6. Conclusions

It should be evident from the above review that the doubly-labelled water method has rapidly established itself as the best available technique for assessing total energy expenditure. It is ideally suited to studies of infants and young children, and has already produced a large body of new data which is influencing current concepts in energy metabolism in these age groups. So far the results have withstood critical analysis which has probed for potential flaws by using 'worst case' theoretical assumptions in order to establish the maximum possible limits of error and bias. It is crucial that this level of sceptical scrutiny is maintained, and that investigators do not consider the method to be irrefutable in all instances simply because no other techniques are available for use in young children. IDECG has already played an important role in ensuring the maintenance of high standards by convening an expert workshop whose consensus views are soon to be published (IDECG, 1990). It is to be hoped that this publication will help other laboratories to establish the method soon in order to assist in tackling the many outstanding questions regarding activity, energy expenditure and energy requirements in children.