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

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<.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.