A new doubly labelled water anthropometry-based equation for prediction of total daily energy expenditure in older people from low- and middle-income countries

Background: For community-living older people, the ability to estimate total daily energy expenditure (TDEE) with validated predictive equations based on anthropometry is limited. To our knowledge no studies exist for non-Caucasian populations Objective: To design and validate an anthropometry-based equation to estimate TDEE using doubly-labelled water (DLW) as the criterion measure, and to assess the performance of three other published equations in community-living older people from rural and urban areas of Brazil, Chile, Guatemala, Senegal, Cuba, and Mexico Methods: This cross-sectional study measured anthropometry and TDEE using DLW in 69 men and 43 women aged 60–89 years. TDEE was also estimated with an anthropometry-based equation derived from the sub-sample of Mexico (n = 38) and with three other published equations. Predictive accuracy of the equations was tested by an external validation procedure Results: TDEE by DLW in the six country sample was 2411 ± 41 kcal/day (mean ± SE) in men and 1939 ± 51 kcal/day in women. The best new Mexican equation was TDEE, kcal/d = [223.4 + (27.9 × weight, kg) + (239.7 × sex)]; where sex: Man = 1 and Woman = 0; having high precision; R² = 0.89, lowest RMSE = 149.2, and Cp value of 2.0. This new Mexican equation estimated TDEE accurately in the five country sample and at country level after correction for Guatemalan older men, while the published equations performed poorly Conclusions: The Mexican equation performed better that other published equations and is recommended to accurately estimate energy requirements for community-living older people in five Latin American and one African country.