As can be seen, Schofields equation exhibited higher REE [1492 220kcal/day (mean SD)] in relation to Harris and Benedicts equation (1431 214kcal/day; P < 0.001), and both prediction equations showed higher REE in comparison with the indirect calorimetry (1352 252kcal/day; P < 0.001) in the CKD group. Demographic, clinical and nutritional characteristics of the patients and controls. [Determining energy and substrate metabolism from indirect calorimtery. 2009 Feb;25(2):188-93. doi: 10.1016/j.nut.2008.08.006. The differences between the explained variances observed in our study and in other studies may be explained in part by the methologic limitations of body composition analysis used in field studies (see Subjects and Methods). Actually, a number of equations have been developed for such a purpose. The WHO reference population also included a substantial number of subjects with a BMI < 17. Abdi F, Zuberi S, Blom JJ, Armstrong D, Pinto-Sanchez MI. For sex, female = 0 and male = 1. It became evident that BMI groupspecific REE prediction is necessary in severely underweight subjects (see Results). We studied patients from the renal outpatient clinic and the dialysis unit of the Federal University of So Paulo (So Paulo, Brazil) who had participated in previous studies (10, 3033) by following the same protocol for the assessment of REE.
Four prediction equations were identified as the most commonly used in clinical practice (Harris-Benedict, Mifflin-St Jeor, Owen, and World Health Organization/Food and Agriculture Organization/United Nations University [WHO/FAO/UNU]). Results. Mean (SD) resting energy expenditure (REE), REE adjusted for fat-free mass (FFM), and REE adjusted for FFM and fat mass (FM) in underweight (n = 98 F, 9 M), normal-weight (n = 551 F, 375 M), overweight (n = 313 F, 220 M), and obese (n = 345 F, 194 M) women () and men (). None declared. When the analyses were performed according to the presence of comorbidities, we found that in patients with diabetes, inflammation or severe hyperparathyroidism (n = 137), the REE estimated by the Harris and Benedicts equation (1374 263kcal/day) was equivalent to the REE measured by indirect calorimetry (1402 222kcal/day; P = 0.13). By contrast, a lower ratio of REE to body mass (or FFM) is observed in overweight and obese subjects (20, 37, 38). 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The discrepancies between measured and predicted REE values may be explained in part by methodologic problems and biological factors. Forty-nine subjects were diagnosed with anorexia nervosa according Lightly active men should multiply Recently, when Weijs et al. WebThis approach is limited by the choice of equation (Schofield et al 1985) used to calculate basal metabolic rate, and by lack of easily interpretable activity tables for children. REE prediction from weight groupspecific formulas is superior to that from weight groupunspecific formulas. Bethesda, MD 20894, Web Policies WebThe Schofield equations were widely used by dietitians in clinical practice (Reference Judges, Knight and Graham 45) until relatively recently, but key advisory groups now recommend Flack KD, Siders WA, Johnson L, Roemmich JN. {{{;}#tp8_\.
However, prediction of REE within 10% compared to REE measured by IC (mREE) was only noticed in about 35% of children. Energy expenditure was calculated by using the Weir equation (35) or in the case of chamber measurements by using REE (kJ) = 16.18VO2 + 5.02VCO2 5.99Nexcretion (29, 36). [BMI percentiles for children and adolescents considering several German samples. Energy metabolism. Exclusion criteria were age <18years, amputation, pregnancy, altered thyroid function, presence of malignancy, and hospitalization in the month prior to the study. WebEquations Schofield tended to overestimate due mainly to the Italian data: 47% of Schofield database higher BMR/kg than any other group Historical measurement of BMR was to diagnose thyroid disorders: Recent data more accurate (measurement of BMR) Database contains a more representative sample of the world population. Fat mass (FM) was derived from the equation FM = body weight - FFM, and percentage FM (%FM) was derived from the equation %FM = FM/body weight. For children and adolescents, the prevalence of BMI under or over a certain percentile (according to reference 32); for adults, the prevalence of underweight (BMI < 18.5), normal weight (BMI of 18.5 to <26), overweight (BMI of 26 to <30), and obesity (BMI 30). With respect to practical utility, we compared the measured REE of normal and overweight adults with dietary recommended intakes from the Institute of Medicine (IOM; reference 39) and the German (D), Austrian (A), and Swiss (CH) societies for nutrition (DACH; reference 40) (Figure 5). This point was discussed in detail by Elia (1). Results The demographic characteristics, blood biochemistry, clinical, nutritional and energy expenditure data of the patients are summarized in Table 1 . 2006 Updates: hemodialysis adequacy, peritoneal dialysis adequacy, vascular access, New methods for calculating metabolic rate with special reference to protein metabolism, Institute of Medicine/Food and Nutrition Board, Validation of predictive equations for resting energy expenditure in adult outpatients and inpatients, The HarrisBenedict studies of human basal metabolism: history and limitations, Human energy requirements: overestimation by widely used prediction equation, New predictive equations for the estimation of basal metabolic rate in tropical peoples, Basal metabolic rate of Indian men: no evidence of metabolic adaptation to a low plane of nutrition, Twenty-four-hour energy expenditure: the role of body composition thyroid status, sympathetic activity, and family membership. Physical characteristics of the study population 1. WHO prediction equations systematically overestimated REE at low REE values but underestimated REE at high REE values. Nelson KM, Weinsier R, Long CL, Schutz Y. Wang Z, Heshka S, Gallagher D, Boozer CN, Kotler DP, Heymsfield SB. In a comparison of the normative REE data from the IOM (42) with our data, a mean deviation of 82 kcal/d (range: 0187 kcal/d for the different age and sex groups) was observed. WebThe Schofield equation estimate was 798 +/- 595 kcals/24 hrs and the White equation estimate was 815 +/- 564 kcals/24 hrs (p = not significant). Subpopulations 1 and 2 were matched in age, BMI, and REE (Table 3). Measured resting energy expenditure (REE), REE adjusted for fat-free mass (REEadj1), and REE adjusted for fat-free mass and fat mass (REEadj2) in the study population1. Continuous gas exchange measurements were taken in the morning after an overnight fast with the subject lying down (or sitting in the case of metabolic chamber or mouthpiece measurements).
Twenty-six patients (9%) had diabetes, 25% had inflammation (defined as CRP 1.0mg/dL) and 20% had severe hyperparathyroidism (defined as PTH 700pg/mL). Resting energy expenditure (REE) plotted against body weight or fat-free mass (FFM) in children and adolescents and in adults (total n = 2348). The PALs necessary to meet the IOM recommendations exceed the measured PALs of most subjects in Western Europe (ie, 1.481.70 in old and young females and 1.541.85 in old and young males; reference 17). /Length 11 0 R However, predictive equations might generate errors large enough to impact outcome. Single-pool Kt/V was calculated for haemodialysis and peritoneal dialysis patients according to the KDOQI guidelines for dialysis (2006) [17].
Weight was measured to the nearest 0.1kg and height to the nearest 0.1cm with a stadiometer. official website and that any information you provide is encrypted In two-factor repeated-measures ANOVA, the interaction term (sex age) was not significant for any of the 3 variables (ie, REEWHO, REEm REEWHO in MJ/d, and REEm REEWHO as a percentage). The relation between REE and FFM in the male adolescents with SCA (upper solid line) was significantly greater than that in the These numbers are 5.8% higher than the respective PALs derived from the DACH estimates (ie, 1.491.73). The findings showed that the two Schofield equations [along with Talbot tables ( 24 )] compared with many other equations were the least inaccurate ( 23 ). A reference database has to have a sample size with an acceptable statistical power and be reasonably representative of the variables tested. There were no significant differences between the subpopulations in any of the measured variables (Mann-Whitney U test). Basal metabolism related to sex, stature, age, climate and race. According to the WHO criteria (33), a high prevalence of overweight and obesity was found in the whole study population. The data in the present study suggest that in comparison with the metabolic rate per kilogram body weight or FFM in overweight and obese subjects, that in underweight subjects is lower than expected, and thus REE cannot be predicted from body mass alone. For full access to this pdf, sign in to an existing account, or purchase an annual subscription.
By using Harris and Benedicts equation, 64% of the patients and, by using Schofields equation, 66% of the patients did not meet the same quartile of TEE estimated by using indirect calorimetry. Two prediction equations using easily measurable variables were compared with the reference indirect calorimetry for the estimation of REE. All subjects were healthy (defined as the absence of a clinical condition) except for 97 adults who were underweight (BMI < 18.5), with a mean (SD) BMI of 16.2 1.6 (range: 12.418.4). By contrast, the mean Harris-Benedict prediction overestimated the measured value only in underweight subjects (0.54 0.84 MJ/d; P < 0.001), whereas in normal-weight, overweight, and obese subjects, the mean REE predicted according to the Harris-Benedict formula was not significantly different from the measured value (differences of 0.02 0.88, 0.00 0.78, and 0.05 0.95 MJ/d in normal-weight, overweight, and obese subjects, respectively).
REEm, REE measured by using indirect calorimetry; REEWHO, REE predicted according to Schofield (3); REEp1, REE predicted according to subpopulation 1 model 1; REEp2, REE predicted according to subpopulation 1 model 2; REEp11, REE predicted according to BMI subgroups of subpopulation 1 model 1; REEp22, REE predicted according to BMI subgroups of subpopulation 1 model 2. However, previous recommendations of energy requirements were based on the most recent equations predicting REE (Schofield equations; references 3, 5). The agreement of the REE prediction equations with the indirect calorimetry is shown in Figure2. Do handheld calorimeters have a role in assessment of nutrition needs in hospitalized patients?
However, the overestimation by the equations was noticeable also among healthy controls. Accordingly, in the present study, the REE error (predicted minus measured) by both equations correlated inversely with serum glucose, parathyroid hormone and C-reactive protein, suggesting that the higher the concentration of these markers, the lower the error of the REE prediction equations. (Carnegie Institute of Washington Publication 279. In the control group, the correlations between measured and predicted REE were similar (Harris and Benedict r = 0.65; P < 0.001 and Schofield r = 0.62; P < 0.001). The slope is derived from the regression equation between REE and FFM. WHO prediction, which uses body weight as one determinant, systematically overestimates REE at low metabolic rate (Figure 3) and thus low body mass. Comparison of predictive equations for resting metabolic rate in obese psychiatric patients taking olanzapine, Resting energy expenditure in pre-dialysis diabetic patients, Increased resting energy expenditure in hemodialysis patients with severe hyperparathyroidism, Inflammation is associated with increased energy expenditure in chronic kidney disease patients, Resting energy expenditure of chronic kidney disease patients: influence of renal function and subclinical inflammation, Serum and cellular interleukin-6 in hemodialysis patients: relationship with energy expenditure. And, as known, lean body mass is the main determinant of the energy expenditure accounting for 73% of the variations in REE and 80% of the variations in TEE [25]. In reality, as age increases, the association between weight and A number of metabolic disturbances and catabolic conditions related to renal failure and dialysis therapy adversely affect the nutritional condition of CKD patients [2]. Skouroliakou M, Giannopoulou I, Kostara C, Vasilopoulou M. Nutrition. Overestimation was greatest with the equation proposed by Schofield followed by the one by Harris and Benedict. In addition, the above-mentioned prediction formulas are considered unsuitable for predicting REE in obese (15) and underweight (16) subjects. In order to overcome these limitations, Anjos et al. FFM alone explained 61.7% of the variance in REE in adults. Haemodialysis patients were dialysed for 4h thrice a week, and the predominant vascular access was arteriovenous fistula (92% of the patients). ], Grundri der Ernhrungslehre. Serum creatinine, urea and glucose were determined by a standard autoanalyser. However, both conditions are common in developing countries, and the incidence of obesity is also still growing in developed countries. The equations used for the predicting REE are as follows: (i) Harris and Benedicts equations [12]: (ii) Schofields equations reported by the World Health Organization [13]: Data are expressed as mean standard deviation (SD), median and interquartile ranges, or proportions. WebConclusions: The Mifflin-St Jeor equation is more likely than the other equations tested to estimate RMR to within 10% of that measured, but noteworthy errors and limitations exist Forty-nine subjects were diagnosed with anorexia nervosa according to DSM IV criteria. RMR estimation errors would be eliminated by valid measurement of RMR with indirect calorimetry, using an evidence-based protocol to minimize measurement error. The interindividual CV of REE is 813% (18), which leads to a considerable number of over- and underestimations of REE with the use of a prediction formula. A biometric study of basal metabolism in man. Glomerular filtration rate was evaluated using standard creatinine clearance (CrCl) corrected for body surface area. In addition, anthropometric measurements were used in a small subgroup of subjects. Finally, a potential explanation for an inaccurate estimation of REE by the prediction equations in the present study can be the differences between the study population and the population from which the equations were originally derived.
Bland and Altman plot analysis allowed us to evaluate the agreement between the prediction equations and the reference for the REE measurements. /N 3 All values are x SD. The Mifflin-St Jeor equation is more likely than the other equations tested to estimate RMR to within 10% of that measured, but noteworthy errors and limitations exist when it is applied to individuals and possibly when it is generalized to certain age and ethnic groups.
A more recent and heterogeneous database of 574 energy expenditure measurements showed an SD of 20% of the mean values obtained in different age and sex groups (17). Schofields equation exhibited higher REE [1492 220kcal/day (mean SD)] in relation to Harris and Benedicts equation (1431 214kcal/day; P < 0.001), and both prediction equations showed higher REE in comparison with the reference indirect calorimetry (1352 252kcal/day; P < 0.001). Prediction of REE from 90% to 110% measured by indirect calorimetry was considered acceptable. xwTS7PkhRH
H. 74 W + 2 754. The five continuum of care criteria that should accompany rectal artesunate interventions: lessons learned from an implementation study in Malawi. @~ (* {d+}G}WL$cGD2QZ4 E@@ A(q`1D `'u46ptc48.`R0) In CKD patients, REE might be reduced due to the diminished lean body mass as a result of a cluster of catabolic conditions to which these patients are commonly exposed. Two prediction formulas including weight, sex, and age or fat-free mass, fat mass, sex, and age, respectively, were generated in a subpopulation and cross-validated in another subpopulation. Firstly, the error of such equations might be attributed to the fact that they were developed for estimating basal metabolic rate and not REE. Regarding biological determinants of REE, FFM was found to be it's major determinant (see Results). Pullicino E, Copperstone C, Luzi L, McNeill G, Elia M. Black AE, Coward WA, Cole TJ, Prentice AM.
Finally, Schofield equation, similar to all equations used to estimate energy requirement, has limitations and can potentially overestimate the energy requirement.13 Bookshelf
Participants had a single tetrapolar BIA measurement of resistance and reactance taken between the right wrist and ankle while in a supine position. The IOM physical activity recommendations were based on measurements of total energy expenditure (doubly labeled water) and predicted REE (in the case of children) or measured REE (values for adults). Mller MJ, Bosy-Westphal A, Kutzner D, Heller M. Brooks GA, Butte NF, Rand WM, Flatt JP, Caballero B.
There were no significant differences between the subgroups in any of the measured variables (Mann-Whitney U test). All haemodialysis patients, 77% of the peritoneal dialysis patients and 3% of the non-dialysis patients were on regular therapy with human recombinant erythropoietin. Indirect calorimetry is among the methods that most accurately measure the REE. In peritoneal dialysis patients, the Harris and Benedicts equation exhibited similar REE in relation to the reference.
When compared with measured REE, REE predicted according to WHO formulas showed considerable deviations (Figure 3). Percentage of subjects according to the adequacy of REE [(REE predicted by the equations 100) / REE measured by indirect calorimetry]. [11] developed predictive equations for BMR Quenouille MH, Boyne AW, Fisher WB, Leitch I. Mifflin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO.
700. WebSchofield equation. Because obesity research was the main focus in some of the study centers, all age groups except young adults had a high prevalence of overweight and obesity. eCollection 2023. 8600 Rockville Pike Body composition was assessed by bioelectrical impedance analysis using a single frequency tetrapolar technique with an electrical current of 800A at 50kHz (BIA 101 Quantum, RJL Systems, USA). Deltatrac, TM MBM-100; Hoyer, Bremen, Germany/GEM; NutrEn Technology Limited, Padiham, United Kingdom, Deltatrac, TM II MBM-200; Hoyer/Sensor Medics 2900Z; NewMedics Medizinelektronic GmbH, hringen, Germany, Beckmann Horizon; Beckmann Sensormedics, Milan, Italy, Data Input; Data Input GmbH, Darmstadt, Germany, Data Input Akern RJL101S; Data Input GmbH, BIA-101; RJL Systems Inc, Clinton Township, MI, REE (MJ/d) = 0.02606 weight (kg) + 0.04129 height (cm) + 0.311 sex 0.08369 age (y) 0.808, REE (MJ/d) = 0.07885 FFM (kg) + 0.02132 FM (kg) + 0.327 sex + 2.694, REE (MJ/d) = 0.047 weight (kg) + 1.009 sex 0.01452 age (y) + 3.21, REE (MJ/d) = 0.05192 FFM (kg) + 0.04036 FM (kg) + 0.869 sex 0.01181 age (y) + 2.992, REE (MJ/d) = 0.07122 weight (kg) 0.02149 age (y) + 0.82 sex + 0.731, REE (MJ/d) = 0.08961 FFM (kg) + 0.05662 FM (kg) + 0.667, REE (MJ/d) = 0.02219 weight (kg) + 0.02118 height (cm) + 0.884 sex 0.01191 age (y) + 1.233, REE (MJ/d) = 0.0455 FFM (kg) + 0.0278 FM (kg) + 0.879 sex 0.01291 age (y) + 3.634, REE (MJ/d) = 0.04507 weight (kg) + 1.006 sex 0.01553 age (y) + 3.407, REE (MJ/d) = 0.03776 FFM (kg) + 0.03013 FM (kg) + 0.93 sex 0.01196 age (y) + 3.928, REE (MJ/d) = 0.05 weight (kg) + 1.103 sex 0.01586 age (y) + 2.924, REE (MJ/d) = 0.05685 FFM (kg) + 0.04022 FM (kg) + 0.808 sex 0.01402 age (y) + 2.818, Copyright 2023 American Society for Nutrition. Our approach is a post hoc compilation and analysis of data. A total of 281 CKD patients (124 non-dialysis, 99 haemodialysis and 58 peritoneal dialysis) and 81 healthy control individuals were recruited. WebFinally, Schofield equation, similar to all equations used to estimate energy requirement, has limitations and can potentially overestimate the energy requirement.13 35 This may be In fact, the 2 prediction formulas have been reported to overpredict but also to underestimate measured REE in more recent studies (615). Bicarbonate (normal range: 2327mmol/L) was measured by an automated potentiometer, thyroid-stimulating hormone (TSH, normal range: 0.34.0mIU/L) by immunofluorometric assays and albumin (normal range: 3.44.8g/dL) by bromcresol green technique. 441. The Schofield equations resulted in positive estimates in all but one woman and one man. Dietary reference intakes: energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. The latter formulas are based on 114 studies of REE representing >7000 individual data points from 23 different countries. Hasson RE, Howe CA, Jones BL, Freedson PS.
Hasson RE, Howe CA, Jones BL, Freedson PS.