Determining energy requirement and evaluating energy expenditure in neurological diseases

Objectives: It has been reported that in most neurological patients, resting energy expenditure due to hypermetabolism is increased. Physical activity, which is another component of energy expenditure, varies depending on the course of the disease. Different mechanisms are used to explain changes in energy expenditure in this population. Pathological problems of centers that regulate energy balance in the brain, endocrine and metabolic dysfunction, mitochondrial damage, autonomic dysfunction and inflammatory anomalies are thought to be at the root of this situation. In this review study, studies about energy expenditure and energy requirement in neurological diseases have been examined and suggested practices in this field have been presented. Methods: We reviewed articles regarding selected from PubMed, Science Direct, EBSCO, and databases about energy expenditure and neurological diseases. Results: Based on the type of neurological diseases; factors such as stage of the disease, disease complications, metabolic status, mechanical ventilation, body composition, movement restrictions or hyperactivity change energy expenditure and, as a result, nutrition requirement. Determination of the energy requirement is the basic variable for adjusting medical nutrition therapy. Despite an increase in resting energy expenditure as a result of metabolic processes in most neurological disorders, the daily energy expenditure is reported to change based on the restriction of physical activity due to the disorder. Discussion: Determining patient's energy expenditure and energy requirements is regarded as the right approach in terms of improving the patient's quality of life, regulating appropriate medical nutrition treatment and increasing the effectiveness of other treatments.