Chronic spinal cord injury (SCI) can result in a number of physical changes that can impact an individual’s energy expenditure (EE). Reduced activity levels and changes in muscle mass can result in a decrease in EE, while an increase in body fat can lead to an increase in EE. Weight management is an important part of care for people with chronic SCI, as both too much and too little weight can lead to health complications.
There are a number of methods that can be used to predict an individual’s resting energy expenditure (REE). The most accurate method is to measure oxygen consumption (VO2) using a calorimeter. However, this method is not practical for routine use. Instead, a number of prediction equations have been developed that use easily measured variables, such as height, weight, and age, to estimate REE.
The most commonly used prediction equation for people with chronic SCI is the Harris-Benedict equation. This equation has been shown to be reasonably accurate in a number of studies. However, it should be noted that there is considerable variation in EE between individuals with chronic SCI, and that any prediction equation will only provide an estimate of an individual’s EE.
If an individual with chronic SCI is aiming to lose weight, they may need to reduce their energy intake to below their REE. On the other hand, if an individual is aiming to gain weight, they will need to increase their energy intake above their REE. It is important to work with a Registered Dietitian to individualize energy needs, as too much or too little energy can lead to health complications.
Predicting energy expenditure can be helpful for people with chronic SCI who are aiming to lose, gain, or maintain their weight. However, it is important to remember that there is considerable variation in EE between individuals, and that any prediction equation will only provide an estimate of an individual’s EE.
There are many variables to consider when calculating energy expenditure (EE) in people with chronic spinal cord injury (SCI). In addition to weight, height, age, and sex, activity level, type of EE (basal or resting), and level of SCI must all be taken into account. The most common prediction equations used to estimate EE in people with SCI are the Harris-Benedict (H-B) and the Schofield equations.
The H-B equation is the most widely used equation for calculating basal metabolic rate (BMR) and has been found to be accurate in people with SCI. The H-B equation is:
EE (kcal/day) = 66.5 + (13.75 x weight (kg)) + (5.003 x height (cm)) – (6.775 x age (years))
For men: EE (kcal/day) = 66.5 + (13.75 x weight (kg)) + (5.003 x height (cm)) – (6.775 x age (years)) + 5
For women: EE (kcal/day) = 66.5 + (13.75 x weight (kg)) + (5.003 x height (cm)) – (6.775 x age (years)) – 161
The Schofield equation is another predictive equation that is used to estimate BMR and has been found to be accurate in people with SCI. The Schofield equation is:
EE (kcal/day) = 10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) + 5
For men: EE (kcal/day) = 10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) + 5 + 5
For women: EE (kcal/day) = 10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) – 161 + 5
Once BMR has been predicted using either the H-B or Schofield equation, it can be used to estimate resting EE (REE) by multiplying BMR by a factors ranging from 1.2 to 1.9, depending on the level of activity. For example, a person with SCI who is sedentary would have an REE of 1.2 x BMR, while a person with SCI who is very active would have an REE of 1.9 x BMR.
The H-B and Schofield equations are predictive equations that can be used to estimate EE in people with SCI. However, these equations should be used as a guide and individualized for each person.
