TY - JOUR
T1 - Nutrition Intervention Informed by Indirect Calorimetry Compared to Predictive Equations to Achieve Weight Goals in Geriatric Rehabilitation Inpatients
T2 - The NEED Study
AU - Hettiarachchi, J.
AU - Fetterplace, K.
AU - Maier, Andrea B.
AU - Reijnierse, E. M.
N1 - Funding Information:
Funding and sponsorship: The RESORT study was supported by an unrestricted grant of the University of Melbourne received by A. B. Maier and the Medical Research Future Fund (MRFF) provided by the Melbourne Academic Centre for Health (MACH). A.B. Maier has received grants from Danone Nutricia Research outside this study. Jeewanadee Hettiarachchi was financially supported by the Melbourne Research Scholarship of the University of Melbourne. Kate Fetterplace has received conference, travel grants and/or honoraria from Baxter, Avonos, Nutricia, and Abbott outside this study.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/10
Y1 - 2023/10
N2 - Objectives: To assess if nutritional interventions informed by indirect calorimetry (IC), compared to predictive equations, show greater improvements in achieving weight goals, muscle mass, strength, physical and functional performance. Design: Quasi-experimental study. Setting and Participants: Geriatric rehabilitation inpatients referred to dietitian. Intervention and Measurements: Patients were allocated based on admission ward to either the IC or equation (EQ) group. Measured resting metabolic rate (RMR) by IC was communicated to the treating dietitian for the IC group but concealed for the EQ group. Achieving weight goals was determined by comparing individualised weight goals with weight changes from inclusion to discharge (weight gain/loss: >2% change, maintenance: ≤2%). Muscle mass, strength, physical and functional performance were assessed at admission and discharge. Food intake was assessed twice over three-days at inclusion and before discharge using plate waste observation. Results: Fifty-three patients were included (IC n=22; EQ n=31; age: 84.3±8.4 years). The measured RMR was lower than the estimated RMR within both groups [mean difference IC −282 (95%CI −490;−203), EQ −273 (−381;−42) kcal/day)] and comparable between-groups (median IC 1271 [interquartile range 1111;1446] versus EQ 1302 [1135;1397] kcal/day, p=0.800). Energy targets in the IC group were lower than the EQ group [mean difference −317 (95%CI −479;−155) kcal/day]. There were no between-group differences in energy intake, achieving weight goals, changes in muscle mass, strength, physical and functional performance. Conclusions: In geriatric rehabilitation inpatients, nutritional interventions informed by IC compared to predictive equations showed no greater improvement in achieving weight goals, muscle mass, strength, physical and functional performance. IC facilitates more accurate determination of energy targets in this population. However, evidence for the potential benefits of its use in nutrition interventions was limited by a lack of agreement between patients’ energy intake and energy targets.
AB - Objectives: To assess if nutritional interventions informed by indirect calorimetry (IC), compared to predictive equations, show greater improvements in achieving weight goals, muscle mass, strength, physical and functional performance. Design: Quasi-experimental study. Setting and Participants: Geriatric rehabilitation inpatients referred to dietitian. Intervention and Measurements: Patients were allocated based on admission ward to either the IC or equation (EQ) group. Measured resting metabolic rate (RMR) by IC was communicated to the treating dietitian for the IC group but concealed for the EQ group. Achieving weight goals was determined by comparing individualised weight goals with weight changes from inclusion to discharge (weight gain/loss: >2% change, maintenance: ≤2%). Muscle mass, strength, physical and functional performance were assessed at admission and discharge. Food intake was assessed twice over three-days at inclusion and before discharge using plate waste observation. Results: Fifty-three patients were included (IC n=22; EQ n=31; age: 84.3±8.4 years). The measured RMR was lower than the estimated RMR within both groups [mean difference IC −282 (95%CI −490;−203), EQ −273 (−381;−42) kcal/day)] and comparable between-groups (median IC 1271 [interquartile range 1111;1446] versus EQ 1302 [1135;1397] kcal/day, p=0.800). Energy targets in the IC group were lower than the EQ group [mean difference −317 (95%CI −479;−155) kcal/day]. There were no between-group differences in energy intake, achieving weight goals, changes in muscle mass, strength, physical and functional performance. Conclusions: In geriatric rehabilitation inpatients, nutritional interventions informed by IC compared to predictive equations showed no greater improvement in achieving weight goals, muscle mass, strength, physical and functional performance. IC facilitates more accurate determination of energy targets in this population. However, evidence for the potential benefits of its use in nutrition interventions was limited by a lack of agreement between patients’ energy intake and energy targets.
KW - Indirect calorimetry
KW - body weight
KW - energy targets
KW - inpatients
KW - muscle mass
KW - older adults
UR - https://www.scopus.com/pages/publications/85172030762
U2 - 10.1007/s12603-023-1970-5
DO - 10.1007/s12603-023-1970-5
M3 - Article
C2 - 37960906
SN - 1279-7707
VL - 27
SP - 833
EP - 841
JO - Journal of Nutrition, Health and Aging
JF - Journal of Nutrition, Health and Aging
IS - 10
ER -