Standard medical nutrition therapy of 25 kcal/kg ideal bodyweight/day often does not reach even resting energy expenditure for patients with type 2 diabetes

对于2型糖尿病患者而言,每日每公斤理想体重25千卡的标准医学营养治疗往往无法满足其静息能量消耗。

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Abstract

AIMS/INTRODUCTION: In Japan, an ideal bodyweight (IBW) calculated by 22 × height (m)(2) has commonly been used in the planning of medical nutrition therapy (MNT). However, there have been concerns regarding calorie deficits in fulfilling resting energy expenditure (REE) for patients with type 2 diabetes undergoing MNT as defined by 25 kcal/kg IBW/day. The objective of the present study was to measure REE in patients with type 2 diabetes and verify the validity of MNT with 25 kcal/kg IBW/day. MATERIALS AND METHODS: A retrospective cross-sectional study was carried out in 52 patients with type 2 diabetes (mean age was 65.9 ± 7.3 years, bodyweight 65.0 ± 11.3 kg, body mass index 24.9 ± 3.8 kg/m(2) ). REE was measured by indirect calorimetry. RESULTS: The mean REE was 1,601.0 ± 253.1 kcal/day. Assuming that all patients strictly observed daily energy intake as 25 kcal/kg IBW/day, 41 of 52 patients (78.9%) did not reach their REE. The greater the bodyweight, the greater the difference between assumed energy intake as 25 kcal/kg IBW and REE. CONCLUSIONS: We call attention to the potential risk of total dietary energy intake set to 25 kcal/kg IBW/day. Clinicians should carefully plan MNT to not fall below a patient's REE to prevent sarcopenia and ensure MNT continuity.

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