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Title:   Author  item
                                            COMPHER, CHARLENE - UNIV.PENN., PHIL.PAitem
                                            FRANKENFIELD, DAVID - MILTON S. HERSHEY MED.CNTitem
                                            Keim, Nancyitem
                                            ROTH-YOUSEY, LORI - DIETITIAN, N. BRANCH MN
  Submitted to: Journal Of The American Dietetic Association
                                    Publication Type: Peer Reviewed Journal
                                    Publication Acceptance Date: 12/20/2005
                                    Publication  Date: 5/1/2006
                                    Citation: Compher, C., Frankenfield, D., Keim, N.L., Roth-Yousey, L. Best practice methods to apply to measurement of resting metabolic rate, a systematic review. Journal Of The American Dietetic Association. 106:881-903, 2006.Interpretive Summary: The determination of daily caloric need is a key component of nutrition assessment and necessary for helping individuals attain and maintain a healthy body weight. Caloric need is measured using the classic technique of indirect calorimetry – the measurement of oxygen consumption and carbon dioxide production by the body.  This manuscript represents a comprehensive, systematic review outlining the most accurate way to measure resting metabolic rate, the primary indicator of daily caloric need. The material covers the processes to be followed by individuals being measured to assure a resting state and those to be applied by the operator conducting the test procedure. Specific recommendations for standardizing the procedure and obtaining accurate measures are made for healthy subjects and those with special clinical considerations.
                                Technical Abstract: Several factors may alter apparent resting metabolic rate (RMR) during measurement with indirect calorimetry. Likewise, numerous indirect calorimetry measurement protocols have been developed over the years, and the methodology employed could influence test results. As part of a larger project to determine the role of indirect calorimetry in clinical practice, a systematic review 
of the literature was undertaken to determine the ideal subject condition and test methodology for obtaining reliable measurement of RMR with indirect calorimetry. Food, ethanol, caffeine, and nicotine affect RMR for a variable number of hr after consumption and so intake of these items must be controlled prior to measurement. Activities of daily living increase metabolic rate but a short rest (<20 min) prior to testing is sufficient for 
the effect to dissipate. Moderate or vigorous physical activity has a longer carry-over effect and therefore must be controlled 
in the hr before a measurement of RMR is attempted. Limited data 
were found regarding ideal ambient conditions for RMR testing.  Measurement duration of 10 min with the first five min deleted 
and the remaining five min having a coefficient of variation 
< 10% gave accurate readings of RMR. Individuals preparing for 
RMR measurement via indirect calorimetry should refrain from eating, consuming ethanol and nicotine, smoking, and physical activity for varying times prior to measurement. The test site should be physically comfortable and the individual should have 10-20 min to rest before the measurement commences. A 10-min test duration with the first five min discarded and the remaining five min having a coefficient of variation of <10% will give an accurate measure of RMR.


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