Resting Energy Expenditure Prediction Equations in the Pediatric Population: A Systematic Review

Abstract

Background and Aims: The determination of energy requirements is necessary to promote adequate growth and nutritional status in pediatric populations. Currently, several predictive equations have been designed and modified to estimate energy expenditure at rest. Our objectives were (1) to identify the equations designed for energy expenditure prediction and (2) to identify the anthropometric and demographic variables used in the design of the equations for pediatric patients who are healthy and have illness.Methods: A systematic search in the Medline/PubMed, EMBASE and LILACS databases for observational studies published up to January 2021 that reported the design of predictive equations to estimate basal or resting energy expenditure in pediatric populations was carried out. Studies were excluded if the study population included athletes, adult patients, or any patients taking medications that altered energy expenditure. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.Results: Of the 769 studies identified in the search, 39 met the inclusion criteria and were analyzed. Predictive equations were established for three pediatric populations: those who were healthy (n = 8), those who had overweight or obesity (n = 17), and those with a specific clinical situation (n = 14). In the healthy pediatric population, the FAO/WHO and Schofield equations had the highest R2 values, while in the population with obesity, the Molnár and Dietz equations had the highest R2 values for both boys and girls.Conclusions: Many different predictive equations for energy expenditure in pediatric patients have been published. This review is a compendium of most of these equations; this information will enable clinicians to critically evaluate their use in clinical practice.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=226270, PROSPERO [CRD42021226270].

External Validation of Equations to Estimate Resting Energy Expenditure in Critically Ill Children and Adolescents with and without Malnutrition: A Cross-Sectional Study

“…Suggested equations for use in healthy children and adolescents are the Harris and Benedict [ 2 ], FAO/WHO/UNU [ 3 ], Institute for Medicine of the National Academies and Food and Nutrition Board (IOM) [ 4 ], and Schofield (height and weight, WHO) [ 5 ] equations, and the Henry (Oxford with weight and height) [ 6 ], Lawrence (Equation (3)) [ 7 ], and Kaneko [ 8 ] equations. Among the predictive equations based on age, weight, height, and sex in the pediatric population with overweight or obesity, the Dietz [ 9 ], Maffeis [ 10 ], Molnár [ 11 ], Muller [ 12 ], and Lazzer (Equation (1)) [ 13 ] equations have been reported [ 14 ]. In addition, the Mifflin equation [ 15 ] has been recently shown to be an accurate eREE equation in girls and boys without or with obesity [ 16 ].…”

“…In addition, the Mifflin equation [ 15 ] has been recently shown to be an accurate eREE equation in girls and boys without or with obesity [ 16 ]. Simplified equations reported for use in mechanically ventilated children [ 14 , 17 ] were the Caldwell–Kennedy equation [ 18 ], the White (Equation (2)) [ 19 ], and the Meyer (equation-C) [ 20 ]. Other equations have been either established for use in specific situations, such as anorexia nervosa or burn injuries, or were using changing indices, such as organ failures or non-standard anthropometric measurements [ 14 ].…”

“…Simplified equations reported for use in mechanically ventilated children [ 14 , 17 ] were the Caldwell–Kennedy equation [ 18 ], the White (Equation (2)) [ 19 ], and the Meyer (equation-C) [ 20 ]. Other equations have been either established for use in specific situations, such as anorexia nervosa or burn injuries, or were using changing indices, such as organ failures or non-standard anthropometric measurements [ 14 ]. Still, there are units using the Recommended Dietary Allowances (RDA) [ 21 ] for estimating REE in pediatric patients.…”

Resting energy expenditure in adolescents with Down syndrome: a comparison of commonly used predictive equations

“…Molnar and WHO equations), performance in paediatric populations (Fuentes‐Servín et al . 2021) and diversity in the variables used to estimate REE in adolescents.…”

“…The rationale for choosing the selected predictive equations included a long history of use (e.g. Molnar and WHO equations), performance in paediatric populations (Fuentes-Servín et al 2021) and diversity in the variables used to estimate REE in adolescents.…”