A computer-implemented method of adjusting enteral feeding of a patient by an enteral feeding controller, comprising: computing an estimate of energy expenditure of the patient based on oxygen measurements and carbon dioxide measurements of the patient, computing a target composition and target feeding rate for the enteral feeding according to the computed estimate of energy expenditure, when the target composition and target feeding rate differ from a current enteral feeding composition and feeding rate by a requirement, generating instructions for adjustment, by an enteral feeding controller, of the rate of delivery of the enteral feeding according to the target composition, wherein the receiving the oxygen measurement, receiving the carbon dioxide measurement, and computing the estimate of energy expenditure are performing iteratively for every first time interval, and the generating instructions for adjustment are performed for a second time interval that is larger than the first time interval.