• Assessment
    In obese adults, what is the prediction accuracy and maximum overestimation and understimation errors compared to measured resting metabolic rate when using the Harris-Benedict formula (actual body weight)?
    • Conclusion

      In a study of high-quality research methods, the Harris-Benedict equation predicted RMR within 10% of measured RMR in 64% of obese individuals, and, of the 36% remaining, 30% were overestimations and 6% were underestimations. A concurring, high quality research methods study reported that the Harris-Benedict equation predicted within +/-10% of measured RMR in 64% of obese males; the remaining 36% were overestimation errors. In a moderate quality research design, the Harris-Benedict equation predicted RMR within 10% of measured RMR in obese individuals by 39%; in the remaining 61%, 52% were overestimations and 9% were underestimations. In another moderate quality research design study with only females, 59% were within +/-10% of predicted values using Harris-Benedict; of the remaining 41%, 21% were overestimations and 20% were underestimations. A small study reported individual RMR estimation errors in overweight and obese women of approximately 396 kcals/day using actual weight. Overestimations by 43% to underestimations by 35% occurred in obese individuals using all studies that reported individual errors ranges.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In obese adults, what is the prediction accuracy and maximum overestimation and understimation errors compared to measured resting metabolic rate when using the Harris-Benedict formula (adjusted body weight)?
    • Conclusion

      A high quality study reports Harris-Benedict estimated within +/-10% of measured RMR in 26% of individuals with the remaining 74% including 2% overestimations and 72% underestimations. In the same study, when extremely obese individuals were evaluated separately using adjusted body weight, the Harris-Benedict equation did not predict RMR within +/-10% of measured with underestimations occurring in all individuals. A small study reported individual RMR error in females of approximately 272 kcals/day using adjusted body weight. The individual error range was a maximal overestimation by 25% to an underestimation by 42%.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In obese adults, what is the prediction accuracy and maximum overestimation and understimation errors compared to measured resting metabolic rate when using the Harris-Benedict formula (ideal body weight)?
    • Conclusion

      In a high quality research methods study, the Harris-Benedict equation predicted RMR within +/- 10% in only 26% of obese males; and of the remaining 74%, 4% were overestimations and 70% were underestimations. A neutral research method design reports Harris-Benedict estimated within +/- 10% of measured RMR in 13% of obese individuals with the remaining 87% as underestimations. The individual error range was a maximal overestimation by 5% to an underestimation by 94%.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In obese adults, what is the prediction accuracy and maximum overestimation and understimation errors compared to measured resting metabolic rate when using the Mifflin-St.Jeor formula?
    • Conclusion

      One study of high research quality design reported that the Mifflin-St. Jeor equation accurately predicted RMR using actual body weight within +/- 10% of measured RMR in 70% of obese individuals. Of the remaining 30%, 9% were overestimations and 21% were underestimations. The individual error range was a maximum overestimate of 15% to a maximum underestimate of 20%.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In obese adults, what is the prediction accuracy and maximum overestimation and understimation errors compared to measured resting metabolic rate when using the Owen et al formula?
    • Conclusion

      The Owen, et al. equation predicted RMR within 10% of measured RMR in obese (BMI 30-40 kg/m2) individuals by 75% with the remaining 25% including 5% overestimations and 20% underestimations. In the same study, the Owen, et al. equation predicted RMR within 10% of measured RMR in 33% of severely obese (BMI >40 kg/m2) individuals with the remaining 67% including 7% overestimations and 60% underestimations. The individual error range was a maximum overestimate of 15% to a maximum underestimate of 37%.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In obese adults, what is the group mean error in estimating resting metabolic rate (RMR) compared to measured RMR when using the Harris-Benedict formula?
    • Conclusion

      A study of high research methods design reported a group RMR mean overestimation error by ~9% in obese males, 30-60 years; representing a group mean overestimation of 166 kcals/day. A study of moderate quality research design reported a group RMR mean overestimation error of 408 kcals/day in males within the same age range. Another moderate research quality design quality reported that the Harris-Benedict equation overestimated group RMR means by 12% and 11% in obese males and females, respectively; and represented errors of 336 kcals/day and 202 kcals/day. In two high quality studies of only females, the Harris-Benedict equation overestimates group mean by ~166 kcals/day and 396 kcals/day. In another study of females and when measured RMR was adjusted for difference in lean body mass, the Harris-Benedict equation underestimated by 233 kcals/day in Caucasian women and slightly overestimated by 35 kcals/day in African-American women.

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In obese adults, what is the group mean error in estimating resting metabolic rate (RMR) compared to measured RMR when using the Owen et al formula?
    • Conclusion

      One high quality research methods study reported group RMR mean overestimation error of 132 kcals/day and underestimation error of 137 kcals/day in U.S.-residing males and females, respectively. Three high quality research methods design study report underestimation errors in Italian women using the Owen, et al. equation with group mean underestimation errors around 10%. In the study that included men (DeLorenzo), group mean underestimation errors also occured.

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    In obese adults, what is the prediction accuracy and maximum overestimation and underestimation resting metabolic rate (RMR) errors compared to measured RMR when using the WHO/FAO/UNU formula?
    • Conclusion

      Individual prediction accuracy within +/- 10% is not reported for obese U.S.-residing adults using the World Health Organization/ Food & Agricultural Organization/United Nations University (WHO/FAO/UNU) equation.

    • Grade: V
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.