Basal metabolic rate in Brazilian patients with type 2 diabetes: comparison between measured and estimated values

ABSTRACT Objectives: The aims of this study are to investigate which of the seven selected predictive equation for estimating basal metabolic rate (BMR) is the best alternative to indirect calorimetry (IC) and to evaluate the dietary energy intake in patients with type 2 diabetes. Subjects and methods: Twenty-one patients with type 2 diabetes participated in this diagnostic test study. Clinical and laboratorial variables were evaluated as well as body composition by absorptiometry dual X-ray emission (DXA) and BMR measured by IC and estimated by prediction equations. Dietary intake was evaluated by a quantitative food frequency questionnaire. Data were analyzed using Bland-Altman plots, paired t-tests, and Pearson's correlation coefficients. Results: Patients were 62 (48-70) years old, have had diabetes for 8 (2-36) yeas, and 52.4% were females. The mean body composition comprised a fat-free mass of 49.8 ± 9.4 kg and a fat mass of 28.3 ± 7.2 kg. The energy intake was 2134.3 ± 730.2 kcal/day and the BMR by IC was 1745 ± 315 kcal/day. There was a wide variation in the accuracy of BMR values predicted by equations when compared to IC BMR measurement. Harris-Benedict, Oxford, FAO/WHO/UNO equations produced the smallest differences to IC, with a general bias of < 8%. The FAO/WHO/UNO equation provided the best BMR prediction in comparison to measured BMR. Conclusion: In patients with type 2 diabetes, the equation of the FAO/WHO/UNO was the one closest to the BMR values as measured by IC.

Fatores determinantes de perda de peso em adultos submetidos a intervenções dietoterápicas / Determinant factors associated with weight loss in adults on diet interventions

OBJETIVO: Analisar os fatores determinantes da perda de peso (> 5%) resultante de atendimento ambulatorial individual. SUJEITOS E MÉTODOS: Estudo de coorte retrospectivo com 318 pacientes com sobrepeso/obesidade em atendimento individual para perder peso. RESULTADOS: Quinze por cento dos pacientes não perderam peso, 35,1% apresentaram perda < 5%, 35,4% entre 5-10% e 13,9% perda > 10%. Os pacientes que perderam > 5% de peso (-7,6 ± 3,3 kg; n = 156) tiveram maior número e menor intervalo entre consultas e maior frequência de atendimentos particulares, acompanhamento por nutricionista e atendimentos multidisciplinares. Ainda, houve neste grupo menor prescrição de medicamentos antiobesidade e o valor calórico total da dieta foi maior do que nos demais pacientes. Em análises multivariadas de regressão de Cox apenas o intervalo entre consultas e o número total de consultas permaneceram inversamente associados à perda de peso. CONCLUSÕES: Os determinantes de perda de peso > 5% foram um menor número de consultas com um menor intervalo entre os atendimentos.

OBJECTIVE: To analyze the determinants for weight loss (> 5%) resulting from outpatient individual appointments. SUBJECTS AND METHODS: A retrospective cohort study was conduct in 318 overweight/obese patients seeking individual care to lose weight. RESULTS: Fifteen percent of the patients did not lose weight; 35.1% had lost < 5%; 35.4% had lost between 5 and 10%; and 13.9% had lost > 10%. Patients who lost > 5% body weight (-7.6 ± 3.3 kg, n = 156) had a greater number of visits at a shorter interval, and greater frequency of visits with a registered dietitian and multidisciplinary care. This group had a lower prescription of anti-obesity drugs and their total calorie intake was higher than the other patients. In multivariate Cox regression, only the interval between appointments and the total number of visits remained inversely associated with weight loss. CONCLUSIONS: The determinants of > 5% weight loss were fewer visits with a shorter interval between appointments.