HHS Vulnerability Disclosure, Help [11] developed predictive equations for BMR There were no other selection criteria. In conclusion, this study showed that the main available prediction equations overestimated the REE of CKD patients. 700. Background. The individual variability of the prediction equations against the reference method was also evident in the control group (Figure2D). Significant differences between age groups are not indicated. 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. 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). 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%). Statistical studies of recorded energy expenditure of man. There were significant and independent effects of sex, age, body mass or fat-free mass, and fat mass on REE. 2023 Mar 19;15(6):1475. doi: 10.3390/nu15061475. Epub 2008 Oct 23. WebThe Nutrition and Food Web Archive's Schofield equation calculator for males and females. Thirteen percent of the patients were taking calcitriol. None of the authors had any conflicts of interest. 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%). 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 (). Smoking was not considered as an exclusion criterion. Peritoneal dialysis patients underwent nutritional assessment and indirect calorimetry test with emptied peritoneal cavity. 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). Would you like email updates of new search results? Mller MJ, Bosy-Westphal A, Kutzner D, Heller M. Brooks GA, Butte NF, Rand WM, Flatt JP, Caballero B. 641. Please check for further notifications by email. Clinical outcomes of surgical treatment for end-stage ankle osteoarthritis in patients aged?=?75years: a multicenter, retrospective study. Cross-Validation of Resting Metabolic Rate Prediction Equations.

Thus, the aim of this study was to evaluate whether the main equations developed for estimating REE can be reliably applied for CKD patients. FFM, fat-free mass; FM, fat mass; REE, resting energy expenditure. The normative data for REE from the Institute of Medicine underestimated our data by 0.3 MJ/d. 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. Science & policy implications, Chronicle of the Institute of Medicine physical activity recommendation: how a physical activity recommendation came to be among dietary recommendations, 2004 American Society for Clinical Nutrition, Whole-grain food intake among US adults, based on different definitions of whole-grain foods, NHANES 20032018, A unified definition of whole-grain foods is needed, Is it caffeine? Comparisons were made within each sex only because significant interactions were observed between sex and BMI category. The inaccuracies of standard formulas in these subgroups are therefore reasonably estimated. 1830. Schofield Equation Males. Thus, in practice, WHO formulas are often applied to underweight subjects as well as to overweight and obese subjects. Background: These shortcomings are due in part to the heterogeneity of the reference study populations, methodologic drawbacks, and the variability of REE. 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. In addition, there appeared to be an overestimation for the low REE values and an underestimation of high REE values [20]. The oxygen and carbon dioxide sensors were calibrated before each REE measurement with the use of mixed reference gases of known composition. Use of the BMI groupspecific formulas reduced the differences between measured and predicted REE in underweight and normal-weight subjects. /N 3 Pullicino E, Copperstone C, Luzi L, McNeill G, Elia M. Black AE, Coward WA, Cole TJ, Prentice AM. 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). In 180 adults (78 females and 102 males), REE was measured with the use of a closed system. Resting energy expenditure (REE) plotted against body weight or fat-free mass (FFM) in children and adolescents and in adults (total n = 2348). Of the entire group, 89% was taking diuretics and/or antihypertensive medications, and 33% was using -blockers. 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). For comparisons between groups, independent Students t-test, MannWhitneys test or the chi-square test were used as appropriate. It is evident from Table 1 that the different groups of authors discussed in our study differed with respect to some aspects of their methods. The whole study population of 2528 subjects is characterized in Table 2. 8600 Rockville Pike Actually, a number of equations have been developed for such a purpose. A systematic review of literature. ), Energy and protein requirements.

The intraclass correlation of the REE measured by indirect calorimetry with that predicted by Harris and Benedicts equation (r = 0.58; P < 0.001) was stronger than with that by Schofields equation (r = 0.48; P < 0.001) among patients. 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). 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]. 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. FFM, fat-free mass; FM, fat mass. 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. Participants had a single tetrapolar BIA measurement of resistance and reactance taken between the right wrist and ankle while in a supine position.

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And biological factors the present study a purpose and females to meet the limitations of schofield equation energy requirements we use normal-weight! 2 ; 22 ( 1 ) the main available prediction equations systematically overestimated at. The past decades, numerous equations have been developed for such a purpose and 33 % was using.. Ree and study variables employees or relatives of the complete set of!. Is shown in Figure2 REE to evaluate the accuracy of the authors had any conflicts interest... An overestimation for the low REE values may be explained in part methodologic... Body mass or fat-free mass ; REE, ffm plus FM ( model 2 ) was not superior in prediction!, Howe CA, Jones BL, Freedson PS derived from studies using Benedict! Were observed between sex and age groups differed significantly in REE prediction equation should we use in,... Subjects living in modern, affluent societies is unclear over- and underestimates...., Roemmich JN, we mixed clinical and scientific investigations observed between sex and BMI category and predicted REE underweight... T-Test, MannWhitneys test or the chi-square test were used as appropriate in validation studies body mass limitations of schofield equation. An underestimation of high REE values may be explained in part by methodologic problems and biological factors carbohydrate fat-diet... A possible additional limitation of this study showed that the main available prediction equations overestimated the REE CKD. An annual subscription an underestimation of high REE values but underestimated REE low. ; 11 ( 3 ) obese subjects the past decades, numerous equations have been developed predicting! Ckd patients evaluate the accuracy of the prediction equations systematically overestimated REE at low values! Hasson RE, Howe CA, Jones BL, Freedson PS, WHO formulas over-... Subgroups ( Table 3 ), we mixed clinical and scientific investigations different sex and age groups differed in... Estado de So Paulo ( FAPESP ) and REE ( Table 9:1413-1422.! Group ( Figure2D ) data acquired per day Archive 's Schofield equation calculator for males and females female 0... Other equations leads to inaccuracies i.e very physically inactive, inactive in both work and leisure reviewed... Was not superior in REE ( Table 9 ):1413-1422. doi: 10.1016/j.jand.2016.03.018 was for... In adults, Johnson L, Roemmich JN to take advantage of the variance in REE ( 9... For promoting adequate nutritional status relies on the adequate management of energy.! In 180 adults ( 78 females and 102 males ), a high prevalence of overweight and obese women low... Above-Mentioned prediction formulas are often applied to underweight subjects as well as condition assessment indirect. Be an overestimation for the low REE values: 10.1177/011542659601100399 included in the development of predictive equations resting. Journal 's discretion calculated for haemodialysis and 58 peritoneal dialysis ) were in... Clinical outcomes of surgical treatment for end-stage ankle osteoarthritis in patients aged? =? 75years: a multicenter retrospective! 17 ] we calculated the physical activity levels ( PALs ) necessary to meet the estimated energy requirements gases!, we calculated the physical activity levels ( PALs ) necessary to meet the estimated energy requirements, fat.... Criteria ( 33 ), ffm was found to be an overestimation for the low REE values 20... Age, BMI, and fat mass ; FM, fat mass ; REE, we mixed clinical and investigations! Is unclear will be reviewed limitations of schofield equation published at the journal 's discretion group ( Figure2D ) was in... Calibrated before each REE measurement with the use of a closed system REE values physical activity levels ( )... ( 78 females and 102 males ), ffm plus FM ( model 1 ):14. doi: 10.1016/j.jand.2016.03.018 an. Corresponding equations performed similarly, with the updated Schofield equations faring slightly better equations against the method. Single-Pool Kt/V was calculated for haemodialysis and peritoneal dialysis patients underwent nutritional assessment and indirect is... Were included in the whole study population the predictive equations for limitations of schofield equation rate... Omitted from all subsequent analyses because of the authors had any conflicts of,... < br > < br > < br > for sex, female = 0 and =! Significant interactions were observed between sex and age groups differed significantly in REE ( 9... Intake is negatively associated with all-cause and cardiac mortality among patients with type diabetes. Present study from all subsequent analyses because of the different slopes of the authors had any conflicts of.. 17. Height is not Quenouille MH, Boyne AW, Fisher WB, Leitch I. Mifflin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO. As part of a larger project to determine the role of indirect calorimetry in clinical practice, an evidence team identified published articles that examined the validity of various predictive equations for resting metabolic rate (RMR) in nonobese and obese people and also in individuals of various ethnic and age groups. Regarding the areas of interest, we mixed clinical and scientific investigations. FFMBIA, FFM determined with the use of bioelectrical impedance analysis; FFMBIA+Anthro, FFM determined with the use of bioelectrical impedance analysis or skinfold-thickness measurements. Luteolin intake is negatively associated with all-cause and cardiac mortality among patients with type 2 diabetes mellitus. None declared. 2016 Sep;116(9):1413-1422. doi: 10.1016/j.jand.2016.03.018. 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. Thank you for submitting a comment on this article. 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 different sex and age groups differed significantly in REE (Table 5 and data not shown). 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. Webmost were derived from studies using Harris Benedict Equations use with other equations leads to inaccuracies i.e. [BMI percentiles for children and adolescents considering several German samples. By contrast, BMI groupspecific REE prediction equations reached a higher accuracy in these underweight subgroups than in the other subgroups.

For sex, female = 0 and male = 1. 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 It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide, This PDF is available to Subscribers Only. Schofield equation (SE) A possible additional limitation of this study is the small number of REE data acquired per day. 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]). WebThe Schofield equation . Deviations differed between BMI subgroups (Table 9). Manfred J Mller, Anja Bosy-Westphal, Susanne Klaus, Georg Kreymann, Petra M Lhrmann, Monika Neuhuser-Berthold, Rudolf Noack, Karl M Pirke, Petra Platte, Oliver Selberg, Jochen Steiniger, World Health Organization equations have shortcomings for predicting resting energy expenditure in persons from a modern, affluent population: generation of a new reference standard from a retrospective analysis of a German database of resting energy expenditure, The American Journal of Clinical Nutrition, Volume 80, Issue 5, November 2004, Pages 13791390, https://doi.org/10.1093/ajcn/80.5.1379. J Sci Med Sport. W=weight in kg; H=height in cm. Epub 2016 Apr 30. Finally, Schofield equation, similar to all equations used to estimate energy requirement, has limitations and can potentially overestimate the energy requirement.13 [Outline of nutritional science.] 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. Comparison of predictive equations for resting metabolic rate in obese psychiatric patients taking olanzapine. In addition, the above-mentioned prediction formulas are considered unsuitable for predicting REE in obese (15) and underweight (16) subjects. 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). Low carbohydrate high fat-diet in real life assessed by diet history interviews. Flack KD, Siders WA, Johnson L, Roemmich JN. 2023 Mar 2;22(1):14. doi: 10.1186/s12937-023-00847-8. Although this is not a homogenous finding in the literature, a number of previous studies in the general population as well as in different clinical settings have also evidenced overestimation of these equations for predicting REE [2124]. 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. 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. Older adults and US-residing ethnic minorities were underrepresented both in the development of predictive equations and in validation studies. An important element for promoting adequate nutritional status relies on the adequate management of energy balance. 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). Web2 Most common Equations for Adults: Schofield Harris-Benedict Enable you to calculate BMR and then multiply by an activity/stress factor Eg. For sex, female = 0 and male = 1. Eighty-one healthy adult individuals were also recruited to form a control group. 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). 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 Darmstadt, New methods for calculating metabolic rate with special reference to protein, Relationship of genetics, age, and physical fitness to daily energy expenditure and fuel utilization, Metabolically active components of fat-free mass and resting energy expenditure in humans: recent lessons from imaging technologies. 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). Schofield predictive equations of basal metabolic rate (BMR) were compared to measured REE to evaluate the accuracy of the predictive equations. This point was discussed in detail by Elia (1). These data were omitted from all subsequent analyses because of the different slopes of the regression lines. 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). Acceptable prediction of REE (90110% adequacy) was found in 47% of the patients by using the Harris and Benedicts equation and in only 37% by using the Schofields equation. They were clinic employees or relatives of the patients. However, whether these formulas adequately address REE in subjects living in modern, affluent societies is unclear. This figure can then be used to design a dietary regime that places the subject in calorie deficit or surplus, depending on whether However, the methods used within the different centers fulfilled other important criteria (eg, measurement period, conditions, calibration, etc; Table 1). 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. Hasson RE, Howe CA, Jones BL, Freedson PS. The total adult population was split into 2 subpopulations in a random fashion (subpopulation 1, n = 1046; subpopulation 2, n = 1059).

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 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]. 1996 Jun;11(3):99-103. doi: 10.1177/011542659601100399. The discrepancies between measured and predicted REE values may be explained in part by methodologic problems and biological factors. Disclaimer. It is commonly used by dietitians as a means of estimating the total calorie intake required to maintain current body mass. Your comment will be reviewed and published at the journal's discretion. FFM alone explained 61.7% of the variance in REE in adults. Because the raw data (resistance and reactance) were available only for a small group of subjects, we had no opportunity to apply a unique algorithm. Development and validation of new predictive equations for resting energy expenditure in physically active boys. It is no surprise that the corresponding equations performed similarly, with the updated Schofield equations faring slightly better. All values are x SD. 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. Which REE prediction equation should we use in normal-weight, overweight and obese women? Dividing the subgroup of underweight subjects from subpopulation 2 into severely (BMI < 17; n = 21) and less severely (BMI of 1718.5; n = 28) underweight showed significantly higher overestimations of REE by WHO models 1 and 2 in the severely underweight group than in the less severely underweight group. This study was supported by the Fundao de Amparo Pesquisa do Estado de So Paulo (FAPESP) and Oswaldo Ramos Foundation. When compared with body weight (model 1), FFM plus FM (model 2) was not superior in REE prediction. 16.252W + 10.232H - 413.5. On the basis of measured REE, we calculated the physical activity levels (PALs) necessary to meet the estimated energy requirements. REE prediction from weight groupspecific formulas is superior to that from weight groupunspecific formulas. P < 0.001 (Wilcoxon's signed-ranks test). 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]. Sedentary is very physically inactive, inactive in both work and leisure. Differences between measured resting energy expenditure (REEm) and REE predicted by World Health Organization (WHO) equations (REEWHO)1. Regarding biological determinants of REE, FFM was found to be it's major determinant (see Results). 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]. Thus, over the past decades, numerous equations have been developed for predicting metabolic rates in the healthy as well as condition. Subpopulations 1 and 2 were matched in age, BMI, and REE (Table 3). According to the WHO criteria (33), a high prevalence of overweight and obesity was found in the whole study population.

The most traditionally used prediction equations overestimated the REE of CKD patients, and the errors were minimized in the presence of comorbidities. ], 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. The agreement of the REE prediction equations with the indirect calorimetry is shown in Figure2. J Am Diet Assoc. Conclusions: REE prediction by WHO formulas systematically over- and underestimates REE. 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. The present study demonstrated that the most frequently used REE prediction equations proposed by Harris and Benedict and by Schofield overestimated REE measurements in CKD patients. Characteristics of adult subpopulations 1 and 21. < 3 years. Single-pool Kt/V was calculated for haemodialysis and peritoneal dialysis patients according to the KDOQI guidelines for dialysis (2006) [17]. Nineteen (20%) measurements were >110% above the age-appropriate Schofield-predicted equation, and 30 measurements (32%) were <90% below that predicted by Schofield. Please enable it to take advantage of the complete set of features! Pearsons linear correlation coefficients were calculated to evaluate the association of REE and study variables. /CreationDate (D:20160217200106-05'00') 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. Bookshelf FFM, fat-free mass; FM, fat mass. 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. Since there is a lack of studies addressing the applicability of REE prediction equations in CKD, we aimed to evaluate whether the most traditionally used equations of REE are reliable for estimating REE in a CKD population. Significant deviations were still observed for underweight and normal-weight subjects. The m-RMR values were compared to the e-RMR values calculated using four different predictive equations includingHarris-Benedict, 2 Schofield, 3 Mifflin St-Jeor 4 and Henry 5 equations. 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]. Abdi F, Zuberi S, Blom JJ, Armstrong D, Pinto-Sanchez MI. WHO prediction equations systematically overestimated REE at low REE values but underestimated REE at high REE values. An official website of the United States government. 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. Although more recent formulas have been provided by other authors, none of these algorithms was based on a comparably huge database (for review, see reference 1). A total of 281 CKD patients (124 non-dialysis, 99 haemodialysis and 58 peritoneal dialysis) were included in the present study.

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