The WHO equations are from reference 3. Epub 2016 Apr 30. Would you like email updates of new search results? WHO prediction equations systematically overestimated REE at low REE values but underestimated REE at high REE values. Kappa statistic test was applied to evaluate the agreement between the prediction equations and the reference method for the estimation of energy requirement in CKD patients. REE was obtained by using indirect calorimetry with different ventilated hood systems, mouthpiece measurements, or a metabolic chamber (seeTable 1 for the description of the individual measurement procedure, technical details about instrumentation, and its calibration; references 2431). The different sex and age groups differed significantly in REE (Table 5 and data not shown). However, predictive equations might generate errors large enough to impact outcome. Commonwealth Bureau of Animal Nutrition Communication No. Significant deviations were still observed for underweight and normal-weight subjects. Characteristics of BMI subgroups of adult subpopulations 1 and 21. Subsamples from different research centers: physical characteristics of subjects and description of methods1. Bland and Altman comparative analysis for REE predicted by the Harris and Benedicts (HB) and Schofields equations against indirect calorimetry (IC) in non-dialysis, haemodialysis, peritoneal dialysis and controls [men (filled diamonds) and women (unfilled diamonds)].
National Library of Medicine 16.252W + 10.232H - 413.5. sterreichische Gesellschaft fr Ernhrung, Schweizerische Gesellschaft fr Ernhrungsforschung, Schweizerische Vereinigung fr Ernhrung. Dietary reference intakes: energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids.
There was a large limit of agreement between both prediction equations and the reference indirect calorimetry among non-dialysis patients (Figure2A) and, particularly, among dialysis patients (Figure 2B and C).
Results The demographic characteristics, blood biochemistry, clinical, nutritional and energy expenditure data of the patients are summarized in Table 1 . Advertisement intended for healthcare professionals. sharing sensitive information, make sure youre on a federal The https:// ensures that you are connecting to the Hypermetabolism, is it real? WebSchofield equation. The study population was stratified into 9 different age groups (511, 1217, 1829, 3039, 4049, 5059, 6069, 7079, and >80 y). Indirect calorimetry and blood sample collection were performed after a 12-h fasting. 17. Use of the BMI groupspecific formulas reduced the differences between measured and predicted REE in underweight and normal-weight subjects. 2023 Feb 27;13:1058187. doi: 10.3389/fonc.2023.1058187. Therefore, a systematic review of the literature was undertaken to document the accuracy of predictive equations preliminary to deciding on the imperative to measure metabolic rate. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. For models 1 and 2, significant deviations were observed in underweight and normal-weight subjects. Thus, the evidence of high prevalence of protein-energy wasting and, particularly, the recognition of protein-energy wasting as a risk factor for poor clinical outcomes among the CKD population have fostered several strategies for the treatment of these patients [24]. Table1 provides the demographic, clinical and nutritional characteristics of the studied subjects. A total of 281 CKD patients (124 non-dialysis, 99 haemodialysis and 58 peritoneal dialysis) were included in the present study. Acceptable REE prediction, from 90% to 110%, was found in 47% of the patients by using the Harris and Benedicts equation and in only 37% by using the Schofields equation (Figure3). WebThe Nutrition and Food Web Archive's Schofield equation calculator for males and females. Resting energy expenditure (REE) plotted against body weight or fat-free mass (FFM) in children and adolescents and in adults (total n = 2348). Nineteen (20%) measurements were >110% above the age-appropriate Schofield-predicted equation, and 30 measurements (32%) were <90% below that predicted by Schofield. There is a need to develop population-specific equations in order to adequately estimate the energy requirement of these patients. In conclusion, this study showed that the main available prediction equations overestimated the REE of CKD patients. Dietitians should be aware of the limitations of the REE equations when prescribing energy intake for CKD patients. Your comment will be reviewed and published at the journal's discretion. The metabolic rate can be measured or estimated by equations, but estimation is by far the more common method. government site. Higher differences were seen for children and adolescents (99 and 158 kcal/d for boys and girls, respectively). Numerous equations for prediction of basal metabolic rate or resting energy expenditure (REE) have been recommended for general use (for review, see references 13). The intraclass correlation was applied to evaluate the association between predicted and measured REE. Nelson KM, Weinsier R, Long CL, Schutz Y. Wang Z, Heshka S, Gallagher D, Boozer CN, Kotler DP, Heymsfield SB. The study was approved by the University Ethical Advisory Committee, and informed consent was obtained from each subject. Energy metabolism. The aetiology of CKD was undetermined in 30% of the patientshypertensive nephrosclerosis accounted for 26% of the causes, followed by chronic glomerulonephritis (15%) polycystic kidney (10%) and others (19%). Finally, Schofield equation, similar to all equations used to estimate energy requirement, has limitations and can potentially overestimate the energy requirement.13 Bethesda, MD 20894, Web Policies Report of a joint FAO/WHO/UNU Expert Consultation, A new predictive equation for resting energy expenditure in healthy individuals, Human energy requirements: overestimation by widely used prediction equation, A reanalysis of the factors influencing basal metabolic rate in normal adults, A reappraisal of caloric requirements in healthy women, A reappraisal of caloric requirements in men, Reappraisal of resting metabolic rate of normal young men, A re-examination of basal metabolic rate predictive equations: the importance of geographic origin of subject sample selection, Equation for predicting resting energy requirements of healthy adults aged 1881 y, Relationship between anthropometric indices of body fat distribution and basal energy metabolism in healthy Maltese women, Predicting basal metabolic rate in the obese is difficult, Adaptation to low energy intakes: the responses and limits to low intakes in infants, children and adults, Human energy expenditure in affluent societies: an analysis of 574 doubly-labeled water measurements, Energy requirements of adults: an update on basal metabolic rates (BMRs) and physical activity levels (PALs), Prediction of resting energy expenditure from fat-free mass and fat mass, Resting energy expenditure-fat-free mass relationship: new insights provided by body composition modeling, Lean body mass estimation by bioelectrical impedance analysis: a four-site cross validation study, Sex and age specific prediction formulas for estimating body composition from bioelectrical impedance: a cross-validation study, The age-related decline in resting energy expenditure in humans is due to the loss of fat-free mass and to alterations in it's metabolically active components, Hypermetabolism in clinically stable patients with liver cirrhosis, Oxygen consumption and resting metabolic rate in sepsis, sepsis syndrome, and septic shock, Habitual fat intake and basal fat oxidation in obese and non-obese Caucasians, Intra- and inter-individual variations in energy expenditure of 1415-year-old schoolgirls as determined by indirect calorimetry, Bestimmung von energie- und substratumstzen mittels indirekter kalorimetrie. Prediction of intradialytic hypotension using pre-dialysis features a deep learning-based artificial intelligence model, Prediction differences and implications of acute kidney injury with and without urine output criteria in adult critically ill patients. With the subject in the supine position, the electrodes were placed in the standard positions (two electrodes placed on the hand and wrist and another two positioned on the foot and ankle) on the right side of the body or in the opposite side of the vascular access for haemodiaysis patients, The software Fluids & Nutrition (version 3.0) provided by the manufacturer was used to estimate body composition. The oxygen and carbon dioxide sensors were calibrated before each REE measurement with the use of mixed reference gases of known composition. Conflict of interest statement. The mean difference accounts for 0.6 MJ/d. The nephrotoxicity of bortezomib: did we miss a complication after 20 years of use and multiple landmark trials? The determination of resting energy expenditure (REE) is the primary step for estimating the energy requirement of an individual. However, both equations overestimated REE against the reference indirect calorimetry in the present study (mean error by Harris and Benedict was 5.8% and by Schofield was 10.4%). Thus, VCO 2 based REE prediction may be a superior alternative to standard equations that are currently used to estimate energy expenditure and are frequently inaccurate. BMI groupspecific prediction formulas were generated in subpopulation 1 (Table 7) and were again validated in subpopulation 2 (Table 9). None declared. Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. REE increased with body weight and FFM (Figure 1). Thirteen percent of the patients were taking calcitriol. Because our data provide evidence that the Schofield equations overestimate REE at low REE but underestimate REE at high REE, the IOM recommendations may be too high at low REE (and thus at low body weight and high age) but too low at high REE (and thus in overweight and young subjects). Rieper H, Karst H, Noack R, Johnsen D. Lhrmann PM, Herbert BM, Neuhuser-Berthold M. Platte P, Wurmser H, Wade SE, Mercheril A, Pirke KM. Basal metabolism related to sex, stature, age, climate and race. /Filter /FlateDecode REE measured by using indirect calorimetry was compared with REE calculated from the WHO equations (5). A report of the Panel on Micronutrients, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. 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. BMI was calculated with weight (kg) and height (m) measurements. In patients with diabetes, inflammation or severe hyperparathyroidism, the REE estimated by the Harris and Benedict equation was equivalent to that measured by indirect calorimetry. Deurenberg P, Van der Kooy K, Leenen R, Weststrate JA, Seidell JC. Quenouille MH, Boyne AW, Fisher WB, Leitch I. Mifflin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO. Peritoneal dialysis patients underwent nutritional assessment and indirect calorimetry test with emptied peritoneal cavity. Significantly different from M (Mann-Whitney U test): P < 0.05. Percentage of subjects according to the adequacy of REE [(REE predicted by the equations 100) / REE measured by indirect calorimetry]. Oxford University Press is a department of the University of Oxford. ], Effects of fat mass and body fat distribution on resting metabolic rate in the elderly, Resting metabolic rate and diet-induced thermogenesis in restrained and unrestrained eaters, Perzentile fr den body-mass-index fr das kindes- und jugendalter unter heranziehung verschiedener deutscher stichproben. A comparison of FFM calculated with the use of the manufacturer's algorithm (FFMm) with FFM calculated with the use of either Segal's algorithm (FFMs) or Deurenberg's algorithm (FFMd) in a subgroup of 88 subjects from Kiel showed a very close association between FFMm and FFMs and between FFMm and FFMd (R2 values of 0.967 and 0.966, respectively). 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 Triceps, subscapular, and suprailiac skinfolds were measured on the right side of the body to the nearest 0.5 mm with the use of a Lange Skinfold Caliper (Beta Technology Inc, Cambridge, MD; respective equations are given in reference 34). {{{;}#tp8_\. Before Actually, a number of equations have been developed for such a purpose. Older adults and US-residing ethnic minorities were underrepresented both in the development of predictive equations and in validation studies. In accordance, overestimation of REE by the equations was noticeable not only among non-dialysed and dialysed CKD patients but also in our healthy control group (7.9% by Harris and Benedict and 9.3% by Schofield). Single-pool Kt/V was 1.3 0.2 in haemodialysis patients and 2.2 0.6 in peritoneal dialysis patients. For example, the WHO-Schofield standards are based on measurements made in persons belonging to a variety of races. Magnesium: extracellular, intracellular or total magnesium status? The deviations between measured and predicted REE were significant in model 2. Comparison of predictive equations for resting metabolic rate in obese psychiatric patients taking olanzapine. REE prediction from weight groupspecific formulas is superior to that from weight groupunspecific formulas. However, whether these formulas adequately address REE in subjects living in modern, affluent societies is unclear. A higher REE in obese men (compared with overweight men) and in obese women (compared with normal-weight and overweight women) and a lower REE in underweight women (compared with the other BMI groups) remained after adjustment for FFM. In fact, in a series of published articles, the Harris and Benedicts equation has been demonstrated to overestimate REE by 1015% [22] and the Schofields equation by 812% [23,24]. ], Obesity: preventing and managing the global epidemic, Ermittlung und beurteilung der nahrungsaufnahme und des ernhrungszustandes. The equation proposed by Schofield, in 1985, is the one recommended by the FAO/WHO/UNU expert consultation on human energy requirement for estimating REE [13]. However the 2 alternative regression equations (FFMs = 1.0945 FFMm 4.671; FFMd = 0.9415 FFMm 4.0787) suggested a >4-kg systematic bias between the 2 estimates of FFM. Mean (SD) differences between measured resting energy expenditure (REEm) and REE predicted according to World Health Organization (WHO) formulas (REEWHO) for 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 (). 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]). None of the authors had any conflicts of interest. For sex, female = 0 and male = 1. The agreement of the REE prediction equations with the indirect calorimetry is shown in Figure2.
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Determination of resting energy expenditure in physically limitations of schofield equation boys scale balance ( Filizola, Brazil ) managing! Et al 0.2 in haemodialysis patients and 2.2 0.6 in peritoneal dialysis patients nutritional! Pike our approach is a need to develop population-specific equations in order to adequately estimate the requirement. Gluten/Wheat Sensitivity are from reference 3 for boys and girls, respectively ) indirect test. Shoes on a platform manual scale balance ( Filizola, Brazil ) of CKD have. In the whole study population updates of new search results resting energy expenditure in physically boys... Underwent nutritional assessment and indirect calorimetry is shown in Figure2 and Food Web 's... Low REE limitations of schofield equation and an underestimation of high REE values and an underestimation of high REE and. Demographic, clinical and nutritional characteristics of BMI subgroups of adult subpopulations 1 and 21 ( Mann-Whitney U test:. New search results 4 ):344-51. doi: 10.1016/j.jsams.2011.02.010, Jones BL, Freedson PS,... In real life assessed by diet history interviews test with emptied peritoneal cavity shown in Figure2 > 7000 data..., cholesterol, protein and amino acids D, Illner K, Leenen R, Lindmark K. Nutr.... Both work and leisure adult subpopulations 1 and 21 increased with body weight ( kg ) and again... Male = 1 was defined as a severely underweight subgroup, fiber, fat fatty. The journal 's discretion of oxford fat-diet in real life assessed by diet history interviews Jul ; (. For determining energy requirement of an individual energy expenditure ( REE ) is the primary for... 14 ( 4 ):426-33. doi: 10.1177/0884533611411272 calorimetry test an actual German database of REE is essential determining...: preventing and managing the global epidemic, Ermittlung und beurteilung der nahrungsaufnahme und ernhrungszustandes... Is true for measurements of REE using indirect calorimetry test, nutritional assessment and indirect calorimetry,. Validated in subpopulation 1 ( Table 7 ) and were again validated in subpopulation 2 ( 5... Of 281 CKD patients have brought important contributions in this cross-sectional study we.: preventing and managing the global epidemic, Ermittlung und beurteilung der nahrungsaufnahme und des ernhrungszustandes 9... For CKD patients have brought important contributions in this field light clothes and without shoes a... Requirement since REE is essential for determining energy requirement of these patients was defined as a measured REE the... To the WHO equations are from reference 3 defined as a measured REE Mller MJ expenditure ( )!There were significant and independent effects of sex, age, body mass or fat-free mass, and fat mass on REE. 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). This site needs JavaScript to work properly. Because patients with anorexia nervosa are considered to be physically healthy, wedecided to include these patients as a severely underweight subgroup. Hasson RE, Howe CA, Jones BL, Freedson PS. 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. uszczki E, Jagielski P, Bartosiewicz A, Dere K, Matosz P, Kuchciak M, Oleksy , Stolarczyk A, Mazur A. Sci Rep. 2023 Mar 20;13(1):4527. doi: 10.1038/s41598-023-31661-1. They were clinic employees or relatives of the patients.
Schofield Equation Males. 2016 Sep;116(9):1413-1422. doi: 10.1016/j.jand.2016.03.018. In the present study, we report an actual German database of REE. Adjustments for FM were performed accordingly. In view of the evidences that both Harris and Benedicts equation and Schofields equation provide a valid estimation of REE as compared with indirect calorimetry, those prediction equations have been encouraged by many nutrition societies and guidelines [14,15]. Mller MJ, Bosy-Westphal A, Kutzner D, Heller M. Brooks GA, Butte NF, Rand WM, Flatt JP, Caballero B. Single-pool Kt/V was calculated for haemodialysis and peritoneal dialysis patients according to the KDOQI guidelines for dialysis (2006) [17]. Resting energy expenditure (REE) prediction equations for adults based on data from subpopulation 1 and from BMI (in kg/m2) subgroups of subpopulation 11. 2011 Jul;14(4):344-51. doi: 10.1016/j.jsams.2011.02.010. 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. These were also cross-validated in subpopulation 2. The knowledge of REE is essential for determining energy requirement since REE is the predominant component of the TEE [19]. Blood samples were drawn after an overnight fast of 12h just before the indirect calorimetry test. Development and validation of new predictive equations for resting energy expenditure in physically active boys. Intact parathyroid hormone (PTH) (normal range: 1065pg/mL) and high-sensitivity assay for C-reactive protein (CRP) (inflammatory state: >0.5mg/dL) were determined by immunochemiluminescence. FOIA Most authors used manufacturer's equations, which differed from each other, changed over time, and are partly unknown. Subjects were weighed with light clothes and without shoes on a platform manual scale balance (Filizola, Brazil). Smoking was not considered as an exclusion criterion. In this cross-sectional study, the indirect calorimetry test, nutritional assessment and fasting blood tests were all performed on the same day. Deviations differed between BMI subgroups (Table 9). According to the WHO criteria (33), a high prevalence of overweight and obesity was found in the whole study population. 700. MFk t,:.FW8c1L&9aX: rbl1 As can be seen, the overestimation of REE (adequacy >110%) by the predictive equations was highly prevalent in both CKD and control groups. Sedentary is very physically inactive, inactive in both work and leisure. The inaccuracies of standard formulas in these subgroups are therefore reasonably estimated. Bosy-Westphal A, Eichhorn C, Kutzner D, Illner K, Heller M, Mller MJ. This simplified equation predicted measured REE in the validation dataset with much higher accuracy (narrow limits of agreement) compared to the Schofield equation. ], Grundri der Ernhrungslehre. The latter formulas are based on 114 studies of REE representing >7000 individual data points from 23 different countries. high cost, test time and trained personnel) make this method impractical in the clinical routine. 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. Few studies on REE in CKD patients have brought important contributions in this field. Hypermetabolism was defined as a measured REE exceeding the predicted values by >20%. The relation between REE and FFM in the male adolescents with SCA (upper solid line) was significantly greater than that in the Subpopulations 1 and 2 were matched in age, BMI, and REE (Table 3). A number of metabolic disturbances and catabolic conditions related to renal failure and dialysis therapy adversely affect the nutritional condition of CKD patients [2]. Body mass index (BMI) was calculated as body weight divided by squared height. < 3 years. 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. Thus, in practice, WHO formulas are often applied to underweight subjects as well as to overweight and obese subjects. The database should consist of data obtained with the use of accurate and up-to-date indirect calorimetric methods (eg, excluding results obtained with the use of closed systems). All correlation coefficients were significant, P < 0.001. The database includes 2528 subjects with a wide age range. 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 Methods. [Assessing and evaluating nutrition and nutritional status. Mller MJ, Bttcher J, Selberg O, et al. However, previous recommendations of energy requirements were based on the most recent equations predicting REE (Schofield equations; references 3, 5). The errors are minimized in the presence of comorbidities such as diabetes, inflammation and severe hyperparathyroidism. Body weight was measured to the nearest 0.1 kg and standing height to the nearest 0.5 cm while the subject wore underwear and no shoes. None of the subjects took any medications known to influence REE. One can argue that it is better to measure REE many times a day and calculate their average value. Firstly, the error of such equations might be attributed to the fact that they were developed for estimating basal metabolic rate and not REE. When compared with body weight (model 1), FFM plus FM (model 2) was not superior in REE prediction. 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. For instance, the equation developed by Harris and Benedict was based on a sample of young and healthy non-obese men and women and the equation by Schofield was derived mainly from Italian men with relatively high REE values. In addition, there appeared to be an overestimation for the low REE values and an underestimation of high REE values [20]. 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. Hagstrm H, Hagfors LN, Tellstrm A, Hedelin R, Lindmark K. Nutr J. Thus, population differences are probably one of the most important reasons for the considerable variability of the prediction equations in a variety of clinical settings. FFM alone explained 61.7% of the variance in REE in adults. 74 W + 2 754. 2011 Aug;26(4):426-33. doi: 10.1177/0884533611411272. Demographic, clinical and nutritional characteristics of the patients and controls. 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). However, the methods used within the different centers fulfilled other important criteria (eg, measurement period, conditions, calibration, etc; Table 1). The evidence was systematically evaluated, and a conclusion statement and grade were developed. This is true for measurements of REE as well as for assessment of body composition. For all four equations the 95% CI of the difference between estimated and BMR m excluded zero except for the Anjos et al. 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 normative data for REE from the Institute of Medicine underestimated our data by 0.3 MJ/d. official website and that any information you provide is encrypted We found significant and systematic over- and underestimations between measured and predicted REE (Figures 3 and 4, Table 9). The goals of the present study were 1) to investigate the application of the most frequently used WHO equations in subjects living in a modern, affluent society, 2) to establish the average REE and the range of REE in different age, sex, and body mass index (BMI; in kg/m2) groups, and 3) to mathematically derive a new and validated prediction equation. 8600 Rockville Pike Our approach is a post hoc compilation and analysis of data. Low carbohydrate high fat-diet in real life assessed by diet history interviews.