HF: Energy Needs (2007)
For the clinically stable HF patient, what is the calorie level needed to maintain lean body mass in underweight (BMI<19), appropriate body weight (BMI 19-24.9) and overweight (BMI>24.9) individuals?
Based on research to date, insufficient data was available to determine calorie needs at varying BMI levels. The results provide conflicting information regarding the impact on REE and TEE. Two of the five studies reviewed indicate patients with HF have increased REE and TEE vs. healthy controls. One different study indicates a lower DEE vs. healthy controls. A different study compared cachectic and non-cachectic HF patients vs. healthy controls. This study found a lower DEE and REE in the cachectic patients vs. the two other groups. Age and HF classification status varied among all studies.
Two studies found that equations designed to predict daily energy needs developed from healthy subjects either over- or underestimated caloric needs in HF patients.
Further research is needed to determine calorie needs in HF patients.
- 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: Energy Needs and Heart Failure
- Quality Rating Summary
For a summary of the Quality Rating results, click here.
- Aquilani R, Opasich C, Verri M, Boschi F, Febo O, Pasini E, Pastoris O. Is Nutritional Intake Adequate in Chronic Heart Failure Patients? J Am Coll Cardiol. 2003, 42 (7): 1,218-1,223.
- Obisesan TO, Toth MJ, Poehlman ET, Prediction of resting energy needs in older men with heart failure. Eur J Clin Nutr. 1997 Oct; 51 (10): 678-681.
- Pasini E, Opasich C, Pastoris O, Aquilani R. Inadequate Nutritional Intake for Daily Life Activity of Clinically Stable Patients with Chronic Heart Failure, Am J Cardiol. 2004, 93 (Suppl): 41A-43A.
- Toth MJ, Gottlieb SS, Goran MI, Fisher ML, Poehlman ET. Daily energy expenditure in free-living heart failure patients. Am J Physiol. 1997; 272 (Endocrinol Metab. 35): E469-E475.
- Toth MJ, Gottlieb SS, Fisher ML, Poehlman ET. Daily energy requirements in heart failure patients, Metabolism. 1997; 46 (11): 1,294-1,298.
Search Plan and Results: Energy and Protein Needs and Heart Failure 2006