Resting energy expenditure and prediction equations in young children with failure to thrive.
OBJECTIVE
To compare predicted and measured resting energy expenditure (REE) in young children (birth to 3 years) with failure to thrive (FTT).


METHODS
REE (kcal/d) was measured by indirect calorimetry and compared with predicted REE from 3 sex and age group equations: World Health Organization (WHO), Schofield weight-based (SCH-WT), and Schofield weight- and height-based (SCH-WT-HT). The clinical characteristics associated with inaccuracy of predicted REE were examined.


RESULTS
Forty-five subjects (47% female) were evaluated. Their clinical characteristics (mean +/- SD) included age 1.2 +/- 0.7 years, length/height z score -2.1 +/- 1.3, weight z score -2.7 +/- 1.0, and measured REE 438 +/- 111 kcal/d. All prediction equations were within 10% accuracy <50% of the time. However, SCH-WT-HT did not significantly differ from measured REE (450 +/- 138 vs 438 +/- 111 kcal/d, P =.2) and was least likely to underestimate REE. Younger age and more severe growth failure (based on weight, length/height, or both) were associated with underestimation of REE by prediction equations.


CONCLUSIONS
REE should be measured in young infants and children with moderate to severe FTT when knowledge of caloric needs is required for optimal clinical care. The SCH-WT-HT equation was least likely to underestimate REE and is therefore preferred when REE cannot be measured in this group of children.
Sentongo
T A
TA
Division of Gastroenterology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Tershakovec
A M
AM
Mascarenhas
M R
MR
Watson
M H
MH
Stallings
V A
VA
D001827:Body Height; D001835:Body Weight; D004734:Energy Metabolism / Q000502:physiology*; D005183:Failure to Thrive / Q000378:metabolism*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012146:Rest / Q000502:physiology*