PD562 - COMPARISON OF MIFFLIN-ST JEOR EQUATION WITH INDIRECT CALORIMETRY IN EVALUATING RESTING ENERGY EXPENDITURE AMONG ADULT OVERWEIGHT AND OBESE FILIPINO PATIENTS

PD562

COMPARISON OF MIFFLIN-ST JEOR EQUATION WITH INDIRECT CALORIMETRY IN EVALUATING RESTING ENERGY EXPENDITURE AMONG ADULT OVERWEIGHT AND OBESE FILIPINO PATIENTS

K. R. U. Ramillano^1,*, S. N. L. C. Chan¹, J. M. D. C. Muarip¹, M. M. Esculto ¹

¹Internal Medicine, Makati Medical Center, Makati City, Philippines

Rationale: Accurate estimation of resting energy expenditure (REE) is essential for individualized nutritional management in patients with obesity and metabolic diseases. Although indirect calorimetry (IC) is the gold standard for REE measurement, predictive equations such as the Mifflin–St Jeor (MSJ) equation are commonly used due to limited access to IC. However, data validating REE predictive equations in Filipino adults remain scarce, particularly among patients with metabolic comorbidities. 

Methods: This retrospective observational study included adult Filipino patients (≥18 years) who underwent IC testing at a tertiary hospital between January 2021 and June 2025. Participants were overweight or obese and had at least one metabolic comorbidity. REE measured by IC was compared with REE predicted using the MSJ equation using the Wilcoxon signed-rank test, Spearman correlation, and Bland–Altman analysis.

Results: Thirty-four patients were included (mean age 50.3 ± 17.7 years; 50% male; mean BMI 34.0 ± 9.1 kg/m²). Mean REE measured by IC was significantly higher than that predicted by the MSJ equation (1820.6 vs 1646.7 kcal/day; p < 0.0001). Only 41.2% of MSJ estimates fell within ±10% of measured REE, while 47.1% underestimated and 11.8% overestimated energy expenditure. Predicted REE demonstrated significant correlations with weight (ρ = 0.76), BMI (ρ = 0.65), height (ρ = 0.57), age (ρ = −0.52), and measured REE (ρ = 0.87) (p < 0.05). Bland–Altman analysis revealed a consistent negative bias, indicating systematic underestimation by the MSJ equation.

Conclusion: The MSJ equation significantly underestimates REE in overweight and obese Filipino adults with metabolic comorbidities. Population-specific REE prediction models may improve accuracy in this population.

Disclosure of Interest: None declared