Prediction equations for resting energy expenditure in overweight and normal-weight black and white children

Background: Accurate estimation of children's resting energy expenditure (REE) is important for planning dietary therapy. Objective: Our objective was to compare the utility of 5 REE prediction equations in a diverse sample of young children. Design: REE was obtained in 502 black and white girls and boys aged 6-11 y by using indirect calorimetry at 4 US sites. Measured REE and REE predicted from the equations were compared. Results: None of the equations provided both accurate and unbiased estimates of REE. Two new sets of sex-specific equations including race as a factor were generated and evaluated. One set used easily measured variables--females: REE = 0.046 x weight - 4.492 x 1/[height.sup.2] - 0.151 x race + 5.841; males: REE = 0.037 x weight - 4.67 x 1/[height.sup.2] - 0.159 x race + 6.792--and accounted for 72% and 69%, respectively, of REE variance. The other set used body-composition variables females: REE = 0.101 x fat-free mass + 0.025 x fat mass + 0.293 x [height.sup.3] - 0.185 x race + 1.643; males: REE = 0.078 x fat-free mass + 0.026 x fat mass - 2.646 x 1/height: - 0.244 x race + 4.8--and accounted for 75% and 71%, respectively, of REE variance. When split by race and adiposity, the small bias generated could be corrected to within 0.25 MJ (60 kcal) of the mean measured value. Conclusion: Sex-specific equations must take race into account to predict REE adequately in children. KEY WORDS Child, prediction equation, energy expenditure, metabolic rate, race, obesity