Measured versus predicted energy expenditure in children with inactive Crohn's disease.
BACKGROUND
The aim of the study was to assess if the estimated average requirements for energy for normal children (EAR) and the Schofield equation could reliably predict energy requirements in children with inactive Crohn's disease (CD).


METHODS
Twenty-three children with inactive CD were studied, median age 14.3 years (range 7.8-16.9). Resting energy expenditure (REE) was measured by indirect calorimetry and compared with that predicted using the Schofield equation (BMR). Total energy expenditure (TEE) was measured using REE and a 3-day activity diary and compared with EAR.


RESULTS
REE ranged from 79% to 136% of BMR. Mean REE was not significantly greater than mean BMR (P=0.25 2-tailed t-test). TEE ranged from 72% to 163% of estimated average requirements for energy for children of that weight (EARw). EARw tended to underestimate TEE in large children and overestimate TEE in small children (Bland-Altman plot R=0.5, P=0.002). EARw was a poor predictor of TEE (R=0.35, P=0.1). EAR underestimated energy requirements by >500 kcal/day in 40% of the children.


CONCLUSIONS
The Schofield equation and EAR are unreliable methods of predicting total energy requirements in children with inactive CD with a significant potential to underestimate energy needs. When energy requirements were greater than EAR it was due to physical activity and body habitus rather than raised REE.
Hart
J W
JW
Department Child Health, Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, and Institute Human Nutrition, Southampton University, UK. James.Hart@rdehc-tr.swest.nhs.uk
Bremner
A R
AR
Wootton
S A
SA
Beattie
R M
RM
D000293:Adolescent; D000886:Anthropometry; D001481:Basal Metabolism / Q000502:physiology*; D001835:Body Weight / Q000502:physiology; D002153:Calorimetry, Indirect / Q000379:methods; D002648:Child; D003424:Crohn Disease / Q000378:metabolism*; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008433:Mathematics; D009751:Nutritional Requirements; D011237:Predictive Value of Tests