Prediction models of basal energy expenditure in children and adolescents across the BMI spectrum based on room calorimetry: a cross-sectional cohort study.

Background: Existing equations for prediction of basal energy expenditure (BEE) may not be accurate in children with overweight or obesity (OW/OB). We aimed to develop BEE prediction equations applicable to children and adolescents across a wide BMI spectrum using gold standard room calorimetry.

Methods: We measured weight, height, and waist and hip circumferences; body composition (dual-energy X-ray absorptiometry); and BEE (whole room calorimetry) in a cross-sectional cohort of 1155 healthy children, aged 5-19 y; 67% of the males and 51% of the females were classified as OW/OB. We applied multiple linear regression analyses to develop BEE prediction models for each sex. Using relevant predictors, we developed models with fat-free mass; waist and hip circumferences; weight and height only; and weight only. A representative sample of participants (83 males, 125 females) served as a validation data set to test model performance. The models' performance in predicting BEE was compared with existing models in the literature.

Results: Model fits (R²) for the new BEE prediction models were 0.84 (P < 0.0001). Our BEE prediction models performed equally in children with normal weight and OW/OB, with <1.5% difference between the measured and predicted BEE in the validation data set for both sexes. In Bland-Altman analysis, our BEE prediction models were superior to existing prediction models, especially for children with higher BEEs.

Conclusions: New BEE prediction models developed and tested in cohorts representative of children with normal weight and OW/OB has superior performance compared with existing models. The BEE prediction equations based on simple anthropometrics or body composition provided improved accuracy and precision for children with NW or OW/OB (ages 5-19 y). More accurate estimates of BEE should allow for better estimates of energy requirements of children.