No difference in young adult athletes' resting energy expenditure when measured under inpatient or outpatient conditions

Low energy availability can place athletes at increased risk of injury and illness and can be detected by a lower metabolic rate. The lowest metabolic rate is captured at the bedside, after an overnight fast and termed inpatient resting energy expenditure (REE). Measurements done in a laboratory with a shorter overnight fast are termed outpatient REE. Although important to know what the lowest energy expenditure, a bedside measure and/or 12-hr fast is not always practical or logistically possible particularly when you take into account an athlete’s training schedule. The aim of this investigation was to compare a bedside measure of resting metabolism with a laboratory measure in athletes following an 8-hr fast. Thirty-two athletes (24 females and eight males) underwent measures of resting metabolism using indirect calorimetry once at their bedside (inpatient) and once in a simulated laboratory setting (outpatient). Paired t test was used to compare the mean ± SD differences between the two protocols. Inpatient REE was 7,302 ± 1,272 kJ/day and outpatient REE was 7,216 ± 1,116 kJ/day (p = .448). Thirteen participants repeated the outpatient protocol and 17 repeated the inpatient protocol to assess the day-to-day variation. Reliability was assessed using the intraclass correlation coefficient and typical error. The inpatient-protocol variability was 96% with a typical error of 336.2 kJ/day. For the outpatient protocol, the intraclass correlation coefficient and typical error were 87% and 477.6 kJ/day, respectively. Results indicate no difference in REE when measured under inpatient and outpatient conditions; however, the inpatient protocol has greater reliability.