Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
J Nutr Health Aging. 2013 Jan;17(1):39-44. doi: 10.1007/s12603-012-0387-3.
Assessment of energy needs is a critical step in developing the nutrition care plan, especially for individuals unable to modulate their own energy intakes. The purpose of this study was to assess precision and accuracy of commonly used prediction equations in comparison to measured resting energy expenditure in a sample of "oldest old" adults residing in long term care (LTC).
Resting energy expenditure (mREE) was measured by indirect calorimetry in 45 residents aged 86.1 ± 7.3 years, and compared to frequently used prediction equations (pREE): Mifflin St.Jeor, Harris Benedict, World Health Organization and Owen. Precision and accuracy were determined by concordance correlation coefficients and number of individuals within ± 10% of mREE. Bland Altman plots with linear dependence trends were constructed to visualize agreement. To complete analyses, the common 25 kcal/kg formula was assessed and alternative formulas were determined for best fit by regressing adjusted mREE on body weight.
mREE averaged 976.2 ± 190.3 kcal/day for females and 1260.0 ± 275.9 kcal/d for males. The strength of the relationships between pREE and mREE were only moderate (r = 0.41 - 0.72). In examining linear trends in the Bland Altman plots, significant systematic deviation from mREE was detected for all pREE. Two kcal/kg formulas were generated: 20.6 kcal/kg for females and 22.7 kcal/kg for males, which were not significantly different.
None of the prediction equations adequately estimated energy needs in this sample of the "oldest old." A simple formula using 21-23 kcal/kg may be a more practical and reliable method to determine energy needs in the LTC setting.
评估能量需求是制定营养护理计划的关键步骤，特别是对于那些无法调节自身能量摄入的个体。本研究旨在评估常用预测方程在长期护理（LTC）中“最年长”老年人样本中与测量静息能量消耗（REE）相比的精确性和准确性。
通过间接测热法测量了 45 名年龄为 86.1 ± 7.3 岁的居民的静息能量消耗（mREE），并与常用的预测方程（pREE）进行了比较：Mifflin St. Jeor、Harris Benedict、世界卫生组织和 Owen。通过一致性相关系数和 mREE 的±10%范围内的个体数量来确定精密度和准确性。构建 Bland Altman 图以可视化线性依赖趋势的一致性。为了完成分析，评估了常用的 25kcal/kg 公式，并通过回归调整后的 mREE 与体重来确定最佳拟合的替代公式。
女性的 mREE 平均值为 976.2 ± 190.3kcal/天，男性为 1260.0 ± 275.9kcal/d。pREE 与 mREE 之间的关系强度仅为中度（r = 0.41-0.72）。在检查 Bland Altman 图中的线性趋势时，所有 pREE 均检测到与 mREE 存在显著的系统偏差。生成了两种千卡/公斤的公式：女性为 20.6kcal/kg，男性为 22.7kcal/kg，两者无显著差异。
在这个“最年长”老年人样本中，没有一种预测方程能够充分估计能量需求。使用 21-23kcal/kg 的简单公式可能是确定 LTC 环境中能量需求的更实用和可靠的方法。
