An Evaluation of Physical Fitness and Accuracy of Resting Metabolic Rate Prediction Equations in

126 Pages·2014·4.95 MB·English

An  Evaluation  of  Physical  Fitness  and  Accuracy  of  Resting  Metabolic  Rate  
Prediction  Equations  in    
Reserve  Officers’  Training  Corps  Cadets  and  Midshipmen  
A  Thesis  
Submitted  to  the  Faculty  
of    
Drexel  University  
by  
Rachel  Catherine  Kelley  
in  partial  fulfillment  of  the  
requirements  for  the  degree  
of  
Master  of  Science  in  Human  Nutrition  
June  2014

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DEDICATIONS  

This  thesis,  in  its  entirety,  is  dedicated  to  my  parents,  Gwen  and  Bill  
Kelley,  for  their  unconditional  love  and  encouragement.    Mom  and  Dad,  thank  
you,  and  I  love  you  both  so  much.
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ACKNOWLEDGMENTS  

I  would  like  to  acknowledge  all  of  the  participants  from  the  Army  and  
Navy  ROTC  programs  for  their  generosity  and  enthusiasm.  

I  would  also  like  to  thank  my  thesis  committee,  Patricia  Shewokis,  PhD,  
Sinclair  Smith,  PhD,  and  Stella  Volpe,  PhD,  RD  for  their  supportive  and  expert  
advise.    

Many  laboratory  members  offered  assistance  during  this  project,  but  I  am  
especially  grateful  for  the  work  that  Francesco  Alessio  and  Jillian  Hawkins  
contributed.  

  My  fellow  graduate  assistant,  Jacqui  Van  Grouw,  was  invaluable  
throughout  this  experience.    I  am  incredibly  fortunate  to  have  had  her  as  a  
colleague  and  friend  throughout.  

  Finally,  I  want  to  thank  Stella  Volpe,  PhD,  RD,  again,  for  not  only  chairing  
my  committee  and  funding  this  project,  but  also  for  fiercely  believing  in  my  
potential  every  day.    Dr.  Volpe,  you  have  defined  my  Drexel  years.
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TABLE  OF  CONTENTS  
LIST  OF  TABLES  ..........................................................................................................  vii  
LIST  OF  FIGURES  ......................................................................................................  viii  
ABSTRACT  ......................................................................................................................  x  
CHAPTER  1:  INTRODUCTION  AND  SPECIFIC  AIMS  ........................................  1  
1.1  Introduction  ................................................................................................................  1  
1.2  Specific  Aims  ..............................................................................................................  3  
CHAPTER  2:  LITERATURE  REVIEW  ........................................................................  6  
2.1  Resting  Metabolic  Rate  ..............................................................................................  6  
2.2  Prediction  of  Resting  Metabolic  Rate  ......................................................................  8  
2.2.1  Harris-­‐‑Benedict  ............................................................................................  9  
2.2.2  Mifflin-­‐‑St.  Jeor  ............................................................................................  11  
2.2.3  Owen  ...........................................................................................................  12  
2.2.4  Cunningham  ..............................................................................................  13  
2.2.5  Schofield  .....................................................................................................  15  
2.3  Determinants  of  Resting  Metabolic  Rate  ..............................................................  16  
2.3.1  Body  Composition  –  Lean  Body  Mass  ...................................................  17  
2.3.2  Aerobic  Fitness  –  Maximal  Oxygen  Consumption  ..............................  19  
2.3.3  Dietary  Intake  ............................................................................................  22
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CHAPTER  3:  METHODS  ............................................................................................  30  
3.1  Institutional  Review  Board  Approval  ...................................................................  30  
3.2  Recruiting  Participants  ............................................................................................  30  
3.3  Attaining  Fitness  Characteristics  of  Trained  ROTC  Cadets  and  Midshipmen  31  
3.3.1  Informed  Consent  .....................................................................................  32  
3.3.2  Anthropometric  Measurements  ..............................................................  33  
3.3.3  Resting  Metabolic  Rate  (RMR)  Measurement  .......................................  34  
3.3.4  Maximal  Oxygen  Consumption  (VO max)  ...........................................  37  
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3.3.5  Energy  Intake  and  Fruit  and  Vegetable  Consumption  ........................  40  
3.4  Data  Storage  ..............................................................................................................  41  
3.5  Statistical  Analyses  ..................................................................................................  41  
CHAPTER  4:  RESULTS  ...............................................................................................  44  
4.1  Descriptive  Statistics  of  the  ROTC  Sample  ..........................................................  44  
4.2  Accuracy  of  RMR  Prediction  Equations  ...............................................................  47  
4.3  Correlations  Between  Physical  Fitness  Characteristics  and  RMR  ....................  74  
CHAPTER  5:  DISCUSSION  .......................................................................................  77  
5.1  Descriptive  Statistics  of  the  ROTC  Sample  ..........................................................  77  
5.2  Accuracy  of  RMR  Prediction  Equations  ...............................................................  79  
5.3  Correlations  Between  Physical  Fitness  Characteristics  and  RMR  ....................  82  
5.4  Limitations  and  Assumptions  ................................................................................  83
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5.5  Conclusion  ................................................................................................................  87  
LIST  OF  REFERENCES  ................................................................................................  89  
APPENDIX  A.  RECRUITMENT  FLYER  ...................................................................  96  
APPENDIX  B.  RECRUITMENT  LETTER  ................................................................  97  
APPENDIX  C.  SCREENING  SURVEY  .....................................................................  98  
APPENDIX  D.  INFORMED  CONSENT  DOCUMENT  ......................................  100  
APPENDIX  E.  DATA  COLLECTION  SHEET  .......................................................  108  
APPENDIX  F.  RAW  DATASET  ...............................................................................  110
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LIST  OF  TABLES  
Table  1.  Resting  metabolic  rate  prediction  equations  and  the  study  population  of  
derivation  ........................................................................................................................  26  

Table  2.  Conclusions  regarding  validity  of  RMR  prediction  equations  in  select  
accuracy  studies  .............................................................................................................  28  

Table  3.  Phases  of  the  modified  Taylor  graded  exercise  test  protocol  for  the  
determination  of  maximal  oxygen  consumption  (VO max)  ....................................  43  
2

Table  4.  Summary  of  anthropometric  and  fitness  characteristics  ...........................  45  

Table  5.  Summary  of  anthropometric  and  fitness  characteristics  separated  by    
sex  .....................................................................................................................................  46  

Table  6.  Average  RMR  values  from  measurement  and  from  prediction    
equations  .........................................................................................................................  49  

Table  7.  Paired  t-­‐‑test  of  average  predicted  RMR  and  average  measured  RMR  ....  52  

Table  8.  Correlations  between  predicted  RMR  and  measured  RMR  .....................  54  

Table  9.  Mean  differences  between  predicted  and  measured  RMR  along  with  95%  
limits  of  agreement  depicted  in  Bland-­‐‑Altman  plots  ................................................  70  

Table  10.  Accepted  error  range  analysis  of  prediction  equations  ...........................  72  

Table  11.  Percentage  of  the  out-­‐‑of-­‐‑accepted  error  range  participants  for  each  
equation  who  were  over-­‐‑  or  underestimated  by  the  prediction  equation  .............  73  

Table  12.  Bivariate  correlations  between  physical  fitness  characteristics  and  
measured  RMR  ...............................................................................................................  75  

Table  13.Partial  correlations  between  physical  fitness  characteristics  and  
measured  RMR  controlling  for  effects  of  weight  ......................................................  76
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LIST  OF  FIGURES  
Figure  1.  Frequency  of  participants  (n  =  17)  by  measured  resting  metabolic  rate  
(RMR)  ...............................................................................................................................  48  

Figure  2.  Bar  graph  of  average  resting  metabolic  rates  (RMRs)  via  measurement  
or  calculation  with  prediction  equation  ......................................................................  50  

Figure  3.  Scatter  plot  depicting  the  relationship  between  measured  RMR  and  
Harris-­‐‑Benedict  predicted  RMR  ..................................................................................  55  

Figure  4.  Scatter  plot  depicting  the  relationship  between  measured  RMR  and  
Mifflin-­‐‑St.  Jeor  predicted  RMR  ....................................................................................  56  

Figure  5.  Scatter  plot  depicting  the  relationship  between  measured  RMR  and  
Owen  Weight  predicted  RMR  ......................................................................................  57  

Figure  6.  Scatter  plot  depicting  the  relationship  between  measured  RMR  and  
Owen  Fat  Free  Mass  predicted  RMR  ..........................................................................  58  

Figure  7.  Scatter  plot  depicting  the  relationship  between  measured  RMR  and  
Cunningham  predicted  RMR  .......................................................................................  59  

Figure  8.  Scatter  plot  depicting  the  relationship  between  measured  RMR  and  
Schofield  Weight  predicted  RMR  ................................................................................  60  

Figure  9.  Scatter  plot  depicting  the  relationship  between  measured  RMR  and  
Schofield  Weight  Height  predicted  RMR  ...................................................................  61  

Figure  10.  Bland-­‐‑Altman  plot  displaying  the  bias  and  agreement  between  the  
Harris-­‐‑Benedict  predicted  RMR  and  the  measured  RMR  ........................................  63  

Figure  11.  Bland-­‐‑Altman  plot  displaying  the  bias  and  agreement  between  the  
Mifflin-­‐‑St.  Jeor  predicted  RMR  and  the  measured  RMR  ..........................................  64  

Figure  12.  Bland-­‐‑Altman  plot  displaying  the  bias  and  agreement  between  the  
Owen  Weight  predicted  RMR  and  the  measured  RMR  ...........................................  65
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Figure  13.  Bland-­‐‑Altman  plot  displaying  the  bias  and  agreement  between  the  
Owen  Fat  Free  Mass  predicted  RMR  and  the  measured  RMR  ...............................  66  

Figure  14.  Bland-­‐‑Altman  plot  displaying  the  bias  and  agreement  between  the  
Cunningham  predicted  RMR  and  the  measured  RMR  ............................................  67  

Figure  15.  Bland-­‐‑Altman  plot  displaying  the  bias  and  agreement  between  the  
Schofield  Weight  predicted  RMR  and  the  measured  RMR  .....................................  68  

Figure  16.  Bland-­‐‑Altman  plot  displaying  the  bias  and  agreement  between  the  
Schofield  Weight  Height  predicted  RMR  and  the  measured  RMR  ........................  69