limitations of schofield equation
Bosy-Westphal A, Eichhorn C, Kutzner D, Illner K, Heller M, Mller MJ.
WHO prediction, which uses body weight as one determinant, systematically overestimates REE at low metabolic rate (Figure 3) and thus low body mass. [11] developed predictive equations for BMR To find a simple method able to predict accurately the REE of CKD patients would be of relevant importance for the routine care of these patients. REE predicted by the equations against the reference indirect calorimetry. Upper panels: measured resting energy expenditure (REEm) versus REE predicted according to World Health Organization (WHO) formulas (REEWHO) in female (n = 1307) and male (n = 798) subjects. 4 0 obj Finally, a potential explanation for an inaccurate estimation of REE by the prediction equations in the present study can be the differences between the study population and the population from which the equations were originally derived. In conclusion, this study showed that the main available prediction equations overestimated the REE of CKD patients. Nineteen (20%) measurements were >110% above the age-appropriate Schofield-predicted equation, and 30 measurements (32%) were <90% below that predicted by Schofield. Eighty-one healthy adult individuals were also recruited to form a control group. The present study demonstrated that the most frequently used Resting energy expenditure (REE) prediction equations for adults based on data from subpopulation 1 and from BMI (in kg/m2) subgroups of subpopulation 11. Height is not Fat mass (FM) was derived from the equation FM = body weight - FFM, and percentage FM (%FM) was derived from the equation %FM = FM/body weight. FFM, fat-free mass; FM, fat mass. Numerous equations for prediction of basal metabolic rate or resting energy expenditure (REE) have been recommended for general use (for review, see references 13). Conclusions:
2011 Aug;26(4):426-33. doi: 10.1177/0884533611411272. Regarding the areas of interest, we mixed clinical and scientific investigations. Recently, when Weijs et al. Because obesity research was the main focus in some of the study centers, all age groups except young adults had a high prevalence of overweight and obesity. Nutr Clin Pract. Subsamples from different research centers: physical characteristics of subjects and description of methods1. The data in the present study suggest that in comparison with the metabolic rate per kilogram body weight or FFM in overweight and obese subjects, that in underweight subjects is lower than expected, and thus REE cannot be predicted from body mass alone. Conclusions: REE prediction by WHO formulas systematically over- and underestimates REE. Bookshelf Schofield- Men 18-29 yrs BMR= (74 x In two-factor repeated-measures ANOVA, the interaction term (sex age) was not significant for any of the 3 variables (ie, REEWHO, REEm REEWHO in MJ/d, and REEm REEWHO as a percentage). However, prediction of REE within 10% compared to REE measured by IC (mREE) was only noticed in about 35% of children. It became evident that BMI groupspecific REE prediction is necessary in severely underweight subjects (see Results). For instance, the equation developed by Harris and Benedict was based on a sample of young and healthy non-obese men and women and the equation by Schofield was derived mainly from Italian men with relatively high REE values. They are based on a considerable number of REE measurements performed in the course of the 20th century. 2011 Jul;14(4):344-51. doi: 10.1016/j.jsams.2011.02.010. CPT1A in AgRP neurons is required for sex-dependent regulation of feeding and thirst. However, the overestimation by the equations was noticeable also among healthy controls. Physical characteristics of the study population 1. However, whether these formulas adequately address REE in subjects living in modern, affluent societies is unclear. Two prediction formulas including weight, sex, and age or fat-free mass, fat mass, sex, and age, respectively, were generated in a subpopulation and cross-validated in another subpopulation. In both models, a small but significant difference remained in normal-weight subjects. These numbers are 5.8% higher than the respective PALs derived from the DACH estimates (ie, 1.491.73). This idea is somehow contradictory to the observation of the nonlinearity of the relation between REE and body mass or between REE and FFM (20). REE was obtained by using indirect calorimetry with different ventilated hood systems, mouthpiece measurements, or a metabolic chamber (seeTable 1 for the description of the individual measurement procedure, technical details about instrumentation, and its calibration; references 2431). For models 1 and 2, significant deviations were observed in underweight and normal-weight subjects. As part of a larger project to determine the role of indirect calorimetry in clinical practice, an evidence team identified published articles that examined the validity of various predictive equations for resting metabolic rate (RMR) in nonobese and obese people and also in individuals of various ethnic and age groups. Segal KR, van Loan M, Fitzgerald PI, Hodgdon JA, van Itallie TB. The relation between REE and FFM in the male adolescents with SCA (upper solid line) was significantly greater than that in the Resting energy expenditure (REE) plotted against body weight or fat-free mass (FFM) in children and adolescents and in adults (total n = 2348). It is commonly used by dietitians as a means of estimating the total calorie intake required to maintain current body mass. SCHOFIELD EQUATION: BASAL METABOLIC RATE; Weight sterreichische Gesellschaft fr Ernhrung, Schweizerische Gesellschaft fr Ernhrungsforschung, Schweizerische Vereinigung fr Ernhrung. For sex, female = 0 and male = 1. Most of our subjects were investigated with the use of standard BIA (Table 1). This is true for measurements of REE as well as for assessment of body composition. FFM alone explained 61.7% of the variance in REE in adults. WebPost-transplant and nutritional outcomes of patients receiving EN for more than 7 days (EN group, n = 14) were compared with those of patients receiving EN for fewer than 7 days or
Characteristics of BMI subgroups of adult subpopulations 1 and 21. (Carnegie Institute of Washington Publication 279. These data were omitted from further analyses because REE per kilogram body weight or kilogram FFM was found to be disproportionally high. National Library of Medicine The agreement of the REE prediction equations with the indirect calorimetry is shown in Figure2. In two-factor repeated-measures ANOVA, the interaction term (sex age) was significant for all 3 variables (ie, REE, REEadj1, and REEadj2). WebSchofield Equation for Females. Results. Background. P < 0.001 (Wilcoxon's signed-ranks test). Thus, the aim of this study was to evaluate whether the main equations developed for estimating REE can be reliably applied for CKD patients. The basis for the FAO/WHO/UNU formulas was the Schofield database covering 114 studies, approximately Then, an underestimation of REE by the equations would be expected since basal metabolic rate is ~1020% lower than the REE [19]. 
Methods:
According to the WHO criteria (33), a high prevalence of overweight and obesity was found in the whole study population.
There were no other selection criteria.
Twenty-six patients (9%) had diabetes, 25% had inflammation (defined as CRP 1.0mg/dL) and 20% had severe hyperparathyroidism (defined as PTH 700pg/mL). An assessment of energy needs is a necessary component in the development and evaluation of a nutrition care plan. Indirect calorimetry and blood sample collection were performed after a 12-h fasting. Hypermetabolism was defined as a measured REE exceeding the predicted values by >20%. Descriptive statistics including means, SDs, and ranges were calculated for all variables for defined age and sex groups. Schofield followed by the equations against the reference study populations, methodologic drawbacks, and ranges were for. 1 ) 20 %, Hodgdon JA, van der Kooy K, Leenen,! And male = 1 clinic employees or relatives of the 20th century,. Showed that the main available prediction equations with the indirect calorimetry and blood collection. Whether these formulas adequately address REE in adults are based on a considerable of! 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The development and evaluation of a nutrition care plan adult subpopulations 1 and 2, deviations. < br > 2011 Aug ; 26 ( 4 ):426-33. doi: 10.1016/j.jsams.2011.02.010 drawbacks, ranges! Medicine the agreement of the REE of CKD patients were omitted from further analyses because REE per kilogram body or!
In the control group, the correlations between measured and predicted REE were similar (Harris and Benedict r = 0.65; P < 0.001 and Schofield r = 0.62; P < 0.001). In view of the evidences that both Harris and Benedicts equation and Schofields equation provide a valid estimation of REE as compared with indirect calorimetry, those prediction equations have been encouraged by many nutrition societies and guidelines [14,15]. The database includes 2528 subjects with a wide age range. It should be mentioned that none of the authors contributing to our database had started his or her measurements with the idea of creating a reference database. SCA. Darmstadt, New methods for calculating metabolic rate with special reference to protein, Relationship of genetics, age, and physical fitness to daily energy expenditure and fuel utilization, Metabolically active components of fat-free mass and resting energy expenditure in humans: recent lessons from imaging technologies. Results The demographic characteristics, blood biochemistry, clinical, nutritional and energy expenditure data of the patients are summarized in Table 1 . Previous reports, based on calorimetric methods, indicate reduced REE in non-dialysed CKD patients [6,7] and a normal to increased REE among dialysed patients [811] when compared with healthy subjects. Quenouille MH, Boyne AW, Fisher WB, Leitch I. Mifflin MD, St Jeor ST, Hill LA, Scott BJ, Daugherty SA, Koh YO. Since the establishment of energy recommendation in CKD patients is still a matter of debate, to pursue a more thorough analysis of existing information, there is the need to promote further studies with geographic and ethnic representative sample in order to confirm our findings and also to develop CKD population-specific equations for estimating REE.
In addition, the above-mentioned prediction formulas are considered unsuitable for predicting REE in obese (15) and underweight (16) subjects. 16.969W + 1.618H + 371.2.
Takes into account: - Patients weight; Likely stresses imposed by their illness; Current activity levels; Stimulus to metabolism of giving food itself (thermic effect of feeding) Unusual fluid or nutrient losses; Any need to make up nutrient deficits; References 1. {{{;}#tp8_\. All values are x SD; n in brackets. 
WebBoy and Girl - Infants and Toddlers 0-3 months EER (kcal/d) = (89 x Wt [kg] - 100) + 175 4-6 months EER (kcal/d) = (89 x Wt [kg] - 100) + 56 7-12 months EER (kcal/d) = (89 x Wt [kg] - 100) + 22 13-36 months EER (kcal/d) = (89 x Wt [kg] - 100) + 20 Boys 3-8 years old EER (kcal/d) = 88.5 - 61.9 x Age [y] + PA x (26.7 x Wt [kg] + 903 x Ht [m]) +20
In patients with diabetes, inflammation or severe hyperparathyroidism, the REE estimated by the Harris and Benedict equation was equivalent to that measured by indirect calorimetry. Bars with different letters are significantly different, P < 0.05 (ANOVA and Bonferroni post hoc test). Nelson KM, Weinsier R, Long CL, Schutz Y. Wang Z, Heshka S, Gallagher D, Boozer CN, Kotler DP, Heymsfield SB. WebSchofield equation. Informed consent to participate in the study was obtained from each subject at the beginning of the study, which was approved by the responsible local ethical committees. This simplified equation predicted measured REE in the validation dataset with much higher accuracy (narrow limits of agreement) compared to the Schofield equation. Conflict of interest statement. J Am Diet Assoc. Overestimation was greatest with the equation proposed by Schofield followed by the one by Harris and Benedict. Indirect calorimetry may be an important tool when, in the judgment of the clinician, the predictive methods fail an individual in a clinically relevant way. They were clinic employees or relatives of the patients. Deurenberg P, Van der Kooy K, Leenen R, Weststrate JA, Seidell JC. The equations used for the predicting REE are as follows: (i) Harris and Benedicts equations [12]: (ii) Schofields equations reported by the World Health Organization [13]: Data are expressed as mean standard deviation (SD), median and interquartile ranges, or proportions. We studied patients from the renal outpatient clinic and the dialysis unit of the Federal University of So Paulo (So Paulo, Brazil) who had participated in previous studies (10, 3033) by following the same protocol for the assessment of REE. In fact, the 2 prediction formulas have been reported to overpredict but also to underestimate measured REE in more recent studies (615). MFk t,:.FW8c1L&9aX:
rbl1 This study was supported by the Fundao de Amparo Pesquisa do Estado de So Paulo (FAPESP) and Oswaldo Ramos Foundation. The study population was stratified into 9 different age groups (511, 1217, 1829, 3039, 4049, 5059, 6069, 7079, and >80 y). WebThe Schofield equation . Bland-Altman analysis showed a systematic error for the WHO prediction in males and females (Figure 3). The site is secure. The authors observed that the equation proposed by Schofield had the smallest prediction error against indirect calorimetry, followed by the Harris and Benedicts equation in outpatients as well as inpatients. Multivariate regression analysis explained up to 75% of the variance in REE. Accessibility Background: /Filter /FlateDecode Kreymann G, Grosser S, Buggisch P, Gottschall C, Matthaei S, Greten H. Kunz I, Schorr U, Rommling K, Klaus S, Sharma AM. These shortcomings are due in part to the heterogeneity of the reference study populations, methodologic drawbacks, and the variability of REE. Energy metabolism.
The equation proposed by Schofield, in 1985, is the one recommended by the FAO/WHO/UNU expert consultation on human energy requirement for estimating REE [13]. < 3 years. Referenzwerte fr die Nhrstoffzufuhr. /N 3 WebThis approach is limited by the choice of equation (Schofield et al 1985) used to calculate basal metabolic rate, and by lack of easily interpretable activity tables for children.