Pediatric Nutrition in Practice

1 Specific Aspects of Childhood Nutrition

Key Words

Resting energy expenditure · Dual-energy

X-ray absorptiometry · Indirect calorimetry ·

Body composition

Key Messages

• Accurate nutritional assessment should be an inte-
  gral part of pediatric care and may require technical
  measurements


• The measurement of resting energy expenditure
  using indirect calorimetry is the best available
  method to accurately estimate a child’s caloric
  needs to promote weight gain or maintenance


• In addition to anthropometry, the most commonly
  used clinical method of body composition assess-
  ment is dual-energy X-ray absorptiometry (DXA).
  DXA-based bone density measurements are in-
  creasingly being used to assess bone health in chil-
  dren with chronic diseases © 2015 S. Karger AG, Basel

Introduction

Accurate nutritional assessment should be an in-
tegral part of pediatric care. Children at risk of
malnutrition or who are chronically ill should
undergo a detailed nutritional assessment, which

sometimes requires technical measurements. An

important aspect of nutritional assessment is es-

timating daily energy needs for optimal growth

and development. This is especially important in

children with health conditions causing under-

nutrition or obesity. However, the energy needs

of such children can be difficult to estimate [1].

Resting energy expenditure (REE) represents a

large portion of the energy needed each day. The

measurement of REE using indirect calorimetry

is the best available method to accurately estimate

an individual child’s caloric needs to promote

weight gain or maintenance.

Growth evaluation by measuring length or

stature and weight is the first step in nutritional

assessment, but measurement of body composi-

tion provides more detailed information about

nutritional status than anthropometry alone.

The relative and absolute amounts of muscle, fat

and bone change during growth [2]. In addition

to a nt h rop ome t r y, t he most com mon ly u s e d cl i n-

ical method of body composition assessment is

dual-energy X-ray absorptiometry (DXA). Al-

t houg h ma i n ly used to assess bone hea lt h, whole-

body DXA scans also provide measurements of

three compartments: bone, fat and lean body

mass. DXA-based bone density measurements

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 19–22
DOI: 10.1159/000367867

1.2 Nutritional Assessment

1.2.3 Use of Technical Measurements in Nutritional

Assessment

Babette S. Zemel  Virginia A. Stallings

1