title: Predicting energy requirement with pedometer-determined physical-activity level in women with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  In clinical practice, in the absence of objective measures, simple methods to predict energy requirement in patients with chronic obstructive pulmonary disease (COPD) needs to be evaluated. The aim of the present study was to evaluate predicted energy requirement in females with COPD using pedometer-determined physical activity level (PAL) multiplied by resting metabolic rate (RMR) equations.
  
  
  METHODS
  Energy requirement was predicted in 18 women with COPD using pedometer-determined PAL multiplied by six different RMR equations (Harris-Benedict; Schofield; World Health Organization; Moore; Nordic Nutrition Recommendations; Nordenson). Total energy expenditure (TEE) was measured by the criterion method: doubly labeled water. The predicted energy requirement was compared with measured TEE using intraclass correlation coefficient (ICC) and Bland-Altman analyses.
  
  
  RESULTS
  The energy requirement predicted by pedometer-determined PAL multiplied by six different RMR equations was within a reasonable accuracy (±10%) of the measured TEE for all equations except one (Nordenson equation). The ICC values between the criterion method (TEE) and predicted energy requirement were: Harris-Benedict, ICC =0.70, 95% confidence interval (CI) 0.23-0.89; Schofield, ICC =0.71, 95% CI 0.21-0.89; World Health Organization, ICC =0.74, 95% CI 0.33-0.90; Moore, ICC =0.69, 95% CI 0.21-0.88; Nordic Nutrition Recommendations, ICC =0.70, 95% CI 0.17-0.89; and Nordenson, ICC =0.40, 95% CI -0.19 to 0.77. Bland-Altman plots revealed no systematic bias for predicted energy requirement except for Nordenson estimates.
  
  
  CONCLUSIONS
  For clinical purposes, in absence of objective methods such as doubly labeled water method and motion sensors, energy requirement can be predicted using pedometer-determined PAL and common RMR equations. However, for assessment of nutritional status and for the purpose of giving nutritional treatment, a clinical judgment is important regarding when to accept a predicted energy requirement both at individual and group levels.
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Respiratory Medicine and Allergy, Umeå University, Umeå, Sweden.
authors.forename: Nighat
authors.initials: N
authors.lastname: Farooqi
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Frode
authors.initials: F
authors.lastname: Slinde
authors.affiliation: Department of Community Medicine and Rehabilitation, Division of Geriatric Medicine, Umeå University, Umeå, Sweden.
authors.forename: Maine
authors.initials: M
authors.lastname: Carlsson
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Family Medicine, Umeå University, Umeå, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Håglin
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Respiratory Medicine and Allergy, Umeå University, Umeå, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sandström
mesh_terms: D056044:Actigraphy / Q000295:instrumentation*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002153:Calorimetry, Indirect; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D004867:Equipment Design; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008875:Middle Aged; D008954:Models, Biological; D009043:Motor Activity; D009752:Nutritional Status; D011237:Predictive Value of Tests; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D015203:Reproducibility of Results; D012737:Sex Factors
keywords: DLW method; energy expenditure; pedometer-determined PAL; women with COPD