Pediatric Nutrition in Practice

Energy Requirements of Infants, Children and Adolescents 35

1

nents of basal metabolism, thermogenesis,
physical activity and energy cost of growth [2].
Basal metabolism is defined as that energy ex-
p ende d to ma i nt a i n c el lu la r a nd t i s sue pro c e s s -
es fundamental to the organism. The Schofield
equations [3] to predict basal metabolic rate
(BMR) are presented in table 1. Thermic effect
of feeding refers to the energy required for the
ingestion and digestion of food and for the ab-
sorption, transport and utilization of nutri-
ents. The thermic effect of feeding amounts to
about 10% of daily energy expenditure. Ther-
moregulation can constitute an additional en-
ergy cost when exposed to temperatures below
and above thermoneutrality; however, clothing
and behavior usually counteract such environ-
mental influences. Physical activity is the most
variable component of energy requirements,
and entails both obligatory and discretionary
physical activities. The energy cost of growth
as a percentage of total energy requirements
decreases from around 35% at 1 month to 3% at
12 months of age, and remains low until the
pubertal growth spurt, at which time it in-
creases to about 4% [2].

Approaches to Estimating Energy

Requirements

Energy requirements can be derived from TEE

based on the factorial approach, measurements us-

ing the DLW method or heart rate monitoring.

DLW is a stable (nonradioactive) isotope method

that provides an estimate of TEE in free-living indi-

viduals [4]. By the heart rate method, TEE is pre-

dicted from the heart rate based on the nearly linear

relationship between heart rate and oxygen con-

sumption during submaximal muscular work [5].

Energy Requirements of Infants

In the recent FAO/WHO/UNU recommendations

[1] , the average energy requirements of infants

were based upon the TEE and growth rates of

healthy, well-nourished infants ( tables 2 , 3 ; fig. 1 ,

2 ). In the FAO/WHO/UNU report, the median

weight-for-age and monthly rates of weight gain of

the WHO pooled breastfed data set were used to

calculate energy requirements [6]. A prediction

equation (1) for TEE was developed, based on

Ta b l e 1. Schofield equations for estimating BMR from weight (kilograms) [3] in children

Under 3 years

Males

Females

BMR (MJ/day) = 0.249 weight – 0.127

BMR (MJ/day) = 0.244 weight – 0.130

SEE = 0.293

SEE = 0.246

Males

Females

BMR (kcal/day) = 59.5 weight – 30.4

BMR (kcal/day) = 58.3 weight – 31.1

SEE = 70

SEE = 59

3 – 10 years

Males

Females

BMR (MJ/day) = 0.095 weight + 2.110

BMR (MJ/day) = 0.085 weight + 2.033

SEE = 0.280

SEE = 0.292

Males

Females

BMR (kcal/day) = 22.7 weight + 504.3

BMR (kcal/day) = 20.3 weight + 485.9

SEE = 67

SEE = 70

10 – 18 years

Males

Females

BMR (MJ/day) = 0.074 weight + 2.754

BMR (MJ/day) = 0.056 weight + 2.898

SEE = 0.440

SEE = 0.466

Males

Females

BMR (kcal/day) = 17.7 weight + 658.2

BMR (kcal/day) = 13.4 weight + 692.6

SEE = 105

SEE = 111

SEE = Standard error of estimation.

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 34–40
DOI: 10.1159/000360315