Resting energy expenditure in the parenterally fed pediatric population with Crohn's disease.
BACKGROUND
Malnutrition is a common sequela of Crohn's disease (CD) and may result in reduced skeletal muscle function and growth retardation. Energy requirements of parenterally fed hospitalized pediatric patients with active CD were measured using indirect calorimetry, to assess whether Food Agriculture Organization (FAO)/World Health Organization (WHO)/United Nations University (UNU) equations provide appropriate estimations of energy requirements in this patient population.


METHODS
Twenty hospitalized patients with active CD fed exclusively via parenteral nutrition (PN) were investigated. A chart review and patient interviews were conducted to assess disease duration, location, laboratory parameters, and symptomology associated with CD. Disease severity was quantified using the Pediatric Crohn's Disease Activity Index. Each subject underwent indirect calorimetry, bioelectrical impedance analysis, and anthropometric assessment once the ordered PN met estimated macronutrient requirements of each patient (predicted resting energy expenditure x1.3). Predicted resting energy expenditure (REE) was determined using the FAO/WHO/UNU equations.


RESULTS
REE showed a strong correlation with predicted REE (r(2) = .73, p < .01).


CONCLUSIONS
Measured REE did not significantly differ from predicted resting energy requirements. This indicates that REE for the parenterally fed pediatric patients with CD can be accurately predicted using the FAO/WHO/UNU equations.
Cormier
Kathryn
K
Division of Gastroenterology/Nutrition, Department of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada.
Mager
Diana
D
Bannister
Louise
L
Fortin
Marie
M
Richards
Helen
H
Jackson
Cheryl
C
Pencharz
Paul
P
D000293:Adolescent; D000886:Anthropometry; D001481:Basal Metabolism / Q000502:physiology*; D001823:Body Composition / Q000502:physiology; D002153:Calorimetry, Indirect / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000378:metabolism*; D017097:Electric Impedance; D002149:Energy Intake / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009751:Nutritional Requirements; D010288:Parenteral Nutrition; D012720:Severity of Illness Index