Accuracy of Resting Energy Expenditure Estimation Equations in Polio Survivors

Abstract

Objective: To evaluate the accuracy of 4 equations validated for the general population to determine resting energy expenditure (REE) in polio survivors.

Design: A descriptive, ambispective, single-center observational cohort study of minimal risk care.

Setting: Tertiary university care hospital.

Participants: DATAPOL database of polio survivors followed up in a specialist department (N=298).

Interventions: None.

Main outcomes measures: REE measurement by indirect calorimetry and estimated REE using 4 equations and comparing the values with indirect calorimetry. Analysis of correlations between measured REE and weight, height, and body mass index (BMI) and indicators of severity of polio sequelae.

Results: Of the 298 polio cases in the database between January 2014 and May 2017, 41 were included (19 men and 22 women). Mean±SD BMI was 26.0±5.6 kg/m² (56.1% below 25). Measured REE correlated significantly and positively with weight and weaker with BMI. Correlations between measured and estimated REE were strong (between 0.49 and 0.59); correlations were strongest for the simplified World Health Organization and the Harris and Benedict equations. However, the equations systematically overestimated REE by more than 20%, especially in men. We calculated a correction factor for the World Health Organization scale: -340.3 kcal/d for women and -618.8 kcal/d for men.

Conclusion: Analysis of REE is important for polio survivors; The use of estimation equations could lead to the prescription of a nonadapted diet. We determined a correction factor that should be validated in prospective studies.

Keywords: Basal metabolism; Calorimetry; Energy metabolism; Obesity; Poliomyelitis; Rehabilitation.