The Age-Related Decline in Resting Energy Expenditure in Humans Is Due to the Loss of Fat-Free Mass and to Alterations in Its Metabolically Active Components

There is conflicting evidence as to whether the age-related decline in resting energy expenditure (REE) can be attributed to i) absolute changes in fat-free mass (FFM), ii) alterations in the composition of FFM or iii) decreasing organ metabolic rates. This study directly addressed the first and second hypotheses by quantification of metabolically active components of FFM assuming constant tissue respiration rates to calculate REE (REEc). REE was measured (REEm) in 26 young (13 females, 13 males, age 22–31 y) and 26 elderly subjects (15 females, 11 males, age 60–82 y) by indirect calorimetry and detailed body composition analysis was obtained using bioelectrical impedance analysis (BIA), dual energy X-ray absorptiometry (DXA), and MRI. Specific organ metabolic rates were taken from the literature. REEm adjusted for differences in FFM was lower in older subjects than in younger control subjects (5.43 ± 0.61 MJ/d compared with 6.37 ± 0.48 MJ/d; P < 0.001). Skeletal muscle mass plus liver mass accounted for 86% and 48% of the variance in REE in young and elderly subjects, respectively. The difference between REEm and REEc was 0.03 ± 0.40 MJ/d and −0.36 ± 0.70 MJ/d in young and elderly subjects, respectively. In the elderly 58% of the difference in variance was attributed to heart mass. REEm − REEc was −1.40 ± 0.44 MJ/d in subjects with hypertensive cardiac hypertrophy, i.e., heart mass > 500 g, suggesting a decrease in heart metabolic rate with increasing heart mass. Excluding five elderly subjects with cardiac hypertrophy resulted in agreement between REEm and REEc in the elderly (−0.10 ± 0.48 MJ/d). We concluded that the age-related decline in REE is attributed to a reduction in FFM as well as in proportional changes in its metabolically active components. There is no evidence for a decreasing organ metabolic rate in healthy aging.