If REE is measured while fasting or feedings are intermittently provided, what adjustment is reasonable?

If REE is measured while fasting or feedings are intermittently provided, what adjustment is reasonable?

• A. Subtract 5%
• B. Add 5% for thermogenesis
• C. Add 20% for activity
• D. Ignore adjustments

Answer: (B)

When REE is measured, you’re capturing energy use at rest after fasting, so it doesn’t include the extra energy required to digest and process meals. If feedings are intermittent, there will be periods with little thermogenesis and other periods with meal-induced thermogenesis, so a small allowance is reasonable to approximate those fluctuations. Adding about 5% for diet-induced thermogenesis provides a practical correction to REE to better reflect total energy needs without overestimating them. Larger adjustments for activity aren’t appropriate here, since that would reflect physical activity rather than the energy cost of feeding, and skipping adjustments would ignore a predictable component of energy expenditure. Remember that the exact amount can vary with meal size and composition, but 5% is a common, reasonable estimate in this scenario.

When REE is measured, you’re capturing energy use at rest after fasting, so it doesn’t include the extra energy required to digest and process meals. If feedings are intermittent, there will be periods with little thermogenesis and other periods with meal-induced thermogenesis, so a small allowance is reasonable to approximate those fluctuations. Adding about 5% for diet-induced thermogenesis provides a practical correction to REE to better reflect total energy needs without overestimating them. Larger adjustments for activity aren’t appropriate here, since that would reflect physical activity rather than the energy cost of feeding, and skipping adjustments would ignore a predictable component of energy expenditure. Remember that the exact amount can vary with meal size and composition, but 5% is a common, reasonable estimate in this scenario.