Calculation of energy requirements in overweight and obese adults

Estimation of energy expenditure using prediction equations in overweight and obese adults: a systematic review

Madden et al., JHND Early View


Estimates of energy requirements are needed in weight management and are usually determined using prediction equations. The objective of these two systematic reviews was to identify which equations based on simple anthropometric and demographic variables provide the most accurate and precise estimates of (1) resting energy expenditure (REE) and (2) total energy expenditure (TEE) in healthy obese adults.


Systematic searches for relevant studies in healthy adults with body mass index (BMI) ≥25 kg m−2 and published in English were undertaken using Cinahl, Cochrane Library, OpenGrey, PubMed and Web of Science (completed March 2014). Search terms included metabolism, calorimetry, obesity and prediction equations. Data extraction, study appraisal and synthesis followed guidelines from PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses).


From 243 REE papers and 254 TEE papers identified, 21 and four studies, respectively, met the inclusion criteria. (1) The most accurate REE predictions varied with BMI subgroup: WHO (weight and height) ≥25 and ≥30 kg m−2; Mifflin 30–39.9 kg m−2; Henry ≥40 kg m−2. The most precise REE predictions were obtained using Mifflin in BMI 30–39.9 and ≥40 kg m−2, where approximately 75% of predictions were within 10% of measured REE. (2) No accurate or precise predictions of TEE were identified.


No single prediction equation provides accurate and precise REE estimates in all obese adults. Mifflin equations are recommended in this population, although errors exceed 10% in 25% of those assessed. There is no evidence to support the use of prediction equations in estimating TEE in obesity.

Out now!


The abstracts from the British Dietetic Association Research Symposium held in Birmingham in December 2016, have now been published. The special symposium issue is available to view here.

The issue features abstracts from the symposium sections on Clinical Nutrition, Paediatrics, Public Health, Service Evaluation and New to Research.

Promoting water as a strategy for reducing energy intake


Plain water consumption in relation to energy intake and diet quality among US adults, 2005–2012

An and McCaffrey JHND Early View


The present study examined plain water consumption in relation to energy intake and diet quality among US adults.


A nationally representative sample of 18 311 adults aged ≥18 years, from the National Health and Nutrition Examination Survey 2005–2012, was analysed. The first-difference estimator approach addressed confounding bias from time-invariant unobservables (e.g. eating habits, taste preferences) by using within-individual variations in diet and plain water consumption between two nonconsecutive 24-h dietary recalls.


One percentage point increase in the proportion of daily plain water in total dietary water consumption was associated with a reduction in mean (95% confidence interval) daily total energy intake of 8.58 (7.87–9.29) kcal, energy intake from sugar-sweetened beverages of 1.43 (1.27–1.59) kcal, energy intake from discretionary foods of 0.88 (0.44–1.32) kcal, total fat intake of 0.21 (0.17–0.25) g, saturated fat intake of 0.07 (0.06–0.09) g, sugar intake of 0.74 (0.67–0.82) g, sodium intake of 9.80 (8.20–11.39) mg and cholesterol intake of 0.88 (0.64–1.13) g. The effects of plain water intake on diet were similar across race/ethnicity, education attainment, income level and body weight status, whereas they were larger among males and young/middle-aged adults than among females and older adults, respectively. Daily overall diet quality measured by the Healthy Eating Index-2010 was not found to be associated with the proportion of daily plain water in total dietary water consumption.


Promoting plain water intake could be a useful public health strategy for reducing energy and targeted nutrient consumption in US adults, which warrants confirmation in future controlled interventions.


Editor’s Pick for February/March



The Editor’s Pick paper to accompany our forthcoming issue is by Ptomey and colleagues from the University of Kansas and Texas Tech University. The paper is free to access for 2 months and will appear in JHND 29(2).

Portion-controlled meals provide increases in diet quality during weight loss and maintenance


Behavioural weight-loss interventions utilising portion-controlled meals (PCMs) produce significant decreases in weight. However, their impact on diet quality during weight maintenance is unknown. The present study aimed to assess the influence of a weight management intervention employing PCMs and increased physical activity on diet quality during weight loss and weight maintenance.


One hundred and ninety-seven overweight and obese adults [67% women; mean (SD) BMI = 34.0 (4.6) kg m−2; age = 46.1 (8.9) years] completed an 18-month trial. The weight-loss phase (0–6 months) consisted of energy restriction, which was achieved using PCMs plus fruits and vegetables and increased physical activity. During weight maintenance (6–18 months), participants consumed a diet designed to maintain weight loss. Body weight and dietary intake were assessed at baseline, and at 6, 12 and 18 months. The Healthy Eating Index-2010 (HEI) was calculated using data obtained from 3-day food records.


Mean (SD) body weight was 14.3% (6.6%) and 8.7% (8.0%) below baseline at 6 and 18 months, respectively. The mean (SD) HEI-2010 score after weight loss [66.6 (9.4)] was significantly higher than baseline [46.4 (8.9)] and remained significantly higher than baseline at 18 months [57.7 (10.6)] (both P < 0.001).


A weight management intervention using PCMs resulted in both clinically significant weight loss and increased diet quality scores, demonstrating that the use of PCMs during weight loss allows for meaningful changes in diet quality during weight maintenance.

Associations between diet, food habits and body weight status in Malay families

The Family Diet Study: a cross-sectional study into the associations between diet, food habits and body weight status in Malay families

Yang et al,. JHND Early View


Childhood obesity is becoming more common as Malaysia experiences rapid nutrition transition. Current evidence related to parental influences on child dietary intake and body weight status is limited. The present study aimed to report, among Malay families, the prevalence of energy mis-reporting and dietary relationships within family dyads.


The cross-sectional Family Diet Study (n = 236) was conducted at five primary schools in central of Peninsular Malaysia. Each family consisted of a Malay child, aged 8–12 years, and their main caregiver(s). Information on socio-demographics, dietary intake and anthropometry were collected. Correlations and regression analyses were used to assess dietary relationships within family dyads.


Approximately 29.6% of the children and 75.0% parents were categorised as being overweight or obese. Intakes of nutrients and food groups were below the national recommended targets for majority of children and adults. A large proportion of energy intake mis-reporters were identified: mothers (55.5%), fathers (40.2%) and children (40.2%). Children’s body mass index (BMI) was positively associated with parental BMI (fathers, r = 0.37; mothers, r = 0.34; P < 0.01). For dietary intakes, moderate-to-strong (0.35–0.72) and weak-to-moderate (0.16–0.35) correlations were found between mother–father and child–parent dyads, respectively. Multiple regression revealed that maternal percentage energy from fat (β = 0.09, P < 0.01) explained 81% of the variation in children’s fat intake.


Clear parental dietary relationships, especially child–mother dyads, were found. Despite a significant proportion of families with members who were overweight or obese, the majority reported dietary intakes below recommended levels, distorted by energy mis-reporting. The findings of the present study can inform interventions targeting parent–child relationships to improve family dietary patterns in Malaysia.