Re: Is this formula have a name?

[Guest guest]

No, Merav, it does not have a name and it does not have any evidence behind it.

 

My understanding/memory of the history of this: Years ago it was published in a

newsletter from the Renal Dietitians Practice Group and then in the 5th Ed of

the ADA Diet Manual. Removed by the 6th Ed and not in the online manual.

 

Evidence based energy estimation calculations show strongest for Penn State (for

intubated patients - we use it for all of our ICU patients in our hospital) and

Mifflin-StJeor (we use for all ambulatory patients).

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 MDS, NAS JRB Fort Worth (Carswell), TX

Joint Base Balad, Iraq (Jan-Jul 2009)

>________________________________

>

>To: rd-usa <rd-usa >; nutrition_reports

<nutrition_reports >

>Sent: Tuesday, November 1, 2011 5:54 AM

>Subject: Is this formula have a name?

>

>

>

> 

>

>

>Hi All and sorry for the cross-posting,

>

>We are all using the formula for estimating needs : 25-30 Kcal/kg etc.

>Does this formula has a name?

>

>Thanks

>

>Merav Levi, RD, MS, CDN, CSG

>A dietitian, not the food police.

>

>http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin

> " People don't forget the truth, they just become better in lying "

(Revolutionary Road)

>

>

>

>

[Guest guest]

No, Merav, it does not have a name and it does not have any evidence behind it.

 

My understanding/memory of the history of this: Years ago it was published in a

newsletter from the Renal Dietitians Practice Group and then in the 5th Ed of

the ADA Diet Manual. Removed by the 6th Ed and not in the online manual.

 

Evidence based energy estimation calculations show strongest for Penn State (for

intubated patients - we use it for all of our ICU patients in our hospital) and

Mifflin-StJeor (we use for all ambulatory patients).

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 MDS, NAS JRB Fort Worth (Carswell), TX

Joint Base Balad, Iraq (Jan-Jul 2009)

>________________________________

>

>To: rd-usa <rd-usa >; nutrition_reports

<nutrition_reports >

>Sent: Tuesday, November 1, 2011 5:54 AM

>Subject: Is this formula have a name?

>

>

>

> 

>

>

>Hi All and sorry for the cross-posting,

>

>We are all using the formula for estimating needs : 25-30 Kcal/kg etc.

>Does this formula has a name?

>

>Thanks

>

>Merav Levi, RD, MS, CDN, CSG

>A dietitian, not the food police.

>

>http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin

> " People don't forget the truth, they just become better in lying "

(Revolutionary Road)

>

>

>

>

[Guest guest]

Thanks Holly.

It is intersting because sometimes you can still find it mentioned in some

studies.

Thansk a lot.

Merav Levi, RD, MS, CDN, CSG

A dietitian, not the food police.

http://www.linkedin.com/in/meravlevi

" Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin

" People don't forget the truth, they just become better in lying " (Revolutionary

Road)

To: rd-usa

From: hlbrewer@...

Date: Tue, 1 Nov 2011 07:13:10 -0700

Subject: Re: Is this formula have a name?

No, Merav, it does not have a name and it does not have any evidence behind it.

My understanding/memory of the history of this: Years ago it was published in a

newsletter from the Renal Dietitians Practice Group and then in the 5th Ed of

the ADA Diet Manual. Removed by the 6th Ed and not in the online manual.

Evidence based energy estimation calculations show strongest for Penn State (for

intubated patients - we use it for all of our ICU patients in our hospital) and

Mifflin-StJeor (we use for all ambulatory patients).

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 MDS, NAS JRB Fort Worth (Carswell), TX

Joint Base Balad, Iraq (Jan-Jul 2009)

>________________________________

>

>To: rd-usa <rd-usa >; nutrition_reports

<nutrition_reports >

>Sent: Tuesday, November 1, 2011 5:54 AM

>Subject: Is this formula have a name?

>

>

>

>

>

>

>Hi All and sorry for the cross-posting,

>

>We are all using the formula for estimating needs : 25-30 Kcal/kg etc.

>Does this formula has a name?

>

>Thanks

>

>Merav Levi, RD, MS, CDN, CSG

>A dietitian, not the food police.

>

>http://www.linkedin.com/in/meravlevi

>

> " Life is not measured by the number of breath you take, but by the moments that

take your breath away. " - Carlin

> " People don't forget the truth, they just become better in lying "

(Revolutionary Road)

>

>

>

>

[Guest guest]

The simplified formula was tested vs the standard harris-benedict formula and vs

indirect calorimetry. There is no significant difference between using the rule

of the thumb (that is what we call that formula here in europe) and estimated

energy needs by indirect calorimetry and harris-benedict. ESPEN recommends it

and from my knowledge also GANEP (Brazilian office of parenteral and enteral

nutrition). There are several studies published with the comparison you can find

those references in ESPEN guidelines.

Cátia Borges, nutricionista

ARS Norte, Portugal

>

>

> Hi All and sorry for the cross-posting,

>

> We are all using the formula for estimating needs : 25-30 Kcal/kg etc.

> Does this formula has a name?

>

> Thanks

>

>

> Merav Levi, RD, MS, CDN, CSG

> A dietitian, not the food police.

>

> http://www.linkedin.com/in/meravlevi

>

>

>

>

>

>

> " Life is not measured by the number of breath you take, but by the moments

that take your breath away. " - Carlin

> " People don't forget the truth, they just become better in lying "

(Revolutionary Road)

>

>

>

>

[Guest guest]

The gold standard in clinical practice would be to use indirect calorimetry,

though those devices are not available in every facility.

In ESPEN ICU guidelines you can read

" In the absence of indirect calorimetry, ICU patients should receive 25

kcal/kg/day increasing to target over the next 2–3 days " (http://espen.org)

For renal patients I saw several studies (over 4y ago when I was working in that

field) with studies about energy expenditure calculated with indirect

calorimetry and estimated needs with the KDOQI recommendations, I don't have

those references with me anymore.

In the part 1 of ESPEN guidelines for renal patients " The energy needs of these

patients are similar to those

of normal populations; 35 kcal/kg IBW/day or more (7) are

recommended with adaptation to individual needs in case of

severe underweight or overweight/obesity "

The adjustment for obesity is ridiculous, fat is a metabolic active tissue, also

overweight patients most of the times also have more muscle mass than normal

patients. The idea that the obese patient should receive 20kcal/kg is based on

nothing as well. Also de formula for adjusted body weight has no scientific

background proving that is correct to use in overweight patients, it was

published as a suggestion and it sticked.

I don't forget the words of Soeters in ESPEN course this year regarding

guidelines: " It is just a group of us old ppl that get together and if there

isn't any clear evidence we decide according to our practice. " Almost all of the

ESPEN guidelines authors are medical doctors.

Cátia Borges, nutricionista

ARS Norte

> > >>

> > >>

> > >> Hi All and sorry for the cross-posting,

> > >>

> > >> We are all using the formula for estimating needs : 25-30 Kcal/kg etc.

> > >> Does this formula has a name?

> > >>

> > >> Thanks

> > >>

> > >>

> > >> Merav Levi, RD, MS, CDN, CSG

> > >> A dietitian, not the food police.

> > >>

> > >> http://www.linkedin.com/in/meravlevi

> > >>

> > >>

> > >>

> > >>

> > >>

> > >>

> > >> " Life is not measured by the number of breath you take, but by the

moments that take your breath away. " - Carlin

> > >> " People don't forget the truth, they just become better in lying "

(Revolutionary Road)

> > >>

> > >>

> > >>

> > >>