Department of Endocrinology and Metabolism, Peninsula Medical School (Plymouth Campus), Plymouth, UK.
J Hum Nutr Diet. 2010 Apr;23(2):169-75. doi: 10.1111/j.1365-277X.2009.01032.x. Epub 2010 Jan 15.
Few weight management clinics have access to indirect calorimetry with which to measure energy expenditure. Instead, they use energy expenditure prediction equations, which were not designed for use in obesity. We aimed to establish the extent to which such equations overestimate and underestimate resting energy expenditure (REE) in overweight and obese individuals.
We compared the Schofield, Harris & Benedict, James & Lean and World Health Organisation (WHO) REE prediction equations with the clinical gold standard of indirect calorimetry in 28 males and 168 females, with a mean (SD) age of 28.9 (6.4) years and body mass index (BMI) of 19-67 kg m(-2).
The mean REE estimated by indirect calorimetry, and the Schofield, Harris & Benedict, James & Lean and WHO equations were 8.09, 8.30, 8.09, 8.37 and 8.23 MJ day(-1) (1934, 1983, 1933, 2001 and 1966 kcal day(-1)), respectively. Although rising BMI exerted only a small effect on the mean differences between indirect calorimetry and the predicted REE [Schofield: +272 kJ (+65 kcal)/10 units BMI, P = 0.02; Harris & Benedict: +42 kJ (+10 kcal)/10 units BMI, P = 0.69; James & Lean: +217 kJ (+52 kcal) 10 units BMI, P = 0.06 and WHO: +42 kJ (+10 kcal) BMI, P = 0.11], the variance among overweight and obese patients of BMI >25 was substantially higher compared to that among normal weight subjects of BMI <25, on whom the equations were based. The estimated REE by Schofield for an individual of BMI 35 kg m(-2), for example, could lie anywhere from 2.78 MJ (661 kcal) above the indirect calorimetry value to 2.59 MJ (618) kcal below it.
Prediction equations offer a quick assessment of energy needs for hypocaloric diets although, in reality, they run the random risk of excessive restriction or further weight gain.
很少有体重管理诊所能够使用间接测热法来测量能量消耗。相反，他们使用能量消耗预测方程，而这些方程并不是专门为肥胖人群设计的。我们的目的是确定这些方程在多大程度上高估或低估超重和肥胖个体的静息能量消耗（REE）。
我们将临床金标准间接测热法与 Schofield、Harris & Benedict、James & Lean 和世界卫生组织（WHO）REE 预测方程进行比较，共纳入 28 名男性和 168 名女性，平均（SD）年龄为 28.9（6.4）岁，体重指数（BMI）为 19-67 kg/m²。
间接测热法、Schofield、Harris & Benedict、James & Lean 和 WHO 方程分别估计的平均 REE 为 8.09、8.30、8.09、8.37 和 8.23 MJ/天（1934、1983、1933、2001 和 1966 kcal/天）。尽管 BMI 的升高对间接测热法和预测 REE 之间的平均差异影响很小[Schofield：+272 kJ（+65 kcal）/10 个单位 BMI，P=0.02；Harris & Benedict：+42 kJ（+10 kcal）/10 个单位 BMI，P=0.69；James & Lean：+217 kJ（+52 kcal）/10 个单位 BMI，P=0.06；WHO：+42 kJ（+10 kcal）/BMI，P=0.11]，但 BMI>25 的超重和肥胖患者之间的方差明显高于基于这些方程的 BMI<25 的正常体重患者之间的方差。例如，BMI 为 35 kg/m²的个体的 Schofield 估计 REE 可能在间接测热值的 2.78 MJ（661 kcal）以上到 2.59 MJ（618 kcal）以下的任何位置。
尽管预测方程可快速评估低热量饮食的能量需求，但实际上，它们存在过度限制或进一步体重增加的随机风险。
