P294 - DOES PHYSICAL ACTIVITY LEVEL IMPROVE TOTAL ENERGY EXPENDITURE ESTIMATIONS OF COLORECTAL CANCER SURVIVORS?

P294

DOES PHYSICAL ACTIVITY LEVEL IMPROVE TOTAL ENERGY EXPENDITURE ESTIMATIONS OF COLORECTAL CANCER SURVIVORS?

A. P. Pagano¹, J. F. Mota^1,2,3, I. Matias de Sousa¹, S. A. Purcell^1,4,5, M. B. Sawyer⁶, R. Elango^7,8,9, C. Prado^1,*

¹Human Nutrition Research Unit, Department of Agricultural, Food, & Nutritional Science, University of Alberta, Edmonton, Canada, ²School of Nutrition, Federal University of Goiás, Goiás, Brazil, ³APC Microbiome Ireland, Department of Medicine, School of Microbiology, University College Cork, Cork, Ireland, ⁴Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, ⁵School of Health and Exercise Sciences, University of British Columbia, Kelowna, ⁶Department of Oncology, University of Alberta, Edmonton, ⁷Department of Pediatrics, University of British Columbia, ⁸BC Children’s Hospital Research Institute, BC Children’s Hospital, ⁹School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada

Rationale: Predictive equations for estimating energy needs in clinical settings often lack accuracy. We investigated whether incorporating physical activity level (PAL) into updated Dietary Reference Intake (DRI) equations improves estimates of total energy expenditure (TEE) in post-treatment colorectal cancer survivors (CRCS).

Methods: In this cross-sectional study, DRI equations were applied using age, sex, and two different approaches for PAL: 1) estimated PAL determined via self-reported physical activity from the International Physical Activity Questionnaire (IPAQ), and 2) the “inactive” PAL category, as generally reflective of this population. Both approaches were compared to measured TEE (TEEm) using doubly labelled water. Paired t-tests, Bland-Altman analysis, and proportion of estimates within 10% of TEEm were used for accuracy. Significance was considered when p<0.05.

Results: Twenty participants (M:F 10:10; mean±SD age: 61.4±14.1y; BMI: 28.8±6.4 kg/m²; colon cancer: 55%; stage III: 75%) were included. Most participants (70%) had a measured PAL (ratio between TEE and resting energy expenditure [REE]), falling within the inactive category of the DRI (TEE:REE: 1.45±0.23). DRI with inactive PAL (2232±351 kcal) differed from TEEm (2467±684 kcal, p=0.036). DRI with estimated PAL (2498±410 kcal) showed lower bias (31±364 kcal) and narrower limits of agreement (-682 to 745 kcal) compared to TEEm, though variance remained high (up to 1427 kcal). The inactive PAL DRI equation underestimated 45% and overestimated 10% of participants’ requirements. With estimated PAL, underestimation dropped to 10%, but overestimation rose to 35%.

Conclusion: Incorporating brief PAL questionnaires modestly improves the accuracy of DRI-based TEE estimates in CRCS, though variability remains high.

Funding:

AHS Cancer SCN/Cancer Control Alberta Seed Grant and CIHR FRN: PJT-159537.

Disclosure of Interest: A. P. Pagano: None declared, J. F. Mota: None declared, I. Matias de Sousa: None declared, S. Purcell: None declared, M. Sawyer Other: Speaker engagement: Viatris, R. Elango: None declared, C. Prado Consultant for: Abbott Nutrition, Nutricia, Novo Nordisk, Other: Speaker engagement: Abbott Nutrition, Nutricia, Nestle Health Science, Novo Nordisk