Question 3
The researchers focused on patients with BMI over 18 and under 30. Do you think that the results of this study would change with BMI’s outside of this range? How would you calculate energy needs for those patients?
posted by Jordan @ 11:54 AM
10 comments
10 Comments:
I think the results would have stayed the same (i.e they still would have found that HB and MSJ were the best equations) It would have been nice to see a group with higher BMI so they could evaluate using adjusted body or actual body weight for obese individuals and compare which method was best at calculating needs.
I don’t believe that the overall study results would have changed, but I do think that they would have seen different (possibly more extreme) numbers if the researchers had chosen to include participants with BMI classifications of underweight and overweight. I also think that including overweight and underweight individuals would have just complicated the study more and left more room for errors in calculated numbers. Ireton-Jones equation does actually account for obesity being present, so I think it would be interesting to see how it compared to the other equations and mREE in an obese individual.
I was happy to see that the researchers set guidelines for BMI for participants of the study. When an individual is either under or over weight, more manipulation of the energy calculations is needed (which could potentially increase error). Again this could serve as the building blocks for another study including pts with BMIs < 18 and > 30. However, from my experience, most ALS patients are underweight and would benefit from the findings of a said study.
I do not believe using BMI's outside of that range would have changed the results. I would use adjusted body weight for those with a higher BMI to ensure they are not being overfed. I would still use the same formulas to calculate their needs. I would compare the results and choose the lower calorie calculation. There may be more room for error with more calculations but I don't think the results would change overall.
Amanda- You bring up a good point about ALS patients being underweight. The BMI specifications are good for this population and
I think the results can be applied.
Yes I do. While it is a limitation of this study I still think that this study is useful for patients who fit the specific criteria indicated in this study. Many obese patients will have their energy calculated based off their adjusted body weight. Harris Benedict has been proven to be inaccurate for overweight individuals, while Mifflin St. Jour has shown to be the most accurate. Ireton Jones however, is the only equation of the three that includes an obesity factor which aids it ability to provide reliable results for obese patients. As far as underweight individuals I am not sure how the results would differ.
I agree with Brooke, and believe that more extreme results would have been experienced. I have also experienced many ALS patients being underweight just like Amanda.
As a whole, I do not think the results of this study would be hugely altered. I would consider using Harris Benedict to determine the patient's needs to maintain their current weight (whether over or underweight) and then consider other nutrition history (like malnutrition or open wounds) on each individual basis to determine the energy needs.
I think the results would definitely have changed. Patient's with weights outside of normal can have very different energy needs which can greatly effect their mREE and cREE thus affecting the final results of the study.
Amanda, I agree that error may increase with the manipulation of energy equations for over and under weight individuals. I also find it very interesting that you mentioned a lot of ALS patients are underweight. It would be interesting to see a study that acknowledges this factor.
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