Unintended Weight Loss in Older Adults

UWL: Caloric Needs (2007)

Unintended Weight Loss in Older Adults -- Nutrition Assessment

Caloric Needs of Older Adults

• Healthy Older Adults
• Older Adults with Chronic or Acute Illness

• Intervention
  What are the caloric needs of healthy older adults (over age 65)?

  • Conclusion

    Seven studies were evaluated regarding the caloric needs of healthy adults over age 65.  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.  Further research is needed regarding differences in race and ethnicity.  

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What are the caloric needs of healthy older adults (over age 65)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Luhrmann PM, Neuhaeuser Berthold M.  Are the equations published in literature for predicting resting metabolic rate accurate for use in the elderly?  J Nutr Health Aging 2004;8(3):144-9.
      • Meunier N, Beattie JH, Ciarapica D, O'Connor JM, Andriollo-Sanchez M, Taras A, Coudray C, Polito A.  Basal metabolic rate and thyroid hormones of late-middle-aged and older human subjects:  the ZENITH study.  Eur J Clin Nutr 2005;59:S53-S57.
      • Nhung BT, Khan NC, Hop LT, Lam NT, Khanh NLB, Lien DTK, Nakamori M, Hien VTT, Kassu A, Yamamoto S.  Resting metabolic rate of elderly Vietnamese.  Ann Nutr Metab 2007; 51:7-13.
      • Ozeki T, Ebisawa H, Ichikawa M, Nagasawa N, Sato F, Fujita Y.  Physical activities and energy expenditures of institutionalized Japanese elderly women.  J Nutr Sci Vitaminol 2000;46:188-192.
      • Rizzo MR, Mari D, Barbieri M, Ragno E, Grella R, Provenzano R, Villa I, Esposito K, Giugliano D, Paolisso G.  Resting metabolic rate and respiratory quotient in human longevity.  J Clin Endocrinol Metab 2005;90(1):409-13.
      • Rothenberg EM, Bosaeus IG, Westerterp KR, Steen BC.  Resting energy expenditure, activity energy expenditure and total energy expenditure at age 91 - 96 years.  Br J Nutr 2000;84:319-324.
      • Rothenberg EM, Bosaeus IG, Steen BC.  Energy expenditure at age 73 and 78 - a five year follow up.  Acta Diabetol 2003;40:S134-138.
  • Search Plan and Results: Caloric Needs 2007
     
  What are the caloric needs of older adults (over age 65) who are acutely or chronically ill or underweight?

  • Conclusion

    Five studies were evaluated regarding the caloric needs of older adults who are acutely or chronically ill or underweight. As measured by indirect calorimetry, the caloric needs of acutely or chronically ill older adults range from 18kcal to 22kcal per kg per day in females and 20kcal to 23kcal per kg per day in males. The caloric needs of underweight older adults (BMI<20kg/m²) may be as high as 27kcal to 28kcal per kg per day. Emerging research supports a relationship between an increased number of medications with decreased energy needs. Further research is needed in this area.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What are the caloric needs of older adults (over age 65) who are acutely/chronically ill and/or underweight?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dambach B, Salle A, Marteau C, Mouzet JB, Ghali A, Favreau AM, Berrut G, Ritz P.  Energy requirements are not greater in elderly patients suffering from pressure ulcers.  J Am Geriatr Soc 2005;53:478-482.
      • Gariballa S, Forster S.  Energy expenditure of acutely ill hospitalized patients.  Nutr J 2006;5:9.
      • Lammes E, Akner G.  Resting metabolic rate in elderly nursing home patients with multiple diagnoses.  J Nutr Health Aging 2006;10(4):263-70.
      • Schneider SM, Al-Jaouni R, Pivot X, Braulio VB, Rampal P, Hebuterne X.  Lack of adaptation to severe malnutrition in elderly patients.  Clin Nutr 2002;21(6):499-504.
      • Sergi G, Coin A, Bussolotto M, Beninca P, Tomasi G, Pisent C, Peruzza S, Inelmen EM, Enzi G.  Influence of fat-free mass and functional status on resting energy expenditure in underweight elders.  J Gerontol A Biol Sci Med Sci 2002;57(5):M302-7.
  • Search Plan and Results: Caloric Needs 2007