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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
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Implications of new knowledge for the prevention and treatment of obesity in infants and children

(Discussion leader W. DIETZ, rapporteur W.P.T. JAMES)

Although there have been few developments in the treatment of childhood obesity, a picture is emerging of what should be done to prevent obesity. In childhood, as distinct from infancy, many societies have shown a secular trend towards a reduction in physical activity, and this has been accompanied by a progressive fall in food intake. There may be greater difficulty in allowing the normal control of appetite to operate when children and adults are inactive and a wide choice of tempting, energy-rich food is easily available. There are hints that the obesity-prone child tends to be less physically active and that there is a breakdown in the normal physiological regulation of food intake. The quality of the diet, i.e., its high energy density, particularly from fat, may also be conducive to weight gain.

The problem of specifying requirements to prevent childhood obesity is substantial; one can identify a minimum energy need, but thereafter it seems necessary to specify a reasonable degree of physical activity to prevent obesity. How much activity is needed to reduce the rate of obesity is, however, unknown.

There is little coherent evidence in humans that rapid weight gain in infancy leads to obesity in adults. Most adult obesity of early onset stems from childhood rather than infancy, so that a proposal to reduce food intake in infancy, in order to prevent adult obesity, is probably unwise at this stage. The long-term programming in infancy of energy and nutrient metabolism needs, however, to be assessed because of its public health implications.

There are subgroups within the population which have special problems in relation to energy requirements. Handicapped children may need special care because their requirements may be very low if they are inactive and confined to a wheelchair or bed, whereas some other children may have special needs because of high rates of energy expenditure.