Total energy expenditure assessed by 24-h whole-room indirect calorimeter in patients with colorectal cancer: baseline findings from the PRIMe study

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Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
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Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
FORD, Katherine L.
PICHARD, Claude
SAWYER, Michael B.
TROTTIER, Claire F.
PURCELL, Sarah A.
GHOSH, Sunita
SIERVO, Mario
DEUTZ, Nicolaas E. P.
PRADO, Carla M.
Citação
AMERICAN JOURNAL OF CLINICAL NUTRITION, v.118, n.2, p.422-432, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Total energy expenditure (TEE) determines energy requirements, but objective data in patients with cancer are limited. Objectives: We aimed to characterize TEE, investigate its predictors, and compare TEE with cancer-specific predicted energy requirements. Methods: This cross-sectional analysis included patients with stages II-IV colorectal cancer from the Protein Recommendation to Increase Muscle (PRIMe) trial. TEE was assessed by 24-h stay in a whole-room indirect calorimeter before dietary intervention and compared with cancer-specific predicted energy requirements (25-30 kcal/kg). Generalized linear models, paired-samples t tests, and Pearson correlation were applied. Results: Thirty-one patients (56 & PLUSMN; 10 y; body mass index [BMI]: 27.9 & PLUSMN; 5.5 kg/m2; 68% male) were included. Absolute TEE was higher in males (mean difference: 391 kcal/d; 95% CI: 167, 616 kcal/d; P < 0.001), patients with colon cancer (mean difference: 279 kcal/d; 95% CI: 73, 485 kcal/d; P = 0.010), and patients with obesity (mean difference: 393 kcal/d; 95% CI: 182, 604 kcal/d; P < 0.001). Appendicular lean soft tissue (fl: 46.72; 95% CI: 34.27, 59.17; P < 0.001) and tumor location (colon-fl: 139.69; 95% CI: 19.44, 259.95; P = 0.023) independently predicted TEE when adjusted for sex. Error between measured TEE and energy requirements predicted by 25 kcal/kg (mean difference: 241 kcal/d; 95% CI: 76, 405 kcal/d; P = 0.010) or 30 kcal/kg (mean difference: 367 kcal/d; 95% CI: 163, 571 kcal/d; P < 0.001) was higher for patients with obesity, and proportional error was observed (25 kcal/kg: r = -0.587; P < 0.001; and 30 kcal/kg: r = -0.751; P < 0.001). TEE (mean difference: 25 kcal/kg; 95% CI: 24, 27 kcal/kg) was below predicted requirements using 30 kcal/kg (-430 & PLUSMN; 322 kcal/d; P < 0.001). Conclusions: This is the largest study to assess TEE of patients with cancer using whole-room indirect calorimeter and highlights the need for improved assessment of energy requirements in this population. Energy requirements predicted using 30 kcal/kg overestimated TEE by 1.44 times in a controlled sedentary environment and TEE was outside of the predicted requirement range for most. Special considerations are warranted when determining TEE of patients with colorectal cancer, such as BMI, body composition, and tumor location. This is a baseline cross-sectional analysis from a clinical trial registered at clinicaltrials.gov as NCT02788955 (https://clinicaltrials.gov/ct2/show/NC T02788955).
Palavras-chave
whole-room indirect calorimetry, whole-body indirect calorimetry, cancer, energy expenditure, energy requirements, body composition
URI
https://observatorio.fm.usp.br/handle/OPI/59100
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