A new model for predicting energy requirements of children during catch-up growth developed using doubly labeled water.
Energy partitioned to maintenance plus activity, tissue synthesis, and storage was measured in 41 children in early recovery [W/L (wt/length) less than 5th percentile] from severe protein-energy malnutrition and in late recovery (W/L = 25th percentile) to determine energy requirements during catch-up growth. Metabolizable energy intake was measured by bomb calorimetry and metabolic collections. Energy expended (means +/- SD) for maintenance and activity estimated by the doubly labeled water method was 97 +/- 12 kcal/kg FFM (fat-free mass) in early recovery and 98 +/- 12 kcal/kg FFM in late recovery (p greater than 0.5). Energy stored was 5-6 kcal/g of wt gain. Tissue synthesis increased energy expenditure by 1 +/- 0.7 kcal/g gain in both early and late recovery. From these data a mathematical model was developed to predict energy requirements for children during catch-up growth as a function of initial body composition and rate and composition of wt gain. The model for predicting metabolizable energy requirements is [(98 x FFM + A (11.1 B + 2.2 C)], kcal/kg.d, where FFM is fat-free mass expressed as a percentage of body wt, A is wt gain (g/kg.d), B and C are percentage of wt gain/100 as fat and FFM, respectively. The model was tested retrospectively in separate studies of malnourished children.
Fjeld
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CR
Instituto de Investigación Nutriciońal, Lima, Perú.
Schoeller
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DA
Brown
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KH
D001823:Body Composition; D001827:Body Height; D001834:Body Water / Q000032:analysis*; D001835:Body Weight; D003903:Deuterium; D002149:Energy Intake; D004734:Energy Metabolism; D006128:Growth; D006801:Humans; D007223:Infant; D008954:Models, Biological; D010103:Oxygen Isotopes; D011502:Protein-Energy Malnutrition / Q000378:metabolism* / Q000503:physiopathology
D010103:Oxygen Isotopes; D003903:Deuterium