Submitted to: Book Chapter
Publication Type: Book / Chapter
Publication Acceptance Date: 11/21/2005
Publication Date: 5/16/2006
Citation: Butte, N.F. 2006. Energy requirements of infants and children. In: Rigo, J., Zeigler, E.E., editors. Protein and Energy Requirements in Infancy and Childhood (Nestle Nutrition Workshop Series: Pediatric Program). Basel: Nestle Ltd, Vevey/S. Karger AG. 58:19-37. Interpretive Summary:
Technical Abstract: Energy requirements of infants and children are defined as the amount of food energy needed to balance total energy expenditure (TEE) at a desirable level of physical activity, and to support optimal growth and development consistent with long-term health. Recommendations for dietary energy intake must meet energy requirements to avoid the double burden of under- and overnutrition. Unlike recommendations for other nutrients which meet or exceed the requirements of practically all individuals in the population, recommendations for dietary energy intake are based on the average requirement of the population group to avoid energy intakes that exceed requirements. Recommendations for energy intake and physical activity are intended to support and maintain the growth and development of well-nourished and healthy children and adolescents. Previous recommendations for dietary energy intake of infants and young children less than 10 years of age were based on the observed intakes of healthy children growing normally, largely due to the lack of information on the energy expended in physical activity needed to estimate TEE. For children over 10 years of age, the factorial approach was taken. Since the 1985 FAO/WHO/UNU report, new TEE data derived from doubly labeled water and heart rate monitoring of infants, children and adolescents have become available to derive the energy requirements. Compared with the 1985 FAO/WHO/UNU report, the 2004 FAO/WHO/UNU and 2002 IOM recommendations are ~12% lower from 0 to 3 months, 17% lower from 3 to 9 months, and 20% lower from 9 to 12 months of age. The present 2004 FAO/WHO/UNU recommendations are on average 18% lower for boys and 20% lower for girls under 7 years of age, and 12% lower for boys and 5% lower for girls 7 to 11 years of age. From 12 to 18 years, the requirements are 12% higher for boys and girls. The 2002 IOM recommendations are 8% lower for children under 7 years of age, 2% lower for children 7 to 11 years of age, and 8% higher for children 12 to 18 years of age. Although the basic principles underlying the energy requirements of infants, children and adolescents have not changed, recommendations for energy intake have been decreased in infancy and early childhood, and increased in adolescence based on newly available TEE data. Even though energy requirements also are presented for varying levels of physical activity, moderately active lifestyles are strongly encouraged to maintain fitness and health and to reduce the risk of developing obesity and its comorbidities.