title: Comparison of energy prediction equations with measured resting energy expenditure in children with sickle cell anemia.
abstract: OBJECTIVE
  To determine the accuracy of energy prediction equations when compared with measured resting energy expenditure (REE) in children with sickle cell anemia. To develop a modified equation that more accurately estimates the energy needs of children with sickle cell anemia and to cross-validate these on a different set of patients (test patients).
  
  
  METHODS
  REE was measured in children using indirect calorimetry and compared with predicted values using the Harris-Benedict and the Food and Agriculture Organization/World Health Organization/United Nations University equations (WHO).
  
  
  METHODS
  Eighteen patients participated in the original sample that compared predicted with measured energy expenditure. The modified equations were developed using the original 18 patients. A test population of 20 different patients was used to validate the modified equations.
  
  
  METHODS
  Wilcoxon signed-rank test was performed to compare measured with predicted REE. The correlation analysis method and multiple linear regression method were used to develop 2 modified versions for the Harris-Benedict and WHO prediction equations.
  
  
  RESULTS
  When compared with the mean predicted REE using the Harris-Benedict and WHO equations, the mean measured REE was 14% and 12% greater than both (P=.005 and P=.014, respectively). Two modified equations were developed from the Harris-Benedict and WHO equations. Based on the data from the test patients, the mean measured REE was 15% greater than the mean predicted REE based on the Harris-Benedict and WHO equations (P=.0001 for both). When the modified Harris-Benedict and WHO equations were used, there was almost no difference in the mean measured REE and the mean predicted REE (mean difference using Harris-Benedict = 14, P = .9273; mean difference using WHO = -13, P = .6215).
  
  
  CONCLUSIONS
  Both energy prediction equations underestimated REE in children with sickle cell anemia. The 2 modified versions of the energy prediction equations that we propose predicted the energy needs of these children much more accurately; however, the modified equations need to be validated through application to other children with sickle cell anemia.
authors.affiliation: Clinical Nutrition Services, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. ruth.williams@stjude.org
authors.forename: Ruth
authors.initials: R
authors.lastname: Williams
authors.forename: Stacie
authors.initials: S
authors.lastname: Olivi
authors.forename: Paul
authors.initials: P
authors.lastname: Mackert
authors.forename: Lucille
authors.initials: L
authors.lastname: Fletcher
authors.forename: Guo-Liang
authors.initials: GL
authors.lastname: Tian
authors.forename: Winfred
authors.initials: W
authors.lastname: Wang
mesh_terms: D000704:Analysis of Variance; D000755:Anemia, Sickle Cell / Q000378:metabolism*; D000886:Anthropometry; D001481:Basal Metabolism / Q000502:physiology*; D002153:Calorimetry, Indirect / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008433:Mathematics; D015596:Nutrition Assessment; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D014944:World Health Organization