Energy Requirements for Adults

Energy prediction equations

For resting energy expenditure (REE) or resting metabolic rate (RMR), where weight (W)
in kilograms (kg), height (H) in centimeters, and age (A) in years.
Ireton-Jones
Legend:
B=diagnosis of burn (present=1, absent=0)
O=obesity, body mass index (BMI) >27 kg/m2 (present=1, absent=0)
S=sex (male=1, female=0)
T=diagnosis of trauma (present=1, absent=0)
Spontaneously breathing: 62911(A)+25(W)609(O)
Ventilator dependent (original, 1992): 192510(A)+5(W)+281(S)+292(T)+851(B)
Ventilator-dependent (revised, 2002): 178411(A)+5(W)+244(S)+239(T)+804(B)
Mifflin-St Jeor
Note: According to the Academy of Nutrition and Dietetics (AND) Evidence Analysis
Library, if it is not possible to measure RMR, then the Mifflin-St Jeor equation using
actual weight is the most accurate for estimating RMR for overweight and obese
individuals.
Men: (9.99W)+(6.25H)(4.92A)+5
Women: (9.99W)+(6.25H)(4.92A)161
Harris-Benedict Equation
Men: RMR=66.47+(13.75W)+(5H)(6.75A)
Women: RMR=655.09+(9.56W)+(1.84H)(4.67A)
Owen
Note: Indirect calorimetry is the preferred method for determining RMR in critically ill
patients. If it is necessary to use predictive equations, according to AND evidence-based
practice guidelines, the Ireton-Jones (1992) is one of the equations cited as having the
best prediction accuracy. Harris-Benedict and Mifflin-St Jeor are not recommended for
critically ill patients.
Men: 879+(10.2W)
Women: 795+(7.18W)

Total energy requirements

Total energy requirements (TEE)=REE (activity factor) (injury factor) 500 calories
(for desired weight loss or weight gain, if applicable) + fever factor
Activity factors

 Comatose: 1.1
Confined to bed: 1.2
Out of bed: 1.3
Normal activities of daily living (ADLs): 1.5
Injury factors
Surgery:
Minor: 1.01.2
Major: 1.11.3
Skeletal trauma: 1.11.6
Head trauma: 1.61.8
Infection:
Mild: 1.01.2
Moderate: 1.21.4
Severe: 1.41.8
Burns (% body surface area [BSA]):
<20% BSA: 1.21.5
20%40% BSA: 1.51.8
>40% BSA: 1.82.0
Fever factor
Fahrenheit scale: add 7% of REE for every 1 over normal
Centigrade scale: add 13% of REE for every 1 over normal
References and recommended readings
Academy of Nutrition and Dietetics. Evidence Analysis Library. Available at:
www.adaevidencelibrary.com. Accessed September 11, 2012.
Academy of Nutrition and Dietetics. Nutrition Care Manual. Available by subscription
at: www.nutritioncaremanual.org. Accessed September 11, 2012.
Breen HB, Ireton-Jones CS. Predicting energy needs in obese patients. Nutr Clin Pract.
2004;19:284-289.
Campbell CG, Zander E, Thorland W. Predicted vs measured energy expenditure in
critically ill, underweight patients. Nutr Clin Pract. 2005;20:276-280.
Christie C, ed. Florida Dietetic Association Manual of Medical Nutrition Therapy.
Tallahassee, FL: Florida Dietetic Association; 2012.
Frankenfield D, Roth-Yousey L, Compher C. Comparison of predictive equations for
resting metabolic rate in healthy nonobese and obese adults: a systematic review. J Am
Diet Assoc. 2005;105:775-789.

Review Date 9/12

G-1442