Adequacy of clinical formulae for estimation of energy requirements in children with cystic fibrosis
John J Reillya, T John Evansc, Jane Wilkinsonc, James Y Patonb
a Department of Human
Nutrition, University of Glasgow, Yorkhill Hospitals, Glasgow, G3
8SJ, UK, b Department of Child
Health, University of Glasgow, c Cystic Fibrosis Unit, University of Glasgow
Correspondence to: Dr Reilly. email: jjr2y{at}clinmed.gla.ac.uk
Accepted 29 March 1999
BACKGROUND
Two
clinical formulae (CF conference formula and estimation based on 120%
of average requirement for energy) have been recommended for the
estimation of energy requirements in cystic fibrosis but their accuracy
is unknown.
AIMTo compare the
accuracy of estimates of energy requirement derived from the two formulae.
METHODSEnergy
requirement, defined as total daily energy expenditure, was measured
using the doubly labelled water method in 15 patients (six girls, nine
boys; mean (SD) age, 10.0 (2.4) years) who were well and clinically
stable. The accuracy of the formulae was assessed using calculation of
biases and limits of agreement relative to measured energy requirement.
RESULTSEstimates from
the CF conference formula were lower than measured values (mean paired
difference, 0.52 MJ/day; 95% confidence interval (CI), 
1.10 to
0.10), but this bias was not significant, and was smaller than that
from the alternative formula (mean paired difference, 0.77 MJ/day; 95%
CI, 0.20 to 1.74). Limits of agreement relative to measured total
daily energy expenditure were narrower for the CF conference formula
(2.72 to 1.68 MJ/day) than for that based on 120% of estimated
average requirement (2.75 to 4.29 MJ/day), but with both formulae
errors in estimation at the individual level were large.
CONCLUSIONSThe CF
conference formula offers improved prediction of energy requirements,
but the accuracy of both formulae at the individual level is not
sufficiently good for clinical purposes.
Keywords: cystic fibrosis; energy expenditure; doubly labelled water method
© 1999 by Archives of Disease in Childhood
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