Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples, Italy.
Department of Clinical Medicine and Surgery, Federico II University Hospital, Pansini 5, 80131 Naples, Italy.
Clin Nutr. 2021 May;40(5):3094-3103. doi: 10.1016/j.clnu.2020.11.027. Epub 2020 Nov 26.
BACKGROUND & AIMS: Estimates of energy requirements, based on measured or predicted resting energy expenditure (REE), are needed to avoid undernutrition or overnutrition (and their clinical consequences) in elderly subjects. The aims of this systematic review were to evaluate the prediction accuracy of REE in healthy elderly subjects and to ascertain which equation is more reliable at group level and/or individual level.
Studies assessing prediction of REE in general elderly population were systematically searched using PubMed, EMBASE, Web of Science and CINAHL until March 2020. Prediction accuracy of REE was assessed at both group (bias) and individual (precision) level for each equation.
Fourteen studies met the inclusion criteria of this systematic review. Bias was reported in 8 papers and calculated in another 5 from absolute values. There was a prevalent tendency towards an overestimation of REE across the studies. The least bias was observed for the Mifflin (-0.3%) and Harris-Benedict (+2.6%) equations, with values above 5% for the FAO/WHO/UNU, Fredrix and Muller equations. Precision widely varied between studies for the same equation. The higher precision was observed using the Harris-Benedict equation (~70%), while the Henry and Mifflin equations provided estimates within 10% of measured values in 65% and 61% of elderly individuals, respectively.
None of the prediction equations considered provides accurate and precise REE estimates in healthy older adults. However, the best prediction is given by the Mifflin equation at group level and by the Harris-Benedict equation at individual level. Further studies with strong quality design are needed to evaluate the variability and accuracy of REE in the elderly general population.
需要根据测量或预测的静息能量消耗（REE）来估算能量需求，以避免老年受试者出现营养不足或营养过剩（及其临床后果）。本系统评价的目的是评估 REE 在健康老年受试者中的预测准确性，并确定哪种方程在组水平和/或个体水平上更可靠。
使用 PubMed、EMBASE、Web of Science 和 CINAHL 系统地搜索了评估一般老年人群 REE 预测的研究，直到 2020 年 3 月。对于每个方程，均在组（偏差）和个体（精度）水平上评估 REE 的预测准确性。
本系统评价纳入了 14 项研究。有 8 篇论文报告了偏差，并从绝对值方面计算了另外 5 篇论文的偏差。研究普遍存在 REE 高估的趋势。Mifflin（-0.3%）和 Harris-Benedict（+2.6%）方程的偏差最小，而 FAO/WHO/UNU、Fredrix 和 Muller 方程的偏差超过 5%。对于同一方程，不同研究之间的精度差异很大。使用 Harris-Benedict 方程观察到较高的精度（~70%），而 Henry 和 Mifflin 方程在 65%和 61%的老年个体中分别提供了与实测值相差 10%以内的估计值。
在健康的老年人中，没有一种预测方程能提供准确和精确的 REE 估计。然而，Mifflin 方程在组水平上提供了最佳的预测，而 Harris-Benedict 方程在个体水平上提供了最佳的预测。需要进一步进行具有较高质量设计的研究，以评估老年人群中 REE 的变异性和准确性。
