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Recommendations Summary

UWL: Energy Needs 2009

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)

    UWL: Estimating Energy Needs of Healthy Older Adults

    When estimating energy needs for weight maintenance of healthy older adults, the Registered Dietitian (RD) should prescribe an energy intake of 25 - 35 kcal/kg/day in females and 30 - 40 kcal/kg/day in males. Research reports that applying physical activity levels ranging from 1.25 to 1.75 with measured RMR (via indirect calorimetry) in healthy older adults results in these mean total daily energy estimates.

    Rating: Fair
    Conditional

    UWL: Estimating Energy Needs of Underweight Older Adults

    When estimating energy needs for weight maintenance of underweight older adults, the Registered Dietitian (RD) should prescribe an energy intake of 25 - 30 kcal/kg/day, or higher energy levels for weight gain. Research reports that applying physical activity levels ranging from 1.25 to 1.5 with measured RMR (via indirect calorimetry) in older adults who are chronically or acutely ill and/or underweight results in these mean total daily energy estimates.

    Rating: Weak
    Conditional

    • Risks/Harms of Implementing This Recommendation

      • In some individuals,  RMR estimation may be inadequate or excessive and clinical judgment should be used

    • Conditions of Application

      • Regarding the UWL: Estimating Energy Needs of Healthy Older Adults recommendation, this recommendation applies to healthy older adults.
      • Regarding the UWL: Estimating Energy Needs of Underweight Older Adults recommendation, this recommendation applies to underweight older adults.

    • Potential Costs Associated with Application

      • A calculator is required for calculation of estimations 

    • Recommendation Narrative

      • Regarding the UWL: Estimating Energy Needs of Healthy Older Adults recommendation, seven studies were evaluated regarding the caloric needs of healthy adults over age 65 (Ozeki et al, 2000; Rothenberg et al, 2000; Rothenberg et al, 2003; Luhrmann and Neuhauser-Berthold, 2004; Meunier et al, 2005; Rizzo et al, 2005; Nhung et al, 2007).  As measured by indirect calorimetry, reported caloric needs of healthy adults range from 18 - 22 kcal/kg/day in females and 20 - 24 kcal/kg/day in males.  Five studies were evaluated regarding the caloric needs of older adults who are acutely/chronically ill (Schneider et al, 2002; Sergi et al, 2002; Dambach et al, 2005; Gariballa and Forster, 2006; Lammes and Akner, 2006).  As measured by indirect calorimetry, the caloric needs of acutely/chronically ill older adults range from 18 - 22 kcal/kg/day in females and 20 - 23 kcal/kg/day in males. 

      • Regarding the UWL: Estimating Energy Needs of Healthy Older Adults recommendation, five studies were evaluated regarding the physical activity factors with measured RMR in healthy older adults (Ozeki et al, 2000; Rothenberg et al, 2000; Rothenberg et al, 2002; Malatesta et al, 2003; Rothenberg et al, 2003; Blanc et al, 2004). The use of physical activity levels ranging from 1.25 (sedentary) to 1.75 (very active) resulted in mean total daily energy estimates of 25 - 35 kcal/kg/day in females and 30 - 40 kcal/kg/day in males.   

      • Regarding the UWL: Estimating Energy Needs of Underweight Older Adults recommendation,  the caloric needs of underweight older adults (BMI < 20 kg/m2) may be as high as 27 - 28 kcal/kg/day (Schneider et al, 2002; Sergi et al, 2002).

      • Regarding the UWL: Estimating Energy Needs of Underweight Older Adults recommendation, one study was evaluated regarding the physical activity factors with measured RMR in older adults who are acutely/chronically ill and/or underweight (Dambach et al, 2005).  The use of physical activity levels ranging from 1.25 - 1.5 resulted in mean total daily energy estimates of 25 - 30 kcal/kg/day. 

    • Recommendation Strength Rationale

      • Conclusion Statements in support of the UWL: Estimating Energy Needs of Healthy Older Adults recommendation received Grade II 
      • Conclusion Statements in support of the UWL: Estimating Energy Needs of Underweight Older Adults recommendation received Grades II and III 

    • Minority Opinions

      Consensus reached.