Total energy expenditure and energy intake in the pre-school child: a comparison

Abstract

In a cohort (n81) of healthy children aged 1.5-4.5 years, measurements of energy intake and energy expenditure were compared. Energy intake was calculated following a 4 d weighed record completed by the mother or guardian of the child. Total energy expenditure was measured using the doubly-labelled water technique. Mean energy intake and expenditure in the cohort were 4773 kJ/d and 4928 kJ/d respectively. The mean relative bias between the techniques was 154 kJ/d. In the older children (3.545 years) the mean relative bias was only 37 kJ/d. At the population level the measurements of energy intake and energy expenditure were extremely close, and the study has provided sufficient confidence in weighed intake methodology for it to be used in a major nationwide study of dietary intake and nutritional status of children aged 1.5-4.5 years.Energy intake : Energy expenditure : ChildhoodThe programme of National Diet and Nutrition Surveys (NDNS) sponsored by the Department of Health and the Ministry of Agriculture Fisheries and Food (MAFF) investigates the diets and nutritional status of representative samples of the British population. The first group in this programme is children aged 1.5-4.5 years. This paper describes work that was done as a preliminary to the main study. There were major concerns that weighed dietary records in this age group might not give a sufficiently accurate picture of the dietary intake.Dietary assessment via weighed intake records has formed the basis of numerous studes of nutrition in man. In clinical work it has been recommended that weighed food intake records of up to 14 d are required while in epidemiological studies at least 3 d data are needed (Bingham, 1987). This methodology is time consuming and may lead to alterations in the dietary intake of the subject. Moreover, it has been suggested that such studies have a potential bias to under-recording both in normal individuals and in the obese (Southgate, 1986;Livingstone et al. 1990). Bandini et al. (1990) have shown significant underestimation of food intakes assessed by dietary record by both lean and obese adolescents when compared with energy expenditure estimated from the doubly-labelled water technique.In the absence of data pertaining to total energy expenditure in healthy, normally growing infants and children the Food and Agriculture Organization/World Health Organization/United Nations University (1985) recommendations for daily energy intake are based upon studies of weighed food intake that span the last 50 years. These data show

Validation of food diary method for assessment of dietary energy and macronutrient intake in infants and children aged 6–24 months

“…Although good agreement between measured metabolizable intake and observed energy intake calculated from dietary intake assessment methods has been demonstrated (Davies et al, 1994), several other studies have reported underestimations of habitual intake Livingstone et al, 1990Livingstone et al, , 1992Schoeller et al, 1990;Black et al, 1997). Work by Davies et al (1994) and the present study indicate a moderate but not signi®cant bias of weighed food records against doubly labelled water in infants and young children. However, there are a number of reasons why absolute agreement between these methods is not to be expected.…”

“…Accuracy of the WI method has been considered in preschool children aged 1.5 ± 4.5 y using doubly-labelled water as a reference (Davies et al, 1994). These authors concluded that the WI method was acceptable for assessing dietary intake in groups but not in individuals.…”

Total energy expenditure and physical activity level in healthy young Swedish children 9 or 14 months of age

“…We applied the equation published by Davies et al (1994) with the assumption that 20% of total water losses are fractionated. However, inaccurate assumptions regarding the proportion of fractionated water losses have only minor effects on results obtained by the DLW method (Vasquez-Velasquez, 1988).…”

“…Isotope enrichment in dose and urine samples was analysed using a Sira dual inlet mass spectrometer (Hoffman et al, 2000). Carbon dioxide production was calculated according to Davies et al (1994), assuming that 20% of total water losses were fractionated. Isotope dilution spaces were calculated from the zero-time enrichments obtained from the exponential isotope disappearance curves that provided estimates for the rate constants, k d and k o , for 2 H and 18 O, respectively.…”

The validity of a four day weighed food record for measuring energy intake in female classical ballet dancers

“…Total energy expenditure was measured over a 14 d period via the DLW technique as described in detail elsewhere (Davies et al, 1994). Energy intake was assessed using a four day weighed dietary record.…”