Abstract / Summary
Abstract Purpose Energy requirements for patients with cancer are often estimated using predictive equations that do not typically account for differences in body composition, compared with measured energy requirements by indirect calorimetry (IC). The aim was to assess agreement between measured and estimated energy requirements in patients undergoing cancer treatment and whether specific patient characteristics were associated with resting energy expenditure. Methods In this prospective observational cohort study, patients referred to a clinical dietitian from an oncology outpatient clinic underwent an extended nutritional assessment including IC, bioelectrical impedance analysis, hand grip strength, and 30-second chair-stand test. Estimated energy requirements were assessed by clinical dietitians and retrospectively using the Harris-Benedict equation, with agreement assessed using Bland-Altman plots, and multiple linear regression analyses. Results In total 67 patients (27% women) were assessed, diagnosed with head and neck cancer (n = 46), pancreatic cancer (n = 13), and other cancers (n = 8). Agreement between IC and estimated energy requirements by clinical dietitians was found for 58% of patients (24% were underestimated, 18% were overestimated). With the Harris-Benedict equation agreement was found for 52% of patients (46% were underestimated, 1.5% were overestimated). Higher muscle mass percentage (p = 0.001), comorbidities (p = 0.039), cancer stage (p = 0.003), lower body fat percentage (p < 0.001), and lower whole-body phase angle (p = 0.003) were associated with higher resting energy expenditure. Conclusion A sizeable proportion of patients had incorrectly estimated energy requirements, with both methods tending to underestimate. Body composition, comorbidities, and cancer stage were associated with affected resting energy expenditure, indicating patient groups who could benefit from IC measurement.