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/height² - 0.151 X race + 5.841; males: REE = 0.037 X weight - 4.67 X 1/height² - 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 ³ - 0.185 x race + 1.643; males: REE = 0.078 X fat-free mass + 0.026 x fat mass - 2.646 X 1/height² - 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.