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Resting energy expenditure and body composition in patients with head and neck cancer: An observational study leading to a new predictive equation.
Nutrition. 2018 Jul - Aug; 51-52:60-65.N

Abstract

OBJECTIVES

Patients with head and neck cancer have changes in body composition and resting energy expenditure (REE) related to significant inflammatory processes. We investigated REE and body composition in a population of patients with head and neck cancer, comparing the measured REE with predicted energy expenditure and deriving an equation of anthropometric values and body composition.

METHODS

This retrospective, observational, descriptive study of a single center included patients with head and neck cancer. We evaluated nutritional status by body mass index (BMI) and Patient-Generated Subjective Global Assessment (PG-SGA), body composition by electric bioimpedance, and REE by indirect calorimetry (IC).

RESULTS

We included 140 patients, most of whom were men (80.7%), 60 y or older (58.6%), and had advanced disease (77.9%). Most were malnourished by BMI standards (77.9%) and severely malnourished according to the PG-SGA (49.3%), with a fat-free mass below the ideal values (82.9%) associated with sarcopenia (92.1%). Hypermetabolism was 57%. When comparing REE with the Harris-Benedict formula, we found the agreement limits from -546 613 to 240 708, the mean difference was -152 953 (95% confidence interval [CI], -185 844 to -120 062) and Pitman's variance test was r = -0.294 (P = 0.001). When we included the activity factor and the thermogenesis factor in REE and compared with Harris-Benedict, we found the agreement limits from -764.423 to 337.087, a mean difference of -213.668 (95% CI -259.684 to -167.652), and the Pitman's variance text at r = -0.292 (P = 0.001).

CONCLUSION

Predictive equations, generally recommended by guidelines, are imprecise when compared with IC measures. Therefore, we suggest a new predictive equation.

Authors+Show Affiliations

Indirect Calorimetry and Body Composition Clinic of the Cancer Institute of the State of São Paulo, São Paulo, Brazil. Electronic address: Micheline.pires@gmail.com.Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.Multiprofessional Nutrition and Nutrition Therapy Team of the Cancer Institute of the State of São Paulo, São Paulo, Brazil.Nutrition and Dietetics Service of the Cancer Institute of the State of São Paulo, São Paulo, Brazil.Nutrition and Dietetics Service of the Cancer Institute of the State of São Paulo, São Paulo, Brazil.Center for Translational Research in Oncology (CTO) of the Cancer Institute of the State of São Paulo, São Paulo, Brazil.Department of Gastroenterology, School of Medicine, University of São Paulo, São Paulo, Brazil.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29605765

Citation

Souza, Micheline Tereza Pires, et al. "Resting Energy Expenditure and Body Composition in Patients With Head and Neck Cancer: an Observational Study Leading to a New Predictive Equation." Nutrition (Burbank, Los Angeles County, Calif.), vol. 51-52, 2018, pp. 60-65.
Souza MTP, Singer P, Ozorio GA, et al. Resting energy expenditure and body composition in patients with head and neck cancer: An observational study leading to a new predictive equation. Nutrition. 2018;51-52:60-65.
Souza, M. T. P., Singer, P., Ozorio, G. A., Rosa, V. M., Alves, M. M. F., Mendoza López, R. V., & Waitzberg, D. L. (2018). Resting energy expenditure and body composition in patients with head and neck cancer: An observational study leading to a new predictive equation. Nutrition (Burbank, Los Angeles County, Calif.), 51-52, 60-65. https://doi.org/10.1016/j.nut.2017.12.006
Souza MTP, et al. Resting Energy Expenditure and Body Composition in Patients With Head and Neck Cancer: an Observational Study Leading to a New Predictive Equation. Nutrition. 2018 Jul - Aug;51-52:60-65. PubMed PMID: 29605765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resting energy expenditure and body composition in patients with head and neck cancer: An observational study leading to a new predictive equation. AU - Souza,Micheline Tereza Pires, AU - Singer,Pierre, AU - Ozorio,Gislaine Aparecida, AU - Rosa,Vitor Modesto, AU - Alves,Maria Manuela Ferreira, AU - Mendoza López,Rossana Verónica, AU - Waitzberg,Dan L, Y1 - 2018/02/05/ PY - 2017/09/26/received PY - 2017/12/06/revised PY - 2017/12/08/accepted PY - 2018/4/2/pubmed PY - 2019/10/28/medline PY - 2018/4/2/entrez KW - Harris-Benedict KW - Head and neck cancer KW - Indirect calorimetry KW - Nutrition KW - Predictive equations KW - Resting energy expenditure SP - 60 EP - 65 JF - Nutrition (Burbank, Los Angeles County, Calif.) JO - Nutrition VL - 51-52 N2 - OBJECTIVES: Patients with head and neck cancer have changes in body composition and resting energy expenditure (REE) related to significant inflammatory processes. We investigated REE and body composition in a population of patients with head and neck cancer, comparing the measured REE with predicted energy expenditure and deriving an equation of anthropometric values and body composition. METHODS: This retrospective, observational, descriptive study of a single center included patients with head and neck cancer. We evaluated nutritional status by body mass index (BMI) and Patient-Generated Subjective Global Assessment (PG-SGA), body composition by electric bioimpedance, and REE by indirect calorimetry (IC). RESULTS: We included 140 patients, most of whom were men (80.7%), 60 y or older (58.6%), and had advanced disease (77.9%). Most were malnourished by BMI standards (77.9%) and severely malnourished according to the PG-SGA (49.3%), with a fat-free mass below the ideal values (82.9%) associated with sarcopenia (92.1%). Hypermetabolism was 57%. When comparing REE with the Harris-Benedict formula, we found the agreement limits from -546 613 to 240 708, the mean difference was -152 953 (95% confidence interval [CI], -185 844 to -120 062) and Pitman's variance test was r = -0.294 (P = 0.001). When we included the activity factor and the thermogenesis factor in REE and compared with Harris-Benedict, we found the agreement limits from -764.423 to 337.087, a mean difference of -213.668 (95% CI -259.684 to -167.652), and the Pitman's variance text at r = -0.292 (P = 0.001). CONCLUSION: Predictive equations, generally recommended by guidelines, are imprecise when compared with IC measures. Therefore, we suggest a new predictive equation. SN - 1873-1244 UR - https://www.unboundmedicine.com/medline/citation/29605765/Resting_energy_expenditure_and_body_composition_in_patients_with_head_and_neck_cancer:_An_observational_study_leading_to_a_new_predictive_equation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0899-9007(18)30023-6 DB - PRIME DP - Unbound Medicine ER -