Validity of the dietary reference intakes for determining energy requirements in older adults

Abstract

BACKGROUND/OBJECTIVES The objectives of this study were to evaluate the accuracy of the Dietary Reference Intakes (DRI) for estimating the energy requirements of older adults, and to develop and validate new equations for predicting the energy requirements of this population group. MATERIALS/METHODS The study subjects were 25 men and 23 women with a mean age of 72.2 ± 3.9 years and 70.0 ± 3.3 years, and mean BMI of 24.0 ± 2.1 and 23.9 ± 2.7, respectively. The total energy expenditure (TEE) was measured by using the doubly labeled water (DLW) method, and used to validate the DRI predictive equations for estimated energy requirements (EER) and to develop new EER predictive equations. These developed equations were cross-validated by using the leave-one-out technique. RESULTS In men, the DRI equation had a −7.2% bias and accurately predicted the EER (meaning EER values within ±10% of the measured TEE) for 64% of the subjects, whereas our developed equation had a bias of −0.1% and an accuracy rate of 84%. In women, the bias was −6.6% for the DRI equation and 0.2% for our developed equation, and the accuracy rate was 74% and 83%, respectively. The predicted EER was strongly correlated with the measured TEE, for both the DRI equations and our developed equations (Pearson's r = 0.915 and 0.908, respectively). CONCLUSIONS The DRI equations provided an acceptable prediction of EER in older adults and these study results therefore support the use of these equations in this population group. Our developed equations had a better predictive accuracy than the DRI equations, but more studies need to be performed to assess the performance of these new equations when applied to an independent sample of older adults.

Predictive equations for evaluation for resting energy expenditure in Brazilian patients with type 2 diabetes: what can we use?

“…In our study, these equations estimated higher REE values when compared to the values measured by IC, overestimating in men and women by 14.0 and 7.8% respectively. In a recent study carried out with the elderly, this equation had a bias of − 7.2% in men and − 6.6% in women [46]. Other study she was reported as accurate to estimate REE in men and women [47,48].…”

Predictive equations for evaluation for resting energy expenditure in Brazilian patients with type 2 diabetes: What can we use?

“…In our study, these equations estimated higher REE values when compared to the values measured by IC, overestimating in men and women by 14.0% and 7.8% respectively. In a recent study carried out with the elderly, this equation had a bias of -7.2% in men and − 6.6% in women [46]. Other study she was reported as accurate to estimate REE in men and women [47,48].…”

A narrative review on the application of doubly labeled water method for estimating energy requirement for Koreans

“…Validation parameters included ‘mean % difference’ and ‘prediction % (accurate, underestimation, and overestimation)’. The mean % difference was calculated by the equations [EER(IOM) − TEE(DLW)]/TEE(DLW) × 100; ‘accurate prediction’ indicates the percentage of subjects predicted by the EER(IOM) equations within 90 and 110% TEE(DLW), ‘over-prediction %’ represents the percentage of subjects predicted by the EER(IOM) equations > 110% of TEE(DLW), and ‘under-prediction %’ explains the percentage of subjects predicted by the EER(IOM) equations < 90% of TEE(DLW) [ 3 5 6 11 ].…”

“…Table 1 summarizes the basic characteristics and main outcomes of the 8 out of 11 papers reviewed that validated the EER(IOM) equations for EER based on TEE(DLW) [ 3 4 5 6 7 8 9 10 11 12 13 ]; 3 studies were performed in children (USA 1, Korea 2), 1 in adolescents (Portugal), 2 in adults (Korean), and 2 in the elderly (Korea and USA).…”

“…Estimated energy requirements (EERs) have been calculated through equations developed by the Institute of Medicine of the National Academies (IOM), the World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO), the National Institute of Health and Nutrition (NIHN), the Japanese Dietary Reference Intake (J-DRI), the Japanese Recommended Dietary Allowance for Japanese (J-RDA), and the Recommended Nutrition Intake (RNI). It is also calculated by a method that applies energy balance, factorial approach, and physical record [ 3 4 5 6 7 8 9 10 11 12 13 ].…”