RESUMEN
BACKGROUND: Changes in resting energy expenditure (REE) appear to be one of the causes of nutritional depletion in cancer. Assessing REE may be an important tool for providing adequate nutritional therapy to these patients. The aims of this study were to evaluate REE of patients with gastrointestinal tract cancer and to compare it to that of healthy controls. METHODS: A total of 20 patients, with esophageal (n = 3), gastric (n = 9), and colorectal (n = 8) cancers, and 20 healthy subjects were included. Indirect calorimetry (IC) was used to measure REE in both groups. The "pocket" equation (30 kcal/kg) and the Harris-Benedict equation, with correction factors of 1.3 (activity) and 1.1 (injury), were employed for assessment of the estimated total energy expenditure (TEE). Statistics included Mann-Whitney and paired t tests, Bland Altman analysis, and multivariate regression. RESULTS: The REE of the patients (1,274.5 kcal [1,002.9-2,174.9]) was similar to that of the controls (1,445.5 kcal [1,114.5-1,762.6], not significant), even when corrected for the amount of metabolically active tissue. The pocket equation was effective in predicting the patients' TEE, with a 1.7% (32 kcal) difference being observed in comparison with the IC results corrected with the activity factor (not significant). CONCLUSIONS: The patients with digestive tract cancers showed a similar REE to that of the controls. The current formula of 30 kcal/kg is suitable for estimating the TEE of these patients.
Asunto(s)
Neoplasias Colorrectales/metabolismo , Metabolismo Energético/fisiología , Neoplasias Esofágicas/metabolismo , Neoplasias Gástricas/metabolismo , Adulto , Anciano , Calorimetría Indirecta , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , DescansoRESUMEN
OBJECTIVE: To assess the energy expenditure of women with breast cancer and the effectiveness of available predictive equations (PEs) for the estimation of energy requirements in these subjects. METHODS: Women with breast cancer and healthy women controls underwent indirect calorimetry and nutritional assessment. The estimation of energy requirements included PEs (Harris-Benedict [HB], corrected by injury and activity factors), the Mifflin St. Jeor, and the quick formula of 25 kcal/kg of body weight (BW). Statistical analyses, including Student's t test, a paired t test, Bland-Altman analysis, and backward multivariate linear regression, were performed using the SPSS 17.0 software. Statistical significance was set at P < 0.05. RESULTS: Seventeen women with breast cancer and 19 healthy women were evaluated. Analysis of nutritional status revealed 64.7% of the patients were overweight/obese, and 88.2% had an excess of body fat mass. The resting energy expenditure (REE) of the breast cancer patients was similar to that of the healthy women, even after adjustment for fat free mass (FFM) (P < 0.05). The resting and total energy requirements estimated by the predictive equations widely varied, and the quick formula was the most accurate at determining total energy needs. CONCLUSIONS: The REE of women with breast cancer was similar to that of healthy women. The energy requirements of these patients may be calculated based on the quick formula of 25 kcal/kg of BW. Nonetheless, this estimation should be used cautiously as it results in wide variations when used alone.
Asunto(s)
Metabolismo Basal , Neoplasias de la Mama/metabolismo , Ingestión de Energía , Conceptos Matemáticos , Evaluación Nutricional , Necesidades Nutricionales , Estado Nutricional , Adulto , Anciano , Composición Corporal , Peso Corporal , Neoplasias de la Mama/complicaciones , Calorimetría Indirecta , Femenino , Humanos , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/epidemiologíaRESUMEN
Predictive equations and methods tend to overestimate or underestimate resting energy expenditure (REE) compared with indirect calorimetry (IC). This cross-sectional study aimed to evaluate the agreement between methods and equations for REE estimation of overweight and obese Brazilian men. Data from 48 healthy volunteers, ages 20 to 43 years and with body mass index ranging from 26.4 to 35.2, were collected between October 2008 and October 2009. REE was measured by IC, using Deltatrac (IC1) and KORR-MetaCheck (IC2) devices. It was estimated by bioelectrical impedance analysis (BIA) using tetrapolar (BIA1) and bipolar (BIA2) devices, and by the equations of Mifflin, World Health Organization/Food and Agriculture Organization/United Nations University, Fleisch, Horie-Waitzberg and Gonzalez, and Ireton-Jones. The association and agreement among the methods and equations were assessed by the interclass correlation coefficient, Bland-Altman analysis, and by the percentage of the difference between values obtained from the standard method and alternative methods and equations. Most methods showed high agreement with IC1. The highest agreements were found for Mifflin (-2.14%), Fleisch (-3.05%), Horie-Waitzberg and Gonzalez (4.41%), and BIA2 (5.25%). Similar results were shown by the Bland-Altman analyses. BIA2, followed by BIA1, Ireton-Jones, Mifflin, and Fleisch, showed the highest association with IC1. Thus, the Mifflin, Fleisch, Horie-Waitzberg and Gonzalez equations, and BIA2, were the most accurate methods for REE estimation in this study. However, because those equations have shown considerable variability, they should be used cautiously. In addition, the IC2 was not found to be an accurate method for REE estimation in overweight and obese men included in this study.