked to fast overnight and weight will be measured using a calibrated Seca body weight scale first thing in the morning on subjects wearing light clothes and no shoes. .

10. Cognitive Function Assessment

    Time frame: Cognitive function assessment will be completed within fifteen days after the volunteers are enrolled.

    Cognitive performance will be evaluated using:

    Montreal Cognitive Assessment (MoCA): Screens for impairment across eight cognitive domains. A score ≥26 is considered normal.

11. Bone mass

    Time frame: Bone mass will be completed within fifteen days after the volunteers are enrolled.

    Bone mass will be measured by DXA (HOLOGIC Horizon Wi，America）

12. Hunger Sensation

    Time frame: Hunger sensation assessment will be completed within fifteen days after the volunteers are enrolled.

    After enjoying a standardized lunch, designed according to the energy distribution recommendations and formula method outlined in the Chinese Dietary Guidelines, participants will receive a test meal five hours later. The meal, with its packaging removed, includes preset macro-nutrient and energy levels, allowing participants to determine their intake. Hunger sensation will be assessed using a VAS (Visual Analog Scale) for hunger.

13. PYY

    Time frame: PYY will be measured within fifteen days after the volunteers are enrolled.

    After enjoying a standardized lunch, designed according to the energy distribution recommendations and formula method outlined in the Chinese Dietary Guidelines, participants will receive a test meal five hours later. The meal, which has been removed from its packaging, includes preset macronutrient and energy levels, allowing participants to determine their intake. Blood samples are collected at 15,30, and 60 minutes before dinner, after dinner, and again before bedtime, with each sample being 2ml (a total of four times, with a permanent indwelling needle). PYY is detected through these blood samples.

14. Ghrelin

    Time frame: Ghrelin will be measured within fifteen days after the volunteers are enrolled.

    After enjoying a standardized lunch, designed according to the energy distribution recommendations and formula method outlined in the Chinese Dietary Guidelines, participants will receive a test meal five hours later. The meal, which has been removed from its packaging, includes preset macronutrient and energy levels, allowing participants to determine their intake. Blood samples are collected at 15,30, and 60 minutes before dinner, after dinner, and again before bedtime, with each sample being 2ml (a total of four times, with a permanent indwelling needle). Ghrelin is detected through these blood samples.

15. Total Sleep Duration

    Time frame: Total sleep duration will be completed within fifteen days after the volunteers are enrolled.

    Total sleep duration will be monitored using the Xinxiaoyouhu Pro AI Precision Health Management System.

16. Sleep Efficiency

    Time frame: Sleep efficiency will be completed within fifteen days after the volunteers are enrolled.

    Sleep efficiency will be monitored using the Xinxiaoyouhu Pro AI Precision Health Management System.

17. Sleep Cycle Durations

    Time frame: Sleep cycle durations will be completed within fifteen days after the volunteers are enrolled.

    Sleep cycle durations will be monitored using the Xinxiaoyouhu Pro AI Precision Health Management System.

18. Heart Rate During Sleep

    Time frame: Heart rate during sleep will be completed within fifteen days after the volunteers are enrolled.

    Heart rate during sleep will be monitored using the Xinxiaoyouhu Pro AI Precision Health Management System.

19. Respiratory Patterns During Sleep

    Time frame: Respiratory patterns during sleep will be completed within fifteen days after the volunteers are enrolled.

    Respiratory patterns during sleep will be monitored using the Xinxiaoyouhu Pro AI Precision Health Management System.

20. Step Time

    Time frame: Step time will be completed within fifteen days after the volunteers are enrolled.

    A 3D markerless motion capture system (Xiangneng-Dongxi) will be used for step time.

21. Step Frequency

    Time frame: Step frequency will be completed within fifteen days after the volunteers are enrolled.

    A 3D markerless motion capture system (Xiangneng-Dongxi) will be used for step frequency.

22. Step Speed

    Time frame: Step speed will be completed within fifteen days after the volunteers are enrolled.

    A 3D markerless motion capture system (Xiangneng-Dongxi) will be used for step speed.

23. Stride Length

    Time frame: Stride length will be completed within fifteen days after the volunteers are enrolled.

    A 3D markerless motion capture system (Xiangneng-Dongxi) will be used for stride length.

24. Bilateral Gait Symmetry

    Time frame: Bilateral gait symmetry will be completed within fifteen days after the volunteers are enrolled.

    A 3D markerless motion capture system (Xiangneng-Dongxi) will be used for bilateral gait symmetry.

25. Pelvic, Hip and Knee Joint Angle Parameters

    Time frame: Pelvic, hip and knee joint Angle parameters will be completed within fifteen days after the volunteers are enrolled.

    A 3D markerless motion capture system (Xiangneng-Dongxi) will be used for pelvic, hip and knee joint angle parameters.

26. Joint Torque

    Time frame: Joint torque will be completed within fifteen days after the volunteers are enrolled.

    A 3D markerless motion capture system (Xiangneng-Dongxi) will be used for joint torque.

27. Non-Targeted Microbiome Detection Of Stool Samples

    Time frame: The retention of stool samples for non-targeted microbiome detection will be completed within 15 days after the enrollment of volunteers, and the sample analysis will be completed before November 1, 2025.

    Non-targeted microbiome studies are a comprehensive and unbiased approach to studying microbial communities. This method uses high-throughput sequencing or mass spectrometry to analyze the genomes (metagenomics) or metabolites (metabolomics) of all microorganisms in a sample, without preconceived targets. Since this study does not have a specific target microorganism, we will collect approximately 10ml of midstream fecal samples from participants for the detection of all microorganisms' genomes (metagenomics) or metabolites (metabolomics).

28. Non-Invasive Brain Function Monitoring

    Time frame: Non-invasive brain function monitoring will be completed within fifteen days after the volunteers are enrolled.

    Functional Near-Infrared Spectroscopy (fNIRS) will be used to assess brain activity by measuring changes in oxyhemoglobin and deoxyhemoglobin concentrations. We may use the BS2000 near-infrared imaging system for this purpose.

    Assessment Areas: Prefrontal cortex, motor cortex, frontal pole, dorsolateral prefrontal cortex, primary motor/somatosensory cortex, premotor and supplementary motor cortex-on both healthy and affected sides.

    Key Indicators:HbO, HbR, and HbT concentration changes during a 0-40 sec task window. 3D topological maps (HbO beta values). Activation levels at rest. Functional connectivity (HbO).

29. Cerebral Oxyhemoglobin Concentration

    Time frame: Cerebral oxyhemoglobin concentrationn will be completed within fifteen days after the volunteers are enrolled.

    Functional Near-Infrared Spectroscopy (fNIRS) will be used to measured cerebral oxyhemoglobin concentration.

30. Cerebral Deoxyhemoglobin Concentration

    Time frame: Cerebral deoxyhemoglobin concentration will be completed within fifteen days after the volunteers are enrolled.

    Functional Near-Infrared Spectroscopy (fNIRS) will be used to measured cerebral deoxygenated concentration.

31. Total Hemoglobin Concentration In Cerebral Vasculature

    Time frame: Total hemoglobin concentration in cerebral vasculature will be completed within fifteen days after the volunteers are enrolled.

    Functional Near-Infrared Spectroscopy (fNIRS) will be used to measured total hemoglobin concentration in cerebral vasculature