CROSS-VALIDATION OF PREDICTION EQUATIONS FOR RESTING ENERGY-EXPENDITURE IN YOUNG, HEALTHY-CHILDREN

Objective To examine the accuracy of several prediction equations for resting energy expenditure (REE) in children. Design REE was measured in 113 prepubertal children (60 girls and 53 boys aged 3.9 to 7.8 year s old, weighing 14.7 to 30.0 kg) using Indirect calorimetry and compar ed with values estimated from the prediction equations of Altman and D ittmer, The Food and Agriculture Organization/World Health Organizatio n/United Nations University (FAO/WHO/UNU), Maffeis et al, and Harris a nd Benedict. Statistical analysis Measured REE (MREE) was compared wit h predicted REE (PREE) by means of regression analysis. Prediction equ ations were considered accurate if the regression of MREE vs FREE was not significantly different from the line of identity (slope=1.0; inte rcept=0). Precision was assessed by lie multiple correlation coefficie nt of the regression of MREE vs FREE. Results MREE was 938+/-119 kcal/ day, and FREE was 1,057+/-224 kcal/day for the Altman and Dittmer equa tions, 956+/-84 kcal/day for the FAO/WHO/UNU equations, 948+/-64 kcal/ day for the equations of Maffeis et al, and 954+/-102 kcal/day for the Harris-Benedict equations. The regression of MREE vs PREE was signifi cantly different from the line of identity for all prediction equation s except the FAO/WHO/UNU equations (slope=0.96, P=.735, intercept=-15 kcal/day P=.885 for girls and slope=1.08, P=.635; intercept=-62 kcal/d ay; P=.635 for boys). None of the equations was precise for MREE vs FR EE (for all. R(2)<.6). For the FAO/WHO/UNU equations, less than half o f the predictions were within +/-50 kcal/day but 99% were within 200 k cal/day. Conclusion Most prediction equations for REE in children do n ot accurately or precisely estimate REEs. The exception is the FAO/WHO /UNU equations, which are reasonably accurate and precise for practica l purposes.