Guest guest Posted June 2, 2010 Report Share Posted June 2, 2010 I use Kcal per Kg...  old but reliable...  Subject: Calorie Needs To: rd-usa Date: Wednesday, June 2, 2010, 6:35 PM  This question may have been asked before...but what equation are most of you using to estimate calorie needs for in-patients and out-patients? I " grew up " in the age of the -Benedict equation, but I'm seeing Mifflin-St. Jeor more and more frequently. Thanks. Audley, M.S., R.D., L.D. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2010 Report Share Posted June 2, 2010 I use Kcal per Kg...  old but reliable...  Subject: Calorie Needs To: rd-usa Date: Wednesday, June 2, 2010, 6:35 PM  This question may have been asked before...but what equation are most of you using to estimate calorie needs for in-patients and out-patients? I " grew up " in the age of the -Benedict equation, but I'm seeing Mifflin-St. Jeor more and more frequently. Thanks. Audley, M.S., R.D., L.D. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 2, 2010 Report Share Posted June 2, 2010 Evidence-based library and the current ADA Manual support the use of Penn State for inpatient ICU/Vent, and Mifflin StJeor for all others. Kcal/kg was never used/verified against calorimetry - it came from the Renal Practice Group newsletter, used in 1 edition of the ADA manual and removed subsequently. Easy but no science behind it.  We're using Mifflin StJeor in the USAF, and in my civilian hospital for all patients except those on vent.  Holly ---------- Holly Lee Brewer, MS RD CDE Pediatric Dietitian, Diabetes Educator Medical Nutrition Therapist, Las Vegas, NV Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com 301st MDG, Nut Med Flt Cmd, NAS JRB Fort Worth (Carswell), TX Malcom Grow Medical Center, s AFB, MD (Oct-Dec 2009) Joint Base Balad, Iraq (Jan-Jul 2009) Subject: Calorie Needs To: rd-usa Date: Wednesday, June 2, 2010, 6:35 PM  This question may have been asked before...but what equation are most of you using to estimate calorie needs for in-patients and out-patients? I " grew up " in the age of the -Benedict equation, but I'm seeing Mifflin-St. Jeor more and more frequently. Thanks. Audley, M.S., R.D., L.D. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2010 Report Share Posted June 3, 2010 I have tried those calculations against the kcal/ kg - and only get a few calories difference- ok maybe 200 once -- but really ... ??? Not much difference. I have followed thousands of patients for months- some loose some gain. I adjust based on how they respond - not based on a formula. Metabolism varies from person to person and day to day .. medications effect weight. In the end it's more of an art than a science - and knowing the patient. I do think the calculations are good to give new dietitians a starting point - but eventually you need to evaluate what works for the patient - not just multiply and divide. Sent from my iPhone Evidence-based library and the current ADA Manual support the use of Penn State for inpatient ICU/Vent, and Mifflin StJeor for all others. Kcal/kg was never used/verified against calorimetry - it came from the Renal Practice Group newsletter, used in 1 edition of the ADA manual and removed subsequently. Easy but no science behind it. We're using Mifflin StJeor in the USAF, and in my civilian hospital for all patients except those on vent. Holly ---------- Holly Lee Brewer, MS RD CDE Pediatric Dietitian, Diabetes Educator Medical Nutrition Therapist, Las Vegas, NV Maj Holly Brewer, USAFR BSC http://hollyinbalad.blogspot.com 301st MDG, Nut Med Flt Cmd, NAS JRB Fort Worth (Carswell), TX Malcom Grow Medical Center, s AFB, MD (Oct-Dec 2009) Joint Base Balad, Iraq (Jan-Jul 2009) Subject: Calorie Needs To: rd-usa Date: Wednesday, June 2, 2010, 6:35 PM This question may have been asked before...but what equation are most of you using to estimate calorie needs for in-patients and out-patients? I " grew up " in the age of the -Benedict equation, but I'm seeing Mifflin-St. Jeor more and more frequently. Thanks. Audley, M.S., R.D., L.D. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2010 Report Share Posted June 3, 2010 Thank you, Holly. You hit the nail on the head with the point that all the dietitians in a facility need to be consistent with their starting recommendations. That's why I asked the question. L. Audley, M.S., R.D., L.D. In a message dated 6/3/2010 1:44:22 P.M. Eastern Daylight Time, hlbrewer@... writes: Totally agree with " following the patient " . But in an institution with more than one medical nutrition therapist, we all need to be consistent in our starting recommendations. If we have a patient long enough to evaluate efficacy of our recommendation, we can adjust from there. Using kcal/kg doesn't have any evidence behind it. Prior to the publication of kcal/kg in the manual we were all using -Benedict because it was the only published estimation of needs (even though we now know how flawed it is). Mifflin-StJeor has been tested & evaluated. Penn State as well. So using ASPEN and ADA guidelines this has become our current policy. The original question was posed and I was responding what we (my civilian and my military facilities), and why. Holly ---------- From: _Audley3@..._ (mailto:Audley3@...) <_Audley3@..._ (mailto:Audley3@...) > Subject: Calorie Needs To: _rd-usa _ (mailto:rd-usa ) Date: Wednesday, June 2, 2010, 6:35 PM This question may have been asked before...but what equation are most of you using to estimate calorie needs for in-patients and out-patients? I " grew up " in the age of the -Benedict equation, but I'm seeing Mifflin-St. Jeor more and more frequently. Thanks. Audley, M.S., R.D., L.D. [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2010 Report Share Posted June 3, 2010 Thank you, Holly. You hit the nail on the head with the point that all the dietitians in a facility need to be consistent with their starting recommendations. That's why I asked the question. L. Audley, M.S., R.D., L.D. In a message dated 6/3/2010 1:44:22 P.M. Eastern Daylight Time, hlbrewer@... writes: Totally agree with " following the patient " . But in an institution with more than one medical nutrition therapist, we all need to be consistent in our starting recommendations. If we have a patient long enough to evaluate efficacy of our recommendation, we can adjust from there. Using kcal/kg doesn't have any evidence behind it. Prior to the publication of kcal/kg in the manual we were all using -Benedict because it was the only published estimation of needs (even though we now know how flawed it is). Mifflin-StJeor has been tested & evaluated. Penn State as well. So using ASPEN and ADA guidelines this has become our current policy. The original question was posed and I was responding what we (my civilian and my military facilities), and why. Holly ---------- From: _Audley3@..._ (mailto:Audley3@...) <_Audley3@..._ (mailto:Audley3@...) > Subject: Calorie Needs To: _rd-usa _ (mailto:rd-usa ) Date: Wednesday, June 2, 2010, 6:35 PM This question may have been asked before...but what equation are most of you using to estimate calorie needs for in-patients and out-patients? I " grew up " in the age of the -Benedict equation, but I'm seeing Mifflin-St. Jeor more and more frequently. Thanks. Audley, M.S., R.D., L.D. [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2010 Report Share Posted June 3, 2010 Thank you, Holly. You hit the nail on the head with the point that all the dietitians in a facility need to be consistent with their starting recommendations. That's why I asked the question. L. Audley, M.S., R.D., L.D. In a message dated 6/3/2010 1:44:22 P.M. Eastern Daylight Time, hlbrewer@... writes: Totally agree with " following the patient " . But in an institution with more than one medical nutrition therapist, we all need to be consistent in our starting recommendations. If we have a patient long enough to evaluate efficacy of our recommendation, we can adjust from there. Using kcal/kg doesn't have any evidence behind it. Prior to the publication of kcal/kg in the manual we were all using -Benedict because it was the only published estimation of needs (even though we now know how flawed it is). Mifflin-StJeor has been tested & evaluated. Penn State as well. So using ASPEN and ADA guidelines this has become our current policy. The original question was posed and I was responding what we (my civilian and my military facilities), and why. Holly ---------- From: _Audley3@..._ (mailto:Audley3@...) <_Audley3@..._ (mailto:Audley3@...) > Subject: Calorie Needs To: _rd-usa _ (mailto:rd-usa ) Date: Wednesday, June 2, 2010, 6:35 PM This question may have been asked before...but what equation are most of you using to estimate calorie needs for in-patients and out-patients? I " grew up " in the age of the -Benedict equation, but I'm seeing Mifflin-St. Jeor more and more frequently. Thanks. Audley, M.S., R.D., L.D. [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 3, 2010 Report Share Posted June 3, 2010 Totally agree with " following the patient " . But in an institution with more than one medical nutrition therapist, we all need to be consistent in our starting recommendations. If we have a patient long enough to evaluate efficacy of our recommendation, we can adjust from there.  Using kcal/kg doesn't have any evidence behind it. Prior to the publication of kcal/kg in the manual we were all using -Benedict because it was the only published estimation of needs (even though we now know how flawed it is). Mifflin-StJeor has been tested & evaluated. Penn State as well. So using ASPEN and ADA guidelines this has become our current policy. The original question was posed and I was responding what we (my civilian and my military facilities), and why.  Holly ---------- Subject: Calorie Needs To: rd-usa Date: Wednesday, June 2, 2010, 6:35 PM This question may have been asked before...but what equation are most of you using to estimate calorie needs for in-patients and out-patients? I " grew up " in the age of the -Benedict equation, but I'm seeing Mifflin-St. Jeor more and more frequently. Thanks. Audley, M.S., R.D., L.D. Quote Link to comment Share on other sites More sharing options...
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