Resting Energy Expenditure during Breastfeeding: Body Composition Analysis vs. Predictive Equations Based on Anthropometric Parameters

Nutrients. 2020 Apr 30;12(5):1274. doi: 10.3390/nu12051274.

Abstract

Accurate estimation of energy expenditure in a breastfeeding woman is crucial for maintaining the proper nutritional status of the woman and healthy development of the infant. The current literature does not contain data regarding resting energy expenditure (REE) in breastfeeding women. Using mathematical equations is the most common method of REE assessment. However, due to changes in metabolism and body composition during pregnancy and lactation, the mathematical equations used among the general population may not apply. The aim of this study was to evaluate the resting energy expenditure of exclusively breastfeeding women by using body composition analysis - estimated REE (eREE) and to provide the most appropriate predictive equations - predicted REE (pREE) based on anthropometric parameters to estimate it. This was a pilot study with 40 exclusively breastfeeding women. Height and weight were measured and body composition analysis was performed. We predicted REE using fourteen self-selected equations, based on anthropometric parameters and/or age, and/or sex. The median eREE was 1515.0 ± 68.4 kcal (95% Cl, 1477-1582 kcal) and the pREE ranged from 1149.7 kcal (95% Cl, 1088.7-1215.0) by Bernstein et al., to 1576.8 kcal (95% Cl, 1479.9-1683.4), by Müller et al. Significant differences between eREE and all pREE were observed (p < 0.001, except Korth et al. equations). The Müller et al. equation was the most accurate with the smallest individual variation. All predictive equations showed low agreement, and in most cases, the results were underestimated. These findings indicate the need for further studies to propose more suitable methods to determine the energy requirements for breastfeeding women.

Keywords: bioelectrical impedance analysis; body composition; breastfeeding; predictive equations; resting energy expenditure.