Accuracy of Equations to Predict Basal Metabolic Rate in Older Women

Objective To assess the accuracy of several published equations for predicting basal metabolic rate (BMR) in older women.

Design BMR was assessed in 116 healthy, older white women, aged 60 to 82 years, on three successive mornings by indirect calorimetry. Body composition was determined by dual energy X-ray absorptiometry or hydrostatic weighing. The measured BMRs were compared with values obtained from eight published prediction equations that used solely, or in various combinations, measures of height, weight, fat-free mass, age, and menopausal status.

Statistical analyses performed The root mean squared prediction error (RMSPE) was used to determine how accurately predicted BMR matched actual BMR for each subject. In addition, regression analysis was used to evaluate accuracy of predicted BMR vs directly measured BMR.

Results Predicted mean BMR determined using all eight equations was significantly correlated to measured BMR (P=.0001), accounting for 30% to 52% of the variance of measured BMR. When analyzed by RMSPE, however, the equations of Owen et al (1986), Fredrix et al (1990), and Harris-Benedict (1919) predicted actual BMR for each subject within an average of 116 kcal/day, and the equation of Cunningham (1980) resulted in the largest prediction error at 208 kcal/day.

Applications/conclusions The regression equations of Owen et al (1986), which used body weight, Fredrix et al (1990), which used body weight and age, and Harris-Benedict (1919), which used age, weight, and height as variables, were most accurate in predicting BMR in our sample of healthy older women. J Am Diet Assoc. 1995; 95:1387-1392.     

Culturally Sensitive Prenatal Care for Southeast Asians

OBJECTIVE: To evaluate the success of the Southeast Asian Health Project in terms of client satisfaction with the prenatal care and other services. To obtain additional data about Southeast Asian women's health practices regarding childbearing. DESIGN: Survey through questionnaires administered as interviews. SETTING: In clients' homes or via telephone. PARTICIPANTS: 119 women from SEAHP's case files of recently delivered clients. MEASUREMENTS AND MAIN RESULTS: Interviews were conducted by four community workers fluent in Cambodian or Lao. The majority of women were satisfied with SEAHP, particularly the interpretation and education in native languages. Women were also satisfied with SEAHP, encouraging others to seek care. CONCLUSIONS: SEAHP appears to meet prenatal care needs of Southeast Asian women in Long Beach, California. More objective outcome data await analyses, but the program's approach may ensure access to and use of health services.     

Exercise and older adults

The benefits of regular physical activity in older persons are numerous and well established. Regular physical activity in older adults is associated with an overall improvement in health, functional capacity, quality of life, and independence. Many questions arise for healthcare providers regarding an older person’s ability and motivation to be physically active. The healthcare provider has a unique opportunity to assess the older client’s incentives, preferences, and abilities for physical activities, as well as to prescribe a safe, appropriate, and enjoyable exercise plan. The exercise precription can be simple yet thorough enough to ensure benefits in an older person’s health and functional capacity.     

Nutritional Status Outcomes for Children: Ethnic, Cultural, and Environmental Contexts

The objective of this literature review was to explore the relationship between nutritional status outcomes among ethnically diverse children and cultural and environmental contexts. Articles from the literature on anthropometric/body composition measures, diet, and physiologic outcomes among ethnically diverse children were identified through on-line literature searches and references from articles reviewed. These studies were critically reviewed and selected if they reported findings resulting from use of accepted methodologies. Explanations consistent with evaluation of results from the studies and reports were developed by synthesis of the findings. Children from underserved, ethnically diverse population groups were at increased risk for obesity, increased serum lipid levels, and dietary consumption patterns that do not meet the Dietary Guidelines for Americans. More than 80% of all US children consume more than the recommended amount of total fat and saturated fat. These factors, which were noted during childhood, may track into adolescence, placing these children at increased risk for the early onset of chronic diseases such as non-insulin-dependent diabetes mellitus, cardiovascular disease, hypertension, and some forms of cancer. Although federally funded food assistance programs are changing rapidly, currently they provide foods that, when eaten as recommended, exceed the Dietary Guidelines for these children. Future interventions to improve the health and nutritional status of our nation's children, especially those from underserved, ethnically diverse groups, should be culturally appropriate and implemented at the levels of individuals, families, and communities. J Am Diet Assoc. 1996; 96:891-900,903.     

Essential Nature of Choline with Implications for Total Parenteral Nutrition

Choline is known to be important in many metabolic pathways; at this time, however, it is not considered an essential nutrient for human beings. Current evidence strongly suggests that choline is “conditionally essential,” particularly for patients receiving total parenteral nutrition (TPN). Studies in patients receiving long-term TPN have shown that low levels of plasma choline are common and can be associated with hepatic steatosis. Treatment of these patients with oral administration of choline improved plasma levels and decreased hepatic fat content; however, oral choline supplements are associated with poor compliance. More recently, investigators have evaluated intravenous administration of choline as a treatment for TPN-associated hepatic steatosis in patients with documented subnormal plasma free-choline levels. Initial results indicate that intravenous administration of choline may be an effective treatment for TPN-associated hepatic dysfunction.