Abstract
The objective of this study was to assess the validity and acceptability of a handheld
indirect calorimeter for measurement of resting energy expenditure in a sample of
community-dwelling older adults. It was a measurement study involving 48 healthy community-dwelling
older adults. Assessment of resting energy expenditure was performed in 48 healthy
older adults under fasting conditions using the Europa Gas Exchange Monitor (GEM;
ventilated hood indirect calorimeter, NutrEn Technology Ltd, Cheshire, UK) and the
MedGem (handheld indirect calorimeter, HealtheTech Inc, Golden, CO). An eight-item
self-administered survey was used to determine the acceptability of the two measurement
devices. Bias and limits of agreement were calculated to determine the level of agreement
between the two measurements. The Wilcoxon signed-ranks test was used to test for
significant differences across items of the self-administered survey. Participants
mean age was 80 years and mean body mass index (calculated as kg/m2) was 23. Mean (95% confidence interval) resting energy expenditure was 1,149 kcal/day
(1,086, 1,194) and 1,489 kcal/day (1,386, 1,592) for the traditional and handheld
indirect calorimeter, respectively; paired t test P<0.001. Mean bias and limits of agreement were 349 kcal (−270, 969) or 5 kcal/kg/day
(−3.6, 13.2) with least products regression resulting in a slope of b1=1.9 (95% confidence interval 1.2, 2.7, P<0.05). The handheld indirect calorimeter was less acceptable to participants than
the ventilated hood indirect calorimeter. Measurement of resting energy expenditure
from the handheld indirect calorimeter used in this study is not acceptable for use
in healthy older adults given the magnitude of the overestimate, the wide limits of
agreement, the significant slope of the bias, and the discomfort experienced by the
participants.
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Biography
S. Fares is a student and M. Crotty is head, Flinders University Department of Rehabilitation and Aged Care, Repatriation General Hospital, Daw Park, South Australia, Australia.
Biography
M. D. Miller is a lecturer, Flinders University Department of Nutrition and Dietetics, and S. Masters is a research officer, Flinders University Centre for Clinical Change and Health Care Research, Adelaide, South Australia, Australia.
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© 2008 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
