Prediction of resting energy expenditure for adolescents with severe obesity: A multi-centre analysis

Amy A Rydin; Cameron Severn; Laura Pyle; Nazeen Morelli; Ashley H Shoemaker; Stephanie T Chung; Jack A Yanovski; Joan C Han; Janine A Higgins; Kristen J Nadeau; Claudia Fox; Aaron S Kelly; Melanie G Cree

doi:10.1111/ijpo.13123

Prediction of resting energy expenditure for adolescents with severe obesity: A multi-centre analysis

Pediatr Obes. 2024 Apr 24:e13123. doi: 10.1111/ijpo.13123. Online ahead of print.

Authors

Amy A Rydin¹, Cameron Severn^{2

3}, Laura Pyle^{2

3}, Nazeen Morelli¹, Ashley H Shoemaker⁴, Stephanie T Chung⁵, Jack A Yanovski⁶, Joan C Han⁷, Janine A Higgins^{1

8}, Kristen J Nadeau^{1

9}, Claudia Fox¹⁰, Aaron S Kelly¹⁰, Melanie G Cree^{1

9}

Affiliations

¹ Section of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
² Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado, USA.
³ Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado, USA.
⁴ Division of Pediatric Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
⁵ Section on Pediatric Diabetes, Obesity, and Metabolism, National Institutes of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, Maryland, USA.
⁶ Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.
⁷ Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Mount Sinai Kravis Children's Hospital, Icahn School of Medicine, New York, New York, USA.
⁸ Section of Nutrition, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
⁹ Ludeman Family Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
¹⁰ Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, USA.

PMID: 38658523
DOI: 10.1111/ijpo.13123

Abstract

Background and objectives: Resting energy expenditure (REE) assessments can help inform clinical treatment decisions in adolescents with elevated body mass index (BMI), but current equations are suboptimal for severe obesity. We developed a predictive REE equation for youth with severe obesity and obesity-related comorbidities and compared results to previously published predictive equations.

Methods: Data from indirect calorimetry, clinical measures, and body composition per Dual x-ray absorptiometry (DXA) were collected from five sites. Data were randomly divided into development (N = 438) and validation (N = 118) cohorts. A predictive equation was developed using Elastic Net regression, using sex, race, ethnicity, weight, height, BMI percent of the 95th%ile (BMIp95), waist circumference, hip circumference, waist/hip ratio, age, Tanner stage, fat and fat-free mass. This equation was verified in the validation cohort and compared with 11 prior equations.

Results: Data from the total cohort (n = 556, age 15 ± 1.7 years, 77% female, BMIp95 3.3 ± 0.94) were utilized. The best fit equation was REE = -2048 + 18.17 × (Height in cm) - 2.57 × (Weight in kg) + 7.88 × (BMIp95) + 189 × (1 = male, 0 = female), R² = 0.466, and mean bias of 23 kcal/day.

Conclusion: This new equation provides an updated REE prediction that accounts for severe obesity and metabolic complications frequently observed in contemporary youth.

Keywords: DXA; comorbidities; nutrition; obesity; resting energy expenditure.

Abstract

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