Comparison of Resting Energy Expenditure Between Cancer Subjects and Healthy Controls: A Meta-Analysis

There is conflicting evidence surrounding the extent of changes in resting energy expenditure (REE) in cancer. This meta-analysis aimed to establish the mean difference in REE, as kilojoules per kilogram fat-free mass, among cancer patients when compared to healthy control subjects. The secondary aim was to determine differences among different cancer types. PubMed, Cochrane Library, Medline, Science Direct, Scopus, Web of Science, Wiley Online Library, and ProQuest Central were searched from the earliest records until March 2014. Studies were included if measured REE was reported as kilojoules or kilocalories per kilogram fat-free mass (FFM) in adult subjects with cancer. Twenty-seven studies were included in the meta-analysis. Fourteen studies included both cancer (n = 1453) and control (n = 1145) groups. The meta-analysis shows an average increase in REE of 9.66 (95% confidence interval: 3.34, 15.98) kJ/kgFFM/day in cancer patients when compared to control subjects. Heterogeneity was detected (P < 0.001) which suggest variations in REE among cancer types. Elevations are most noticeable in patients with cancers of metabolically demanding organs.