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J Nutr Sci Vitaminol (Tokyo). 2019;65(2):148-156. doi: 10.3177/jnsv.65.148.

Validity of One-Day Physical Activity Recall for Estimating Total Energy Expenditure in Elderly Residents at Long-Term Care Facilities: CLinical EValuation of Energy Requirements Study (CLEVER Study).

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Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition.
Division of Bioengineering, Graduate School of Engineering Science, Osaka University.
Section of Healthy Longevity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition.
Japan Institute of Sports Sciences.
Department of Epidemiology and Prevention National Center for Global Health and Medicine.
Silverpia-Kaga Long-Term Care Health Facility.
Dentistry and Oral Surgery, Tokyo Metropolitan Institute of Gerontology.
Department of Social and Preventive Epidemiology, Graduate School of Medicine, The University of Tokyo.
Institute for Integrated Sports Medicine, Keio University School of Medicine.


Malnutrition is a severe problem among elderly residents living in long-term care facilities. A simple and accurate estimation for total daily energy expenditure (TEE) is required in order to provide them with an adequate amount of food. The purpose of this study was to validate a physical activity assessment tool for estimating TEE among elderly residents. The data of 58 subjects aged 69-99 y were analyzed in this study. The one-day physical activity recall was filled out by facility staff for a typical day. TEE was measured by the doubly labeled water (DLW) method (TEEDLW), and predicted by one-day physical activity recall using the basal metabolic rate (pTEEBMR) and body weight (pTEEBW). The TEEDLW, pTEEBMR and pTEEBW were 1,129±196 kcal/d, 1,186±251 kcal/d and 1,326±236 kcal/d, respectively. In a regression model, body weight, movement means and sex explained 39.0% of the variance in the difference between pTEEBMR and TEEDLW (p<0.05). Percentage of fat mass, body weight, and Barthel Index except mobility explained 47.3% of the variance in the difference between pTEEBW and TEEDLW (p<0.05). The current results suggested that pTEEBW is not recommended to estimate TEE because the error depends on body size, and pTEEBMR was significantly correlated with TEEDLW but also included systematic errors in elderly residents. In order to improve the accuracy of the present assessment to estimate TEE, it is necessary to establish a new equation of basal metabolic rate for elderly residents and consider sex and movement means to estimate TEE.


doubly labeled water; elderly residents; long-term care facilities; one-day physical activity recall; total energy expenditure

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