Resting energy expenditure in children and adolescents: agreement between calorimetry and prediction equations

Background and Aims: To assess the degree of agreement between indirect calorimetry and five equations commonly used to predict resting energy expenditure (REE) in obese and non-obese children and adolescents. Methods: In 116 children and adolescents (57 obese and 59 non-obese) aged between 7.8 and 16.6 years, REE was measured (MREE) by open-circuit indirect calorimetry under standardized conditions. REE was predicted (PREE) in all subjects with equations from the Food and Agriculture/World Health Organization/United Nations University (FAO/WHO/UNU), Maffeis et al., Harris and Benedict, and two from Schofield: one using weight (W) and one using height and weight (H–W). Agreement between indirect calorimetry and equations was assessed following the Bland–Altman method. Results: In the entire cohort group, only data from FAO/WHO/UNU, Schofield-W and Schofield-HW equations showed non-statistic differences against calorimetry results. When agreement between equations and calorimetry was tested, Schofield-HW equation showed the lowest mean MREE-PREE difference: 3.7 kcal/d (limits of agreement −293 and 300 kcal/d; 95% confidence interval for the bias −24.0 to 31.5 kcal/d) and the best agreement. Group by group, equations which obtained the best agreement were: FAO/WHO/UNU in girls, Schofield-HW in boys, Schofield-HW in obese, and Schofield-W in non-obese. Conclusions: Until more accurate prediction equations are developed, we recommend Schofield-HW equations for REE studies with a mixed population of obese and non-obese children and adolescents; however, FAO/WHO/UNU equation may also be useful in girls and Schofield-W equation in non-obese children.