Abstract When measurement of resting metabolic rate (RMR) by indirect calorimetry is necessary, following evidence-based protocols will ensure the individual has achieved a resting state. The purpose ...of this project was to update the best practices for measuring RMR by indirect calorimetry in healthy and non–critically ill adults and children found the Evidence Analysis Library of the Academy of Nutrition and Dietetics. The Evidence Analysis process described by the Academy of Nutrition and Dietetics was followed. The Ovid database was searched for papers published between 2003 and 2012 using key words identified by the work group and research consultants, studies used in the previous project were also considered (1980 to 2003), and references were hand searched. The work group worked in pairs to assign papers to specific questions; however, the work group developed evidence summaries, conclusion statements, and recommendations as a group. Only 43 papers were included to answer 21 questions about the best practices to ensure an individual is at rest when measuring RMR in the non–critically ill population. In summary, subjects should be fasted for at least 7 hours and rest for 30 minutes in a thermoneutral, quiet, and dimly lit room in the supine position before the test, without doing any activities, including fidgeting, reading, or listening to music. RMR can be measured at any time of the day as long as resting conditions are met. The duration of the effects of nicotine and caffeine and other stimulants is unknown, but lasts longer than 140 minutes and 240 minutes, respectively. The duration of the effects of various types of exercise on RMR is unknown. Recommendations for achieving steady state, preferred gas-collection devices, and use of respiratory quotient to detect measurement errors are also given. Of the 21 conclusions statements developed in this systemic review, only 5 received a grade I or II. One limitation is the low number of studies available to address the questions and most of the included studies had small sample sizes and were conducted in healthy adults. More research on how to conduct an indirect calorimetry measurement in healthy adults and children and in sick, but not critically ill, individuals is needed.
Abstract Indirect calorimetry is often done early in the morning in a fasting state, with the subject unshowered and abstained from caffeine or other stimulants. Subjects often fall asleep, resulting ...in measurement of a sleeping metabolic rate rather than a resting metabolic rate. The objective of this study was to determine whether listening to self-selected relaxing music or reading an electronic device or magazine affects resting energy expenditure (REE) during measurement in healthy adults. A randomized trial comparing three different conditions (ie, resting, reading, and listening to music) was performed. Sixty-five subjects (36 female and 29 male) were used in final data analysis. Inclusion criteria included healthy subjects between the ages of 18 and 50 years with a stable weight. Exclusion criteria included pregnant or lactating women or use of medications known to affect metabolism. Results showed that reading either a magazine or an electronic device significantly increased REE by 102.7 kcal/day when compared with resting ( P <0.0001); however, there was no difference in REE between the electronic device and magazine. Listening to self-selected relaxing music increased REE by 27.6 kcal/day compared with rest ( P =0.0072). Based on our results, we recommend subjects refrain from reading a magazine or electronic device during an indirect calorimetry test. Whether or not the smaller difference found while listening to music is practically significant would be a decision for the indirect calorimetry test administrator.
