Simple kcal/kg formula is comparable to prediction equations for estimating resting energy expenditure in older cognitively impaired long term care residents

Abstract

Objective Assessment of energy needs is a critical step in developing the nutrition care plan, especially for individuals unable to modulate their own energy intakes. The purpose of this study was to assess precision and accuracy of commonly used prediction equations in comparison to measured resting energy expenditure in a sample of “oldest old” adults residing in long term care (LTC). Subjects and Design Resting energy expenditure (mREE) was measured by indirect calorimetry in 45 residents aged 86.1 ± 7.3 years, and compared to frequently used prediction equations (pREE): Mifflin St.Jeor, Harris Benedict, World Health Organization and Owen. Precision and accuracy were determined by concordance correlation coefficients and number of individuals within ± 10% of mREE. Bland Altman plots with linear dependence trends were constructed to visualize agreement. To complete analyses, the common 25 kcal/kg formula was assessed and alternative formulas were determined for best fit by regressing adjusted mREE on body weight. Results mREE averaged 976.2 ± 190.3 kcal/day for females and 1260.0 ± 275.9 kcal/d for males. The strength of the relationships between pREE and mREE were only moderate (r = 0.41 – 0.72). In examining linear trends in the Bland Altman plots, significant systematic deviation from mREE was detected for all pREE. Two kcal/kg formulas were generated: 20.6 kcal/kg for females and 22.7 kcal/kg for males, which were not significantly different. Conclusion None of the prediction equations adequately estimated energy needs in this sample of the “oldest old.” A simple formula using 21-23 kcal/kg may be a more practical and reliable method to determine energy needs in the LTC setting.

Cost‐Effectiveness of Nutrition Intervention in Long‐Term Care

“…(See Table footnotes for formula. ) There were no significant differences between participants who completed (n = 113) and those lost from (n = 62) the study for any of the characteristics shown in Table , although there were significant differences between groups at baseline, despite randomization, for length of stay ( P = .03) and MMSE score ( P = .005).…”

Resting Energy Expenditure in the Elderly: Systematic Review and Comparison of Equations in an Experimental Population

“…The studies were mainly conducted in healthy patients (N = 36, 53%) in an outpatient setting; only 3 studies were carried out in clinical settings [ 52 , 60 , 69 ]. Only 19 (28%) studies focused on obese patients [ 39 , 41 , 45 , 46 , 55 , 57 , 58 , 60 , 62 , 65 , 76 , 84 , 86 , 90 , 91 , 92 , 93 , 95 , 99 ], and 11 (19.6%) studies focused on a diseased population [ 49 , 60 , 79 ], such as patients with diabetes [ 51 , 56 , 60 , 82 ], oncological diseases [ 60 ], rheumatoid arthritis [ 68 ], chronic obstructive pulmonary disease (COPD) [ 70 ], and heart failure [ 63 ].…”

“…Some studies compared their results with other previously validated equations as well as with a gold standard. Twenty-six different predictive equations were used as comparisons with the new equations in the articles retrieved: the most frequently used equations were those of Harris Benedict [ 21 , 36 , 37 , 38 , 40 , 41 , 45 , 46 , 48 , 49 , 51 , 56 , 60 , 65 , 68 , 70 , 71 , 72 , 73 , 74 , 76 , 78 , 79 , 80 , 84 , 86 , 89 , 90 , 91 , 92 , 94 , 95 , 98 , 100 ], WHO/FAO/UNU, Schofield [ 36 , 37 , 38 , 57 , 60 , 65 , 74 , 80 , 84 , 89 , 98 , 100 , 102 ], Owen [ 37 , 38 ,…”

Nutrient Intake and Body Composition in CrossFit Athletes: a Cross-sectional Study

“…To estimate the energy needs of athletes and avoid caloric deficits in CrossFit® athletes, one of the suggested calculation methods is the Kcal recommendations per kg of weight. This simplified and quick approach estimates energy expenditure (Silver et al, 2013). The calorie range used in the calculation should be between 35 and 40 kcal per kilogram of total body mass, according to our results.…”