|Energy and Protein requirements, Proceedings of an IDECG workshop, November 1994, London, UK, Supplement of the European Journal of Clinical Nutrition (International Dietary Energy Consultative Group - IDECG, 1994, 198 pages)|
|Report of the working group on energy requirements of older individuals|
Working Group: JL Dupont,1 JVGA Durnin,2 A Ferro-Luzzi,3 SB Roberts,4 B Schürch5 and PS Shetty6
1Agricultural Research Service, United States
Department of Agriculture, Beltsville, MD 20705, USA; 2Department of
Human Nutrition, Yorkhill Hospitals, Glasgow G3 8SJ, Scotland, UK;
3Instituto Nazionale della Nutrizione, Via Ardeatina 546, 00179 Rome,
Italy; 4The Jean Mayer USDA Human Nutrition Research Center on Aging
at Tufts University, 711 Washington Street, Boston, MA 02111, USA;
5International Dietary Energy Consultative Group (IDECG), c/o Nestlé
Foundation, P.O. Box 581,1001 Lausanne, Switzerland; 6Centre for
Human Nutrition, London School of Hygiene and Tropical Medicine, 2 Taviton
WC1H OBT, UK
Descriptors: energy requirements, energy expenditure, physical activity, research needs
Typically, the energy requirements of an individual can be expected to decrease with age, due to decreases in both basal metabolism and physical activity (thus giving a decrease in PAL). It is recognized, however, that the older population is an extremely heterogeneous group and that individuals may differ widely from the expected norm in their changes in energy requirements with advancing years.
1. Equations to predict BMR from weight or weight and height should be revised to include recently available data and to divide the older population into three age ranges. The ranges 65-75, 76-85 and 86 + years are suggested.
2. Recommendations on expected energy requirements (expressed in the PAL system) should be integrated into a PAL system appropriate for adults of all ages.
3. It is expected that the range of healthy PALs in the older population (defined as >65 years) is 1.5-1.8. Limitations in the availability of valid TEE data in the older population currently prevent specific recommendations on typical PALs in relation to age. However, it was agreed that in general PALs will decrease with increasing age over 65 years, that older men can be expected to have somewhat higher energy requirements than older women (because of a lower proportion of fat) and that individuals with high levels of physical activity will have higher values for PAL than individuals with low physical activity. The lower end of the recommended range for PAL, 1.5 units, does not represent the minimum expected level of energy requirements in the older population but rather the lower limit thought to be compatible with levels of physical activity required to prevent accelerated changes in muscle and bone. It is recommended that older individuals be sufficiently physically active to at least meet a PAL level of 1.5. Older individuals who are extremely sedentary may have undesirably low requirements down to 1.4 PAL.
Correspondence to: B Schürch
Information is required to determine representative values for PAL for light, moderate and strenuous physical activity in the older population, because the ranges of values will differ from those appropriate for younger adults. Within the older population, determination of PAL for three age groups (65-75, 76-85, 86+) and in both men and women is important. Values for light, moderate and strenuous activity should be representative of population data on physical activity in this age group. In addition, information is required from older individuals in both affluent and developing countries.