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Accuracy of Resting Energy Expenditure Predictive Equations in Patients With Cancer.
Nutr Clin Pract. 2019 Dec; 34(6):922-934.NC

Abstract

BACKGROUND

Our purpose was to assess the accuracy of resting energy expenditure (REE) equations in patients with newly diagnosed stage I-IV non-small cell lung, rectal, colon, renal, or pancreatic cancer.

METHODS

In this cross-sectional study, REE was measured using indirect calorimetry and compared with 23 equations. Agreement between measured and predicted REE was assessed via paired t-tests, Bland-Altman analysis, and percent of estimations ≤ 10% of measured values. Accuracy was measured among subgroups of body mass index (BMI), stage (I-III vs IV), and cancer type (lung, rectal, and colon) categories. Fat mass (FM) and fat-free mass (FFM) were assessed using dual x-ray absorptiometry.

RESULTS

Among 125 patients, most had lung, colon, or rectal cancer (92%, BMI: 27.5 ± 5.6 kg/m2 , age: 61 ± 11 years, REE: 1629 ± 321 kcal/d). Thirteen (56.5%) equations yielded REE values different than measured (P < 0.05). Limits of agreement were wide for all equations, with Mifflin-St. Jeor equation having the smallest limits of agreement, -21.7% to 11.3% (-394 to 203 kcal/d). Equations with FFM were not more accurate except for one equation (Huang with body composition; bias, limits of agreement: -0.3 ± 11.3% vs without body composition: 2.3 ± 10.1%, P < 0.001). Bias in body composition equations was consistently positively correlated with age and frequently negatively correlated with FM. Bias and limits of agreement were similar among subgroups of patients.

CONCLUSION

REE cannot be accurately predicted on an individual level, and bias relates to age and FM.

Authors+Show Affiliations

Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.Department of Oncology, University of Alberta, Edmonton, Alberta, Canada. Department of Medical Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.Department of Oncology, University of Alberta, Edmonton, Alberta, Canada. Department of Medical Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.Department of Kinesiology, Applied Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.Department of Medical Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.Department of Oncology, University of Alberta, Edmonton, Alberta, Canada. Department of Medical Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada.School of Life Sciences, Queen's Medical Centre, The University of Nottingham Medical School, Nottingham, UK.Human Nutrition Research Unit, Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31347209

Citation

Purcell, Sarah A., et al. "Accuracy of Resting Energy Expenditure Predictive Equations in Patients With Cancer." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 34, no. 6, 2019, pp. 922-934.
Purcell SA, Elliott SA, Baracos VE, et al. Accuracy of Resting Energy Expenditure Predictive Equations in Patients With Cancer. Nutr Clin Pract. 2019;34(6):922-934.
Purcell, S. A., Elliott, S. A., Baracos, V. E., Chu, Q. S. C., Sawyer, M. B., Mourtzakis, M., Easaw, J. C., Spratlin, J. L., Siervo, M., & Prado, C. M. (2019). Accuracy of Resting Energy Expenditure Predictive Equations in Patients With Cancer. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 34(6), 922-934. https://doi.org/10.1002/ncp.10374
Purcell SA, et al. Accuracy of Resting Energy Expenditure Predictive Equations in Patients With Cancer. Nutr Clin Pract. 2019;34(6):922-934. PubMed PMID: 31347209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Accuracy of Resting Energy Expenditure Predictive Equations in Patients With Cancer. AU - Purcell,Sarah A, AU - Elliott,Sarah A, AU - Baracos,Vickie E, AU - Chu,Quincy S C, AU - Sawyer,Michael B, AU - Mourtzakis,Marina, AU - Easaw,Jacob C, AU - Spratlin,Jennifer L, AU - Siervo,Mario, AU - Prado,Carla M, Y1 - 2019/07/25/ PY - 2019/7/28/pubmed PY - 2020/4/11/medline PY - 2019/7/27/entrez KW - body composition KW - cancer KW - energy expenditure KW - energy metabolism KW - fat mass KW - fat-free mass KW - indirect calorimetry SP - 922 EP - 934 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 34 IS - 6 N2 - BACKGROUND: Our purpose was to assess the accuracy of resting energy expenditure (REE) equations in patients with newly diagnosed stage I-IV non-small cell lung, rectal, colon, renal, or pancreatic cancer. METHODS: In this cross-sectional study, REE was measured using indirect calorimetry and compared with 23 equations. Agreement between measured and predicted REE was assessed via paired t-tests, Bland-Altman analysis, and percent of estimations ≤ 10% of measured values. Accuracy was measured among subgroups of body mass index (BMI), stage (I-III vs IV), and cancer type (lung, rectal, and colon) categories. Fat mass (FM) and fat-free mass (FFM) were assessed using dual x-ray absorptiometry. RESULTS: Among 125 patients, most had lung, colon, or rectal cancer (92%, BMI: 27.5 ± 5.6 kg/m2 , age: 61 ± 11 years, REE: 1629 ± 321 kcal/d). Thirteen (56.5%) equations yielded REE values different than measured (P < 0.05). Limits of agreement were wide for all equations, with Mifflin-St. Jeor equation having the smallest limits of agreement, -21.7% to 11.3% (-394 to 203 kcal/d). Equations with FFM were not more accurate except for one equation (Huang with body composition; bias, limits of agreement: -0.3 ± 11.3% vs without body composition: 2.3 ± 10.1%, P < 0.001). Bias in body composition equations was consistently positively correlated with age and frequently negatively correlated with FM. Bias and limits of agreement were similar among subgroups of patients. CONCLUSION: REE cannot be accurately predicted on an individual level, and bias relates to age and FM. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/31347209/Accuracy_of_Resting_Energy_Expenditure_Predictive_Equations_in_Patients_With_Cancer_ L2 - https://doi.org/10.1002/ncp.10374 DB - PRIME DP - Unbound Medicine ER -