Kalix's templates and documents contain auto-calculated fields, which calculate growth percentiles (weight-for-age, BMI-for-age, and height-for-age), BMI, ideal body weight (IBW), percentage IBW, energy, and macronutrient requirements. The auto-calculated terms are associated with Kalix's NCPT terms, please click here for information about Kalix's different term types. For troubleshooting around auto-calculations, please click here.

Turning Auto-calculated Fields On & Off

All auto-calculated fields can be turned off for the entry for manual data entry. 

To turn off auto-calculated fields, click on the lightning bolt, the field will enter into its manual state (as shown below). To reactive, click on the gray lightening bolt. 

Weight as a Percentage of IBW

  •  Percentage of ideal body weight (% of IBW) is calculated using two NCPT terms - Weight and Ideal/reference body weight (IBW). 
  • The equation used is: %IBW = (current weight / IBW) x 100 
  • Ideal/reference body weight (IBW), is also an auto-calculated field, for information about its calculation, please see the section below entitled Ideal Body Weight. 

Requirements

For the specific document you are creating, you are required to enter the client's weight (pounds or kilograms) into the NCPT Weight term and their IBW into the Ideal/reference body weight NCPT term (or IBW will be auto-calculated for you).

Please note: for the ideal body weight to be auto calculated, you are also required to enter client's height into the NCPT Height term. The client's age and gender must also be saved as part of the Client's Details page, click here for details

Height/Length - Updated

  • Uses the  NCPT term - Height/length.
  • Will calculate height in inches or centimeters from height entered in feet and inches (or meters and centimeters). 
  • The height measurement in brackets, (in inches or cm) is what is used as the height value by other auto-calculations. 

Weight Change

 The Weight Change calculation (shown below) uses the NCPT term - Weight change. The result contains three different values:

  •  Weight change since last session = current weight - weight from last session
  •  Weight change since first session = current weight - weight from first session
  • Total percentage weight change = [(current weight - weight from first entry)/weight for first entry] x 100

Requirements

For the specific document you are creating, you are required to enter the client's weight (pounds or kilograms) into the NCPT Weight term. There must also be at least one other weight value saved against other client's documents. 

Body Mass Index (BMI)

  • The calculation is based on the NCPT term - Body mass index.
  •  BMI is calculated using the equation - [Weight in Kilograms / (Height in Meters x Height in Meters)]. 
  • The calculation is dependent on the weight value entered into the NCPT Weight term and the height value entered into the NCPT Height/Length term. 
  • As part of the automated equation, if weight is entered as lbs, Kalix will automatically convert this value to kilograms. 
  • Likewise, Kalix automatically converts the value entered into the bracketed field (see Height/length section above) within the Height/length NCPT term field to meters (whether it is in inches or centimeters). 

Requirements

For the specific document you are creating, you are required to enter the client's weight (pounds or kilograms) into the NCPT Weight term and the client's height into the NCPT Height/length term.

Ideal/Reference Body Weight (IBW)

  • The calculation is based on the NCPT term - Ideal/reference body weight (IBW).
  • You can choose between three different methods for calculating IBW: Hamwi equation, adjusted IBW and BMI at 25kg/m2.
  • The result is outputted in kilograms or pounds, depending on your selected unit of measurement. 

Requirements

For the specific document you are creating, you are required to enter the client's weight into the NCPT Weight term and the client's height into the NCPT Height/length term. For the calculation to work, the client's age and gender must be saved as part of the Client's Details page, click here for details

Equations Used*

An additional requirement of the IBW auto-calculation is to select an equation to use. To select an equation, click on the applicable field as shown in the image below. The different equations are calculated as follows:

Hamwi Equation 

  •  Men = 106 pounds + 6 pounds for every inch over 5 feet. 
  • Women = 100 pounds + 5 pounds for every inch over 5 feet (or the corresponding metric equation).

Adjusted Ideal Body Weight

  •  [(actual body weight - weight at BMI of 25) x 0.25] + weight at BMI of 25. 

Weight at BMI of 25

  • 25 x (Height in Meters x Height in Meters).

*Note: all results are automatically converted to the applicable measure (kg or pounds) based on your preference. 

Total Energy Estimated Needs - Updated

This calculation uses the NCPT term - Total energy estimated needs. Both total energies estimated needs and resting energy expenditure (REE) or basal metabolic rate are calculated. There are many options to customize how Kalix calculates total energy estimated needs. For information about this, please see below:

  • Choose whether the results are outputted in kJ/day, kJ/kg/day, kcal/day or kcal/kg/day**
  • Select whether you would like to add or subtract energy (from the total energy estimated needs) to achieve weight loss or weight gain. 
  • Select the energy equation you wish to use. See below for details.** 
  •  Select the activity level used in the calculation. Kalix will automatically add the applicable activity factor range based on your selection and the energy equation used. Alternatively, you can enter your own activity range. 
  • If you wish to use a stress/injury factor, select the application medical condition. Kalix will auto add the applicable stress factor range. Alternatively, enter your own stress factor. 
  •  Select whether you wish for the calculation to use the client's actual body weight (as entered in the NCPT Weight field) or their ideal body weight (as calculated by the NCPT Ideal/Reference Body Weight (IBW) term).**

** these options are required to be selected for the auto-calculation to occur. 

Requirements

For the specific document you are creating, you are required to enter the client's weight into the NCPT Weight term and the client's height into the NCPT Height/length term. If you are using IBW as the calculation's weight, IBW needs to be calculated (or manually entered) as part of the NCPT  term - Ideal/reference body weight (IBW).

For the calculation to work, the client's age and gender must be saved as part of the Client's Details page, click here for details.

A final requirement is that you must complete certain fields within the NCPT term i.e. choose the unit of measurement for the outputted result, select the energy equation you wish to use and choose whether you wish for the calculation to use the client's actual body weight or their ideal body weight.

Equations & Activity Factors Used*

Kalix currently supports six energy equations, please see below for details. For all equations Kalix automatically conversions from pounds to kilograms and kilojoules to kilocalories (and vice versa), as required.

 * Please note, for Total Energy Estimated Needs to calculate, you must select the applicable energy equation to use in the calculation. If you do not select an energy equation, the Kalix cannot complete the calculation. 

Schofield Equation

The Schofield Equation is a commonly used method for estimating the basal metabolic rate. It was published in 1985. 

Activity Factors

If Schofield equation is selected, Kalix uses the following activity factors. Alternatively, you can enter your own activity factors. 

Harris Benedict

Harris Benedict another commonly used energy equation, which was first published in 1919 and then revised in 1984. 

  •  Men: 88.362 + (13.397 x weight in kg) + (4.799 x height in cm) - (5.677 x age in years) 
  • Women: 447.593 + (9.247 x weight in kg) + (3.098 x height in cm) - (4.330 x age in years)

Activity Factors
If the Harris Benedict equation is selected, Kalix uses the following activity factors. Alternatively, you can enter your own activity factors.

Mifflin-St Jeor - Adults

Is recommended by the Academy of Nutrition and Dietetics for estimating energy needs in adult overweight populations. Actual body weight is recommended for use over ideal body weight/adjusted. 

  • Men: RMR = (9.99 X weight) + (6.25 X height) – (4.92 X age) + 5
  • Women: RMR = (9.99 X weight )+ (6.25 X height) – (4.92 X age) – 161

 Activity Factors

If Mifflin-St Jeor equation is selected, Kalix uses the following activity factors. Alternatively, you can enter your own activity factors.

Estimated Energy Requirements (0 - 18 years)

The Estimated energy requirements are for use in healthy infants and children. They were released by the Institute of Medicine Equation in 2002 and are used in dietary guidelines.
Note: PA = Physical Activity Coefficients (called activity factors in Kalix). 

  •  0 - 3 months EER (kcal/d) = (89 x weight [kg]) + 75
  •  4 - 6 months EER (kcal/d) = (89 x weight [kg]) - 44
  •  7 - 12 months EER (kcal/d) = (89 x weight [kg]) - 78
  • 13 - 35 months EER (kcal/d) = (89 x weight [kg]) - 80
  • Boys 3 - 8 years old EER (kcal/d) = 108.5 - 61.9 x Age [y] + PA x (26.7 x Wt [kg] + 903 x Ht [m])
  • Girls 3 - 8 years old EER (kcal/d) = 155.3 - 30.8 x age [y] + PA x (10.0 x weight [kg] + 934 x height [m]) 
  • Boys 9 - 18 years old EER (kcal/d) = 113.5 - 61.9 x Age [y] + PA x (26.7 x Wt [kg] + 903 x Ht [m])
  • Girls 9 -1 8 years old EER (kcal/d) = 160.3 - 30.8 x age [y] + PA x (10.0 x weight [kg] + 934 x height [m])

Activity Factors

If the Estimated Energy Requirements equation is selected, Kalix uses the following activity factors (for children over 3 years only, activity factors are not applicable in children under 3 years.) Alternatively, you can enter your own activity factors.

World Health Organization Equations for Estimating Resting Energy Expenditures (REEs)

The World Health Organization equations for estimating resting energy expenditure (published in 1985) are calculated as shown below. The equations were developed based on a healthy population, but the results can be multiplied by a stress factor to account for the altered energy needs of children with special conditions. They do not support an activity factor.

  • Boys 0 - 3 years: 60.9 x W(kg) - 54
  • Girls 0 - 3 years: 61.0 x W(kg) - 51
  • Boys 3 - 10 years: 22.7 x W(kg) + 495
  • Girls 3 - 10 years: 22.5 x W(kg) + 499 
  • Boys 10 - 18 years: 17.5 x W(kg) + 651
  • Girls 10 - 18 years: 12.2 x W(kg) + 746

The Total Energy Expenditure for Weight Maintenance in Overweight (Obese) Children 

"The total energy expenditure (kcal/d) for weight maintenance in overweight (obese) children (3 - 18 years)" is calculated as shown below. The equation was developed by the Institute of Medicine.

  • Boys: -114 -50.9 x Age [y] + PA x (19.5 x Wt [kg] + 1161.4 x Ht [m])
  • Girls: 389 - 41.2 x Age [y] + PA x (15 x Wt [kg] + 701.6 x Ht [m]) 

Activity Factors
If this equation is selected, Kalix uses the following activity factors. Alternatively, you can enter your own activity factors.

Stress Factors

REE is often multiplied by a stress factor to take into account for the increased energy requirements associated with certain medical conditions. Kalix has a number of stress factors included as part of the Total Energy Estimated Needs. While these are not a completed list, those included are based on current best practice guidelines. Kalix allows you to modify these stress factors and add your own if needed.

The Total Energy Estimated Needs calculation supports the use of stress/injury factors are as follows: Mifflin-St Jeor, Schofield Equation, Harris Benedict, and World Health Organization Equations. 

  • None: 1.0
  • Surgery - Minor: 1.0 – 1.2
  • Surgery - Major: 1.1 – 1.3
  • Skeletal trauma: 1.1 – 1.6
  • Closed head injury: 1.30
  • Major head trauma: 1.6 – 1.8 
  • Infection - Mild: 1.0 – 1.2
  • Infection - Moderate: 1.2 – 1.4
  • Infection - Severe: 1.4 – 1.8
  • Burns - <20% body surface area: 1.2 – 1.5
  • Burns - 20%–40% body surface area: 1.5 – 1.8
  • Burns - >40% body surface area: 1.8 – 2.0
  • Growth failure: 1.5 - 2.0

Total Protein Estimated Needs (Updated)

  • This equation uses the NCPT Term - Total protein estimated needs. 
  • The result is outputted in g/day or g/kg/day. 
  • Results are calculated using protein factor multiplied by weight (client's weight or Ideal Body Weight).

Requirements

For the specific document you are creating, you are required to enter the client's weight into the NCPT Weight term. If you are using IBW as the calculation's weight, IBW needs to be calculated (or manually entered) as part of the NCPT term - Ideal/reference body weight (IBW).

For the calculation to work, the client's age and gender must be saved as part of the Client's Details page, click here for details.

A final requirement is that you must complete certain fields within the NCPT term: 

  • Choose the unit of measurement for the outputted result
  • Select the protein factor to be used
  • Select whether you wish for the calculation to use the client's actual body weight or their ideal body weight

Details

Kalix allows you to select the protein factor to be used as part of the equation. Normal nutrition can be selected or another protein factor recommended for certain medical conditions. While these protein factors are not a completed list, those included are based the current best practice guidelines. Kalix allows you to modify these protein factors and add your own if needed. 

Normal Nutrition

Calculations use the USA Recommended Dietary Allowances (RDA), Adequate Intakes (AI) and the Australian Recommended Daily Intake (RDI) or Adequate Intakes (AI) for protein (for normal nutrition). 

  • < 1 year = 1.5g/kg/day
  • 1 - 3 years = 1.1 g/kg/day
  • 4 - 13 years = 0.9 g/kg/day
  • 14 - 18 years = 0.85 g/kg/day
  • 19 - 69 years = 0 .8 g/kg/day
  • > 70 years = 1 g/kg/day.

Protein Requirements for Special Conditions 

  • Acute renal failure - 0.8 - 1.2 g/kg/day
  • Acute renal failure + catabolic - 1.2 - 1.5 g/kg/day 
  • Anorexia Nervosa - 1.5 g/kg/day Note: please use ideal body weight (IBW)
  • Burns >20% – 40% body surface area - 1.5–2.0 g/kg/day 
  • Burns <20% BSA 1.0 – 1.5 g/kg/day 
  • Cancer 1.0 – 1.2 g/kg/day 
  • Cancer cachexia 1.5 – 2.5 g/kg/day 
  • Cancer + treatment - 1.2 – 1.5 g/kg/day 
  • Chronic wounds - 1.25 – 1.5 g/kg/day 
  • Head trauma: 1.5 – 2.0 g/kg/day 
  • Hemodialysis - 1.2 – 1.4 g/kg/day 
  • Major GI surgery - 1.5 g/kg/day 
  • Major surgery/trauma - 1.5 – 2.0 g/kg/day 
  • Minor surgery - 1.0 -1.2 g/kg/day 
  • Pneumonia - 1.0 – 1.5 g/kg/day
  • Non-dialysis chronic kidney disease (GFR <50) - 0.6 – 0.8 g/kg/day 
  • Pressure ulcers - 1.2 – 1.8 g/kg/day 
  • Peritoneal Dialysis - 1.2 – 1.3 g/kg/day 
  • Sepsis - 1.5 – 2.0 g/kg/day 
  • Short bowel syndrome - 1.5 – 2.0 g/kg/day 
  • Ulcerative Colitis / Crohn’s - 0.8 – 1.0 g/kg/day

Total Carbohydrate Estimated Needs - Updated

This equation uses the NCPT Term - Total carbohydrate estimated needs. The results are outputted in g/day.

For children under 12 months, the calculations are based on USA and Australian Adequate Intakes (AI) for carbohydrates: 0 - 6 months = 60g/day and 7 - 12 months 95g/day. For clients over 12 months, you are required to enter the percentage total energy range that carbohydrate intake will contribute.

Please note: the Acceptable Macronutrient Distribution Range for carbohydrate is 45 - 65% and the US Dietary Guidelines recommend 45 - 60% of total energy.

Requirements  
For the specific document you are creating, you are required to have a valued entered to the Total Energy Estimated Needs field (therefore also enter the client's weight and height in the applicable fields). The client's date of birth and gender must be saved as part of the Client's Details page. 

Total Fiber Estimated Needs

  • Uses the NCPT Term - Total fiber estimated needs. 
  • The results are outputted in g/day. 
  • You can specify whether the client is lactating or pregnant. 
  • Calculations use the USA Adequate Intakes (AI) for fiber
  • You can override these values and enter your own amount if needed.

Requirements
 The client's date of birth and gender must be saved as part of the Client's Details page. 

Total Fat Estimated Needs - Updated

  •  Uses the NCPT Term - Total fat estimated needs. 
  • The results are outputted in g/day. 
  • For children under 12 months, the calculations are based on USA and Australian Adequate Intakes (AI) for fat :0 - 6 months = 31g/day and 7-12 months = 30g/day.
  • For clients over 12 months, you are required to enter the percentage total energy range that fat intake will contribute. 

Please note: The USA Acceptable Macronutrient Distribution Range (AMDR), 1 - 3 years is 30 - 40% of energy requirements and over 3 years = 25 - 35 % of energy requirements.

Requirements
For the specific document you are creating, you are required to have a valued entered to the Total Energy Estimated Needs field (therefore also enter the client's weight and height in the applicable fields). The client's date of birth and gender must be saved as part of the Client's Details page. 

Total Fluid Estimated Needs

  • Uses the NCPT Term - Total fluid estimated needs. 
  • The results are outputted in mL/day. 
  • Results are calculated using protein factor multiplied by weight (client's weight or Ideal Body Weight).

Requirements
For the specific document you are creating, you are required to enter the client's weight into the NCPT Weight term. If you are using IBW as the calculation's weight, IBW needs to be calculated (or manually entered) as part of the NCPT term - Ideal/reference body weight (IBW).

For the calculation to work, the client's age and gender must be saved as part of the Client's Details page, click here for details.

A final requirement is that you must complete certain fields within the NCPT term i.e. select an option to calculate fluid needs using and select whether you wish for the calculation to use the client's actual body weight or their ideal body weight.

Calculation Options
Kalix allows you to select an option relating to how fluid estimated needs are calculated. The following options are supported.

Normal Nutrition 

Calculations use the USA Adequate Intakes (AI) for water.

Note: Fluid factors (mL/kg of body weight) are used for clients over 18yrs; 18-54 years = 35 mL/kg, 55-75 years = 30 mL/kg and >75 years = 25 mL/kg. 

Other

If you would like to enter your own fluid factor, select other as shown below. Enter your fluid factor in the next field. 

Other Conditions

Kalix will enter special fluid requirements for conditions which require this (calculations are based on current evidence-based guidelines);. 

  • Pregnancy = 3000 mL
  • Lactation = 3800 mL
  • Heart failure = 1500 mL
  • Renal stones = 3000 mL pregnancy (3.0L/day), lactation (3.8L/day), heart failure (1.5L/day) and Renal stones (3L/day).
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