A new model for predicting energy requirements of children during catch-up growth developed using doubly labeled water

Pediatr Res. 1989 May;25(5):503-8. doi: 10.1203/00006450-198905000-00016.

Abstract

Energy partitioned to maintenance plus activity, tissue synthesis, and storage was measured in 41 children in early recovery [W/L (wt/length) less than 5th percentile] from severe protein-energy malnutrition and in late recovery (W/L = 25th percentile) to determine energy requirements during catch-up growth. Metabolizable energy intake was measured by bomb calorimetry and metabolic collections. Energy expended (means +/- SD) for maintenance and activity estimated by the doubly labeled water method was 97 +/- 12 kcal/kg FFM (fat-free mass) in early recovery and 98 +/- 12 kcal/kg FFM in late recovery (p greater than 0.5). Energy stored was 5-6 kcal/g of wt gain. Tissue synthesis increased energy expenditure by 1 +/- 0.7 kcal/g gain in both early and late recovery. From these data a mathematical model was developed to predict energy requirements for children during catch-up growth as a function of initial body composition and rate and composition of wt gain. The model for predicting metabolizable energy requirements is [(98 x FFM + A (11.1 B + 2.2 C)], kcal/kg.d, where FFM is fat-free mass expressed as a percentage of body wt, A is wt gain (g/kg.d), B and C are percentage of wt gain/100 as fat and FFM, respectively. The model was tested retrospectively in separate studies of malnourished children.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Body Composition
  • Body Height
  • Body Water / analysis*
  • Body Weight
  • Deuterium
  • Energy Intake
  • Energy Metabolism*
  • Growth*
  • Humans
  • Infant
  • Models, Biological
  • Oxygen Isotopes
  • Protein-Energy Malnutrition / metabolism*
  • Protein-Energy Malnutrition / physiopathology

Substances

  • Oxygen Isotopes
  • Deuterium