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Recommendations Summary

Adult Weight Management (AWM) Determination of Resting Metabolic Rate

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)

    AWM: Determining Energy Needs

    Estimated energy needs should be based on RMR. If possible, RMR should be measured (e.g., indirect calorimetry). If RMR cannot be measured, then the Mifflin-St. Jeor equation using actual weight is the most accurate for estimating RMR for overweight and obese individuals.

    Rating: Strong
    Conditional

    Mifflin-St Jeor Equations
    Men: RMR = (9.99 X weight) + (6.25 X height) – (4.92 X age) + 5
    Women: RMR = (9.99 X weight )+ (6.25 X height) – (4.92 X age) – 161
    Equations use weight in kilograms (kg), height in centimeters (cm).

    • Risks/Harms of Implementing This Recommendation

      The Mifflin-St. Jeor equation was not tested on racial groups other than Caucasian and so may not be accurate for these groups.  Research separating obese from non-obese subjects is limited.

    • Conditions of Application

      Equations to estimate RMR should be used when RMR cannot be measured.

    • Potential Costs Associated with Application

      Costs vary by RMR measurement method.

    • Recommendation Narrative

      • Nine cross-sectional studies reported the evaluation of the Mifflin-St. Jeor equation in overweight and obese populations, however, only one separated obese from non-obese subjects.  The Mifflin-St. Jeor equation predicted RMR within 10% of measured RMR in 70% of obese individuals; up to 9% were overestimations and up to 21% were underestimations (Arciero et al, 1993; De Lorenzo et al, 2001; Frankenfield et al, 2003; Garrel et al, 1996; Heshka et al, 1993; Liu et al, 1995; Mifflin et al, 1987; Scalfi et al, 1993; Taaffe et al, 1995) 
      • Eleven cross-sectional studies reported the evaluation of the Harris-Benedict equation in overweight and obese U.S. and Canadian populations, however, only five separated obese from non-obese subjects.  In studies using actual weight, the Harris-Benedict equation predicted RMR within 10% of measured RMR in 39 - 64% of obese individuals; up to 43% were overestimations and up to 35% were underestimations.  In studies using adjusted body weight, the Harris-Benedict equation predicted RMR within 10% of measured RMR in 0% - 60% of obese individuals; up to 25% were overestimations and up to 100% were underestimations (De Lorenzo et al, 2001; Feurer et al, 1983; Forman et al, 1998; Foster et al, 1988; Frankenfield et al, 2003; Heshka et al, 1993; Hirano et al, 2001; Mifflin et al, 1987; Owen et al, 1986; Owen et al, 1987; Pavlou et al, 1986).  
      • Ten cross-sectional studies reported the evaluation of the Owen equations in overweight and obese populations, however, only three separated obese from non-obese subjects.  The Owen equations predicted RMR within 10% of measured RMR in 33 - 51% of individuals; up to 22% were overestimations and up to 60% were underestimations (Arciero et al, 1993; De Lorenzo et al, 2001; Frankenfield et al, 2003; Heshka et al, 1993; Mifflin et al, 1990; Owen et al, 1987; Owen et al, 1986; Scalfi et al, 1993; Siervo et al, 2003; Taaffe et al, 1995)

    • Recommendation Strength Rationale

      • Conclusion statements were Grade I and II
      • Consistent findings across studies

    • Minority Opinions

      Consensus reached.