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Abstract
The aims of this study are to investigate which of the seven selected predictive equation for estimating basal metabolic rate (BMR) is the best alternative to indirect calorimetry (IC) and to evaluate the dietary energy intake in patients with type 2 diabetes. Twenty-one patients with type 2 diabetes participated in this diagnostic test study. Clinical and laboratorial variables were evaluated as well as body composition by absorptiometry dual X-ray emission (DXA) and BMR measured by IC and estimated by prediction equations. Dietary intake was evaluated by a quantitative food frequency questionnaire. Data were analyzed using Bland-Altman plots, paired t-tests, and Pearson's correlation coefficients. Patients were 62 (48-70) years old, have had diabetes for 8 (2-36) yeas, and 52.4% were females. The mean body composition comprised a fat-free mass of 49.8 ± 9.4 kg and a fat mass of 28.3 ± 7.2 kg. The energy intake was 2134.3 ± 730.2 kcal/day and the BMR by IC was 1745 ± 315 kcal/day. There was a wide variation in the accuracy of BMR values predicted by equations when compared to IC BMR measurement. Harris-Benedict, Oxford, FAO/WHO/UNO equations produced the smallest differences to IC, with a general bias of < 8%. The FAO/WHO/UNO equation provided the best BMR prediction in comparison to measured BMR. In patients with type 2 diabetes, the equation of the FAO/WHO/UNO was the one closest to the BMR values as measured by IC.
Highlights
T ype 2 diabetes is the most common form of the diabetes mellitus (DM), usually occurs in adult life, and is associated with obesity in about 80% of cases
There is little research that compares the basal metabolic rate (BMR) measured by indirect calorimetry (IC) with that estimated by prediction equations in patients with type 2 diabetes
Our study shows a wide range of differences between predicted and measured BMR
Summary
T ype 2 diabetes is the most common form of the diabetes mellitus (DM), usually occurs in adult life, and is associated with obesity in about 80% of cases. The primary strategy for treating obese patients with type 2 diabetes is the loss of body mass through changes in lifestyle, which has been associated with improvement in glycemic control (1). Among these interventions, an appropriate dietary prescription with the goal of reducing body weight, taking into account each patient’s daily energy needs, is essential. The main energy requirement component is the total energy expenditure (TEE), and calculating the TEE requires knowledge of the basal metabolic rate (BMR) (2). The most accurate procedure for measuring BMR is indirect calorimetry (IC), which is considered the reference method. Several predictive equations have been developed as alternative methods for estimating BMR (3-6)
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