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Energy Expenditure

Energy Expenditure (EE): Appendix (2006)

Measuring versus Estimating Resting Metabolic Rate

Identifying the most accurate information for an individual's Resting Metabolic Rate (RMR) is critical because RMR accounts for the majority of an individual’s energy expenditure (EE), and the basis upon which stress and activity factors are multiplied.

How Is RMR Determined?

Two approaches have been used to determine RMR:

  • To assess the caloric needs of an individual, dietetics professionals have traditionally used prediction equations to estimate the resting metabolic rate (RMR)a and added a stress and/or activity factor.
  • An alternative to the prediction equations is to measure RMR by indirect calorimetry (IC).

Which method is appropriate in a given situation?

Using Clinical Judgement

Clinical judgment is needed to determine when the RMR will be a critical element of the nutrition care plan and likely to impact significantly important patient/client outcomes. Regardless of the method to determine RMR, estimated or measured, careful clinical judgment is essential to evaluate the RMR value and its application in an individual’s nutrition care and outcomes.

Scientific Judgement as an Aid to Clinical Judgement

This appendix reviews the scientific evidence related to predicting and measuring RMR and provides insight into applying both methods, including a decision making flowchart, supporting tables, and practitioner and patient instructions for measuring RMR.

Evidence analysis—Estimating RMR with prediction equations

Evidence analysis—Measuring RMR with indirect calorimetry (IC)

Sponsor:  Funding for the Energy Expenditure: Measurement versus Estimation Evidence Analysis Project was provided by HealtheTech

ADA acknowledges the generous sponsors who have provided support for Evidence Analysis Projects.
Note:  ADA maintains full control over the content and process of ALL evidence analysis projects including the selection of topics, evaluation of research, assignment of grades, and development of recommendations.