Total energy expenditure by the doubly-labeled water method in rural preschool children in Cuba.

An evaluation of the capacity of the Cuban Nutrition Program for covering the energy requirements of children was carried out in children 5.0 +/- 1.0 years of age in a rural mountain community in Cuba. Five males and six females (19 +/- 3.05 kg average weight) with a mean BMI 15.4 +/- 2.2 kg/m2) were included in the study. Six of the subjects were well-nourished, three were undernourished, and two were overweight. Total energy expenditure was determined by the doubly-labeled water technique. Resting metabolic rate was measured by indirect calorimetry. Energy intake, measured by a three-day weighed dietary record, was 1,527 kcal/day (6.39 MJ). The total energy expenditure of the well-nourished children was 11.8% lower than present energy recommendations (1,773 kcal). This implies that well-nourished children who are moderately to heavily physically active require 82.6 kcal/kg per day. The physical activity level of normal Cuban children is nearly 1.8, which is much higher than that reported in studies of children from industrialized countries using the doubly-labeled water technique. The measured daily energy intake was 1.7 times the resting metabolic rate RMR and 1.04 times the total energy expenditure.