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Recommendations Summary

EE: Resting Activities in Healthy and Non-Critically Ill 2014

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.

• Recommendation(s)

  EE: Resting Activities in Healthy Adults

  The registered dietitian nutritionist (RDN) should ensure healthy adults rest quietly and not engage in any activity during the 30-minute rest period. Some data suggest activities such as laughing, reading, or listening to music may increase resting metabolic rate (RMR).
   

  Rating: Consensus
  Imperative

  • Risks/Harms of Implementing This Recommendation

    There are no potential risks or harms associated with the application of this recommendation.

  • Conditions of Application

    • Clinical judgment should be used in applying this recommendation to healthy children and non-critically ill children and adults, due to no evidence in these populations
    • Fidgeting further increases RMR. Therefore the RDN must assure the subject does not fidget during the entire procedure (Levine et al, 2000).

    
    
     

  • Potential Costs Associated with Application

    There are no obvious costs that may be associated with the application of the recommendation.

  • Recommendation Narrative

    No studies meeting the established inclusion criteria were identified to address what types of activities, if any, could be done during the 30-minute rest period prior to an RMR measurement in healthy and non-critically ill individuals. Data from other studies were considered for this consensus recommendation. Two articles provide support for the recommendation.

    • Snell et al, 2014, showed a significant increase in RMR (N=65) when listening to relaxing music (P=0.0072) or reading either a magazine or electronic device (P<0.0001) compared to no resting activities during RMR measurements in healthy adults
    • Buchowski et al, 2007, found that energy expenditure was significantly increased (P<0.001) by genuine laughter (N=45) compared to resting quietly during RMR measurements in young, healthy adults.

    In sum, resting quietly during the RMR measurement without additional activity is recommended in healthy adults.
     

  • Recommendation Strength Rationale

    The recommendation is consensus.

  • Minority Opinions

    None.

• Supporting Evidence

  The recommendations were created from the evidence analysis on the following questions. To see detail of the evidence analysis, click the blue hyperlinks below (recommendations rated consensus will not have supporting evidence linked).

  What kinds of activities can be done during the rest period in healthy and non-critically ill individuals?

  • References
  • References not graded in Academy of Nutrition and Dietetics Evidence Analysis Process

    Buchowski MS, Majchrzak KM, Blomquist K, Chen KY, Byrne DW, Bachorowski JA. Energy expenditure of genuine laughter. Int J Obes (Lond). 2007 Jan; 31(1): 131-137.
    
    Levine JA, Schleusner SJ, Jensen MD. Energy expenditure of non-exercise activity. Am J Clin Nutr. 2000; 72: 1, 451-1, 454. 
    
    Snell B, Fullmer S, Eggett DL. Reading and listening to music increase resting energy expenditure during an indirect calorimetry test. J Acad Nutr Diet. 2014 Apr 29. pii: S2, 212-S2, 122, 672(14)00356-6. doi: 10.1016/j.jand.2014.03.013. [Epub ahead of print] PMID: 24794837.