One hundred twenty low birth weight infants were enterally fed diets c
ontaining fixed differences in protein and energy content. Serial, biw
eekly measurements were made of metabolizable energy intake, energy ex
penditure, nitrogen balance, and distribution of states of sleep, from
the time the infants were receiving full enteral intakes (180 mL/kg .
d) until weight reached 2200 g. Using multiple regression analysis of
energy expenditure against protein stored, and metabolizable energy,
the energy expended in the deposition of protein was calculated to be
5.5 kcal/g +/- 1.1 kcal/g (SE) and the energy cost of fat deposited wa
s 1.6 kcal/g +/- 0.3 kcal/g (SE), Estimated maintenance energy expendi
ture of the nongrowing low birth weight infant was 42.3 +/- 3.2 kcal/k
g/d. Variations in distribution of sleep state, an assessment of the a
ctivity state of the infant, did not explain additional variability in
energy expenditure, after adjusting for protein and energy storage.