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Determinants of Resting Energy Expenditure in Very Old Nursing Home Residents

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

This study aimed to measure resting energy expenditure (REE) in institutionalized old persons and to determine factors possibly related to change in REE as a basis for estimating energy requirements.

Design and Settings

A monocentric cross-sectional study was conducted. Statistical approaches were conducted to determine independent factors associated with REE. Various published predictive equations of REE were compared to our population.

Participants

72 residents of a nursing home, mostly women (80.5%) aged 87.4±6.6 years were included.

Measurements

REE (indirect calorimetry), body composition (bio-impedance analysis), biological and anthropometric data were collected.

Results

Mean REE was 1006±181 kcal/d and was higher in men than in (1227±195 vs. 953±131 kcal/d, p<0.05). According to criteria adapted from the Global Leadership Initiative on Malnutrition consensus, 65.3 % of the institutionalized population were malnourished. In multivariate analysis adjusted on gender and age, REE was positively associated with calorie intake, fat-free mass (FFM), functional abilities (French Autonomie Gérontologie Groupe Iso Ressources scale), and elevated CRP level (> 25 mg/l). Significant differences (p<0.05) appeared between measured REE and predicted REE by using various published equations.

Conclusion

REE of very old nursing home residents is influenced by FFM, calorie intake, functional abilities, and CRP levels and is poorly predicted by classical equations based on age, gender, height, and weight. This suggests a metabolic adaptation to caloric restriction and inflammation and prompts to consider the level of physical activity and muscle loss when assessing caloric requirements in this population.

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Acknowledgments and contribution

We thank the patients for their valuable contribution to the study. No specific grant supported this study. CL contributed to data analysis, interpretation, and manuscript preparation. HDB contributed to the design of the study, data collection, data analysis and interpretation, and manuscript preparation. CG contributed to data collection, interpretation, and manuscript preparation. BP contributed to data analysis and manuscript preparation. YB was responsible for the study conception, data interpretation, and manuscript preparation.

Author information

Authors and Affiliations

  1. CHU Clermont-Ferrand, Service de gériatrie, Université Clermont Auvergne, Clermont-Ferrand, France

    Clément Lahaye

  2. Université Clermont Auvergne, INRAE, Unité de Nutrition Humaine, CRNH Auvergne, Clermont-Ferrand, France

    Clément Lahaye, C. Guillet & Y. Boirie

  3. Health Economic Unit of the University Hospital of Toulouse, Toulouse, France

    H. Derumeaux-Burel

  4. CHU Clermont-Ferrand, Unité de Biostatistiques, Direction de la Recherche Clinique et de l’Innovation, Clermont-Ferrand, France

    B. Pereira

  5. CHU Clermont-Ferrand, Service de nutrition clinique, Université Clermont Auvergne, Clermont-Ferrand, France

    Y. Boirie

  6. CHU Clermont-Ferrand, Department of Clinical Nutrition, Hôpital Gabriel Montpied, 58 Rue Montalembert, F-63003, Clermont-Ferrand, France

    Clément Lahaye

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  1. Clément Lahaye
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Corresponding author

Correspondence to Clément Lahaye.

Ethics declarations

Conflict of interest: None of the authors had any financial or personal conflicts of interest with this research.

Ethical standards: Each patient completed an information and consent form. The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki as revised in 1983 and received approval from the institution’s human research committee (Comité de Protection des Personnes Sud-Est VI). The study complies with the current French laws concerning clinical research.

Electronic supplementary material

Supplementary Figure

: Bland and Altman analysis to compare REE estimation with WHO equation to measured REE (MJ/d).

Supplementary Table

: Characteristics of malnourished and well-nourished frail old populations

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Lahaye, C., Derumeaux-Burel, H., Guillet, C. et al. Determinants of Resting Energy Expenditure in Very Old Nursing Home Residents. J Nutr Health Aging 26, 872–878 (2022). https://doi.org/10.1007/s12603-022-1837-1

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  • DOI: https://doi.org/10.1007/s12603-022-1837-1

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