![]() ![]() As even MJ equation does not precisely predict REE, it should be better to plan the diet intervention by measuring rather than estimating REE. In conclusion, MJ equation should be preferred to other equations to estimate the energy needs of Caucasian morbidly obese patients when measurement of the REE cannot be performed. The MJ equation had the best performance in obese patients with ≥3 comorbidities (accuracy of 61.1%, bias of −89.87) and in patients with type 2 diabetes and sleep apnoea (accuracy/bias 69%/−19.17 and 66%/−21.67 respectively), who also have the highest levels of measured REE. In the whole cohort of obese patients, as well as in each stratum of comorbidity number, the MJ equation had the highest performance for agreement measures and bias. ![]() The performance of the equations was assessed in the whole cohort, in 4 groups with 0, 1, 2, or ≥ 3 comorbidities and in a subgroup of 1,598 patients with 1 comorbidity (47.1% hypertension, 16.7% psychiatric disorders, 13.3% binge eating disorders, 6.1% endocrine disorders, 6.4% type 2 diabetes, 3.5% sleep apnoea, 3.1% dyslipidemia, 2.5% coronary disease). Data on REE measured by indirect calorimetry and body composition were collected in 4,247 obese patients (69% women, mean age 48 ± 19 years, mean BMI 44 ± 7 Kg/m 2) admitted to the Istituto Auxologico Italiano from 1999 to 2014. In the present cross sectional study, we compared, in a large cohort of morbidly obese patients, the accuracy of REE predictive equations recommended by current obesity guidelines and/or developed for obese patients (Muller, Muller BC, Lazzer, Lazzer BC), focusing on the effect of comorbidities on the accuracy of the equations. Energy needs are estimated assessing the resting energy expenditure (REE) that in the clinical practice is estimated using predictive equations. The treatment of obesity requires creating an energy deficit through caloric restriction and physical activity. ![]()
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