A systematic review and quantitative analysis of resting energy expenditure prediction equations in healthy overweight and obese children and adolescents

© The British Dietetic Association Ltd. This is the peer reviewed version of 'Chima, L., Mulrooney, H. M., Warren, J., & Madden, A. (2020). A systematic review and quantitative analysis of resting energy expenditure prediction equations in healthy overweight and obese children and adolescents. Journal of Human Nutrition and Dietetics. https://doi.org/10.1111/jhn.12735'. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Background:  Resting energy expenditure (REE) estimate sare often needed in young people and can be predicted using prediction equations based on body weight.  However,these equations may perform poorly in obesity and overweight. The aim of this systematic review was to identify equations based on simple anthropometric and demographic variables which provide the most accurate and precise estimates of REE in healthy obese and overweight young people. Methodology:Systematic searches for relevant studies in healthy obese and overweight young people aged ≤18 years were undertaken using PubMed, Scopus, Cinahl, OpenGrey and Cochrane Library (completed January 2018). Search terms included metabolism, calorimetry, obesity and prediction equation. Data extraction,study appraisal and synthesis followed PRISMA guidelines. Results:From 390 screened titles, 13 studies met inclusion criteria. The most accurate REE predictions (least biased) were provided by Schofield equations (+0.8%[3-18 years]; 0% [11-18 years]; +1.1% [3-10 years]). The most precise REE estimations (percentage of predictions ±10% of measured) for 11-18 years were provided by Mifflin equations (62%), and for 7-18 years by the equations of Schmelzle (57%), Henry (56%) and Harris Benedict (54%). Precision of Schofield predictions was 43% in both age groups. No accuracy data were available for those <3 years or for precision for those <7 years. Principal conclusions: No single equation provided accurate and precise REE estimations in this population.  Schofield equations provided the most accurate REE predictions so are useful for groups.  Mifflin equations provided the most precise estimates for individuals aged 11-18 but tended to underestimate REE.  Peer reviewedFinal Accepted Versio

Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence

Behavioural interventions are effective treatments for overactive bladder (OAB) and urgency urinary incontinence (UUI). They are in part aimed at improving symptoms with patient education on healthy bladder habits and lifestyle modifications, including the establishment of normal voiding intervals, elimination of bladder irritants from the diet, management of fluid intake, weight control, management of bowel regularity and smoking cessation. Behavioural interventions also include specific training techniques aimed at re-establishing normal voiding intervals and continence. Training techniques include bladder training, which includes a progressive voiding schedule together with relaxation and distraction for urgency suppression, and multicomponent behavioural training, which, in conjunction with pelvic floor muscle (PFM) exercises, includes PFM contraction to control urgency and increase the interval between voids. Guidelines for the conservative treatment of OAB and UUI have been published by several organisations and the physiological basis and evidence for the effectiveness of behavioural interventions, including lifestyle modifications, in the treatment of OAB and UUI have been described. However, many primary care clinicians may have a limited awareness of the evidence supporting the often straight-forward treatment recommendations and guidance for incorporating behavioural interventions into busy primary care practices, because most of this information has appeared in the specialty literature. The purpose of this review is to provide an overview of behavioural interventions for OAB and UUI that can be incorporated with minimal time and effort into the treatment armamentarium of all clinicians that care for patients with bladder problems. Practical supporting materials that will facilitate the use of these interventions in the clinic are included; these can be used to help patients understand lifestyle choices and voiding behaviours that may improve function in patients experiencing OAB symptoms and/or UUI as well as promote healthy bladder behaviours and perhaps even prevent future bladder problems. Interventions for stress urinary incontinence are beyond the scope of this review