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      Comparisons between predictive equations of resting metabolic rate and indirect calorimetry in obese teenagers Translated title: Las comparaciones entre las ecuaciones de predicción de la tasa metabólica en reposo y la calorimetría indirecta en los adolescentes obesos

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          Abstract

          Objective: To measure the accuracy of predictive equations of resting metabolic rate (RMR) in obese teenagers in relation to indirect calorimetry (IC). Methods: This study was conducted with 116 obese teenagers (60 males; 13.7±1.1 years). The RMR was calculated from Harris and Benedict, Schofield, WHO, Henry and Rees equations. The RMR was measured by the QUARK-RMR system. The comparison between predictive equations and IC was by the Student's t test. The reliability of data between predictive equations and IC was verified by the typical error of measurement (TEM) and the coefficient of variation (CV%). Results: Henry's equation was significantly different from IC (p<0.02). The CV% found for each equations compared to IC turned was low. However, when the TEM was measured it was considered high in absolute values which can cause errors when estimating the RMR. Therefore, it is important that specific predictive equations are developed for Brazilian obese teenagers.

          Translated abstract

          Objetivo: Medir la precisión de las ecuaciones predictivas de la tasa metabólica de reposo (TMR) en los adolescentes obesos en relación con la calorimetría indirecta (CI). Métodos: El estudio se realizó en 116 adolescentes obesos (60 niños, 13,7 ± 1,1 años). La TMR se calculó a partir de las ecuaciones predictivas de Harris y Benedict, Schofield, OMS, Henry y Rees. La TMR se midió por el sistema de QUARK-TMR. La comparación entre las ecuaciones de predicción y IC se realizó mediante el test t de Student. La fiabilidad de los datos entre IC y ecuaciones de predicción fue verificada por el error típico de la medición (TEM) y el coeficiente de variación (CV%). Resultados: La ecuación de Henry fue significativamente diferente de IC (p <0,02). El CV% encontrado para cada ecuación en comparación con IC fue bajo; no obstante, cuando se midió el TEM, este fue considerado alto en valores absolutos que puede provocar errores al estimar la TMR. Por lo tanto, es importante que ecuaciones de predicción específicas sean desarrolladas para adolescentes obesos brasileños.

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          Most cited references54

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          New methods for calculating metabolic rate with special reference to protein metabolism.

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            Comparison of predictive equations for resting metabolic rate in healthy nonobese and obese adults: a systematic review.

            An assessment of energy needs is a necessary component in the development and evaluation of a nutrition care plan. The metabolic rate can be measured or estimated by equations, but estimation is by far the more common method. However, predictive equations might generate errors large enough to impact outcome. Therefore, a systematic review of the literature was undertaken to document the accuracy of predictive equations preliminary to deciding on the imperative to measure metabolic rate. 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. Articles were accepted based on defined criteria and abstracted using evidence analysis tools developed by the American Dietetic Association. Because these equations are applied by dietetics practitioners to individuals, a key inclusion criterion was research reports of individual data. The evidence was systematically evaluated, and a conclusion statement and grade were developed. Four prediction equations were identified as the most commonly used in clinical practice (Harris-Benedict, Mifflin-St Jeor, Owen, and World Health Organization/Food and Agriculture Organization/United Nations University [WHO/FAO/UNU]). Of these equations, the Mifflin-St Jeor equation was the most reliable, predicting RMR within 10% of measured in more nonobese and obese individuals than any other equation, and it also had the narrowest error range. No validation work concentrating on individual errors was found for the WHO/FAO/UNU equation. Older adults and US-residing ethnic minorities were underrepresented both in the development of predictive equations and in validation studies. The Mifflin-St Jeor equation is more likely than the other equations tested to estimate RMR to within 10% of that measured, but noteworthy errors and limitations exist when it is applied to individuals and possibly when it is generalized to certain age and ethnic groups. RMR estimation errors would be eliminated by valid measurement of RMR with indirect calorimetry, using an evidence-based protocol to minimize measurement error. The Expert Panel advises clinical judgment regarding when to accept estimated RMR using predictive equations in any given individual. 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. For members of groups that are greatly underrepresented by existing validation studies of predictive equations, a high level of suspicion regarding the accuracy of the equations is warranted.
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              Measures of reliability in sports medicine and science.

              W Hopkins (2000)
              Reliability refers to the reproducibility of values of a test, assay or other measurement in repeated trials on the same individuals. Better reliability implies better precision of single measurements and better tracking of changes in measurements in research or practical settings. The main measures of reliability are within-subject random variation, systematic change in the mean, and retest correlation. A simple, adaptable form of within-subject variation is the typical (standard) error of measurement: the standard deviation of an individual's repeated measurements. For many measurements in sports medicine and science, the typical error is best expressed as a coefficient of variation (percentage of the mean). A biased, more limited form of within-subject variation is the limits of agreement: the 95% likely range of change of an individual's measurements between 2 trials. Systematic changes in the mean of a measure between consecutive trials represent such effects as learning, motivation or fatigue; these changes need to be eliminated from estimates of within-subject variation. Retest correlation is difficult to interpret, mainly because its value is sensitive to the heterogeneity of the sample of participants. Uses of reliability include decision-making when monitoring individuals, comparison of tests or equipment, estimation of sample size in experiments and estimation of the magnitude of individual differences in the response to a treatment. Reasonable precision for estimates of reliability requires approximately 50 study participants and at least 3 trials. Studies aimed at assessing variation in reliability between tests or equipment require complex designs and analyses that researchers seldom perform correctly. A wider understanding of reliability and adoption of the typical error as the standard measure of reliability would improve the assessment of tests and equipment in our disciplines.
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                Author and article information

                Journal
                rchnut
                Revista chilena de nutrición
                Rev. chil. nutr.
                Sociedad Chilena de Nutrición, Bromatología y Toxicología (Santiago, , Chile )
                0717-7518
                June 2014
                : 41
                : 2
                : 126-130
                Affiliations
                [04] orgnameUniversidade Estadual de Sao Paulo orgdiv1Department of Physical Education Brasil
                [03] orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina de Ribeirão Preto orgdiv2Department of Rehabilitation and Functional Performance Brasil
                [01] Ribeirao Preto SP orgnameUniversity of São Paulo orgdiv1Faculty of Medicine of Ribeirao Preto orgdiv2Department of Internal Medicine Brazil bruno_parenti@ 123456usp.br
                [02] orgnameUniversidade Estadual de Sao Paulo orgdiv1Department of Physiotherapy Brasil
                Article
                S0717-75182014000200001 S0717-7518(14)04100200001
                10.4067/S0717-75182014000200001
                a2f6940a-51a5-43df-b8ff-c0a430cdec74

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 24 February 2014
                : 19 May 2014
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 5
                Product

                SciELO Chile

                Categories
                ORIGINAL ARTICLES

                ecuaciones predictivas,predictive equations,gasto metabólico de reposo,obesidad,obesity,indirect calorimetry,resting metabolic rate,calorimetría indirecta,teenagers

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