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

Abstract

Background: Existing equations for prediction of basal energy expenditure (BEE) may not be accurate in children with overweight or obesity (OW/OB).

Objectives: We aimed to develop BEE prediction equations applicable to children and adolescents across a wide BMI spectrum using gold standard room calorimetry.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: basal energy expenditure; body composition; childhood obesity; energy metabolism; prediction equations; room calorimetry.