Energy requirements of children and adolescents.

Total energy expenditure (TEE) was calculated at 1-18 years of age from measurements with doubly labelled water (DLW) in 483 boys and 646 girls, and heart rate monitoring (HRM) in 318 boys and 162 girls. Studies on obese, underweight and stunted groups were not included. TEE of populations with different lifestyles was estimated by factorial calculations in 42 studies on time allocation involving 1982 boys and 1969 girls in developed industrialised countries, and 1236 boys and 1116 girls in developing countries. Quadratic polynomial models were best to predict TEE in boys (TEE(MJ day(-1)) = 1.298 + 0.265 kg - 0.0011 kg2, r = 0.982, SEE = 0.518) and girls (TEE(MJ day(-1)) = 1.102 + 0.273 kg - 0.0019 kg2, r = 0.955, SEE = 0.650). TEE at 1-2 years was reduced by 7% based on DLW measurements and TEE estimates of infants. Energy requirements (ER) were calculated adding 8.6 kJ (2 kcal) for each gram of weight gained during growth. Compared with the 1985 FAO/WHO/UNU values, ER were 18-20% lower from 1 to 7 years of age, 12% lower for boys and 5% lower for girls at 7-10 years, and 12% higher for either gender from 12 years onwards. Differences between industrialised and developing countries, the variance in DLW and HRM studies, and the standard error of the estimate (SEE) of the quadratic predictive equations, suggested that ER should be adjusted after 5 years of age by +/-15% in populations with more or less physical activity than an average lifestyle. Physical activity recommendations must accompany dietary recommendations in order to maintain optimal health and reduce the risk of diseases associated with sedentary lifestyles.