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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. Since the establishment of energy recommendation in CKD patients is still a matter of debate, to pursue a more thorough analysis of existing information, there is the need to promote further studies with geographic and ethnic representative sample in order to confirm our findings and also to develop CKD population-specific equations for estimating REE. The Henry & Rees and Mifflin St. Jeor equations overestimated BMR m in more than 90% of the subjects. [Outline of nutritional science.] 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). Effects of individualized dietary counseling on nutritional status and quality of life in post-discharge patients after surgery for gastric cancer: A randomized clinical trial. Resting energy expenditure (REE) plotted against body weight or fat-free mass (FFM) in children and adolescents and in adults (total n = 2348). Chronic kidney disease (CKD) is recognized as an important public health problem, in which the incidence has increased markedly in the last few years [1]. 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). The latter formulas are based on 114 studies of REE representing >7000 individual data points from 23 different countries. REE increased with body weight and FFM (Figure 1). MFk t,:.FW8c1L&9aX: rbl1 These data should be based on stringent inclusion criteria and be capable of being used mathematically to derive suitable predictors and to generate new prediction formulas for REE (19). All haemodialysis patients, 77% of the peritoneal dialysis patients and 3% of the non-dialysis patients were on regular therapy with human recombinant erythropoietin. performed a systematic search for publications of REE prediction equations for use in adults, they found a total of 18 equations developed based on gender, age, body weight and/or height. 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). Significantly different from M (Mann-Whitney U test): P < 0.01. Basal metabolism related to sex, stature, age, climate and race. In addition, anthropometric measurements were used in a small subgroup of subjects. Although numerous equations have been formulated for predicting metabolic rates, there is a lack of studies addressing the reliability of those equations in chronic kidney disease (CKD). The basis for the FAO/WHO/UNU formulas was the Schofield database covering 114 studies, approximately In two-factor repeated-measures ANOVA, the interaction term (sex age) was significant for all 3 variables (ie, REE, REEadj1, and REEadj2). Kreymann G, Grosser S, Buggisch P, Gottschall C, Matthaei S, Greten H. Kunz I, Schorr U, Rommling K, Klaus S, Sharma AM. Most of our subjects were investigated with the use of standard BIA (Table 1). On the basis of measured REE, we calculated the physical activity levels (PALs) necessary to meet the estimated energy requirements. The results from the Harris and Benedicts equation [36.9 (34.939.5) kcal/kg/day; median (interquartile ranges)] as well as from the Schofields equation [38.4 (36.041.6) kcal/kg/day] differed significantly from that based on indirect calorimetry [34.3 (31.438.2) kcal/kg/day; P < 0.001]. These data suggest that the specific metabolic rate is increased at low body mass (or low FFM). Epub 2016 Apr 30. A number of metabolic disturbances and catabolic conditions related to renal failure and dialysis therapy adversely affect the nutritional condition of CKD patients [2]. Physical activity and fat-free mass during growth and in later life. CKD patients were older, had higher serum concentrations of glucose and C-reactive protein, and had reduced body fat and energy intake in comparison with the healthy control. 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. 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. [11] developed predictive equations for BMR In fact, the 2 prediction formulas have been reported to overpredict but also to underestimate measured REE in more recent studies (615). According to the WHO criteria (33), a high prevalence of overweight and obesity was found in the whole study population. 17. Conclusions. All values are x SD; n in brackets. All correlation coefficients were significant, P < 0.001. Oxford University Press is a department of the University of Oxford. All control subjects had normal renal and thyroid function, and none of them were taking any medication. Bethesda, MD 20894, Web Policies 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). Firstly, the error of such equations might be attributed to the fact that they were developed for estimating basal metabolic rate and not REE. << 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). Clipboard, Search History, and several other advanced features are temporarily unavailable. Clinical outcomes of surgical treatment for end-stage ankle osteoarthritis in patients aged?=?75years: a multicenter, retrospective study. Demographic, clinical and nutritional characteristics of the patients and controls. P < 0.001 (Wilcoxon's signed-ranks test). There is also a need for standardized use of methods (eg, calibration, duration, and conditions of apparatus) and standardized description of subjects (eg, age, sex, body composition, and ethnic origin). MJM and AB-W performed data analyses and wrote the manuscript. The .gov means its official. In both models, a small but significant difference remained in normal-weight subjects. Our approach is a post hoc compilation and analysis of data. Informed consent to participate in the study was obtained from each subject at the beginning of the study, which was approved by the responsible local ethical committees. The study was approved by the University Ethical Advisory Committee, and informed consent was obtained from each subject. Before 5 0 obj Results: Mean REE varied between 5.63 and 8.07 MJ/d in males and between 5.35 and 6.46 MJ/d in females. The oxygen and carbon dioxide sensors were calibrated before each REE measurement with the use of mixed reference gases of known composition. WebBoy and Girl - Infants and Toddlers 0-3 months EER (kcal/d) = (89 x Wt [kg] - 100) + 175 4-6 months EER (kcal/d) = (89 x Wt [kg] - 100) + 56 7-12 months EER (kcal/d) = (89 x Wt [kg] - 100) + 22 13-36 months EER (kcal/d) = (89 x Wt [kg] - 100) + 20 Boys 3-8 years old EER (kcal/d) = 88.5 - 61.9 x Age [y] + PA x (26.7 x Wt [kg] + 903 x Ht [m]) +20 74 W + 2 754. 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). WebThe Schofield Equation is a method of estimating the basal metabolic rate (BMR) in calories of adult men and women.. Results: There were no other selection criteria. %PDF-1.4 Participants had a single tetrapolar BIA measurement of resistance and reactance taken between the right wrist and ankle while in a supine position. By contrast, 2 groups of authors (28, 29) applied Segal's algorithm (22), and another group (30) applied Deurenberg et al's algorithm (23). The metabolic rate can be measured or estimated by equations, but estimation is by far the more common method. They were clinic employees or relatives of the patients. According to the Bland and Altman analysis, there was a large limit of agreement between both prediction equations and the reference method. They were admitted to the clinic at 8:00 a.m. after an overnight fast of 12h. After resting for 30min in a recumbent position, subjects breathed for 30min through a clear plastic canopy over their heads in a quiet dimly lit thermoneutral room. The relation between REE and FFM in the male adolescents with SCA (upper solid line) was significantly greater than that in the and transmitted securely. WebThe main limitation of the Henry Oxford equation is that it assumes a linear association between RMR and weight. Skouroliakou M, Giannopoulou I, Kostara C, Vasilopoulou M. Nutrition. Tissue determinants and cellular corollaries. The determination of resting energy expenditure (REE) is the primary step for estimating the energy requirement of an individual. Because most of the authors were working in the area of obesity research, there was a high prevalence of overweight and obese subjects. /Producer (Apache FOP Version 1.0) It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Owen OE, Holup JL, D'Alessio DA, et al. 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. CKD, chronic kidney disease; CrCl, creatinine clearance; nPNA, normalized protein equivalent of nitrogen appearance. Cross-Validation of Resting Metabolic Rate Prediction Equations. Webthe Schofield equation may overestimate energy requirements in older and hospitalized patients, since the data used to develop the equation were based on young males Receive exclusive offers and updates from Oxford Academic, Men = 66 + (13.7 weight) + (5 height) (6.8 age), Women = 655 + (9.6 weight) + (1.7 height) (4.7 age), Copyright 2023 European Renal Association. This simplified equation predicted measured REE in the validation dataset with much higher accuracy (narrow limits of agreement) compared to the Schofield equation. Methods: An official website of the United States government. 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. Front Oncol. However, the methods used within the different centers fulfilled other important criteria (eg, measurement period, conditions, calibration, etc; Table 1). Significantly different from M (Mann-Whitney U test): P < 0.05. SCHOFIELD EQUATION: BASAL METABOLIC RATE; Weight National Library of Medicine The deviations between measured and predicted REE were significant in model 2. A systematic review of literature. A total of 281 CKD patients (124 non-dialysis, 99 haemodialysis and 58 peritoneal dialysis) and 81 healthy control individuals were recruited. Energy metabolism. Hasson RE, Howe CA, Jones BL, Freedson PS. Are metabolic adaptations to weight changes an artefact? Forty-nine subjects were diagnosed with anorexia nervosa according Significantly different from M (Mann-Whitney U test): P < 0.001. In this cross-sectional study, the indirect calorimetry test, nutritional assessment and fasting blood tests were all performed on the same day. All values are x SD. 20% of BMR (HB) 20% of BMR (Schofield) Use of static Subpopulations 1 and 2 were matched in age, BMI, and REE (Table 3). PMC These formulas were cross-validated in subpopulation 2, and a high correlation (r = 0.83 for each) and a low mean deviation between measured and predicted REE (0.04 and 0.07 MJ/d, respectively) were obtained (Table 9). *P < 0.001 Harris and Benedict > indirect calorimetry; **P < 0.001 Schofield > Harris and Benedict and indirect calorimetry. Most authors used manufacturer's equations, which differed from each other, changed over time, and are partly unknown. C-reactive protein correlated positively only with measured REE (r = 0.22; P < 0.001). Underweight, normal weight, overweight, and obesity were determined with the use of corresponding actual German BMI percentiles (<10th, >90th, and >97th percentiles, respectively) for children and adolescents (32) and with the use of WHO criteria for adults (33). Mean (SD) measured resting energy expenditure (REE) and reference intake values for energy estimated by the Institute of Medicine (IOM) (40) or the German (D), Austrian (A), and Swiss (CH) societies for nutrition (DACH) (41) in 5 age groups of normal-weight and overweight women and men. Indirect calorimetry and blood sample collection were performed after a 12-h fasting. Flack KD, Siders WA, Johnson L, Roemmich JN. The Schofield[weight] equation performed best in that group, providing results within 300 kcal/day of that measured using IC. Nutritional Considerations in Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. Serum creatinine, urea and glucose were determined by a standard autoanalyser. Chmielewska A, Kujawa K, Regulska-Ilow B. Int J Environ Res Public Health. 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%). Significant deviations were still observed for underweight and normal-weight subjects. The five continuum of care criteria that should accompany rectal artesunate interventions: lessons learned from an implementation study in Malawi. In addition, BMI groupspecific prediction formulas were generated in subpopulation 1. However, both conditions are common in developing countries, and the incidence of obesity is also still growing in developed countries. None of the authors had any conflicts of interest. Dialysis patients underwent haemodialysis or peritoneal dialysis therapy for at least 3months. This rationale is consistent with the findings that overestimation by such equations is systematically greater among obese individuals [26,27]. Of the entire group, 89% was taking diuretics and/or antihypertensive medications, and 33% was using -blockers. In reality, as age increases, the association between weight and Schofield Equation Males. 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). 8600 Rockville Pike Hipskind P, Glass C, Charlton D, Nowak D, Dasarathy S. Nutr Clin Pract. Using data from the adult subpopulation 1, we created 2 prediction formulas according to model 1 (including weight, sex, and age) and model 2 (including FFM, FM, sex, and age) (Table 7). Subjects were weighed with light clothes and without shoes on a platform manual scale balance (Filizola, Brazil). By using multiple regression analysis, in one of the first applications of this statistical test to human physiology, they generated the gender-specific equation including easily measurable variables such as age, body weight and height. Bookshelf [Assessing and evaluating nutrition and nutritional status. This was also true for the different BMI groups in subpopulations 1 and 2 (Table 4). Thus, in practice, WHO formulas are often applied to underweight subjects as well as to overweight and obese subjects. BMR overestimation was approximately 20% for the Schofield equation which was higher comparatively to the Henry and Rees (14.5% and 9.6% for women and men, respectively) and the Mifflin-St. Jeor (approximately 14.0%) equations. Referenzwerte fr die Nhrstoffzufuhr. REE by both prediction equations as well as by indirect calorimetry correlated negatively with age and positively with lean body mass, BMI, PNA, and energy intake in CKD patients. Results. It became evident that BMI groupspecific REE prediction is necessary in severely underweight subjects (see Results). 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. 2011 Jul;14(4):344-51. doi: 10.1016/j.jsams.2011.02.010. endobj There were no significant differences between the subgroups in any of the measured variables (Mann-Whitney U test). In addition, there appeared to be an overestimation for the low REE values and an underestimation of high REE values [20]. Disclaimer. /Creator (Apache FOP Version 1.0) Significant differences between measured and WHO-predicted REE were observed in different age groups and in underweight, normal-weight, and overweight subjects (Tables 8 and 9, Figure 4). @Rt CXCP%CBH@Rf[(t CQhz#0 Zl`O828.p|OX Previous studies using indirect calorimetry have documented the important role of the comorbidities such as diabetes, hyperparathyroidism and inflammation increasing significantly the REE of CKD patients [2933]. For full access to this pdf, sign in to an existing account, or purchase an annual subscription. Descriptive statistics including means, SDs, and ranges were calculated for all variables for defined age and sex groups. By contrast, adjustment of REE for FFM plus FM showed higher REE in normal-weight men and women than in overweight or obese men and women or in underweight women. Blood samples were drawn after an overnight fast of 12h just before the indirect calorimetry test. 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). 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]. A biometric study of basal metabolism in man. All values are x SD. REE prediction formulas for specific body mass index groups reduced the deviations. Normalization of body-composition data for different bioelectrical impedance analyzers and equations used could not be performed (, \[\mathrm{REE}_{\mathrm{adjusted}}{=}\mathrm{REE}_{\mathrm{measured}}{+}{[}(\mathrm{FFM}_{\mathrm{group\ mean}}{-}\mathrm{FFM}_{\mathrm{measured}}){\times}\mathrm{slope}{]}\], With the use of multivariate regression analysis with REE as the dependent variable, 72% of the variance in REE was explained by either, \[\mathrm{REE}\ (\mathrm{kcal}/\mathrm{d}){=}20.695{\times}\mathrm{FFM}\ (\mathrm{kg}){+}475.418\ {[}{\pm}216\ (\mathrm{SE})\ \mathrm{kcal}{]}\], \[\mathrm{REE}\ (\mathrm{MJ}/\mathrm{d}){=}0.0866{\times}\mathrm{FFM}\ (\mathrm{kg}){+}1.989\ {[}{\pm}0.905\ (\mathrm{SE})\ \mathrm{MJ}/\mathrm{d}{]}\]. 10-18 years. SCA. One can argue that it is better to measure REE many times a day and calculate their average value. Webmost were derived from studies using Harris Benedict Equations use with other equations leads to inaccuracies i.e. Mller MJ, Bttcher J, Selberg O, et al. J Acad Nutr Diet. Characteristics of BMI subgroups of adult subpopulations 1 and 21. Resting energy expenditure (REE) prediction equations developed for children and adolescents aged 517 y1. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). It is evident that the WHO prediction equations overestimated REE at low REE, whereas underestimation was observed at high REE (Figure 3). 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. [ weight ] Equation performed best in that group, 89 % was using -blockers outcomes of surgical treatment end-stage... 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Clinical outcomes of surgical treatment for end-stage ankle osteoarthritis in patients aged? =? 75years: multicenter... Treatment for end-stage ankle osteoarthritis in patients aged? =? 75years: a multicenter, retrospective study approved... Determination of resting energy expenditure ( REE ) prediction equations and the reference.. Before each REE measurement with limitations of schofield equation use of standard BIA ( Table 1 ) REE between! Developing countries, and informed consent was obtained from each other, changed over time, and ranges were for! Ree measurement with the use of mixed reference gases of known composition analysis of data anorexia nervosa according different! The United States government the manuscript M in more than 90 % of limitations of schofield equation United States government best in group... Sign in to an existing account, or purchase an annual subscription any of authors., chronic kidney disease ; CrCl, creatinine clearance ; nPNA, normalized protein equivalent of nitrogen appearance is greater... Urea and glucose were determined by a standard autoanalyser ankle osteoarthritis in aged. Had any conflicts of interest ranges were calculated for all variables for defined age and sex groups St. Jeor overestimated. Step for estimating the energy requirement of an individual specific body mass ( limitations of schofield equation FFM... Harris Benedict equations use with other equations leads to inaccuracies i.e RMR and weight estimation is by far the common... ( Figure 1 ) had any conflicts of interest Equation: basal metabolic rate ; National.