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Estimates of Resting Energy Expenditure and Total Energy Expenditure Using Predictive Equations for Individuals After Bariatric Surgery: a Systematic Review with Meta-analysis

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Abstract

Purpose

Patients after metabolic bariatric surgery (MBS) require attention to maintain energy balance and avoid weight regain. Predictive equations for resting energy expenditure (REE) and total energy expenditure (TEE) are needed since gold standard methods like calorimetry and doubly labeled water are rarely available in routine clinical practice. This study aimed to determine which predictive equation for REE and TEE has the lowest bias in subjects after MBS.

Methods

MEDLINE, Embase, Web of Science, and CENTRAL searches were performed. Meta-analyses were performed with the data calculated by the predictive equations and measured by the gold standard methods for those equations that had at least two studies with these data. The DerSimonian and Laird random-effects model and the I2 statistic were used to quantify heterogeneity in the quantitative analyses. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist.

Results

Seven studies were included. The present study found that the Mifflin St. Jeor (1990) equation had the lowest bias (mean difference =  − 39.71 kcal [95%CI =  − 128.97; 49.55]) for calculating REE in post-BS individuals. The Harris-Benedict (1919) equation also yielded satisfactory results (mean difference =  − 54.60 kcal [95%CI =  − 87.92; − 21.28]).

Conclusion

The predictive equation of Mifflin St. Jeor (1990) was the one that showed the lowest bias for calculating the REE of patients following MBS.

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Data Availability

The data will be made available by the authors upon request.

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Funding

M.L.M. is supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brazil (CAPES) research fellowships (grant number: 88887.679721/2022–00). A.E.S.J. is supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brazil (CAPES) research fellowships (grant number: 88887.805029/2023–00). D.T.C.P. is supported by a research scholarship by the Institutional Program for Scientific Initiation Scholarships of Universidade Federal de Alagoas (grant number: 05/2022). D.R.S.P. is supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brazil (CAPES) research fellowships (grant number: 88887.679724/2022–00). N.B.B. is supported by a research grant from the National Council for Scientific and Technological Development – CNPq (grant number: 311401/2022–8).

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Authors and Affiliations

  1. Laboratório de Nutrição e Metabolismo (LANUM), Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, AL, 57072-970, Brazil

    Mateus L. Macena, André E. Silva Júnior, Jennifer M. Melo, Déborah T. Paula, Dafiny R. S. Praxedes & Nassib B. Bueno

  2. Postgraduate Program in Nutrition, Escola Paulista de Medicina, Universidade Federal de São Paulo, Maceió, SP, 04023-062, Brazil

    Mateus L. Macena, André E. Silva Júnior, Dafiny R. S. Praxedes & Nassib B. Bueno

Authors
  1. Mateus L. Macena
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  2. André E. Silva Júnior
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  3. Jennifer M. Melo
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  4. Déborah T. Paula
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  5. Dafiny R. S. Praxedes
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  6. Nassib B. Bueno
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Contributions

A.E.S.J. and M.L.M. conceived the study, wrote, and reviewed the manuscript. J.M.F.M., D.T.C.P., D.R.S.P., and N.B.B. participated in the writing and review of the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to André E. Silva Júnior.

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Key points

• Given the limited number of studies available, we assessed only two REE equations.

• The Mifflin St. Jeor equation showed the smallest bias among the methods.

• The Harris-Benedict equation also yields satisfactory results.

• It was not possible to evaluate the best equation to predict TEE.

Supplementary Information

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Supplementary file1 (DOCX 19 KB)

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Macena, M.L., Silva Júnior, A.E., Melo, J.M. et al. Estimates of Resting Energy Expenditure and Total Energy Expenditure Using Predictive Equations for Individuals After Bariatric Surgery: a Systematic Review with Meta-analysis. OBES SURG 33, 3999–4006 (2023). https://doi.org/10.1007/s11695-023-06908-5

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