Abstract
The accuracy of the SenseWear Pro2 Armband (SWA) in estimating resting energy expenditure (REE) in children and adolescents with obesity, using indirect calorimetry (IC) as a reference was evaluated. REE was assessed using both the SWA and IC in 40 obese subjects (26 M/14 F, age 11.5 ± 2.57 years, z-score BMI 3.14 ± 0.53). The agreement between methods was assessed by the Bland-Altman procedure. The relationship between REE assessments and patients' characteristics was also analyzed. SWA- and IC-derived estimates of REE showed a significant correlation (r = 0.614; P < 0.001), but the SWA overestimated mean REE by 13% (P < 0.001). Age and kilogram of fat-free mass (kg-FFM) were significantly correlated with both REE estimation by SWA (r = 0.434 and r = 0.564, respectively) and IC (r = 0.401 and r = 0.518, respectively). Only kg-FFM was demonstrated to be the main predictor factor of REE variability (r(2) 79% SWA; 75% IC). The SWA overestimated mean REE in childhood obesity, suggesting that the SWA and IC are not yet interchangeable methods. This would require improving the SWA by developing better algorithms for predicting REE and, probably, bias in each individual REE could be reduced by an adjustment for subjects' kg-FFM.
Highlights
Prevalence of childhood obesity has increased worldwide over the last few decades; it appears to be stabilizing in different countries, it remains high, representing a significant public health issue [1,2]
Some studies reported that obese children and adolescents exhibit an increased daily EE due to a higher resting energy expenditure (REE) compared to non-obese subjects [6] and similar or higher physical activity EE because of the more elevated energy cost of weight-bearing activities [7]
These results show that SenseWear Pro2 Armband (SWA) could not provide accurate estimates of REE in childhood obesity, despite the significant correlation with REE by indirect calorimetry (IC)
Summary
Prevalence of childhood obesity has increased worldwide over the last few decades; it appears to be stabilizing in different countries, it remains high, representing a significant public health issue [1,2]. The accurate estimation of daily EE and resting EE (REE – the major component of daily EE) could be important for weight management and for the prevention of lifestyle-related health problems in overweight/obese patients [4]. Their measurement remains difficult [5]. Some studies reported that obese children and adolescents exhibit an increased daily EE due to a higher REE compared to non-obese subjects [6] and similar or higher physical activity EE because of the more elevated energy cost of weight-bearing activities [7]. The increased REE in obese subjects is mostly related to their higher fat-free mass (FFM) and fat mass (FM) [6], the main significant determinants of REE [8]
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