Paula Woo1, Gayathri Murthy2,3, Cindy Wong2,3, Brenden Hursh1,3, Jean-Pierre Chanoine1,3, Rajavel Elango2,3,4. 1. Division of Endocrinology, BC Children's Hospital, Vancouver, British Columbia, Canada. 2. Research Institute, BC Children's Hospital, Vancouver, British Columbia, Canada. 3. Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. 4. School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
BACKGROUND: Accurately determining energy requirements is key for nutritional management of pediatric obesity. Recently, a portable handheld indirect calorimeter, MedGem (MG) has become available to measure resting energy expenditure (REE). Our work aims to determine the clinical validity and usefulness of MG to measure REE in overweight and obese adolescents. METHODS: Thirty-nine overweight and obese adolescents (16 male (M): 23 female (F), 15.2 ± 1.9 y, BMI percentile: 98.6 ± 2.2%) and 15 normal weight adolescents (7M: 8F, age 15.2 ± 2.0 y, BMI percentile: 39.2 ± 20.9%) participated. REE was measured with both MG and standard indirect calorimeter (VMax) in random order. RESULTS: MG REE (1,600 ± 372 kcal/d) was lower than VMax REE (1,727 ± 327 kcal/) in the overweight and obese adolescents. Bland Altman analysis (MG -VMax) showed a mean bias of -127 kcal/d (95% CI = -72 to -182 kcal/d, P < 0.001), and a proportional bias existed such that lower measured REE by VMax was underestimated by MG, and higher measured REE by VMax were overestimated by MG. CONCLUSION: MG systematically underestimates REE in the overweight and adolescent population, thus the MG portable indirect calorimeter is not recommended for routine use. Considering that it is a systematic underestimation of REE, MG may be clinically acceptable, only if used with caution.
BACKGROUND: Accurately determining energy requirements is key for nutritional management of pediatric obesity. Recently, a portable handheld indirect calorimeter, MedGem (MG) has become available to measure resting energy expenditure (REE). Our work aims to determine the clinical validity and usefulness of MG to measure REE in overweight and obese adolescents. METHODS: Thirty-nine overweight and obese adolescents (16 male (M): 23 female (F), 15.2 ± 1.9 y, BMI percentile: 98.6 ± 2.2%) and 15 normal weight adolescents (7M: 8F, age 15.2 ± 2.0 y, BMI percentile: 39.2 ± 20.9%) participated. REE was measured with both MG and standard indirect calorimeter (VMax) in random order. RESULTS: MG REE (1,600 ± 372 kcal/d) was lower than VMax REE (1,727 ± 327 kcal/) in the overweight and obese adolescents. Bland Altman analysis (MG -VMax) showed a mean bias of -127 kcal/d (95% CI = -72 to -182 kcal/d, P < 0.001), and a proportional bias existed such that lower measured REE by VMax was underestimated by MG, and higher measured REE by VMax were overestimated by MG. CONCLUSION: MG systematically underestimates REE in the overweight and adolescent population, thus the MG portable indirect calorimeter is not recommended for routine use. Considering that it is a systematic underestimation of REE, MG may be clinically acceptable, only if used with caution.
Authors: Sarah A Purcell; Sarah A Elliott; Peter J Walter; Tom Preston; Hongyi Cai; Richard J E Skipworth; Michael B Sawyer; Carla M Prado Journal: Am J Clin Nutr Date: 2019-08-01 Impact factor: 7.045
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Authors: Raul A Bastarrachea; Hugo A Laviada-Molina; Edna J Nava-Gonzalez; Irene Leal-Berumen; Claudia Escudero-Lourdes; Fabiola Escalante-Araiza; Vanessa-Giselle Peschard; Rosa A Veloz-Garza; Karin Haack; Angélica Martínez-Hernández; Francisco M Barajas-Olmos; Fernanda Molina-Segui; Fatima A Buenfil-Rello; Lucia Gonzalez-Ramirez; Reinhard Janssen-Aguilar; Ricardo Lopez-Muñoz; Fernanda Perez-Cetina; Janeth F Gaytan-Saucedo; Zoila Vaquera; Judith Cornejo-Barrera; Juan Carlos Castillo-Pineda; Areli Murillo-Ramirez; Sara P Diaz-Tena; Benigno Figueroa-Nuñez; Laura González-López; Rocío A Salinas-Osornio; Melesio E Valencia-Rendón; José Ángeles-Chimal; Jesús Santa-Olalla Tapia; José M Remes-Troche; Salvador B Valdovinos-Chavez; Eira E Huerta-Avila; Xianlin Han; Lorena Orozco; Ernesto Rodriguez-Ayala; Susan Weintraub; Esther C Gallegos-Cabrales; Shelley A Cole; Jack W Kent Journal: Genes (Basel) Date: 2018-11-02 Impact factor: 4.096