Trends in measuring BMR and RMR after spinal cord injury: a comprehensive review

Alazzam, Ahmad M.; Alrubaye, Malak W; Goldsmith, Jacob A.; Gorgey, Ashraf S.

doi:10.1017/s0007114523000831

Cited by 5 publications

(1 citation statement)

References 74 publications

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“…Such methodological differences may contribute to additional bias when comparing values across studies and lead to confusion when prescribing caloric needs for individuals with SCI. Using RMR to estimate caloric requirements may overestimate dietary needs, which could lead to inappropriate caloric intake recommendations that may increase the risk for obesity and secondary cardiometabolic complications (Alazzam, Alrubaye, et al., 2023).…”

Section: Discussionmentioning

confidence: 99%

Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury

Alazzam,

Gorgey

2024

Physiological Reports

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Basal metabolic rate (BMR) measurement is time consuming and requires specialized equipment. Prediction equations allow clinicians and researchers to estimate BMR; however, their accuracy may vary across individuals with chronic spinal cord injury (SCI). The objective of this study was to investigate the validity of SCI‐specific equations as well as able‐bodied (AB) prediction equations in individuals with upper motor neuron (UMN), lower motor neuron (LMN), and females with SCI. Twenty‐six men and women with chronic SCI (n = 12 innervated males, n = 6 innervated females, n = 8 denervated males) participated in this cross‐sectional study. BMR values were measured by indirect calorimetry. Body composition (dual‐energy X‐ray absorptiometry and anthropometrics) assessment was conducted. AB‐prediction equations [Cunningham, Nelson, Owen, Harris and Benedict, Mifflin, Schofield, Henry] and SCI‐specific equations [Chun and Nightingale & Gorgey] were used to estimate and validate BMR. The accuracy of AB‐specific FFM equations in predicting BMR was evaluated using Bland–Altman plots, paired t‐tests, and error metrics. Measured BMR for innervated males, females, and denervated males was 1436 ± 213 kcal/day, 1290 ± 114, and 1597 ± 333 kcal/day, respectively. SCI‐specific equations by Chun et al., Nightingale & Gorgey, and AB‐specific FFM equations accurately predicted BMR for innervated males. For the denervated males, Model 4 equation by Nightingale & Gorgey was not different (p = 0.18), and Bland–Altman analyses showed negative mean bias but similar limits of agreement between measured and predicted BMR for the SCI‐specific equations and AB‐specific FFM equations. We demonstrated that SCI‐specific equations accurately predicted BMR for innervated males but underpredicted it for denervated males. The Model 4 equation by Nightingale & Gorgey accurately estimated BMR in females with SCI. Findings from the current study will help to determine caloric needs in different sub‐groups of SCI.

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Section: Discussionmentioning

confidence: 99%

Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury

Alazzam,

Gorgey

2024

Physiological Reports

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Resting energy expenditure during spinal cord injury rehabilitation and utility of fat-free mass-based energy prediction equations: a pilot study

Nevin,

Atresh,

Vivanti

et al. 2024

Spinal Cord Ser Cases

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Study design Longitudinal observational study. Measurements were undertaken between weeks 4–6 post-spinal cord injury (SCI), repeated at week 8 and every 4 weeks thereafter until week 20 or rehabilitation discharge, whichever occurred first. Objectives Observe variation in measured resting energy expenditure (REE) and body composition in males undergoing SCI rehabilitation, compare REE with SCI-specific prediction equations incorporating fat-free mass (FFM), and explore the prevalence of clinical factors that may influence individual REE. Setting Spinal Injuries Unit, Brisbane, Queensland, Australia. Methods Indirect calorimetry was used to measure REE and bioimpedance spectroscopy to assess body composition. Four SCI-specific FFM-based REE and basal metabolic rate (BMR) prediction equations were compared to measured REE. A clinically significant change in REE was defined as +/− 10% difference from the week 4–6 measurement. Clinical factors that may affect REE variations were collected including infection, pressure injuries, autonomic dysreflexia, spasticity, and medications. Results Fifteen people participated (mean age 35 ± 13 years, 67% paraplegic). There was no statistically significant change in mean REE, weight, or body composition, and the Chun and Nightingale BMR prediction equations performed best (rc > 0.8 at all time points). One-third of participants had >10% change in REE on 11 occasions, with clinical factors not consistently associated with the observed changes. Conclusion During SCI rehabilitation, mean REE, weight, and body composition remain unchanged, and FFM-based BMR prediction equations may be an acceptable alternative to indirect calorimetry. Future research designs should avoid single indirect calorimetry measures as snapshot data may not represent typical REE in this population.

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Basal Metabolic Rate Versus Dietary Vitamin D and Calcium Intakes and the Association With Body Composition and Bone Health After Chronic Spinal Cord Injury

Dora,

Khalil,

Adler

et al. 2024

INQUIRY

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We examined the association among basal metabolic rate (BMR) as well as dietary intakes of vitamin D (Vit D) and calcium on body composition and bone mineral density (BMD) after spinal cord injury (SCI). Cross-sectional design. Veterans Affairs Medical Center, Richmond, VA. About 33 individuals with chronic SCI who recorded their food consumption 3 days per week for 2 weeks. BMR was measured after 10 to 12 h of overnight fast. Average daily vit D and calcium intakes, and total caloric intake were recorded and analyzed using the Nutrition Data System for Research (NDSR) software. Fasting blood analysis for 25-hydroxyvitamin D (25[OH]D) status and Triiodothyronine (T3) status was performed (n = 10). Total and regional BMD, % fat mass (FM), and % lean mass (LM) were measured by dual X-ray absorptiometry scans. Participants consumed less than the Institute of Medicine (IOM) recommended daily allowances (RDA) for vit D (600-800 IU) and calcium (1000-1200 mg) for adults. BMR was positively related to total-lean mass ( r = .62, P = .0001; n = 32) and leg-lean mass ( r = .51, P = .003; n = 32). Adjusted BMR was negatively related to BMD of the left (r = −.38, P = .047; n = 28) and the right (r = −.41, P = .032; n = 28) proximal tibia. Vit D intake was negatively related to percentage total-FM ( r = −.33, P = .07; n = 29) and legs-%FM ( r = −.37, P = .047; n = 29). Multivariate regression models indicated that adjusted BMR explained the variance in leg fat mass (34%; P = .002) and percentage fat mass (44%; P < .0001). Persons with SCI are likely to consume less than the RDAs for vit D and calcium. BMR may explain the changes in body composition and bone metabolism. Dietary vit D should be considered as a prophylactic intervention in maintenance of bone health after SCI.

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Trends in measuring BMR and RMR after spinal cord injury: a comprehensive review

Cited by 5 publications

References 74 publications

Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury

Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury

Resting energy expenditure during spinal cord injury rehabilitation and utility of fat-free mass-based energy prediction equations: a pilot study

Basal Metabolic Rate Versus Dietary Vitamin D and Calcium Intakes and the Association With Body Composition and Bone Health After Chronic Spinal Cord Injury

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