Predicting resting energy expenditure: a critical appraisal

Abstract

Abstract Background The most commonly used prediction models for resting energy expenditure (REE) are Harris-Benedict (1919), Schofield (1985), Owen (1986), and Mifflin-St Jeor (1990), based on height, weight, age and gender, and Cunningham (1991), based on body composition. Methods Here, the five models are compared with reference data, consisting of individual REE measurements (n = 353) from 14 studies, covering a large range of participant characteristics. Results For white adults, prediction of REE with the Harris-Benedict model approached measured REE most, with estimates within 10% for more than 70% of the reference population. For some ethnicities like South Asian Indians or participants with an exceptional high physical activity level like athletes, measurement of body composition is recommended, using a fat-free mass based model. Discussion Sources of differences between measured and predicted REE include measurement validity and measurement conditions. Importantly, a 12- to 14-h overnight fast may not be sufficient to reach post-absorptive conditions and may explain differences between predicted REE and measured REE. In both cases complete fasting REE may not have been achieved, especially in participants with high energy intake. Conclusion In white adults, measured resting energy expenditure was closest to predicted values with the classic Harris-Benedict model. Suggestions for improving resting energy expenditure measurements, as well as prediction models, include the definition of post-absorptive conditions, representing complete fasting conditions with respiratory exchange ratio as indicator.