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Health issues and nutrition in the elderly

Estimating total daily energy requirements in community-dwelling older adults: validity of previous predictive equations and modeling of a new approach

European Journal of Clinical Nutrition volume 75, pages 133–140 (2021)Cite this article

Subjects

Abstract

Background/objectives

Accurate estimation of energy requirements is crucial for health maintenance and prevention of malnutrition in older adults. This study aimed to assess the accuracy of predictive equations for estimating energy requirements in older adults and to test the validity of new predictive equations for this age group.

Subjects/methods

This is a cross-sectional study including 38 Brazilian community-dwelling older adults aged 60–84 years, who had their total energy expenditure measured by doubly labeled water (TEEDLW). The energy expenditure was compared to the Institute of Medicine (Dietary Reference Intake (DRI)) and Vinken et al. previous predictive equations and three predictive models developed in a modeling sample. The agreement was assessed using intra-class correlation coefficient, Bland–Altman plots, and Lin’s concordance correlation. Accuracy was evaluated considering ±10% of the ratio between estimated and measured energy expenditure.

Results

The mean (standard deviation) TEEDLW was 2656.7 (405.6) kcal/day for men and 2168.9 (376.9) for women. Vinken et al. and both DRI equations presented moderate to good degree of agreement, while the developed models vary from fair to very good agreement in comparison to DLW. The accuracy rate was the same for both DRI equations and Vinken et al. equation (60.53%). The new equations developed in this study had accuracy in predicting TEE for Brazilian older adults varying from 43.11% to 73.68%.

Conclusions

The results corroborate the use of previous predictive equations for estimating energy requirements in Brazilian older adults. Further studies have the potential to explore the use of the developed models to assess energy needs in this population.

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Fig. 1: Bland–Altman plots of energy expenditure measured by doubly labeled water (TEEDLW) and predictive equations for energy requirements.

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Acknowledgements

We would like to thank all fieldworkers and all participants. We also acknowledge the work of the Dietary Intake Research Group (Grupo de Avaliação do Consumo Alimentar) at the University of São Paulo and the workers at the Isotope Ratio Mass Spectrometry Laboratory of the Ribeirão Preto Medical School—University of São Paulo, Brazil.

Funding

This work was supported by the São Paulo Research Foundation (grant number 2018/01991-4) and the National Council for Scientific and Technological Development (grant number 134149/2018-1). The Health Survey of São Paulo was supported by the São Paulo Municipal Health Department (grant number 2013-0.235.936-0), São Paulo Research Foundation (grant numbers 98/14099-7, 2007/51488-2, 2009/15831-0, 2012/22113-9), and National Council for Scientific and Technological Development (grant numbers 502948/2003-5, 481176/2008-0, 473100/2009-6, 472873/2012-1, 402674/2016-2, 301597/2017-0).

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Authors and Affiliations

  1. Department of Nutrition, School of Public Health, University of São Paulo, Avenida Dr. Arnaldo 715, Cerqueira Cesar, São Paulo, SP, Brazil

    Lais Duarte Batista, Natasha Aparecida Grande De França, Mariane de Mello Fontanelli & Regina Mara Fisberg

  2. Centro Universitário de Rio Preto (UNIRP), R. Ivete Gabriel Atique, 45—Vila Maria, São José do Rio Preto, SP, Brazil

    Natasha Aparecida Grande De França

  3. Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil

    Karina Pfrimer & Eduardo Ferriolli

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  1. Lais Duarte Batista
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  2. Natasha Aparecida Grande De França
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  4. Mariane de Mello Fontanelli
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  6. Regina Mara Fisberg
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Contributions

LDB contributed to conception and design of the study, analysis and interpretation of findings, and drafting the article. MMF and NAGF contributed to interpretation of findings, and revising it critically for important intellectual content. RMF contributed to conception and design of the study, data acquisition, and revising it critically for important intellectual content. KP and EF contributed to data acquisition, and revising it critically for important intellectual content. All authors approved the final version to be published.

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Correspondence to Regina Mara Fisberg.

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Batista, L.D., De França, N.A.G., Pfrimer, K. et al. Estimating total daily energy requirements in community-dwelling older adults: validity of previous predictive equations and modeling of a new approach. Eur J Clin Nutr 75, 133–140 (2021). https://doi.org/10.1038/s41430-020-00717-0

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