Energy Expenditure in Hospitalized Patients: Implications for Nutritional Support

Miles, John M.
June 2006
Mayo Clinic Proceedings;Jun2006, Vol. 81 Issue 6, p809
Academic Journal
An understanding of energy expenditure in hospitalized patients is necessary to determine optimal energy supply in the care of individuals who require nutritional support. A review was conducted of 19 studies in which resting energy expenditure (REE) had been measured using indirect calorimetry and compared with estimated basal energy expenditure (BEE) from the Harris-Benedict equation. Studies of patients with burns, head injuries, and fever were excluded because REE is known to be increased in these conditions. The studies reported data on 1256 patients with the following diagnoses: postoperative (28%), trauma or sepsis (26%), cancer (18%), pulmonary disease (9%), cardiovascular disease (2%), miscellaneous (9%), and unspecified (6%). The average REE in the 19 studies was 113% of the BEE. The mean ± SD REE/BEE ratio was higher in 11 studies in which the REE was measured during feeding than in 5 studies in which the measurement was made during fasting (117%±3% vs 105%±4%; P = .047). In those 11 studies, overfeeding may have contributed to higher REE values than otherwise would have been observed. Some evidence indicated that the REE/BEE ratio is higher in more severe illness, but results were inconsistent. Unfortunately, little information is available concerning total energy expenditure, which includes the contribution of physical activity, it appears that most patients can be fed adequately with energy equal to 100% to 120% of estimated BEE. Hypoenergetic feeding may be appropriate in some overweight and obese individuals. Additional research in hospitalized patients on total energy expenditure and on the relationship between severity of illness and energy expenditure is needed.


Related Articles

  • Resting energy expenditure in 18-20 year old males and females: Validation of indirect calorimetry and Harris-Benedict prediction equation. Riddell, L. J.; Dardarian, N.; McKinney, S. // Asia Pacific Journal of Clinical Nutrition;2005 Supplement, Vol. 14, pS47 

    Background -- The accurate measurement of Resting Energy Expenditure (REE) is a cornerstone of nutritional assessment. The purpose of this study was to compare two indirect calorimetry methods for measuring REE and the REE estimation obtained by using the Harris-Benedict prediction equation...

  • Energy expenditure of acutely ill hospitalised patients. Gariballa, Salah; Forster, Sarah // Nutrition Journal;2006, Vol. 5, p9 

    Objective: To measure energy expenditure of acutely ill elderly patients in hospital and following discharge in the community. Design: Sixty-three consecutive hospitalised acutely ill elderly patients were recruited. Eight patients were studied to assess the reliability of the Delta Tract...

  • Evaluation of the effect of energy conservation techniques in the performance of activity of daily living tasks. Ip, W. M.; Woo, J.; Yue, S. Y.; Kwan, M.; Sum, S. M. W.; Kwok, T.; Hui, S. S. C. // Clinical Rehabilitation;Mar2006, Vol. 20 Issue 3, p254 

    Objective: To determine whether energy conservation techniques during common activity of daily living tasks actually result in lower energy expenditure, and to document subjective comments regarding any differences in the perceived level of effort. Design: Descriptive study comparing energy...

  • Energy expenditure in underweight chronic obstructive pulmonary disease patients before and during a physiotherapy programme. Slinde, F.; Kvarnhult, K.; Grönberg, A. M.; Nordenson, A.; Larsson, S.; Hulthén, L. // European Journal of Clinical Nutrition;Jul2006, Vol. 60 Issue 7, p870 

    Objective:To investigate how total daily energy expenditure (TEE) changes when underweight patients with chronic obstructive pulmonary disease (COPD) enters a physiotherapy programme.Design:Prospective intervention study.Setting:Sahlgrenska University Hospital, Göteborg,...

  • Energy expenditures & physical activity in rats with chronic suboptimal nutrition. Rising, Russell; Lifshitz, Fima // Nutrition & Metabolism;2006, Vol. 3, p11 

    Background: Sub-optimally nourished rats show reduced growth, biochemical and physiological changes. However, no one has assessed metabolic rate adaptations in rats subjected to chronic suboptimal nutrition (CSN). In this study energy expenditure (EE; kcal/100 g body weight) and physical...

  • Estimación del gasto energético en el paciente quemado mediante la utilización de ecuaciones predictivas; revisión bibliográfica. Núñez-Villaveirán, Teresa; Sánchez, Manuel; Millán, Pablo; Martínez-Méndez, José Ramón; Iglesias, Carmen; Casado-Pérez, César; García-de-Lorenzo, Abelardo // Nutricion Hospitalaria;jun2014, Vol. 29 Issue 6, p1262 

    Introduction: The estimation of the caloric requirements of the burn patient is based on the measurement of his resting energy expenditure (REE) via indirect calorimetry, which is not available in all Burn Units, or its estimation by means of predictive equations. Goals: we analyze the history...

  • REVISÃO SISTEMÃTICA SOBRE MÉTODOS DE DETERMINAÇÃO DE GASTO E CONSUMO ENERGÉTICOS EM CRIANÇAS E ADOLESCENTES. Schilickmann Frainer, Deivis Elton; Adami, Fernando; de Vasconcelos, Francisco de Assis Guedes // Brazilian Journal of Kineanthropometry & Human Performance;2008, Vol. 10 Issue 2, p197 

    The article presents a study which aims to identify, describe and analyze methods used for determining energy expenditure and energy intake in clinical and population-based epidemiological studies. The study population was made up of children and adolescents aged from 6 to 18 years. The methods...

  • Practical aspects of estimating energy components in rodents. van Klinken, Jan B.; van den Berg, Sjoerd A. A.; van Dijk, Ko Willems // Frontiers in Physiology;May2013, Vol. 4, p1 

    Recently there has been an increasing interest in exploiting computational and statistical techniques for the purpose of component analysis of indirect calorimetry data. Using these methods it becomes possible to dissect daily energy expenditure into its components and to assess the dynamic...

  • THE LASTWORD ON ENERGY. Winokur, Len; Cox, Guy // New Scientist;4/19/2014, Vol. 222 Issue 2965, p23 

    The article considers whether there is such a food whose caloric content is exceeded by the energy needed to digest it. The author summarizes the respiration process by which mitochondria in cells burn nutrients from food, then turns his attention to celery. He observes that there are fewer...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics