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The purpose of this manuscript will be to present scientific evidence regarding the effects of videogame playing on different aspects of the social life of children and adolescents, as well as the general potential psychological and physiological effects. A literature review from relevant databases has been performed, and experimental and meta-analytical studies have been scrutinized for positive and negative effects of videogames in children and adolescents. In general, it has been found that there is a billionaire videogame industry and yet, despite the worldwide popularity of videogames, research is still scarce and sometimes contradictory. Some research suggests a correlation between excess time video gaming on negative social and psychological aspects such as isolation and aggressive behavior; while other research suggests a positive association with motor learning, motor re-training and resilience. As far as physiological effects it has been reported that active videogames might promote higher energy expenditure than passive videogames; therefore, given an adequate parental instruction might provide videogames beneficial properties to combat the global epidemic of sedentary behavior and obesity. Videogames and everything related «to be» in front of a screen will be common to future generations, and therefore more systematic studies are required to determine the long-term exposure effects to these devices.

OBJETIVO: Avaliar os efeitos do consumo crônico de etanol e da desintoxicação alcoólica sobre a resistência mecânica do osso e neoformação óssea junto a implantes de hidroxiapatita densa (HAD) realizados em ratos. MÉTODOS: Foram utilizados 15 ratos divididos em três grupos, sendo controle (CT), alcoolista crônico (AC) e desintoxicado (DE). Após quatro semanas, foi realizada implantação de HAD na tíbia e produzida falha no osso parietal, em seguida o grupo AC continuaram a consumir etanol e o grupo DE iniciaram a desintoxicação. Ao completar 13 semanas os animais sofreram eutanásia, os ossos foram coletados para o processamento histomorfométrico e os fêmures encaminhados ao teste mecânico de resistência. RESULTADOS: Os animais do grupo AC apresentaram menores valores de neoformação óssea, de calcemia e resistência mecânica, quando comparado aos grupos CT e DE. Os animais dos grupos DE apresentaram valores superiores em todas as variáveis avaliadas em relação ao grupo AC. CONCLUSÃO: O consumo de etanol interferiu na osteogênese ao redor de implante de HAD, nos níveis de cálcio e na resistência mecânica óssea. A desintoxicação alcoólica se mostrou eficaz, pois aumentou à osteogênese e osseointegração da HAD, a calcemia e resistência mecânica óssea. Nivel de Evidência I, estudo terapeutico.OBJECTIVE: To evaluate the effects of chronic ethanol consumption and alcohol detoxication on the mechanical resistance of bone and bone neoformation around dense hydroxyapatite implants (DHA) in rats. METHODS: Fifteen rats were separated into three groups: (1) control group (CT); (2) chronic alcoholic (CA), and (3) disintoxicated (DI). After four weeks, a DHA was implanted in the right tibia of the animals, and the CA group continued consuming ethanol, while the DI group started detoxication. The solid and liquid feeding of the animals was recorded, and a new alcohol dilution was effected every 48 hours. After 13 weeks, the animals were euthanized and their biological material was collected. RESULTS: Bone tissue was found around DHA in all the animals. Group CA showed less bone neoformation, lower levels of ionic and total calcium when compared to the animals of the CT and DI groups. The DI animals showed higher values in all the variables in relation to the CA group. CONCLUSION: Ethanol consumption interfered in osteogenesis around the DHA implants, and in calcium levels and mechanical bone resistance. Alcohol detoxication was effective, as it increased osteogenesis, DHA osteointegration, calcemia, and mechanical resistance of the bone. Level of Evidence: Level I, therapeutic studies

In 2007, the Intergovernmental Panel on Climate Change (IPCC) presented a large amount of evidence about global warming and the impact of human activities on global climate change. The Lancet Commission have identified a number of ways in which climate change can influence human health: lack of food and safe drinking water, poor sanitation, population migration, changing disease patterns and morbidity, more frequent extreme weather events, and lack of shelter. Pregnant women, the developing fetus, and young children are considered the most vulnerable members of our species and are already marginalized in many countries. Therefore, they may have increased sensitivity to the effects of climate change. Published literature in the fields of climate change, human health, tropical diseases, and direct heat exposure were assessed through the regular search engines. This article demonstrates that climate change will increase the risk of infant and maternal mortality, birth complications, and poorer reproductive health, especially in tropical, developing countries. Thus, climate change will have a substantial impact on the health and survival of the next generation among already challenged populations. There is limited knowledge regarding which regions will be most heavily affected. Research efforts are therefore required to identify the most vulnerable populations, fill knowledge gaps, and coordinate efforts to reduce negative health consequences. The effects of malnutrition, infectious diseases, environmental problems, and direct heat exposure on maternal health outcomes will lead to severe health risks for mothers and children. Increased focus on antenatal care is recommended to prevent worsening maternal health and perinatal mortality and morbidity. Interventions to reduce the negative health impacts caused by climate change are also crucial. Every effort should be made to develop and maintain good antenatal care during extreme life conditions as a result of climate change.

OBJETIVO: La exposición a humo de leña es factor de riesgo para EPOC. A diferencia de la EPOC por cigarrillo (EPOC-C), para un mismo nivel de obstrucción, en la EPOC por leña (EPOC-L), la DLCO está menos disminuida, sugiriendo menos enfisema. Por tanto, el objetivo de este estudio fue comparar los hallazgos en la TCAR en mujeres con EPOC-L y con EPOC- C. MÉTODOS: Veintidós mujeres con EPOC severa (VEF1/CVF OBJECTIVE: Wood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD. METHODS: Twenty-two women with severe COPD (FEV1/FVC ratio < 70% and FEV1 < 50%) were divided into two groups: those with wood smoke-related COPD (n = 12) and those with smoking-related COPD (n = 10). The two groups were compared regarding emphysema scores and airway involvement (as determined by HRCT); and functional abnormalities-spirometry results, DLCO, alveolar volume (VA), the DLCO/VA ratio, lung volumes, and specific airway resistance (sRaw). Results: There were no significant differences between the two groups in terms of FEV1, sRaw, or lung hyperinflation. Decreases in DLCO and in the DLCO/VA ratio were greater in the smoking-related COPD group subjects, who also had higher emphysema scores, in comparison with the wood smoke-related COPD group subjects. In the wood smoke-related COPD group, HRCT scans howed no significant emphysema, the main findings being peribronchial thickening, bronchial dilation, and subsegmental atelectasis. CONCLUSIONS: Female patients with severe wood smoke-related COPD do not appear to develop emphysema, although they do show severe airway involvement. The reduction in DLCO and VA, with a normal DLCO/VA ratio, is probably due to severe bronchial obstruction and incomplete mixing of inspired gas during the determination of single-breath DLCO.

David Bergman,1 Hannes Hagström,2– 4 Andrea Johansson Capusan,5,6 Karl Mårild,7,8 Fredrik Nyberg,9 Kristina Sundquist,10 Jonas F Ludvigsson1,11– 13 1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; 2Division of Hepatology, Department of Upper GI Diseases, Karolinska University Hospital, Stockholm, Sweden; 3Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden; 4Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden; 5Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; 6Department of Psychiatry in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; 7Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden; 8Department of Pediatric Gastroenterology, Queen Silvia Children’s Hospital, Gothenburg, Sweden; 9School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 10Center for Primary Health Care Research, Department of Clinical Sciences, Lund University, Malmö, Sweden; 11Department of Pediatrics, Orebro University Hospital, Orebro, Sweden; 12Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK; 13Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USACorrespondence: Jonas F LudvigssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, SwedenEmail jonasludvigsson@yahoo.comAim: To improve consistency between register studies in Sweden and ensure valid comparisons of possible changes in alcohol-related disorders and diseases (ARDDs) over time, we propose a definition of ARDDs. Based on this definition, we examined Sweden’s incidence rates of ARDDs from 1970 to 2018 in non-primary healthcare settings (inpatient and outpatient).Methods: Swedish Society of Epidemiology members were invited to give feedback on the International Classification of Disease (ICD) codes with a potential link to alcohol use. We then calculated age-standardised and age-specific incidence of ARDDs over time according to the National Patient Register, and the lifetime prevalence of ARDDs diagnosed in adults alive in Sweden on Dec 31, 2018.Results: Sweden’s estimated incidence of ARDDs increased substantially after introducing the new ICD-9 codes in 1987. In the past 10 years (2009– 2018), the incidence of ARDDs has been stable (males: 110/100,000 person-years, females: 49/100,000 person-years). Requiring at least two ICD records for diagnosed ARDDs led to a somewhat lower incidence of ARDDs (males: 71 per 100,000 person-years, females: 29 per 100,000 person-years). In Sweden, the lifetime prevalence of diagnosed ARDDs in adults on Dec 31, 2018, was 1.9% (95% CI=1.9– 1.9).Conclusion: In this nationwide study, we found an incidence of ARDDs of 50– 100/100,000 person-years. In 2018, 1 in 52 adults in Sweden had been diagnosed with ARDDs in the National Patient Register.Keywords: alcohol, alcohol use disorder, alcohol-related disease, alcohol drinking, drug use, ethanol

OBJETIVO: Ainda que as características clássicas da síndrome fetal alcoólica tenham sido descritas desde 1968, a pesquisa sobre a teratogênese do álcool apenas recentemente demonstrou que o cérebro é o órgão do corpo mais vulnerável aos efeitos da exposição pré-natal ao álcool. No presente artigo, fazemos uma revisão da literatura focalizando principalmente os distúrbios comportamentais relacionados à exposição pré-natal ao álcool. FONTES DOS DADOS: Foi realizada uma pesquisa com base no PubMed sobre a literatura publicada entre 1968 e 2006, com as palavras-chave etanol, gestação e comportamento. Foram estabelecidos limites a estudos em humanos. SÍNTESE DOS DADOS: Os dados apresentados nesta revisão sugerem que jovens com efeitos do espectro do álcool fetal estão sob risco maior de terem comportamento social disruptivo, entre outros problemas neurocomportamentais. CONCLUSÕES: Ainda que seja impossível separar completamente a teratogênese sobre o cérebro decorrente da exposição ao álcool de influências ambientais pós-natais como a causa definitiva desses resultados, o pediatra deve ser estimulado ao diagnóstico precoce de crianças afetadas pela síndrome fetal alcoólica e efeitos do espectro do álcool fetal. Isso permite iniciar o manejo e cuidados apropriados para evitar as conseqüências em longo prazo no comportamento e assegurar uma adaptação social e escolar melhor e mais produtiva.OBJECTIVE: Although the classic features of fetal alcohol syndrome have been recognized since 1968, research on alcohol teratogenesis has only recently demonstrated that the brain is the organ in the body most vulnerable to the effects of prenatal alcohol exposure. In this present article, we reviewed the literature focusing mainly on behavioral disturbances related to prenatal ethanol exposure. SOURCES: We performed a PubMed search on the literature published between 1968 and 2006 using the terms ethanol, pregnancy and behavior. We limited our search to studies on humans. SUMMARY OF THE FINDINGS: The data presented in this review suggested that youths with fetal alcohol spectrum disorder are at risk of disruptive social behavior, among other neurobehavioral abnormalities. CONCLUSIONS: Although it is still impossible to completely separate brain teratogenesis secondary to alcohol exposure from environmental postnatal influences as the definite cause for these outcomes, the pediatrician should be encouraged to early diagnose children affected by fetal alcohol syndrome and fetal alcohol spectrum disorder. This provides proper management and care and avoids long-term consequences on their behavior, besides ensuring better and productive school and social adaptation.

{"references": ["Albuquerque, C., 2003. Relat\u00f3rio do Plano de Ordenamento do Parque Natural de Sintra-Cascais. Instituto da Conserva\u00e7\u00e3o da Natureza, Sintra", "Amado, M. (2009). Planeamento Urbano Sustent\u00e1vel, Ed. Caleid\u00f3scopio(2nd ed.). Casal de Cambra (in portuguese)", "GEOTPU, & C\u00e2mara Municipal de Cascais. (2008). Relat\u00f3rio de Caracteriza\u00e7\u00e3o e Diagn\u00f3stico do Plano de Pormenor de Murches. Almada: Faculdade de Ci\u00eancia e Tecnologia, Universidade Nova de Lisboa, (in portuguese)", "Lwin, K. K., & Murayama, Y. (2011). Modelling of urban green space walkability: Eco-friendly walk score calculator. Computers, Environment and Urban Systems, 35(5), 408\u2013420. doi:10.1016/j.compenvurbsys.2011.05.002", "Smith, K. R., Brown, B. B., Yamada, I., Kowaleski-Jones, L., Zick, C. D., & Fan, J. X. (2008). Walkability and Body Mass Index: Density, Design, and New Diversity Measures. 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Medicine and science in sports and exercise, 40(7 Suppl), S512\u2013518. doi:10.1249/MSS.0b013e31817c65d0\n[11]\tDing, D., Sallis, J. F., Kerr, J., Lee, S., & Rosenberg, D. E. (2011). Neighborhood environment and physical activity among youth a review. American journal of preventive medicine, 41(4), 442\u2013455. doi:10.1016/j.amepre.2011.06.036\n[12]\tBrown, B. B., Yamada, I., Smith, K. R., Zick, C. D., Kowaleski-Jones, L., & Fan, J. X. (2009). Mixed land use and walkability: Variations in land use measures and relationships with BMI, overweight, and obesity. Health & Place, 15(4), 1130\u20131141. doi:10.1016/j.healthplace.2009.06.008\n[13]\tUNDP. (2011). Human Development Report 2011. United Nations Development Programme. Retrieved from http://hdr.undp.org/en/reports/global/hdr2011/\n[14]\tUNDP. (1999). Human Development Report 1999. United Nations Development Programme. Retrieved from http://hdr.undp.org/en/reports/global/hdr1999/\n[15]\tGallimore, J. M., Brown, B. B., & Werner, C. M. (2011). Walking routes to school in new urban and suburban neighborhoods: An environmental walkability analysis of blocks and routes. Journal of Environmental Psychology, 31(2), 184\u2013191. doi:10.1016/j.jenvp.2011.01.001\n[16]\tCalthorpe, P. (1995). The Next American Metropolis: Ecology, Community, and the American Dream (3rd ed.). Princeton Architectural Press\n[17]\tUN-HABITAT, U. N. H. S. P. (2010). State of the World's Cities 2010/11: Cities for All: Bridging the Urban Divide. EarthScan.\n[18]\tReid, S. (2008). Fit for purpose: evaluating walkability. Proceedings of the ICE - Engineering Sustainability, 161(2), 105\u2013112. doi:10.1680/ensu.2008.161.2.105\n[19]\tCervero, R., &Kockelman, K. (1997). Travel demand and the 3Ds: Density, diversity, and design. Transportation Research Part D: Transport and Environment, 2(3), 199\u2013219. doi:10.1016/S1361-9209(97)00009-6\n[20]\tFrank, L. D. (2004). Economic determinants of urban form: Resulting trade-offs between active and sedentary forms of travel. American Journal of Preventive Medicine, 27(3, Supplement), 146\u2013153. doi:10.1016/j.amepre.2004.06.018\n[21]\tLeslie, E., Coffee, N., Frank, L., Owen, N., Bauman, A., & Hugo, G. (2007). Walkability of local communities: Using geographic information systems to objectively assess relevant environmental attributes. Health & Place, 13(1), 111\u2013122. doi:10.1016/j.healthplace.2005.11.001\n[22]\tSaelens, B. E., & Handy, S. L. (2008). Built Environment Correlates of Walking: A Review. Medicine and science in sports and exercise, 40(7 Suppl), S550\u2013S566. doi:10.1249/MSS.0b013e31817c67a4\n[23]\tGiles-Corti, B., &Donovan, R. J. (2002). The relative influence of individual, social and physical environment determinants of physical activity. Social Science & Medicine, 54(12), 1793\u20131812. doi:10.1016/S0277-9536(01)00150-2\n[24]\tBoarnet, M., Day, K., Anderson, C., McMillan, T., & Alfonzo, M. (2005). California's Safe Routes to School Program - Impacts on Walking, Bicycling, and Pedestrian Safety. Journal of the American Planning Association, 71(3)\n[25]\tZhu, X., & Lee, C. (2008). Walkability and Safety Around Elementary Schools: Economic and Ethnic Disparities. American Journal of Preventive Medicine, 34(4), 282\u2013290. doi:10.1016/j.amepre.2008.01.024\n[26]\tStren, R. (2001). Thinking about Urban Inclusiveness. Centre for Urban and Community Studies, University of Toronto, Canada\n[27]\tAmado, M., Santos, C., & Pinto, J. (2008). Methods in sustainable urban process. In SB07 - Sustainable Construction, Materials and Practices, Challenges of the Industry for the New Millenium. Presented at the International Conference on Sustainable Construction, Materials and Practices, Lisbon: IOS Press BV"]} The United Nations has defined the inclusive community as “…promoting growth with equity, a place where everyone, regardless of their economic means, gender, race, ethnicity or religion, is enabled and empowered to fully participate in the social, economic and political opportunities that cities have to offer”. In this paper, the concept of walkability is viewed as an important tool towards the planning and future development of more inclusive communities. Walking is the cheapest and cleanest mode of travel available to all providing large benefits to both health and local economic development. To demonstrate the validity of this strategy a set of parameters, selected from existing research, were measure, compared and discussed in the existing and proposed scenarios of a Portuguese small town using GIS software.

Objetivos: La inducción de hipotermia moderada en pacientes con infarto de la arteria cerebral media (ACM) puede ocasionar alteraciones metabólicas y nutricionales. En la actualidad se desconoce cuál es el mejor método para realizar la valoración nutricional en este grupo de población. El objetivo del presente estudio fue valorar la utilidad del balance nitrogenado en el seguimiento de pacientes con infarto de la ACM y sometidos a hipotermia moderada (32-33 ºC) mediante enfriamiento intravascular, en la Unidad de Cuidados Neurocríticos de un hospital de tercer nivel. Material y métodos: Se diseñó un estudio retrospectivo en el que se incluyeron pacientes con infarto de la ACM de los que se recogieron variables biodemográficas, clínicas, de hipotermia y nutricionales. Del mismo modo se realizó el seguimiento prospectivo de un paciente con infarto de la ACM e hipotermia inducida, recogiendo las mismas variables en distintos tiempos de su evolución clínica. Resultados: En la serie retrospectiva se incluyeron 6 pacientes con infarto de ACM sometidos a hipotermia moderada durante un periodo promedio de 12 días (intervalo 9-15). Se constataron pérdidas de nitrógeno (media 9,9 g) inferiores a las que cabría esperar en pacientes críticos durante la fase aguda. En el seguimiento prospectivo del paciente con infarto maligno de la ACM desde día 1 hasta día 22 tras la aplicación de la hipotermia se observaron, al igual que en la serie de pacientes anteriormente descrita, valores bajos de nitrógeno eliminado durante la fase de hipotermia inducida que se elevaron posteriormente cuando el paciente recuperó la normotermia. El nitrógeno eliminado promedio durante el periodo de hipotermia fue de 10,7 g y presentó una elevación hasta 27,3 g durante el periodo normotérmico (día 17). Conclusiones: Estos resultados sugieren que la supresión metabólica inducida por la hipotermia moderada es clínicamente relevante y que, por lo tanto, la determinación del balance nitrogenado no parece ser una herramienta útil en el seguimiento nutricional de este tipo de pacientes.Objectives: Induction of moderate hypothermia in patients with median cerebral artery (MCA) infarction may produce metabolic and nutritional impairments. Currently, we do not know which is the best method to carry out nutritional assessment in this population group. The aim of the present study was to assess the usefulness of nitrogen balance in the follow-up of patients with MCA submitted to moderate hypothermia (32-33 ºC) by means of intravascular cooling at the Neurocritical Patients Unit at a tertiary hospital. Material and methods: We designed a retrospective study including patients with MCA infarction of whom we gathered bio-demographical, clinical, hypothermia, and nutritional variables. Similarly, we carried out a prospective follow-up of a patient with MCA infarction and induced hypothermia, gathering the same variables at different time points of his clinical course. Results: Six patients with MCA infarction submitted to moderate hypothermia for a mean duration of 12 days (interval 9-15) were included in the retrospective series. We observed that nitrogen losses (mean 9.9 g) were lower than those previously thought for critical patients during the acute phase. During the prospective follow-up of the patient with malignant infarction of the MCA from day 1 to day 22 after the application of hypothermia, low levels of nitrogen losses were similarly observed during the phase of induced hypothermia, which increased later on when the patient recovered normothermia. The mean nitrogen expenditure during the period of hypothermia was 10.7 g and increased up to 27.3 g during the normothermia period (day 17). Conclusions: These results suggest that moderate hypothermia-induced metabolic suppression is clinically relevant and thus the determination of nitrogen balance does not seem to be a useful tool in the nutritional followup of this type of patients.

Background: Hydro-meteorological disasters are the focus of this paper. The authors examine, to which extent climate change increases their frequency and intensity. Methods: Review of IPCC-projections of climate-change related extreme weather events and related literature on health effects. Results: Projections show that climate change is likely to increase the frequency, intensity, duration, and spatial distribution of a range of extreme weather events over coming decades. Conclusions: There is a need for strengthened collaboration between climate scientists, the health researchers and policy-makers as well as the disaster community to jointly develop adaptation strategies to protect human.

El tratamiento nutricional es fundamental en la anorexia nerviosa (AN), si bien la reposición de nutrientes debe hacerse de forma progresiva para evitar la aparición del síndrome de realimentación. Objetivo: Comparar el gasto energético en reposo (GER) mediante calorimetría indirecta con el estimado con diferentes fórmulas en mujeres con AN. Material y Métodos: Estudiamos 21 mujeres ingresadas con AN (DSM-IV), edad 17 (DE 5,9) rango 12-34 años. El tiempo de ingreso fue 55,1 ± 20,7 días (21-91). La valoración nutricional inicial incluyó antropometría (IMC, PTC, PSE, CMB,CMMB) y bioimpedancia tetrapolar (HoltainBC). La calorimetría indirecta (CI) se realizó tras ayuno nocturno (Deltatrac TM II MBM-200). En 9 pacientes se repitió el mismo estudio antes del alta. Comparamos el GER (kcal/24 h) medido por CI con el obtenido por diferentes ecuaciones [Fleisch, Harris-Benedict (HB), FAO, Schofield-HW (SHW), Schebendach] mediante el coeficiente de correlación intraclase (CCI) y el método de Bland y Altman. Resultados: El estado nutricional mejoró significativamente durante la hopitalización. El 50% del peso recuperado fue masa grasa. El GER aumentó significativamente durante el ingreso. Las fórmulas sobrestimaron el GER respecto al obtenido por CI (p Nutritional management is essential in anorexia nervosa (AN), although nutrient replenishment must be done progressively to prevent the occurrence of re-alimentation syndrome. Objective: to compare resting energy expenditure (REE) by means of indirect calorimetry and by different equations in AN female patients. Material and methods: we studied 21 women admitted for AN (DSM-IV), mean age 17 years (SD 5.9), range 12-34 years. Admission stay was 55.1 ± 20.7 days (21-91). Initial nutritional assessment included anthropometrics (BMJ, TSF, SSE, MAC, MAMC) and tetrapolar bioimpedance (HoltainBC). Indirect calorimetry (IC) was done after overnight fasting (DeltatracTM II MBM-200). In 9 patients, the same study was repeated before hospital discharge. We compared REE (Kcal/24 h) measured by IC with that obtained by several equations [Fleish, Harris- Benedict, FAO, Schofield-HW (SHW), Schebendach] through the intraclass correlation coefficient (ICC) and the Bland-Altman method. Results: Nutritional status significantly improved during hospital admission. Fifty percent of the recovered weight was fat mass. REE significantly increased during admission. The equations overestimated REE as compared to IC (p < 0.05), except for the Schebendach equation that underestimated REE. The agreement between direct measurement of REE by IC and its estimation through equations was poor [Fleish (ICC = 0.21); HB (ICC = 0.21), SHW (ICC = 0.19), Schebendach (ICC = 0.15)]. Through the Bland-Altman method, we observed that there was a variable bias between IC and equations, with a clinically acceptable agreement for REW values of around 1200 Kcal/day. Conclusions: 1) In our study we obtained a poor agreement between REW values measured by indirect calorimetry and those estimated by equations. 2) Through the Bland-Altman method, we observed that all equations present a variable bias as for IC, the agreement being clinically acceptable for REE values of around 1200 Kcal/day. 3) Thus, indirect calorimetry seems to be a very useful tool to calculate the energy requirements of anorexia nervosa patients.