Development and application of a new equation for estimating energy requirement in metabolic syndrome in a Chinese population

Purpose: A negative energy balance (i.e., daily energy intake less than energy expenditure) is important for dietary interventions in metabolic syndrome (MetS). This study aimed to develop a new energy requirement equation on the basis of negative energy balance to guide dietary intervention with MetS. Methods: This study included two phases. First we developed a new equation for the energy requirement in MetS based on the daily total energy expenditure and daily energy reduction corresponding to a 5~10% annual weight loss in 1292 MetS patients. Second, we randomly assigned 493 MetS patients from the first phase who had greater energy intake than energy expenditure to three groups, including one experimental group and two control groups. For the experimental group (group A, n=164), we estimated the energy requirement using the new estimating equation derived from the first phase, whereas for the control groups, we used either a previously developed energy estimation model for MetS (group B, n=163) or the traditional food exchange method (group C, n=166). Results: After a 6-month intervention, we observed a significant reduction in weight (73.69±7.25 vs.70.19±6.86 kg), waist circumference (92.42±7.13 vs. 88.58±6.75 cm), 2-h postprandial blood glucose (10.63±5.41 vs. 7.53±4.26 mmol/L), and triglyceride level (2.92±1.45 vs. 1.44±1.12 mmol/L) in patients of group A, in parallel with a reduction in energy intake (9.30±2.79 vs. 6.70±1.85 MJ/d). All these changes were significantly different from the measurements in groups B and C over the same period (P<0.05). Conclusion: A new energy requirement equation based on a negative energy balance improves the effect of dietary intervention on weight, waist circumference, glucose, and triglycerides in MetS patients.