Comparing predictive energy-expenditure equations with indirect calorimetry in older adults living in long-term care facilities

In people living in LTCFs, predictive equations showed modest explanatory power and low individual accuracy, with wide limits of agreement indicating that none can reliably replace IC when precise estimation of REE is required. Clinically, predicted REE should be regarded as an estimate rather than a dose, requiring cautious adjustment and verification against short-term monitoring of body weight, intake, and clinical status. When precise energy dosing is critical, IC should be used whenever feasible.