P290 - EXPLORING TOTAL ENERGY EXPENDITURE AND ITS COMPONENTS BY WHOLE-ROOM INDIRECT CALORIMETRY IN PATIENTS WITH BREAST CANCER

P290

EXPLORING TOTAL ENERGY EXPENDITURE AND ITS COMPONENTS BY WHOLE-ROOM INDIRECT CALORIMETRY IN PATIENTS WITH BREAST CANCER

B. R. da Silva^1,*, B. C. Santos¹, A. A. Joy², N. G. Boulé³, C. Pichard⁴, C. M. Prado¹

¹Department of Agricultural, Food & Nutritional Science, ²Department of Oncology, ³Kinesiology, Sport, and Recreation, & Alberta Diabetes Institute, University of Alberta, Edmonton, Canada, ⁴Clinical Nutrition , Geneva University Hospital, Geneva, Switzerland

Rationale: Body weight changes are common in patients with BC and may relate to undesirable fluctuations of food intake and energy needs. Accurate energy recommendations are crucial, yet current guidelines rely on predictions not validated for BC. Few studies have assessed energy needs in BC, and none have used whole-room indirect calorimetry (WRIC), the gold standard for measuring total energy expenditure (TEE).

Methods: Patients (stage I–III BC) completed a 28-hour stay in a WRIC. Selected components of TEE, including resting (REE), postprandial (PEE), and exercise energy expenditure (AEE), were evaluated, the latter consisting of 30 minutes an intensity of 50% of VO₂ peak. Measured TEE (TEEm) was compared against the Harris-Benedict (HB) equation (multiplied by a physical activity factor of 1.2) and fixed values of 25 and 30 kcal/kg. Bland-Altman and Lin’s concordance correlation coefficient (CCC) were used.

Results: 13 females (54 ± 3 years; BMI 27.7 ± 4.8 kg/m²) were included. TEEm averaged 2,069 ± 366 kcal/day. Compared to TEEm, mean prediction errors were −241 kcal/day (HB), −227 kcal/day (25 kcal/kg), and +142 kcal/day (30 kcal/kg). REE and PEE accounted for 73.7% and 18.8% of TEE, respectively. REE was 1526 kcal/day, PEE was 0.27 kcal/min above resting, and AEE was 158 kcal over 30 minutes.  All predictive methods showed poor agreement (Lin’s CCC 0.56–0.67), with wide limits of agreement (up to ±1,333 kcal) and no mean bias within ±5%. 30kcal/kg had the smallest bias (+7%) but was inaccurate for 61.5% of patients (difference >10%).

Conclusion: This is the first study to assess TEE using WRIC in patients with BC. Two of the three predictive equations underestimated energy needs; these findings highlight the importance of accurate assessment tools in guiding nutritional interventions throughout the cancer trajectory and beyond. Funding: Foundation Nutrition 2000 Plus; CRINA

Disclosure of Interest: B. da Silva: None declared, B. Santos: None declared, A. Joy: None declared, N. Boulé: None declared, C. Pichard Grant / Research Support from: Abbott, Baxter, B. Braun, Cosmed, Fresenius Kabi, Nestle Medical Nutrition, Novartis, Nutricia-Numico, Pfizer, Solvay, Consultant for: Abbott, Baxter, B. Braun, Cosmed, Fresenius Kabi, Nestle Medical Nutrition, Novartis, Nutricia-Numico, Procter&Gamble, Pfizer, Solvay, C. Prado Consultant for: Abbott Nutrition, Nutricia, Novo Nordisk, Other: Speaker engagement: Abbott Nutrition, Nutricia, Nestle Health Science, Novo Nordisk