Cover Image
close this bookActivity, Energy Expenditure and Energy Requirements of Infants and Children (International Dietary Energy Consultative Group - IDECG, 1989, 412 pages)
View the document(introductory text...)
View the documentIntroduction
Open this folder and view contentsEnergy requirements in normal infants and children
Open this folder and view contentsLow energy intakes and growth velocities of breast-fed infants: Are there functional consequences?
Open this folder and view contentsMethods to assess physical activity and the energy expended for it by infants and children
Open this folder and view contentsEstimation and validation of energy expenditure obtained by the minute-by-minute measurement of heart-rate
Open this folder and view contentsAssessment and significance of body composition in infants and children
Open this folder and view contentsTotal energy expenditure of free-living infants and children obtained by the doubly-labelled water method
Open this folder and view contentsReference data for total energy expenditure in early infancy
Open this folder and view contentsBasal metabolism of infants
Open this folder and view contentsEnergy cost of various physical activities in healthy children
Open this folder and view contentsThe energy requirements of growth and catch-up growth
Open this folder and view contentsEnergy cost of communicable diseases in infancy and childhood
Open this folder and view contentsEnergy-sparing mechanisms: reductions in body mass, BMR and activity: their relative importance and priority in undernourished infants and children
Open this folder and view contentsThe desirable upper limits of energy intake in childhood: Short- and long-term consequences
Open this folder and view contentsLong-term developmental implications of motor maturation and physical activity in infancy in a nutritionally at risk population
Open this folder and view contentsTemperament, activity and behavioral development of infants and children
Open this folder and view contentsThe cultural regulation of infant and child activities
Open this folder and view contentsShort- and long-term effects of low or restricted energy intakes on the activity of infants and children
Open this folder and view contentsThe relationship between undernutrition, activity levels and development in young children
View the documentIndicators for the extent to which energy requirements are being met in infants and children
View the documentImplications of new knowledge for recommendations of energy intakes
View the documentImplications of new knowledge for the prevention and treatment of PEM in infants and children
View the documentImplications of new knowledge for the prevention and treatment of obesity in infants and children
View the documentNeeds and priorities for research and action from the physiological point of view
View the documentNeeds and priorities for research and action from the behavioral point of view
View the documentNeeds and priorities for research and action from the point of view of policy
View the documentList of participants

Implications of new knowledge for recommendations of energy intakes

(Discussion leader A. LUCAS, rapporteur B. SCH√úRCH)

Requirements can be derived from (1) the sum of individual components of energy expenditure, (2) the dietary intake of children growing normally, or (3) energy intakes associated with optimal health. Longitudinal studies are now underway to obtain data of the third kind, which should provide the best answer. In the meantime, however, we have to decide whether or not to recommend changes of requirements based on results of recent doubly-labelled water studies. Complicating the decision are factors such as secular trends in growth performance which raise questions as to what growth rates to accept as a standard; possible cultural differences in energy needs; and the great intra-individual variation in energy needs, e.g., for catch-up growth.

Most discussants agree that, at least for the first 3 months, exclusive breast-feeding should be recommended under most circumstances. Recommended energy intakes from breast milk cannot be specified, and, it therefore makes sense, at least for the time being, to base recommendations of energy intakes during the first 3 months post partum on the energy intakes of breast-fed infants. This leaves us with the methodological problems of how best to assess the energy intakes of breast-fed infants (test-weighing and milk sampling, breast-shield, or doubly-labelled water method).

In older children, assessments of energy intakes can vary by up to 20% depending on how one measures dietary intake, how one calculates the energy content of the diet, and how one takes into account such factors as fecal losses, non-digestible polysaccharides, etc. The energy source too may be important, if we consider outcomes such as morbidity. Little is known about the extent to which intakes determine expenditure and/or expenditure determines intakes. A French study showed that upper-class children have lower energy intakes than lower-class children, yet upper-class children watch less TV.

Problems like these make it seem safer to base estimates of requirements on what appear to be desirable expenditure levels. This, however, means that we need a considerable amount of information on how children spend their time and energy. Should we then go one step further and stipulate how much energy children should expend? In theory yes, but in practice we may not be able to have much influence on children's activity patterns. We may, therefore, run smaller risks in making recommendations based on their current habitual activity patterns, provided they are not excessively sedentary (e.g., spending hours watching television every day).