PD708 - MEASURED VERSUS ESTIMATED ENERGY REQUIREMENTS IN HOSPITALIZED PATIENTS WITH CANCER: THE ROLE OF INDIRECT CALORIMETRY

PD708

MEASURED VERSUS ESTIMATED ENERGY REQUIREMENTS IN HOSPITALIZED PATIENTS WITH CANCER: THE ROLE OF INDIRECT CALORIMETRY

F. A. Ribeiro¹, G. B. Yacoub¹, M. D. Malta¹, F. T. Romão¹, L. S. Figueredo¹, D. O. Toledo^1,*, J. R. Moraes¹, B. M. Watanabe¹, J. M. S. Junior^1,2

¹Clinical Nutrition, Einstein Israeli Hospital, ²Clinical Nutrition, University of São Paulo, São Paulo, Brazil

Rationale: Indirect calorimetry is recognized as the reference method for defining individualized energy requirements in patients with cancer. Nevertheless, fixed weight-based caloric prescriptions continue to be widely applied in routine clinical practice. This study examined how commonly used targets of 35 and 50 kcal/kg/day compare with measured resting energy expenditure (REE) in hospitalized oncology patients.

Methods: A retrospective analysis was performed using consecutive indirect calorimetry measurements obtained in an oncology and hematology inpatient ward between February 12, 2024 and October 21, 2025. Resting energy expenditure (REE) was recorded in kcal/day and normalized per kilogram of measured body weight. Empirical caloric prescriptions of 35 and 50 kcal/kg/day were simulated for each measurement. Agreement with measured REE was assessed using mean bias, percentage error, and the proportion of estimates within ±10% of measured expenditure.

Results: Fourteen measurements were analyzed. Mean body weight was 61.8 ± 9.7 kg and mean measured REE was 1626.9 ± 279.4 kcal/day, corresponding to 26.9 ± 6.2 kcal/kg/day. A target of 35 kcal/kg/day overestimated REE by 537 ± 444 kcal/day, with a percentage error of 36.3%. Only 28.6% of estimates were within ±10% of measured REE. In contrast, 50 kcal/kg/day markedly overestimated energy needs, with a mean bias of 1464.9 ± 564.9 kcal/day and a percentage error of 94.7%.

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Conclusion: Measured REE in this cohort averaged approximately 27 kcal/kg/day. Fixed caloric prescriptions frequently overestimated patients’ energy requirements, particularly with the 50 kcal/kg/day target. These findings support the use of indirect calorimetry whenever feasible and highlight the risks of overfeeding associated with high empirical caloric targets in hospitalized patients with cancer. 

Disclosure of Interest: None declared