Prediction models of basal energy expenditure in children and adolescents across the BMI spectrum based on room calorimetry: a cross-sectional cohort study

Authors: PUYAU, MAURICE - Children'S Nutrition Research Center (CNRC); SHYPAILO, ROMAN - Children'S Nutrition Research Center (CNRC); BUTTE, NANCY - Children'S Nutrition Research Center (CNRC); MUSAAD, SALMA - Children'S Nutrition Research Center (CNRC); BACHA, FIDA - Children'S Nutrition Research Center (CNRC)

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/4/2024
Publication Date: 12/7/2024
Citation: Puyau, M., Shypailo, R., Butte, N.F., Musaad, S., Bacha, F. 2024. Prediction models of basal energy expenditure in children and adolescents across the BMI spectrum based on room calorimetry: a cross-sectional cohort study. The American Journal of Clinical Nutrition. 121:284-292. https://doi.org/10.1016/j.ajcnut.2024.12.003.
DOI: https://doi.org/10.1016/j.ajcnut.2024.12.003

Interpretive Summary: Current methods for estimating how much energy children with overweight or obesity (OW/OB) need might not be accurate. Investigators at the Children’s Nutrition Research Center in Houston, TX, performed a study to create better prediction methods for energy needs in children and teens of various body sizes using precise measurements. Researchers measured various body metrics (like weight, height, waist and hip size, and body composition) and energy needs in 1155 healthy children aged 5-19. They developed new prediction models using these measurements and tested them with a sample group. The new models were very accurate, predicting energy needs with less than 1.5% difference from actual measurements. They worked well for both children with normal weight and those with overweight or obesity. These new models were better than existing models, especially for children with higher energy needs. The new models provide more accurate predictions of energy needs for children aged 5-19, which can help in better planning their diets and health care. Implications: Accurate BEE predictions can contribute to better overall health outcomes especially for children with overweight or obesity, by ensuring children receive the right amount of energy for growth and development. This is crucial for maintaining a healthy weight and preventing chronic diseases. The findings can inform public health strategies aimed at addressing childhood obesity and promoting healthy growth in children across different BMI ranges.

Technical Abstract: Existing equations for prediction of basal energy expenditure (BEE) may not be accurate in children with overweight or obesity (OW/OB). We aimed to develop BEE prediction equations applicable to children and adolescents across a wide BMI spectrum using gold standard room calorimetry. We measured weight, height, waist and hip circumferences, body composition (DXA), and BEE (whole room calorimetry) in a cross-sectional cohort of 1155 healthy children, 5-19 years of age. 67% of the males and 51% of the females were classified as OW/OB. We applied multiple linear regression analyses to develop BEE prediction models for each sex. Using relevant predictors, we developed models with fat-free mass (FFM); waist and hip circumference; weight and height only; and weight only. A representative sample of participants (83 males, 125 females) served as a validation dataset to test model performance. The models' performance in predicting BEE was compared to existing models in the literature. Model fits (R2) for the new BEE prediction models were = 0.84 (P < 0.0001). Our BEE prediction models performed equally in children with normal weight and OW/OB, with <1.5% difference between the measured versus predicted BEE in the validation dataset for both sexes. In Bland-Altman analysis, our BEE prediction models were superior to existing prediction models, especially for children with higher BEEs. New BEE prediction models developed and tested in cohorts representative of children with normal weight and OW/OB had superior performance compared with existing models. The BEE prediction equations based on simple anthropometrics or body composition provided improved accuracy and precision for children with NW or OW/OB, ages 5 to 19. More accurate estimates of BEE should allow for better estimates of energy requirements of children.