A practical approach to estimate resting energy expenditure in frail elderly people.

OBJECTIVES: Some prediction equations of resting energy expenditure (REE) are available and can be used in clinical wards to determine energy requirements of patients. The aim of the present study was to assess the accuracy of those equations in sick elderly patients, using the Bland and Altman methods with our database of 187 REE measurements. DESIGN: The 3 equations tested were Harris and Benedict equation of 1919, WHO/FAO/UNU equation of 1985 and Fredrix et al. equation of 1990. In addition, three models developed from the present data were tested. RESULTS: The present study shows that the Fredrix et al equation gave an accurate prediction of REE without significant bias along the whole range of REE. It also shows that under-weight sick elderly patients (BMI

Resting energy expenditure is not increased in mildly hyperglycaemic obese diabetic patients.

Resting energy expenditure (REE) is believed to be increased in type 2 diabetes, an increase that is associated with deteriorating glucose tolerance during its development. Meanwhile, insulin resistance, a state linked to obesity and observed in all type 2 diabetic patients, is associated with reduced REE. Our aim was to compare REE in obese patients with and without diabetes. REE, body composition (total body water, density, percentage fat and fat-free mass: 3-compartment model) and metabolic control were assessed in fifty obese Caucasian patients with diabetes (glycated haemoglobin level 7.6 (SD 1.5) %) and fifty obese patients who were non-diabetic. Despite being more overweight and younger, obese non-diabetic patients had an absolute REE (7.73 (SD 1.44) v. 8.12 (SD 1.37) MJ; P=0.17) and percentage fat-free mass similar to those of obese diabetic patients. Even when adjusted for differences in body composition, REE remained similar in both groups. Furthermore, REE (absolute and adjusted) was unaffected by both glucose level and control (glycated haemoglobin), with fat-free mass being the only determinant of REE. We conclude that REE is not necessarily increased by the presence of diabetes in obese people.