Energy expenditure at rest and during exercise

Paralympic athletes represent a unique subset of individuals who demonstrate exceptional athletic performance yet face significant physical or cognitive impairments that modulate their energy expenditure. Understanding the energy expenditure of Paralympic or recreational athletes with a disability is fundamental to generating nutritional targets to manipulate energy balance and achieve body composition goals. This chapter initially describes the concept of total daily energy expenditure (TDEE) and its constitutive components, resting metabolic rate (RMR), diet-induced thermogenesis (DIT), and physical activity energy expenditure (PAEE). The physiological and behavioral underpinnings of each of these components are discussed to provide a foundational understanding. The chapter then elaborates on how various disabilities, loosely grouped based on their neurophysiological consequences ((1) wheelchair use and upper-body exercise, (2) adapted gait, (3) altered body composition or size, and (4) altered autonomic nervous system control), affect each component of TDEE. A succinct overview of the methods employed to assess energy expenditure components is provided, along with information on the practical implications for determining and estimating the energy requirements of Paralympic athletes. The chapter concludes by considering potential future research directions that could further enhance our understanding and inform best practices for managing the energy demands of this unique athlete population.