Comparison of Predictive Equations for Resting Metabolic Rate in Healthy Nonobese and Obese Adults: A Systematic Review

An assessment of energy needs is a necessary component in the development and evaluation of a nutrition care plan. The metabolic rate can be measured or estimated by equations, but estimation is by far the more common method. However, predictive equations might generate errors large enough to impact...

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Bibliographic Details
Published in:Journal of the American Dietetic Association 2005-05, Vol.105 (5), p.775-789
Main Authors: Frankenfield, David, Roth-Yousey, Lori, Compher, Charlene
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adults
Analysis. Health state
Basal Metabolism - physiology
Biological and medical sciences
Body Mass Index
Calorimetry, Indirect
Comparative analysis
Epidemiology
Ethnic Groups
Female
General aspects
Humans
Male
mathematical models
Mathematics
Medical sciences
Metabolism
Middle Aged
Obesity
Obesity - metabolism
Predictive Value of Tests
Public health. Hygiene
Public health. Hygiene-occupational medicine
resting metabolic rate
Sensitivity and Specificity
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Summary:An assessment of energy needs is a necessary component in the development and evaluation of a nutrition care plan. The metabolic rate can be measured or estimated by equations, but estimation is by far the more common method. However, predictive equations might generate errors large enough to impact outcome. 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. 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. Articles were accepted based on defined criteria and abstracted using evidence analysis tools developed by the American Dietetic Association. Because these equations are applied by dietetics practitioners to individuals, a key inclusion criterion was research reports of individual data. The evidence was systematically evaluated, and a conclusion statement and grade were developed. 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]). Of these equations, the Mifflin-St Jeor equation was the most reliable, predicting RMR within 10% of measured in more nonobese and obese individuals than any other equation, and it also had the narrowest error range. No validation work concentrating on individual errors was found for the WHO/FAO/UNU equation. Older adults and US-residing ethnic minorities were underrepresented both in the development of predictive equations and in validation studies. 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. RMR estimation errors would be eliminated by valid measurement of RMR with indirect calorimetry, using an evidence-based protocol to minimize measurement error. The Expert Panel advises clinical judgment regarding when to accept estimated RMR using predictive equations in any given individual. Indirect calorimetry may be an important too
ISSN:0002-8223
2212-2672
1878-3570
2212-2680
DOI:10.1016/j.jada.2005.02.005