Comment on: Measurement of Resting Energy Expenditure in Healthy Children

Abstract

Background: The role that the components of energy expenditure play in the etiology of childhood obesity has highlighted the need for greater accuracy and standardized protocols for the measurement of resting energy expenditure (REE). However, protocols used to assess REE in children are varied, and consensus on a suitable method for measuring REE in children has not been reached. This study was undertaken to determine the effect of measurement time and measurement device (mask or mouthpiece) on REE in healthy children. Design: Following a 12‐hour fast and abstinence from exercise, 23 children (age, 7–12 years) completed two 35‐minute protocols: one with a face mask and the other with a mouthpiece/noseclip. Energy expenditure was measured continuously via indirect calorimetry, while device acceptability was assessed using a 6‐point comfort rating scale. Results: Repeated measures ANOVA indicated that there was no significant difference in REE when measured after 10, 15, 20, or 25 minutes of rest compared to 30 minutes for either the mask or mouthpiece/noseclip (REE range, 1371–1460 kcal/d). Examination of the percentage coefficient of variation (CV) in energy expenditure for each time period by device showed that the least variation existed after 20 minutes of measurement using the mask (CV 6%). Paired t test analysis indicated significantly less discomfort when wearing the mask compared to the mouthpiece/noseclip. Conclusion: It would appear that a 20‐minute protocol using a mask may increase compliance and prove to be a more practical protocol for measuring REE in children.(JPEN J Parenter Enteral Nutr. 2009;33:640‐645)