How are correction factors used in estimating energy expenditure in obese patients?

Updated: Jun 09, 2021
  • Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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In addition, some researchers have recommended using correction factors for estimating energy expenditure in obese patients. [129, 130] In a retrospective cross-sectional study of 1,331 patients with a body mass index (BMI) of at least 25 kg/m2, Wilms and colleagues found that calculating resting oxygen uptake with the widely used 1-MET (metabolic equivalent) value of 3.5 ml O2/kg/min overestimates actual values by 17% to 39% in overweight to severely obese individuals. [129, 130]

All subjects underwent resting energy expenditure (REE) testing with indirect calorimetry and 652 subjects also performed a symptom-limited bicycle cardiopulmonary exercise test to determine maximal achievable METs. Mean REE was 2.47 ml O2/kg/min in women and 2.62 ml O2/kg/min in men. MET-REE decreased significantly with increasing BMI, and the deviation of MET-REE values from the predicted 1-MET value of 3.5 ml O2/kg/min progressively increased.

The researchers developed sex-specific MET correction factors for distinct BMI groups. During the bicycle test, women performed 4.4 MET-peak and men performed 4.7 MET-peak. After the correction factors were applied, MET-peak increased to 6.2 in women and 6.1 in men. [129, 130]

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