Resting energy expenditure

Resting energy expenditure

What does REE mean

Resting energy expenditure represents the amount of calories required for a 24-hour period by the body during a non-active period. Energy expenditure can be estimated by numerous published formulas. There are nearly 200 published energy expenditure formulas dealing with various conditions, disease states, age, presence of obesity and other additional factors. One of the most frequently used formulas for predicted energy expenditure are the Harris-Benedict equations. These were established in 1919 and took into account gender, age, height andweight. However, these formulas are skewed towards young and non-obese persons.

Harris-Benedict Equations (calories/day): Male: (66.5 + 13.8 X weight) + (5.0 X height) - (6.8 X age) Female: (665.1 + 9.6 X weight) + (1.8 X height) - (4.7 X age)

weight in kilograms, height in centimeters, age in years

The Harris-Benedict equations have been found to overestimate by 6% to15% the actual energy expenditure measurements done by indirect calorimetry. There is a large variation between individuals, whencomparing their measured energy expenditure to the calculated amount. These equations have limited clinical value when tailoring nutritionprograms for specific individuals for weight loss purposes or acute as well as chronic illness feeding regimens.

Benefits of using REE in the clinical setting

The REE is useful to prevent under and overfeeding of individuals, especially in the acute care hospital setting. Excessive calories or inadequate feeding regimens can have detrimental effects on clinical outcomes of patients' care. Malnutrition can result from feeding a patient less than his/her metabolic requirements leading to reduced respiratory muscle strength, increased risk of infection, poor wound healing and impaired normal body function. Overfeeding means providing too many calories that can not be used by the body and are therefore converted to fat storage. This can cause more CO2 to be produced and result in increased work of breathing. The REE measurement is especially beneficial in the ventilator dependent patient population during the process of weaning the individual from mechanical ventilation to resume (reestablish) spontaneous breathing.

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