title: Reduced Resting Metabolic Rate in Adults with Hemiparetic Chronic Stroke.
abstract: OBJECTIVE
  Resting metabolic rate (RMR) is the component of energy expenditure that explains the largest proportion of total daily energy requirements. Since RMR is determined largely by fat-free mass and a low RMR predicts weight gain in healthy adults, identifying the role of muscle atrophy following stroke on RMR may help identify ways to mitigate the development of obesity post-stroke.
  
  
  METHODS
  Thirty-nine stroke survivors with chronic hemiparesis (mean ± SEM: age: 61 ± 1 years, latency from stroke: 107 ± 40 months, BMI: 31 ± 3 kg/m2) underwent DXA scans for measurement of body composition, including total, paretic, and non-paretic leg lean mass and fasted, 30-min indirect calorimetry for measurement of RMR.
  
  
  RESULTS
  Predicted RMR was calculated by the Mifflin-St Jeor equation, which considers weight, height, and age for both men and women. RMR was 14% lower than predicted (1438 ± 45 vs. 1669 ± 38 kcals/24 hrs; P<0.01). Total (r=0.73, P<0.01), paretic (r=0.72, P<0.01) and non-paretic (r=0.67, P<0.01) leg lean mass predicted RMR.
  
  
  CONCLUSIONS
  These data indicate that muscle atrophy post stroke may lead to a reduced RMR. This substantiates the need to attenuate the loss of lean mass after a stroke to prevent declines in RMR and possible weight gain common post-stroke.
authors.affiliation: Department of Veterans Affairs, Baltimore VAMC, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, USA.
authors.forename: Monica C
authors.initials: MC
authors.lastname: Serra
authors.affiliation: Department of Veterans Affairs, Baltimore VAMC, Department of Neurology, University of Maryland School of Medicine, Baltimore, USA.
authors.forename: Charlene E
authors.initials: CE
authors.lastname: Hafer-Macko
authors.affiliation: Department of Veterans Affairs, Baltimore VAMC, Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, USA.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ryan
keywords: Chronic stroke; Resting metabolic rate; Weight management