• Ruth Williams, Stacie Olivi, Paul Mackert, Lucille Fletcher, Guo-Liang Tian, and Winfred Wang.
• Clinical Nutrition Services, St Jude Children's Research Hospital, Memphis, TN 38105-2794, USA. ruth.williams@stjude.org
• J Am Diet Assoc. 2002 Jul 1; 102 (7): 956-61.

ObjectiveTo determine the accuracy of energy prediction equations when compared with measured resting energy expenditure (REE) in children with sickle cell anemia. To develop a modified equation that more accurately estimates the energy needs of children with sickle cell anemia and to cross-validate these on a different set of patients (test patients).DesignREE was measured in children using indirect calorimetry and compared with predicted values using the Harris-Benedict and the Food and Agriculture Organization/World Health Organization/United Nations University equations (WHO).Subjects/SettingEighteen patients participated in the original sample that compared predicted with measured energy expenditure. The modified equations were developed using the original 18 patients. A test population of 20 different patients was used to validate the modified equations.Statistical AnalysisWilcoxon signed-rank test was performed to compare measured with predicted REE. The correlation analysis method and multiple linear regression method were used to develop 2 modified versions for the Harris-Benedict and WHO prediction equations.ResultsWhen compared with the mean predicted REE using the Harris-Benedict and WHO equations, the mean measured REE was 14% and 12% greater than both (P=.005 and P=.014, respectively). Two modified equations were developed from the Harris-Benedict and WHO equations. Based on the data from the test patients, the mean measured REE was 15% greater than the mean predicted REE based on the Harris-Benedict and WHO equations (P=.0001 for both). When the modified Harris-Benedict and WHO equations were used, there was almost no difference in the mean measured REE and the mean predicted REE (mean difference using Harris-Benedict = 14, P = .9273; mean difference using WHO = -13, P = .6215).ConclusionBoth energy prediction equations underestimated REE in children with sickle cell anemia. The 2 modified versions of the energy prediction equations that we propose predicted the energy needs of these children much more accurately; however, the modified equations need to be validated through application to other children with sickle cell anemia.

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