Dietary energy intake

The most important criteria in choosing a method for collecting food intake data in children and adolescents are: (a) the technique should not interfere with the subject's dietary pattern; (b) the data should be representative of usual or habitual intake and (c) the technique should be suitable for application in large study groups.

The methods most frequently used in childhood and adolescent population groups are similar to those applied in adult studies, namely:

(1) Retrospective or food recall methods, which depend on dietary information given from memory by the child/ adolescent and/or parent/child carer. Several specific types of data collection fall within this category, including those aimed at quantifying actual intake for a precise time (usually the previous day, or 24-h recall) and those designed to elicit information about usual consumption patterns for a longer, less precisely defined time period (diet history or food frequency methods). More than one 24-h recall should be made on different days of the week, especially when there are cultural cyclic changes in food intake (e.g. weekdays compared with weekends). Recalls of more than 24 h are sometimes performed but the accuracy with which subjects and/or parents can remember food consumption is debatable, particularly if food intake patterns are highly unstructured or unstable. In the food frequency method, subjects and/or parents/child carers report by interview or self-administered questionnaire, the frequency of consumption of particular foods during a specified time span (week, month, year). A quantitative component is added by including the size and number of portions most frequently consumed for each food.

(2) Prospective or food record methods, which require that all food items consumed be recorded at the time of consumption. Intakes are quantified by direct weighing of the food, by estimates using, household measures or by collection of duplicate diets. Quantitative assessment of usual food intake can be obtained by increasing the number of measurement days. Seven days are generally assumed to represent a good compromise between precision, subject/parental cooperation, cultural dietary patterns and investigator workload.

Each of these methods has advantages and drawbacks when applied to children and adolescents. Ultimately, all survey methods are dependent on the motivation, compliance and ability of subjects and/or parents/child carers to report accurately habitual food intake.

Food intake data must then be converted into energy equivalents. This is often done disaggregating recipes into their food components and calculating their metabolizable energy as reported in food composition tables. Care must be taken to make all necessary conversions for the proper use of food composition data. A common error is applying to 'cooked' or 'wet' weight of foods the energy values for 'raw' or 'dry' foods that appear in composition tables, without applying adequate conversion factors.

A more accurate approach is to perform chemical or calorimetric analyses of samples of foods that are ready to be eaten. This is particularly useful to calculate the energy provided by food recipes that are unlikely to appear in food composition tables or that may be subject to variations. When the energy content of food is measured by bomb calorimetry, appropriate corrections must be made to calculate metabolizable energy.

Figure 7a Energy expenditure calculated from estimates of habitual physical activity, compared with measurements using doubly labeled water and heart rate monitoring. Including data of stunted and underweight children: boys.

Figure 7b Energy expenditure calculated from estimates of habitual physical activity, compared with measurements using doubly labeled water and heart rate monitoring. Including data of stunted and underweight children: girls.

Validity of energy intakes in children and adolescents

Most dietary intake studies in children assume that the data obtained are representative of habitual food consumption, and many recent studies concluded that energy intakes (EI) have declined in industrialized countries and more privileged groups in developing countries in response to a secular trend towards lower levels of activity in children and adolescents. However, studies in adults using doubly-labeled water (DLW) measurements of total energy expenditure (TEE) to validate EI have demonstrated that intake data may underestimate habitual food intake to a greater extent than has been appreciated (Prentice et al, 1986; Livingstone et al, 1990b; Schoeller, 1990). It is conceivable, therefore, that the reportedly low intakes of children may be artifacts of dietary survey methodology, rather than indicative of a diminution in energy expenditure.

Validation studies have been reported to assess the accuracy of EI in children and adolescents, using DLW measurements of TEE. These include studies of EI by 4-day weighted dietary record (WDR) in 1.5-4.5 year olds (n = 81) (Davies et al, 1994), by 7-day WDR in 7, 9, 12, 15 and 18 year olds (n = 58), by diet history (DH) in 3, 5, 7, 9, 12, 15 and 18 year olds (Livingstone et al, 1992b) and by 14 day estimated food records in non-obese and obese adolescents (n = 55) (Bandini et al, 1990a).

Figure 8 Comparison (± s.d.) of reported habitual energy intake and energy expenditure in (a) 1.5-4.5 year old children (Davies et al, 1994) and (b) non-obese and obese adolescents (Bandini et al, 1990a).

Figure 8 Comparison (± s.d.) of reported habitual energy intake and energy expenditure in (a) 1.5-4.5 year old children (Davies et al, 1994) and (b) non-obese and obese adolescents (Bandini et al, 1990a).

Figure 9 Comparison (± s.d.) of reported habitual energy intake by diet history and weight dietary record and energy expenditure in 3-18 year old subjects (Livingstone et al, 1992b).

Figure 9 Comparison (± s.d.) of reported habitual energy intake by diet history and weight dietary record and energy expenditure in 3-18 year old subjects (Livingstone et al, 1992b).

The results shown in Figures 8-10 indicate that bias in dietary reporting does not operate uniformly across age groups and that it is influenced by the particular methodology used.

In children aged 1.5-4.5 years, mean El calculated by 4-day WDR were not significantly different from mean TEE (+3%) (Figure 8a). Similarly, the mean EI by 7-day WDR of 7 and 9 year olds were in close correspondence with simultaneous measurements of TEE ( + 2%) (Figure 10a), but in adolescents and young adults there was increasing divergence between EI and TEE as age increased: mean EI were significantly lower than TEE in 12 year olds ( - 14%) and in 15 and 18 year olds (-24%, P<0.01) (Figure 10a). Using 14-day estimated intake records, Bandini et al (1990a) also showed a substantial underestimation of EI by adolescents, with the negative bias being most apparent in obese subjects (Figure 8b). After adjustment for changes in body composition, mean estimated EI were 80 ± 23% (non-obese) and 54 ± 32% (obese) of TEE values (P < 0.001).

The age-related discrepancy differed in the study to validate EI by diet history in 3-18 year olds. There was a bias towards overestimation of EI in the younger children by this technique: as age increased, mean differences were + 12%, + 9%, + 11% and - 1% (Figures 9 and 10b)

These validation studies can be criticized because they only involved a small number of subjects in various age groups. However, all of them indicate that a bias in dietary reporting is highly probable. Thus, considerable caution needs to be applied when interpreting energy intake data sets as a basis for deriving energy requirements. Moreover, the magnitude and direction of the errors in children's EI are likely to be different from those found in adults. These biases are highly relevant to the problem of determining appropriate energy intakes for nitrogen balance studies (see Appendix).

Age is an important variable that affects compliance in dietary reporting. The results presented suggest that the mean EI assessed by weighed dietary records are more likely to represent usual food intake in younger than in older subjects. This could be due to the fact that in young children overall control of food intake and responsibility for dietary reporting are shared by parents and other adults concerned with child caring. Younger children also have less unsupervised access to food in- and out-of-home. On the other hand, by early adolescence the responsibility for reporting shifts more to the subjects themselves. Consequently, their greater food requirements in combination with unstructured eating patterns and a significant degree of out-of-home eating suggest that under-reporting (by WDR) may be partly due to forgetfulness and lack of compliance with a demanding protocol.

Obesity is another important factor. In common with obese adults (Prentice et al, 1986), obese adolescents have been found to under-report EI significantly more than their non-obese counterparts (Bandini et al, 1990a). Preoccupation with body weight and image, which may lead to real or apparent dietary restraint, seems to be well developed in girls with normal and low weight by the age of 12 years. Similar, although less marked trends, have been observed in adolescent boys (Livingstone et al, 1992b).

The method used to assess EI also may influence the results. Validation studies with various EI methods across the entire age range of childhood and adolescence are lacking. Only one study has validated simultaneously EI by WDR and DH with TEE (Livingstone et al, 1992b). Although EI by DH were biased towards overestimation in most age groups and individual measurements lacked precision, mean intakes assessed by DH seemed more representative of habitual EI across the age range than WDR. The apparent superiority of DH in overcoming an age-related bias in dietary reporting is contrary to expectations and needs to be evaluated carefully. Since DH is not a standardized instrument and it only measures memory and perception of usual diet, it is subjective and children may tend to exaggerate the intake of 'good' foods and under-estimate 'bad' foods. Accuracy in reporting is also dependent on motivation, intelligence, an adequately developed concept of time, ability to recognize foods, the complexity and stability of food patterns and the age at which children can reliably report their own food intake without control or supervision of adults.

Other factors which are likely to influence reporting accuracy and about which little is known, include social class and educational background.

In addition to the credibility of food intake reports, assessment of EI can be distorted by the use of inadequate food composition tables and/or overlooking the conversion of cooked and processed foods into their raw ingredients².

² The world-wide food composition data network being developed by INFOODS offers electronic access to information on prepared and processed foods often not available in local food composition tables (for information: http ://www.crop.cri.nz/crop/infoods/infoods.html).

Figure 10a Individual differences between energy expenditure measured by the doubly labeled water method and energy intakes as measured by 7-day weighed dietary records expressed as a percentage of energy expenditure in children aged 7 and 9 years (A), 12 years (B) and 15 and 18 years (C).

Figure 10b Individual differences between energy expenditure measured by the doubly labeled water method and energy intakes as measured by diet history expressed as a percentage of energy expenditure in children aged 3 and 5 years (A), 7 and 9 years (B), 12 years (C) and 15 and 18 years (D) (From data of Livingstone et al, 1992b).

Dietary energy intake data of children and adolescents

A selection of dietary intake studies reported in the literature from about 1980 onwards are reviewed here since earlier studies were evaluated extensively by Ferro-Luzzi & Durnin (1981), as the basis for the 1985 FAO/WHO/UNU estimated requirements. Since 1980, a vast number of dietary intake studies on children and adolescents have been reported and the studies cited in this review are by no means an exhaustive compilation. Many studies were excluded based on the following criteria:

(1) When energy intakes were reported for wide age bands (e.g. 11-16 years) and the mean age was not recorded.
(2) When energy intakes were reported combined for boys and girls over 10 years old.
(3) When data were presented in a format which could not be readily interpreted for the purposes of this review (e.g., in graphs). Unfortunately, many studies in developing countries were excluded for this reason.
(4) When the children studied were generally malnourished or obese, and their mean weight-for-height differed from the NCHS/WHO standards by more than 2 s.d. Many reports were based on representative study populations and therefore included children with a range of body weights.
(5) Only studies of healthy children were included, since many disease states are likely to affect energy intakes and requirements.

Tables 23 and 24 give details of the studies that were reviewed. Forty-eight involved children approximately 110 years old, and 41 studies included children and adolescents approximately 10-18 years old.

Tables 25-30 show the energy intakes of the children, by ascending age. Boys and girls under 5 years are listed together in Table 25, as many studies did not separate the results for each sex. The same is true of the six studies in Table 30. When body weights were not reported, median weights (NCHS) at the mid-point of the age range were assumed and, in Tables 25 and 30, averaged for boys and girls. Energy intake data are presented as absolute values, in relation to body weight, and as multiples of the estimated BMR. The latter were calculated from the mean weights using the equations proposed by Schofield to FAO/WHO/UNU (1985).

Comparison with total energy expenditure and dietary recommendations

When energy intakes are used to assess requirements or to estimate whether the mean intake satisfies a population's dietary recommendations, the possibility of bias must be acknowledged and the data should be analyzed and interpreted accordingly. Information that is incompatible with fundamental principles of energy physiology should not be accepted, as it cannot represent long-term usual intake or is due to methodological bias or inadequate reporting. Goldberg et al (1991) and Black et al (1991) suggested a screening of EI data of adult populations, calculating them as multiples of BMR. For example, a value below 1.27 × BMR, considered as the survival requirement for adults (FAO/ WHO/UNU, 1985), is unacceptable as representative of habitual intake.

Following that logic, we used the PALs shown in Table 21 to establish reasonable limits to evaluate dietary energy surveys among children and adolescents. Mean results lower than two times the coefficient of variation (i.e. 12%) below the PAL corresponding to light habitual activity, or higher than two times the CV above the PAL for heavy habitual activity were considered unlikely to represent the usual intake of healthy children. Since the PALs for boys or girls 6-13 and 14-18 years old in Table 21 are reasonably close, the acceptable limits for those age groups were averaged to simplify the evaluation of the results in Tables 25-30. Further corrections for the energy needs for growth were not made, as they are only about 3% at age 1 and less than 1 % in late adolescence.

Thus, Tables 31-33 were prepared from the data in Tables 25-30 that were between 1.28 and 1.79 × BMR for children 1-5 years, between 1.39 and 2.24 × BMR for boys 6-18, and between 1.30 and 2.10 × BMR for girls 6-18. Mean energy intakes expressed as MJ/d, kJ/kg/d and × BMR, were weighted for the number of children in each study. When a study included more than 500 or 1000 children of a given age and sex, only 30% or 20% of the number, respectively, were used to calculate the weighted means to avoid an extreme bias toward the results of that study.

As Table 31 and Figure 11 show, energy intake per unit of body weight is fairly constant for both boys and girls between 3 and 7 years of age, after which it decreases gradually until age 15 (girls) or 16 (boys).

Compared with total energy expenditure assessed with doubly-labeled water and heart rate monitoring, energy intake tends to overestimate requirements under 8-10 years and to underestimate them after that age. Those trends also apply to the 1985 FAO/WHO/UNU energy recommendations, but the overestimation is markedly higher under 6 years of age. This is partly due to the 5% additional dietary energy recommended in 1985 for children 1-10 years old to accommodate 'a desirable level of physical activity'.

The reported EI of children 1-5 years old is about 13% lower than FAO/WHO/UNU requirements (Figure 11, Table 31). Although the wide range between data sets could reflect real differences in intake, unrepresentative study samples, or artifacts in dietary survey methodology, mean intakes fell short of FAO/WHO/ UNU requirements in about 80% of the data sets.

The influence of sex on dietary energy intake is illustrated in Figure 12 and Tables 31-33. Girls have lower EI than boys, whether expressed in absolute terms or relative to their body weights or their estimated BMR, and the difference becomes greater in adolescence. These findings are consistent with their lower total energy expenditure (Tables 2-7 and 20, and Figure 5).

Conclusions

Recent trends in EI of children and adolescents suggest that if the groups studied are representative of their age and sex, and the EI data are valid measures of habitual intake, then:

(a) Habitual energy intakes of 1-6 year old children are lower than current recommendations. Increasing reported energy intakes by 5% to accommodate a 'desirable level of physical activity' may be unrealistic.
(b) Energy requirements for physical activity may be more variable in adolescent males but lower in the adolescent females, than has been assumed when deriving factorially estimated energy requirements.

For methodological and economic reasons it seems inevitable that we will continue to rely partly on reported EI data as a basis of estimating energy requirements for most populations. However, it is clear that these data can no longer be tacitly accepted as representative of usual intake. Therefore, the following recommendations need to be considered:

(a) At present there are too few studies in which energy intake and energy expenditure have been studied in the same population to know the nature and extent of bias involved in these measurements. This will require more extensive validation studies of energy and nutrient intakes that take into account differences in methodology, social status, education, age, and geographical region in both developing and industrialized countries. From these studies guidelines may emerge for detecting patterns of bias and the characteristics of individuals contributing to it.
(b) Variation among individuals within the same population can be appropriately characterized by a mean and standard deviation whose validity will depend upon the adequacy of the sample. However, the nature and extent of differences in mean values among different populations make it unlikely that they can be appropriately characterized by a single mean and standard deviation, no matter how many populations are sampled. It may be better to express a range of mean values for this purpose.
(c) Research must be done to find ways of minimizing the psychological basis of under- and over-reporting in these age groups.
(d) Appropriate 'cut-off' values based on fundamental principles of energy physiology should be used to determine the acceptance of energy intake results. This will require an extensive data base of basal and total daily energy expenditures (BMR and TEE) in association with objective measures of physical activity. In the meantime, the following estimates of multiples of BMR are suggested as provisional cut-off points: 1-5 years (boys and girls): 1.28-1.79 × BMR; 6-18 years: 1.39-2.24 × BMR (boys) and 1.30-2.10 × BMR (girls).

These recommendations will not guarantee valid data and cannot eliminate the considerable differences among populations, but may lead to the design of more effective instruments for assessing energy intake and requirements of children and adolescents.

Table 23 Dietary surveys of children aged approximately 1-10 years

Source

Country

Sex

Age (y)

No. of subjects

Methoda

Time of year

Socio economic statusb

Urban/ruralc

Race/ethnic background

Bellu et al (1991)	Italy	M & F	1	164	24-h recall	?	?	U	?
Boggio & Klepping (1981)	France	M & F	5-6, 9-11, 14-16	376	7-d weighed record	?	M	U	?
Boulton (1981)	Australia	M & F	2, 3-5, 8-18	198,486, 235	Diet history, 4-d record	12 months	M	U	Mixed
Brault-Dubuc & Mongeau (1989)	Canada	M & F	6-16	402 (L)d	7-d record	12 months	M	U	?
Catassi et al (1988)	Italy	M & F	0.5-2.5	90	3-d weighed record	?	?	?	?
Cunningham & Lee (1990)	Republic of Ireland	M & F	8-18	538	Diet history	12 months	M	U & R	Caucasian
Davies et al (1994)	United Kingdom	M & F	1.5-4.5	81	4-d weighed record	Autumn	M	U	?
Deheeger et al (1991)	France	M & F	2	323	5-d record, diet history	?	M	U	?
Duggan et al (1991)	United Kingdom	M & F	0.3-3.3	97	5-d weighed record	?	L	U	Asian
Durnin (1984)	United Kingdom	M & F	5-6, 10-11	430	5-d weighed record	?	M	U	?
Eastwood et al (1990)	Mexico	M & F	2.8-3.9, 4.0-5.0	45	1-d weighed record	?	L	R	Mixed
Griffiths et al (1987)	United Kingdom	M & F	3-4	37	7-d weighed record & duplicate analysis	?	?	?	?
Hagman et al (1986)	Sweden	M & F	2-3, 4-5, 8-9, 13-14	1020	7-d record, diet history, 24-h recalls	12 months	M	U & R	?
Hitchcock et al (1984)	Australia	M & F	1-3	205 (L)e	7-d record	12 months	M	U	?
Ho et al (1988)	China	M & F	5-6	60	7-d weighed record	?	M	U	Chinese
Hoffmans et al (1986)	Netherlands	M & F	0.3-1.5	124 (L)f	24 h-recall	Spring	M	U	?
Ikemoto et al (1989)	Japan	M & F	1-2	10	Chemical analysis	12 months	?	?	?
Jenner et al (1988)	Australia	M & F	8-10	884	Food frequency questionnaire	April - Aug	M	U	?
Knuiman et al (1983)	Finland, Netherlands, Italy, Phillipines and Ghana	M	8-9	589	7-d record or 7-d recall	Feb May	M	U & R	Mixed
Livingstone et al (1992b)	United Kingdom	M & F	3-18	78	7-d weighed record, diet history	Oct-July	M	U & R	Causasian
Leung et al (1984)	Canada	M & F	3-4	189	4-d record	?	M	U	?
Lopez-Jaramillo et al (1992)	Ecuador	M	9	114	2 × 24 h recalls	?	LU	U	Ecuadorian
Magarey & Boulton (1984)	Australia	M & F	4	178	3-d record	June Sept	M	U	Mixed

Martinez (1982)	Canada	M & F	6-7	193	3-d record	?	M	U & R	?
McKillop & Durnin (1982)	United Kingdom	M & F	1-2	143	5-d weighed record	?	M	U	?
Morgan & Zabik (1981)	USA	M & F	5-12	657	7-d record	Autumn	-	-	-
Morrison et al (1980)	USA	M & F	6-19	949	24-h recall	12 months	M	U	Black & White
Nelson et al (1990)	United Kingdom	M & F	7-12	194	7-d weighed record	April-July	?	U & R	?
Narasinga et al (1983)	India	M & F	2-6	128	Diet questionnaire	12 months	U	?	Asian
Neiderud et al (1992)	Sweden & Greece	M & F	2-8	152	24-h recall	Aug-Nov	?	U & R	Mixed
Oliveria et al (1992)	USA	M & F	3-5	91	4 × 3-d record	12 months	M	U	Caucasian
Palti et al (1979)	Israel	M & F	2.5-4	98 (L)g	24-hr recall	December - April	M	U	Mixed
Pao et al (1985)	USA	M & F	1-18	2826	24-h recall, 2-d record	Spring	M	U & R	Mixed
Parizkova et al (1986)	Czechoslovakia	M & F	3-5	22	7-d record	?	?	U	?
Paul et al (1990)	United Kingdom	M & F	1-3	48 (L)h	7-d weighed record	?	M	?	?
Payne & Belton (1992)	United Kingdom	M & F	2-5	153	7-d weighed record	May-April	M	U & R	?
Persson & Calgren (1984)	Sweden	M & F	4-5, 8-9	477	7-d record	?	M	?	?
Räsänen et al (1985)	Finland	M & F	3-18	1251	24-h recall	Autumn	M	U & R	?
Räsänen et al (1991)	Finland	M & F	9-18	1200	2 × 24-h recalls	Autumn	M	U & R	?
Räsänen & Ylonen (1992)	Finland	M & F	1.5	46	3-d record	August-November	M	U	?
Salas et al (1990)	Spain	M & F	2-9	121	2 × 24-h recall	?	M	U	Caucasian
Salz et al (1993)	USA	M & F	6-9	195	24-h recall	?	M	U & R	Caucasian
Sawaya et al (1988)	Saudi Arabia	M & F	1.1-2.0, 2.1-3.0, 3.1-4.0, 4.1-5.0	540	24-h recall	?	?	U-R1	Arab
Sunnegardh et al (1986)	Sweden	M & F	8-9, 13-14	666	24-h recall, 7-d record, diet history	?	M	U & R	?
Treiber et al (1990)	USA	M & F	3-5	55	2 × 24-h recall	?	M	U	Black and White
Vanderkooy et al (1987)	Canada	M & F	4-5	108	3-d weighed record	May-Sept	MU	U & R	Caucasian
Van Steenbergen (1984)	Kenya	M & F	1-3, 4-6	56	2-d weighed record	wet & dry	L	R	Akamba
Walker et al (1990)	Jamaica	M & F	0.75-2.0	191	4 × 24-h recall	?	L	U	Jamaican, black

^a Records = estimated (household measures) records, weighed records = weighed intake.
^b Socioeconomic status: M = mixed, L = lower, LU = lower and upper, MU = middle and upper, U = upper.
^c Urban/Rural: U = urban, R = rural.
^d L = longitudinal Brault-Dubuc & Mongeau (1984): 402 children studied in two cohorts starting at age 6 and 10 years with yearly measurements made for 7 years.
^e Hitchcock et al (1984): 205 children recruited. Measurements made at 1 year (n = 125), 1½ years (n = 142), 2 years (n = 146) and 3 years (n = 145).
^f Hoffmans et al (1986): 124 children studied. Measurements made at 16 months and 28 months.
^g Palti et al (1979): 98 children studied. Three measurements made (1st study n = 98; 2nd study n = 82; 3rd study n = 75).
^h Paul et al (1990): 48 children recruited at 2 months. Measurements made at 12 months (n = 29), 15 months (n = 25), 18 months (n = 22), 24 months (n = 22) and 36 months (n = 31).
ⁱ Described by authors as semi-rural.

Table 24 Dietary surveys of children and adolescents aged approximately 10-18 years

Source	Country	Sex	Age (y)	No. of subjects		Methoda	Time of year	Socio economic statusb	Urban/ruralc	Race/ethnic background
Adamson et al (1992)	United Kingdom	M & F	11-12	379		2 × 3-d records	January-July	M	U & R	?
Baghurst et al (1983)	Australia	M & F	14-15, 18	490		Food frequency	?	M	U	Mixed
Barber et al (1985)	Great Britain	F	15-18	448		14-d diary	?	?	U	Caucasian
Bergstrom et al (1993)	Sweden	M & F	13-16, 16-18	731		7-d record	Sept-December January-May	M	U & R	?
Boulton (1981)	Australia	M & F	2 3-5 8-18	198 486 235		Record and diet history 4-d record 4-d record	12 months 12 months 12 months	M	U	Mixed
Boggio & Klepping (1981)	France	M & F	5-6, 9-11, 14-16	376		7-d weighed record	?	M	U	?
Brault-Dubuc & Mongeau (1989)	Canada	M & F	6-17	402 (L)d		7-d record	12 months	M	U	?
Bull (1985)	United Kingdom	M & F	15-18	382		14-d record	Spring-Summer	M	U & R	?
Crawley (1993)	United Kingdom	M & F	16-17	4760		4-d record	April-July	M	U & R	?
Cunningham & Lee (1990)	Republic of Ireland	M & F	8-18	538		Diet history	12 months	M	U & R	Caucasian
Department of Health (1989)	United Kingdom	M & F	10-11, 14-15	2697		7-d weighed record	January-June	M	U & R	?
Durnin (1984)	United Kingdom	M & F	5-6, 10-11	430		5-d weighed record	?	M	U	?
Frank et al (1985)	USA	M & F	10-11, 13-14	491		24-h recall	?	?	?	Black & White
Greger et al (1978)	USA	F	12-13	184		Diet recalls, diet history	Autumn & Spring	?	?	?
Hagman et al (1986)	Sweden	M & F	2-3, 4-5, 8-9, 13-14	1020		7-d record, diet history, 24-h recalls	12 months	M	U & R	?
Hackett et al (1984)	United Kingdom	M & F	11-14	375		5 × 3-d records	?	M	U & R	?
Jenner et al (1992)	Australia	M & F	11-12	1215		2-d records	April-August	M	U	?
Johnson & Jensen (1984)	USA	M & F	10-11	60		7-d records, 24-h recalls	?	M	?	Mixed
Kaufman et al (1982)	Israel	M & F	17-18	1178		24-h recall	?	M	U	Mixed
Livingstone et al (1992b)	United Kingdom	M & F	3-18	78		7-d weighed record, diet history	October-July	M	U & R	Caucasian
McCoy et al (1984)	USA	F	12, 14, 16		1247	2 × 24-h recalls	February-May	M	U & R	Black & White
Michaud et al (1991)	France	M & F	15-19		481	1-d record	?	M	U	?
Morgan & Zabik (1981)	USA	M & F	5-12		657	7-d record	Autumn	MU	?	?
Morrison et al (l980)	USA	M & F	6-19		949	24-h recall	12 months	M	U	Black & White
Nelson et al (1990)	United Kingdom	M & F	7-12		194	7-d weighed record	April-July	?	U & R	?
Pao et al (1985)	USA	M & F	1-18		2826	24-h recall, 2-d record	Spring	M	U & R	Mixed
Perusse et al (1984)	Canada	M & F	11-17		580	3-d weighed record	?	?	U & R	?
Post et al (1987)	Netherlands	M & F	12-18		233	Diet history	Jan-April	MU	U	?
Räsänen et al (l985)	Finland	M & F	3-18		1768	2 × 24-h recalls	Autumn	M	U & R	?
Räsänen et al (1991)	Finland	M & F	9-18		1200	2 × 24-h recalls	Autumn	M	U & R	?
Rodriguez (1991)	Guatemala	M	10-11		140	3 × 24-h recalls	July-Sept	LM	U	Mixed
van den Reek et al (1986)	USA	F	12-15		8	7-d weighed duplicate method	Summer	U	U	White
Seone & Roberge (1983)	Canada	M & F	10-18		500	3-d weighed record	?	?	?	?
Skinner et al (1985)	USA	M & F	16-18		225	24-h recall	?	?	U & R	Black & White
Story (1986)	USA	M & F	13 17		277	3 × 24-h recall	?	L	R	Cherokee
Strain et al (1994)	United Kingdom	M & F	12-13, 15-16		1016	Diet history	12 months	M	U & R	Caucasian
Sunnegardh et al (1986)	Sweden	M & F	8-9, 13-14		666	24-h recall, Diet history, 7-d record	?	M	U & R	?
Tan et al (1989)	New Zealand	M & F	12-14		501	3 × 24-h recalls	Autumn	M	U	?
Tayter et al (1989)	USA	M & F	10-12		39	3 d-record	?	M	?	Caucasian
Torun et al (1993)	Guatemala	M	10-12		24(L)e	3 × 24 h recalls every 3 months	12 months	L	U	Mixed
Woodward et al (1984)	Tasmania	M & F	12-16		1055	1-d diet record	?	M	U & R	?

^a Records = estimated (household measures) records, weighed records = weighed intake.
^b Socioeconomic status: M = mixed, L = lower, LU = lower and upper, MU = middle and upper, U = upper.
^c Urban/Rural: U = urban, R = rural.
^d L-Longitudinal. Brault-Dubuc & Mongeau (1989): 402 children studied in two cohorts starting at age 6 and 10 years with yearly measurements made for 7 years.
^e Torun et al (1994): 24 girls studied four times at 3-month intervals.

Table 25 Energy intakes of children aged approximately 1-5 years

						Energy intake (El)
			Weight (kg)			(MJ/d)		(kJ/kg/d)
Source	Age (y)	N	Mean	s.d.	BMRa (MJ/d)	Mean	s.d.	Mean	s.d.	x BMRb
Bellu et al (1991)	1	164	9.81	1.28	2.26	4.15	1.29	423	131	1.84c
		(76M, 88F)
Catassi et al (1988)	1-1.25	12	10.75	1.4	2.50	4.11	0.99	382	92	1.64
	1.25-1.50	10	11.90	1.0	2.79	4.12	0.65	349	55	1.48
	1.50-2.00	18	12.30	1.7	2.90	4.21	0.93	344	76	1.45
Davies et al (1993)	1.5-2.5	23	12.85	1.67	3.04	4.20	0.63	327	49	1.38
Duggan et al (1991)	1-1.5	13	11.00	(M)d	2.57	3.89e	1.26	354	115	1.51
	1.5-2.0	9	11.00	(M)	2.57	3.71	1.06	337	96	1.44
Hitchcock et al (1984)	1	62 (M)	11.0	(M)	2.57	4.15	0.85	377	77	1.55
		63 (F)	11.0	(M)	2.57	3.98	0.83	362	75	1.93c
	1.5	72 (M)	11.0	(M)	2.57	4.96	0.89	451	81	1.74
		70 (F)	11.0	(M)	2.57	4.47	1.00	406	91	1.56
Hoffmans et al (1986)	1-2	124	11.2	-	2.62	4.08	1.06	366	107	1.56
Ikemoto et al (1989)	1-2	10	11.0	1.6	2.57	3.90	0.41	377	40	1.52
McKillop & Durnin (1982)	1-2	73 (M)	11.6	-	2.72	4.79	1.02	413	-	1.76
		70 (F)	10.9	-	2.56	4.59	0.96	420	-	1.79
Pao et al (1985)	1-2	246	11.0	(M)	2.57	4.90	1.43	445	130	1.91c
Paul et al (1990)	1.0	15 (M)	10.00	1.23	2.31	3.72	0.60	370	60	1.61
	1.0	14 (F)	9.07	0.98	2.09	3.39	0.48	370	50	1.62
	1.25	13 (M)	10.37	1.07	2.41	3.90	0.77	380	50	1.62
	1.25	12 (F)	9.70	0.68	2.25	3.63	0.46	370	50	1.73
	1.50	11 (M)	10.87	1.47	2.53	4.02	0.93	370	70	1.59
	1.50	11 (F)	10.45	1.00	2.44	3.68	0.61	350	60	1.51
Räsänen & Ylonen (1992)	1-2	23 (M)	11.0	(M)	2.57	5.20	0.83	473	75	2.02c
		23 (F)	11.0	(M)	2.57	4.57	0.92	415	84	1.78
		46 (Total)	11.0	(M)	2.57	4.89	0.93	445	85	1.90c
Sawaya et al (1988)	1.1-2	178	11.15	-	2.62	3.62	-	325	-	1.38
Van Steenbergen (1984)	1-3	22	12.25		2.90	4.16	1.74	340	142	1.44
Walker et al (1990)	0.75-2	129 stunted	8.43		1.92	3.99	1.87	473	213	2.07c
	0.75-2	62 non-stunted	11.45		2.69	4.07	1.50	356	130	1.51
Boulton (1981)	2.0	102 (M)	12.94	1.67	3.06	5.08	0.99	400	80	1.66
		95 (F)	12.65	2.91	3.00	4.73	1.03	390	90	1.58
		197 (Total)	12.78	2.69	3.02	5.02	1.86	400	140	1.66
Catassi et al (1988)	2.0 2.5	18	14.90	3.3	3.56	4.53	0.93	307	63	1.27c
Davies et al (1994)	2.5-3.5	31	14.96	1.40	3.57	4.64	0.74	310	49	1.30
Deheeger et al (1991)	2.0	131 (M)	12.1	1.6	2.85	5.51	1.34	452	110	1.93c
		192 (F)	12.2	1.9	2.87	5.85	1.08	480	89	2.04c
Duggan et al (1991)	2-3.25	10	13.5	(M)	3.20	4.35	1.62	322	120	1.36
Eastwood et al (1990)	2.75 3.9	45	15.05		3.49	6.48	1.66	430	1.85c
Hagman et al (1986)	2-3	41 (M)	15.1	-	3.61	5.80	-	384	-	1.61
		41 (F)	15.4	-	3.70	5.55	-	360	-	1.50
Hitchcock et al (1984)	2	74 (M)	13.5	(M)	3.20	5.35	1.01	396	75	1.67
		72 (F)	13.5	(M)	3.22	4.85	1.17	359	87	1.51
Hoffmans et al (1980)	2-3	124	13.8	-	3.28	4.74	1.39	344	107	1.45
Narasinga et al (1993)	2-3	9 (M)	13.4	-	3.18	5.44	-	407	-	1.71
		10 (F)	11.7	-	2.76	4.72	-	403	-	1.71
Neiderud et al (1992)	2-3	11 Greek Imm	13.5	(M)	3.20	6.08	-	450	-	1.90c
		13 Swedish	13.5	(M)	3.20	4.99	-	370	-	1.56
		20 Greek	13.5	(M)	3.20	5.63	-	417	-	1.76
Palti et al (1979)	2.5	98	13.2	-	3.12	4.58	13.38	347	105	1.47
Paul et al (1990)	2.0	13 (M)	12.20	1.20	2.87	4.22	0.78	350	60	1.47
		9 (F)	11.61	0.83	2.74	4.03	0.50	350	40	1.47
Payne & Belton (1992)	2-3	31 (M)	14.0	1.5	3.33	4.50	0.76	321	54	1.35
		42 (F)	13.5	1.4	3.22	4.39	0.83	325	61	1.36
Salas et al (1990)	2-5	61	15.0	(M)	3.48	6.68	1.39	445	93	1.92c
Sawaya et al (1988)	2.1-3	97	13.25	-	3.32	4.06	-	306	-	1.22c
Davies et al (1994)	3.5-4 5	27	16.94	2.10	3.66	5.42	0.64	320	38	1.48
Eastwood et al (1990)	2.8-3.9	45	15.05	-	3.49	6.48	1.66	430	-	1.85c
Griffiths et al (1987)	3-4	15 (M)	16.0	2.0	3.58	4.60	0.82	289	42	1.28
		22 (F)	15.4	1.5	3.52	5.48	1.07	360	71	1.56
Hitchcock et al (1984)	3-4	73 (M)	16.5	(M)	3.62	5.74	1.00	348	61	1.59
		72 (F)	16.5	(M)	3.63	5.55	0.94	336	57	1.53
Leung et al (1984)	3-4	189	16.5	(M)	3.62	5.80	1.20	352	73	1.60
Livingstone et al (1992b)	3-4	8	16.4	1.5	3.61	5.91	0.55	360	34	1.64
Narasinga et al (1983)	3 4	23 (M)	14.9	-	3.47	6.33	-	425	-	1.82c
		13 (F)	15.0	-	3.49	5.81	-	387	-	1.66
Oliveria et al (1992)	3-5	55 (M)	16.5	(M)	3.62	6.71	0.95	407	58	1.85c
		36 (F)	16.5	(M)	3.63	6.14	1.23	372	75	1.69
		91 (Total)	16.5	(M)	3.62	6.48	1.10	393	67	1.79
Palti et al (1979)	3	82	14.1	-	3.40	5.09	1.25	360	89	1.50
Pao et al (1985)	3-5	404	16.5	(M)	3.62	5.99	1.62	363	98	1.65
Paul et al (1990)	3	20 (M)	14.53	1.56	3.44	4.96	0.78	340	50	1.44
		13 (F)	14.16	1.35	3.41	4.62	0.50	330	50	1.35
Parizkova et al (1986)	3-5	22	19.3	2.50	3.89	7.25	2.03	376	105	1.86c
Payne & Belton (1992)	3-4	31 (M)	16.3	1.6	3.60	5.01	0.89	307	55	1.39
		38 (F)	15.4	1.7	3.52	4.76	0.71	309	46	1.35
Räsänen et al (1985)	3-4	153 (M)	15.7	(median)f	3.55	6.40	1.70	408	108	1.80c
		128 (F)	15.2	(median)f	3.50	5.80	1.20	382	79	1.66
Sawaya et al (1988)	3.1-4	158	15.4	-	3.53	4.62	-	300	-	1.31
Treiber et al (1990)	3-5	66	16.35	-	3.62	6.84	1.78	418	-	1.89c
Eastwood et al (1990)	4.0-5.0	22	17.25	-	3.71	6.30	1.19	365	-	1.70
Hagman et al (1986)	4-5	154 (M)	18.8	-	3.84	6.90	-	367	-	1.80c
		152 (F)	18.6	-	3.82	6.45	-	347	-	1.69
Magaray & Boulton (1984)	4-5	93 (M)	17.9	-	3.76	5.94	-	331	-	1.58
		85 (F)	17.7	-	3.74	5.44	-	307	-	1.45
Narasinga et al (1983)	4-5	17 (M)	17.3	-	3.70	6.62	-	383	-	1.79
		6 (F)	15.6	-	3.54	5.90	-	378	-	1.67
Palti et al (1979)	4	75	16.5	-	3.62	4.96	0.95	301	58	1.37
Payne & Belton (1992)	4-5	35 (M)	18.0	1.9	3.77	5.30	0.79	294	44	1.41
		30 (F)	17.6	2.2	3.73	5.06	0.89	288	51	1.36
Persson & Calgren (1984)	4-5	Total sample of 477	16.5	(M)	3.62	6.67	1.23	404	75	1.84c
		(including 8-9 y)
Sawaya et al (1988)	4.1-5	107	17.25	-	3.71	4.93	-	286	-	1.33
Vanderkooy et al (1987)	4-5	62 (M)	18.6	-	3.82	6.23	1.64	335	57	1.63
		44 (F)	18.0	-	3.77	5.38	1.47	299	53	1.43
Van Steenbergen (1984)	4-6	34	18.2	-	3.79	5.04	2.03	277	111	1.33

^a BMR = Predicted basal metabolic rate (FAO/WHO/UNU, 1985).
^b Mean energy intakes expressed as a multiple of mean predicted BMR.
^c Excluded from Table 31 because x BMR was < 1.28 or > 1.79.
^d (M) = Median (NCHS) weights at mid-year.
^e Mean energy intakes (MJ/d) calculated from recorded energy intake (kJ/kg/d) and median (NCHS) weights.
^f Median weights reported.

Table 26 Energy intakes of boys aged approximately 5-10 years

							Energy intake
			Weight (kg)			(MJ/d)		(kJ/kg/d)
Source	Age (y)	N	Mean	s.d.	BMRa (MJ/d)	Mean	s.d.	Mean	s.d.	× BMRb
Boggio & Klepping (1981)	5-6	51	19.5	2.2	3.91	6.89	1.12	353	57	1.76
Durnin (1984)	5-6	93	19.5	(Median)c	3.91	6.90	-	354	-	1.76
Livingstone et al (1992b)	5-6	6	17.9	2.5	3.76	6.57	0.83	367	46	1.75
Narasinga et al (1983)	5-6	12	17.4	-	3.71	6.63	-	381	-	1.79
Brault-Dubuc & Mongeau (1989)	6-7	102	20.6	2.52	4.01	8.91	1.73	438	99	2.22
Martinez (1982)	6 7	89	22.4	-	4.18	8.03	2.05	358	92	1.92
Morrison et al (1980)	6-9	95 (white)d	23.8	(M)e	4.31	8.10	2.51	340	105	1.88
		35 (black)	23.8	(M)	4.31	6.97	2.90	293	122	1.62
Räsänen et al (1985)	6-7	139	21.6	(M)	4.11	7.90	1.90	366	88	1.92
Salz et al (1983)	6-9	102	25.8	-	4.50	8.27	2.22	321	101	1.84
Brault-Dubuc & Mongeau (1989)	7-8	84	22.9	3.1	4.23	9.04	1.84	401	95	2.14
Livingstone et al (1992b)	7-8	6	25.4	6.6	4.46	9.75	1.93 (WDR)f	384	76	2.19
					4.46	9.41	1.50 (DH)	370	59	2.11
Nelson et al (1990)	7-10	25	27.0	(M)	4.62	7.59	1.43	281	31	1.64
Boulton (1981)	8-9	17	31.9	-	5.08	8.93	1.81	280	60	1.76
Brault-Dubuc & Mongeau (1989)	8-9	98	25.4	3.7	4.46	9.43	1.73	375	63	2.11
Hagman et al (1986)	8-9	144	27.3	-	4.64	8.90	-	326	-	1.92
Jenner et al (1988)	8-10	434	30.1	-	4.91	7.45	1.80	248	60	1.52
Knuiman et al (1983)	9	133 (Finland)	30.0	5.0	4.90	9.25	1.63	310	54	1.89
	9	117 (Netherlands)	30.0	5.0	4.90	8.75	1.38	293	46	1.79
	9	109 (Italy)	30.0	7.0	4.90	9.25	2.13	310	71	1.89
	9	114 (Philippines)	22.0	3.0	4.14	7.98	1.93	364	88	1.93
	9	116 (Ghana)	24.0	3.0	4.33	7.10	1.40	297	59	1.64
Lopez-Jaramillo et al (1992)	9	78 (LSC)g	25.5	-	4.47	5.20	1.15	204	45	1.16i
		36 (USC)	27.0	-	4.62	6.43	0.96	238	36	1.39
Sunnegardh et al (1986)	8-9	159	27.3	3.8	4.64	8.40	2.50 (24-h R)h	308	92	1.81
		142	27.3	3.8	4.64	8.90	1.20 (DR)	326	44	1.92
Boulton (1981)	9.11	23	31.6	-	5.05	8.85	1.15	280	60	1.75
Brault-Dubuc & Mongeau (1989)	9-10	103	27.8	3.9	4.69	9.74	1.91	355	77	2.08
Livingstone et al (1992b)	9-10	6	30.2	8.4	4.92	8.95	1.36 (WDR)	296	45	1.82
					4.92	9.94	1.38 (DH)	329	46	2.02
Räsänen et al (1985)	9-10	162	29.9	(M)	4.89	9.10	2.30	304	77	1.86
Räsänen et al (1991)	9-10	119	27.0	(M)	4.89	8.30	2.40	307	89	1.70

^a BMR = Predicted basal metabolic rate (FAO/WHO/UNU, 1985).
^b Mean energy intakes expressed as a multiple of mean predicted BMR.
^c Median weight report.
^d White = white children, black = black children.
^e (M) = Median (NCHS) weights at mid-year.
^f WDR = weighed dietary record, DH = diet history.
^g LSC = lower social class, USC = upper social class.
^b 24-h R = 24-h recall, DR = diet records (estimated from household measures).
ⁱ Excluded from Table 31 because × BMR was < 1.39.

Table 27 Energy intakes of girls aged approximately 5-10 years

							Energy intake
			Weight (kg)			(MJ/d)		(kJ/kg/d)
Source	Age (y)	N	Mean	s.d.	BMRa (MJ/d)	Mean	s.d.	Mean	s.d.	× BMRb
Boggio & Kleping (1981)	5-6	52	19.2	2.5	3.88	6.62	1.19	345	62	1.71
Durnin (1984)	5-6	110	18.4	(Median)c	3.80	6.00	-	326	-	1.58
Livingstone et al (1992a,b)	5-6	6	18.1	2.2	3.78	6.54	0.64	361	35	1.73
Narasinga et al (1983)	5-6	9	16.9	-	3.66	5.91	-	350	-	1.61
Brault-Dubuc & Mongeau (1989)	6-7	93	19.0	2.7	3.86	7.86	1.51	416	84	2.04
Martinez (1982)	6-7	104	21.6	-	4.10	7.28	1.38	337	64	1.78
Morrison et al (1980)	6-9	79 (white)d	23.8	(M)e	4.31	8.11	2.34	341	98	1.88
		37 (black)	23.8	(M)	4.31	6.08	2.64	255	111	1.41
Räsänen et al (1985)	6-7	145	20.5	(M)	4.00	6.80	1.30	332	63	1.70
Salz et al (1983)	6-9	93	25.6	-	4.48	7.87	2.12	308	87	1.76
Brault-Dubuc & Mongeau (1989)	7-8	73	21.0	2.81	4.05	8.25	1.43	398	82	2.04
Livingstone et al (1992a,b)	7-8	6	23.5	2.2	4.28	6.62	0.82 (WDR)f	282	35	1.55
					4.28	7.56	1.20 (DH)	322	51	1.77
Nelson et al (1990)	7-10	26	27.0	(M)	4.61	6.92	1.39	256	51	1.50
Boulton (1981)	8-9	17	29.8	-	4.87	7.74	1.12	260	30	1.59
Brault-Dubuc & Mongeau (1989)	8-9	95	23.4	4.8	4.27	8.21	1.37	358	80	1.92
Hagman et al (1986)	8-9	152	28.7	-	4.77	7.85	-	274	-	1.65
Jenner et al (1988)	8-10	450	29.3	-	4.83	6.92	1.85	236	63	1.43
Sunnegardh et al (1986)	8-9	167	28.6	6.6	4.76	7.70	2.60 (24-h R)g	269	91	1.62
		153	28.6	6.6	4.76	8.00	1.20 (DR)	280	42	1.68
Boulton (1981)	9-11	24	34.6	-	5.32	7.62	2.06	220	70	1.43
Brault-Dubuc & Mongeau (1989)	9-10	94	26.6	4.6	4.57	8.38	1.43	321	65	1.83
Livingstone et al (1992a)	9-10	6	32.2	3.6	5.10	7.95	1.26 (WDR)	247	39	1.56
					5.10	8.63	0.43 (DH)	268	13	1.69
Räsänen et al (1985)	9-10	154	30.3	(M)	4.92	7.70	-	254	-	1.57
Räsänen et al (1991)	9-10	109	27.0	(M)	4.92	7.80	2.20	289	81	1.59

^a BMR = Predicted base; metabolic rate (FAO/WHO/UNU, 1985).
^b Mean energy intakes expressed as a multiple of mean predicted BMR.
^c Median weight reported.
^d White = white children, black = black children.
^e (M) = Median (NCHS) weights at mid-year.
^f WDR = weighed dietary record, DH = diet history.
^g 24-h R = 24-h recall, DR = diet records (estimated from household measures).

Table 28 Energy intakes of boys aged approximately 10-18 years

						Energy intake (EI)
			Weight (kg)			(MJ/d)		(kJ/kg/d)
Source	Age (y)	N	Mean	s.d.	BMRa (MJ/d)	Mean	s.d.	Mean	s.d.	× BMRb
Boggio & Klepping (1981)	9-11	37	31.3	4.5	4.99	8.34	1.04	266	33	1.67
Brault-Dubuc & Mongeau (1989)	10	104	31.4	5.5	5.00	10.58	2.20	344	80	2.12
Cunningham & Lee (1990)	8-12	85	34.1	-	5.20	9.70	3.20	284	94	1.87
Department of Health (1989)	10-11	902c	36.8	7.7	5.40	8.67	1.51	236	41	1.61
Durnin (1984)	10-11	102	33.0	(Median)d	5.11	8.40	-	255	-	1.64
Frank et al (1985)	9-11	184	35.0	-	5.26	9.80	-	280	-	1.86
Morrison et al (1980)	10-12	101 (white)e	34.5	(M)f	5.23	10.15	3.68	294	107	1.94
	10-12	31 (black)	34.5	(M)	5.23	8.33	4.13	241	120	1.59
Pao et al (1985)	9-11	196	31.0	(M)	4.99	8.29	2.41	267	-	1.66
Rodriguez (1991)	10-11	140	34.2	8.0	5.22	7.38	1.92	222	59	1.41
Seone & Roberge (1983)	10-12	99	35.8	-	5.32	9.08	1.69	254	47	1.71
Tayter et al (1989)	10-12	20	35.3	-	5.30	9.18	-	260	-	1.73
Adamson et al (1992)	11-12	184	40.5	-	5.67	8.61	1.76	213	-	1.52
Hackett et al (1984)	11-12	193	39.0	5.56	8.90	-	229	-		1.60
Boulton (1981)	11-12	8	39.0	-	5.56	8.57	2.02	220	80	1.54
Brault-Dubuc & Mongeau (1989)	11-12	96	34.6	6.76	5.24	10.26	2.06	305	60	1.96
Jenner et al (1992)	11-12	626c	42.0	-	5.78	8.60	2.30	205	55	1.49
Nelson et al (1990)	11-12	76	37.0	(M)	5.41	7.74	1.67	209	45	1.43
Perusse et al (1984)	11-17	304	49.8	14.7	6.34	11.00	2.91	221	58	1.74
Boulton (1981)	12-13	15	42.7	-	5.83	10.25	1.78	240	70	1.76
Brault-Dubuc & Mongeau (1989)	12-13	79	37.6	6.8	5.45	10.63	1.87	290	50	1.95
Cunningham & Lee (1990)	12-15	93	49.3	-	6.31	11.30	3.30	229	67	1.79
Livingstone et al (1992b)	12-13	6	44.5	6.7	5.96	10.15	1.08 (WDR)g	228	24	1.70
					5.96	11.82	2.64 (DH)	266	59	1.98
Pao et al (1985)	12-14	296	44.0 (M)	5.92	9.49	2.91	216	-		1.60
Post et al (1987)	12-13	26	38.4	-	5.51	11.70	2.55	305	66	2.12
Räsänen et al (1991)	12-13	116	40.9	(M)	5.69	10.20	3.60	249	88	1.79
Strain et al (1994)	12-13	251	43.0	9.4	5.85	11.0	(Median)	256	-	1.88
Tan et al (1989)	12-14	246	44.0	(M)	5.92	10.2	2.9	232	66	1.72
Woodward et al (1984)h	12-13	132h	41.0	(Median)	5.70	9.9	(Median)	241	-	1.74
Boulton (1981)	13-14	12	52.6	-	6.55	10.0	2.54	190	30	1.53
Brault-Dubuc & Mongeau (1989)	13-14	61	42.6	7.2	5.82	10.70	2.05	257	48	1.84
Frank et al (1985)	13-14	78	49.8	-	6.34	11.03	-	221	-	1.74
Hagman et al (1986)	13-14	166	50.5	-	6.40	12.10	-	240	-	1.89
Morrison et al (1980)	13-15	94 (white)	49.8	(M)	6.34	12.06	5 55	242	111	1.90
			40 (black)	49.8 (M)	6.34	10.87	5.08	218	102	1.72
Post et al (1987)	13-14	73	43.4	-	5.88	11.60	1.71	267	39	1.97
Sunnegardh et al (1986)	13-14	171	49.8	11.8	6.34	10.8	3.9 (24-h R)i	217	78	1.70
		166			6.34	12.3	3.9 (DH)	247	78	1.94
Seone & Roberge (1983)	13-15	103	52.5	-	6.54	10.91	2.23	208	42	1.67
Story (1986)	13-17	139	66.4	-	7.58	9.57	4.94	144	75	1.26i
Woodward et al (1984)	13-14	132	48.0	(Median)	6.21	11.70	(Median)	244	-	1.88
Baghurst & Record (1983)	14-15	77	52.6	(M)	6.55	11.95	-	227	-	1.82
Bergstrom et al (1993)	14-16	155	54.3	10.2	6.67	8.90	2.20	164	41	1.33j
Boulton (1981)	14-16	25	62.3	-	7.26	11.84	3.24	190	60	1.63
Boggio & Klepping (1981)	14-16	73	56.7	12.2	6.96	10.94	2.56	193	45	1.57
Brault-Dubuc & Mongeau (1989)	14-15	49	50.0	8.8	6.36	11.60	2.46	238	49	1.82
Department of Health (1989)	14-15	513c	55.7	9.5	6.77	10.40	2.30	187	41	1.54
Post et al (1987)	14-15	95	48.9	-	6.28	12.20	1.95	249	40	1.94
Woodward et al (1984)	14-15	132	54.0	(Median)	6.65	12.10	(Median)	224	-	1.82
Brault-Dubuc & Mongeau (1989)	15-16	46	57.0	8.34	6.87	12.29	2.84	218	50	1.79
Bull (1985)	15-18	198	62.0	(M)	7.23	10.10	-	163	-	1.40
Cunningham & Lee (1990)	15-18	73	63.9	-	7.37	14.0	4.5	219	70	1.90
Livingstone et al (1992a,b)	15-16	6	56.4	9.1	6.83	11.33	1.88 (WDR)	201	33	1.66
					6.83	13.91	2.20 (DH)	247	39	2.04
Michaud et al (1991)	15-19	198	63.7	8.5	7.36	12.39	3.80	195	60	1.68
Pao et al (1985)	15-18	365	61.9	(M)	7.23	10.92	3.55	176	57	1.51
Post et al (1987)	15-16	102	55.6	-	6.77	12.5	3.03	225	54	1.85
Räsänen et al (1985)	15-16	139	58.0	(M)	6.94	11.8	3.70	203	64	1.70
Räsänen et al (1991)	15-16	118	58.0	(M)	6.94	11.8	4.30	203	74	1.70
Strain et al (1994)	15-16	252	59.0	9.4	7.01	13.10	(Median)	222	-	1.87
Woodward et al (1984)	15-16	132	60.0	(Median)	7.09	11.9	(Median)	198	-	1.68
Bergstrom et al (1993)	16-18	211	66.4	8.4	7.55	10.50	2.70	158	41	1.39
Boulton (1981)	16-17	15	65.8	-	7.51	11.84	4.35	180	60	1.50
Brault-Dubuc & Mongeau (1989)	16-17	29	59.8	8.25	7.07	11.72	3.02	198	51	1.66
Crawley (1993)	16-17	2006e	62.7	(M)	7.31	11.40	2.69	182	43	1.56
Morrison et al (1980)	16-19	82 (white)	64.0	(M)	7.37	13.20	4.25	207	67	1.79
		14 (black)	64.0	(M)	7.37	13.11	5.57	205	87	1.78
Post et al (1987)	16-17	76	61.0	-	7.16	12.80	3.49	210	57	1.79
Seone & Roberge (1983)	16-18	69	63.9	-	7.37	12.31	2.82	193	44	1.67
Skinner et al (1985)	16-18	114	64.0	(M)	7.38	12.80	5.20	200	81	1.73
Kaufman et al (1982)	17-18	627c	61.3	-	7.18	10.38	3.91	169	64	1.45
Post et al (1987)	17-18	28	63.8	-	7.36	13.00	3.17	204	50	1.77
Livingstone et al (1992b)	18-19	5	78.5	14.1	7.83	10.72	3.46 (WDR)	137	44	1.37j
					7.83	15.52	2.26 (DH)	198	29	1.98
Räsänen et al (1985)	18-19	124	65.0	(M)	7.45	12.50	3.20	192	49	1.68
Räsänen et al (1991)	18-19	93	65.0	(M)	7.45	12.50	3.80	192	58	1.68

^a BMR = Predicted basal metabolic rate (FAO/WHO/UNU, 1985).
^b Mean energy intakes expressed as a multiple of mean predicted BMR.
^c Only 30% (for n > 500) or 20% (for n > 1000) used to calculate weighted means in Table 32.
^d Median values reported.
^e White = white children, black = black children.
^f (M) = Median weight for height from Baldwin's standards (FAO/WHO/UNU, 1985).
^g WDR = Weighted dietary record, DH = diet history.
h Woodward et al (1984). Total sample size = 1055. Sample sizes for specific groups were not reported but are assumed to be evenly distributed by age group (n = 4) and sex.
ⁱ 24-hr R = 24-h recall.
^j Excluded from Table 32 because × BMR was < 1.39.

Table 29 Energy intakes of girls aged approximately 10-18 years

						Energy intake (El)
			Weight (kg)			(MJ/d)		(kJ/kg/d)
Source	Age (y)	N	Mean	s.d.	BMRa (MJ/d)	Mean	s.d.	Mean	s.d.	× BMRb
Boggio & Klepping (1981)	9-11	38	31.0	5.0	4.68	7.38	1.53	238	49	1.58
Brault-Dubuc & Mongeau (1989)	10	103	30.9	6.8	4.68	9.02	1.99	300	79	1.93
Cunningham & Lee (1990)	8-12	63	34.7	-	4.87	8.40	2.80	242	81	1.72
Department of Health (1989)	10-11	821c	37.1	7.4	4.99	7.69	1.61	207	43	1.54
Durnin (1984)	10-11	125	34.4	Mediand	4.86	7.70	-	224	-	1.58
Frank et al (1985)	9-11	159	35.0	-	4.89	8.64	-	247	-	1.77
Morrison et al (1990)	10-12	103 (white)f	36.0	(M)e	4.94	8.85	2.90	246	81	1.79
	10-12	44 (black)	36.0	(M)	4.94	7.10	4.02	197	112	1.44
Pao et al (1985)	9-11	222	32.0	(M)	5.08	7.69	2.03	240	-	1.51
Seone & Roberge (1983)	10-12	72	37.4	-	5.01	7.91	1.70	211	45	1.58
Tayter et al (1989)	10-12	19	37.0	-	5.01	7.86	-	212	-	1.57
Torun et al (1994)	10-12	72	29.59	3.55	4.63	6.42 (24-h R)g	1.56	218	53	1.39
						5.97 (FFQ)	1.76	204	61	1.29h
Adamson et al (1992)	11-12	195	41.9	-	5.24	8.25	1.95	197	-	1.57
Hackett et al (1984)	11-12	212	39.9		5.14	8.27	-	207	-	1.61
Boulton (1981)	11-12	15	41.8	-	5.23	7.53	3.02	180	40	1.44
Brault-Dubuc & Mongeau (1989)	11-12	85	34.5	7.2	4.86	9.16	1.96	274	57	1.88
Jenner et al (1992)	11-12	589c	42.9	-	5.29	7.50	2.10	175	49	1.42
Nelson et al (1990)	11-12	67	38.7	(M)	5.08	7.45	1.20	193	31	1.47
Pérusse et al (1984)	11-17	276	46.4	11.2	5.47	8.47	2.57	183	47	1.55
Boulton (1981)	12-13	7	49.9	-	5.64	6.98	1.61	140	70	1.24h
Brault-Dubuc & Mongeau (1989)	12-13	71	38.9	7.2	5.09	9.55	1.93	253	50	1.88
Cunningham & Lee (1990)	12-15	114	51.7	-	5.74	9.10	3.0	176	58	1.59
Greger et al (1978)	12-13	183 (fall)	48.0	12.0	5.55	8.46	2.45	176	51	1.52
		184 (spring)	52.0	30.0	5.75	8.08	2.35	155	45	1.41
Livingstone et al (1992a,b)	12-13	6	44.8	3.9	5.39	8.57	1.59 (WDR)i	191	35	1.59
					5.39	12.08	1.47 (DH)	270	33	2.24h
McCoy et al (1984)	12-13	441	44.0	(M)	5.35	8.43	-	192	-	1.58
Pao et al (1985)	12-14	295	46.5	(M)	5.47	7.76	2.58	167	-	1.42
Post et al (1987)	12-13	31	42.2	-	5.25	9.80	1.67	232	40	1.87
Räsänen (1985)	12-13	166	44.0	(M)	5.35	8.20	2.30	186	52	1.53
Räsänen (1991)	12-13	119	44.0	(M)	5.35	8.50	2.60	193	59	1.59
Van den Reek (1986)	12-15	8	47.0	9.0	5.50	6.20	1.94	132	41	1.13h
Strain et al (1994)	12-13	259	44.0	9.0	5.35	9.2	(Median)	209	-	1.72
Tan et al (1989)	12-14	255	46.5	(M)	5.47	7.8	2.1	168	45	1.43
Woodward et al (1984)	12-13	132j	43.0	(Median)	5.29	8.9	(Median)	207	-	1.68
Boulton (1981)	13-14	15	62.4	-	6.28	7.49	2.04	120	40	1.19h
Brault-Dubuc & Mongeau (1989)	13-14	50	44.0	7.99	5.35	9.08	1.62	213	37	1.70
Frank et al (1985)	13-14	70	48.6	-	5.58	8.35	-	172	-	1.50
Hagman et al (1986)	13-14	170	50.3	-	5.67	9.65	-	192	-	1.70
Morrison et al (1980)	13-15	78 (white)	49.3	(M)	5.61	8.55	2.68	173	54	1.52
		32 (black)	49.3	(M)	5.61	7.83	2.78	159	56	1.40
Post et al (1987)	13-14	98	48.0	-	5.55	9.60	1.98	200	41	1.73
Seone & Roberge (1983)	13-15	92	50.5	-	5.68	8.61	1.63	170	32	1.52
Sunnegardh et al (1986)	13 14	169	50.9	9.2	5.70	8.10	2.60 (24-h R)	159	51	1.42
					5.70	9.90	2.60 (DH)	194	51	1.74
Story (1986)	13-17	138	62.8	-	6.32	7.57	2.89	120	46	1.20h
Woodward et al (1984)	13-14	132	49.0	(Median)	5.60	9.00	(Median)	184	-	1.61
Baghurst et al (1983)	14-15	69	51.4	(M)	5.72	9.36	-	182	-	1.64
Bergstrom et al (1993)	14-16	189	53.7	8.2	5.84	7.10	1.60	132	30	1.22h
Boulton et al (1981)	14-16	27	57.5	-	6.03	6.90	1.84	120	30	1.14h
Boggio & Klepping (1981)	14-16	125	51.2	7.50	5.71	8.48	1.97	166	38	1.49
Brault-Dubuc & Mongeau (1989)	14-15	37	48.3	7.30	5.56	8.96	2.31	191	48	1.61
Department of Health (1989)	14-15	461	53.7	9.20	5.84	7.85	1.74	146	32	1.34
McCoy et al (1984)	14-15	440	51.4	(M)	5.72	8.40	-	163	-	1.47
Post et al (1987)	14-15	129	52.0	-	5.75	9.60	2.27	185	44	1.67
Woodward et al (1981)	14-15	132	51.0	(Median)	5.70	9.2	(Median)	180	-	1.61
Barber et al (1985)	15-18	448	56.4	-	6.00	8.6	-	152	-	1.43
Brault-Dubuc & Mongeau (1989)	15-16	32	49.9	4.98	5.64	9.16	2.17	187	43	1.62
Bull (1985)	15-18	184	53.8	(M)	5.84	7.80	-	145	-	1.34
Cunningham et al (1990)	15-18	110	57.2	-	6.02	8.90	2.50	156	44	1.48
Livingstone et al (1992b)	15-16	6	57.2	9.2	6.02	6.84	1.78 (WDR)	120	31	1.14h
					6.02	9.34	1.70 (DH)	163	30	1.55
Michaud et al (1991)	15-19	283	54.6	6.2	5.88	8.40	2.73	154	50	1.43
Pao et al (1985)	15-18	374	53.8	(M)	5.84	7.39	2.73	137	51	1.27h
Post et al (1987)	15-16	130	54.9	-	5.90	9.50	2.28	173	42	1.61
Räsänen et al (1985)	15-16	152	53.0	(M)	5.80	7.60	2.20	143	42	1.31
Räsänen et al (1991)	15-16	112	53.0	-	5.80	8.60	3.30	162	62	1.48
Strain et al (1994)	15-16	254	57.0	8.5	6.01	9.10	(Median)	160	-	1.51
Woodward et al (1984)	15-16	132	52.0	(Median)	5.75	8.50	(Median)	163	-	1.48
Bergstrom et al (1993)	16-18	176	58.4	8.7	6.08	7.10	1.90	122	33	1.17h
Boulton (1981)	16-17	12	55.9	-	5.95	6.15	1.41	110	30	1.03h
Brault-Dubuc & Mongeau (1989)	16-17	18	52.0	5.60	5.75	9.11	2.18	178	42	1.58
Crawley (1993)	16-17	2754c	54.0	(M)	5.85	8.80	2.10	163	39	1.50
Morrison et al (1980)	16-19	71 (white)	54.0	(M)	5.85	8.68	3.41	161	63	1.48
		13 (black)	54.0	(M)	5.85	8.10	5.00	150	93	1.38
Post et al (1987)	16-17	99	57.4	-	6.03	9.30	1.99	162	35	1.54
Seone & Roberge (1983)	16-18	65	54.4	-	5.87	7.96	2.18	146	40	1.36
Skinner et al (1985)	16-18	111	54.0	(M)	5.85	8.60	3.77	159	70	1.47
Kaufman et al (1992)	17-18	551c	55 7	_	5.94	6.71	2.89	120	52	1.13h
Post et al (1987)	17-18	32	57.9	-	6.05	9.80	2.83	169	49	1.62
Livingstone et al (1992b)	18-19	5	63.9	16.2	5.98	7.84	1.74 (WDR)	123	27	1.31
					5.98	10.13	1.58 (DH)	159	25	1.69
Räsänen et al (1985)	18-19	148	54.4	-	5.87	7.70	2.50	142	46	1.31
Räsänen et al (1991)	18-19	116	54.4	-	5.87	7.40	2.50	136	46	1.26h

^a BMR = Predicted basal metabolic rate (FAO WHO/UNU, 1985).
^b Mean energy intakes expressed as a multiple of mean predicted BMR.
^c Only 30% (for n > 500) or 20% (for n > 1000) used to calculate weighted means in Table 33.
^d Median values reported.
^e (M) = Median weight for height from Baldwin's standards [FAO/WHO/UNU, 1985]
^f White = white children, black = black children.
^g 24-h R = 24-hour recall, FFQ = food frequency questionnaire.
^h Excluded from Table 33 because × BMR was < 1.30 or > 2.10.
ⁱ WDR = weighed dietary record, DH = diet history.
^j Woodward et al (1981). Total sample size = 1055. Sample sizes for specific groups were not reported but are assumed to be evenly distributed by age group (n = 4) and sex.

Table 30 Combined energy intakes for male and female subjects aged 5-10 years

						Energy intake
			Weight (kg)			(MJ/d)		(kJ/kg/d)
Source	Age (y)	N	Mean	s.d.	BMRa (MJ/d)	Mean	s.d.	Mean	s.d.	× BMRb
Ho et al (1988)	5-6	60	17.5	-	3.73	5.36	-	312	-	1.44
Morgan & Zabik (1981)	5-6	162	20.5	(M)c	4.00	8.09	-	395	-	2.02
Pao et al (1985)	6-8	428	22.4	(M)	4.18	7.17	1.89	320	-	1.72
Salas et al (1990)	6-9	60	23.8	(M)	4.31	8.63	1.60	363	67	2.00
Morgan & Zabik (1981)	7-8	168	23.6	(M)	4.29	8.75	-	371	-	2.04
Persson & Calgren (1984)	8-9	(Total sample of 477 including 4-5 olds)	27.6	(M)	4.67	8.22	1.56	298	57	1.76
Morgan & Zabik (1981)	9-10	165	30.1	(M)	4.91	9.30	-	309	-	1.89

^a BMR = Predicted basal metabolic rate (FAO WHO/UNU, 1985).
^b Mean energy intakes expressed as a multiple of mean predicted BMR.
^c (M) = Median (NCHS) weights at mid-year (FAO/WHO/UNU, 1985).

Table 31 Energy intakes of subjects (sexes combined) aged 1-5 years, and of boys and girls aged 5-10 years compared with current FAO/WHO/UNU (1985) estimated requirements

			Energy intakea
			(MJ/d)		(kJ/kg/d)		(kcal/kg/d)		× BMR	FAO/WHO/UNU (1985) requirements		Percentage difference (%)b
Age (y)	Studies n	Subjects n	Mean	s.d.	Mean	s.d.	Mean	s.d.	Mean	(MJ/d)	(kJ/kg/d)	(MJ/d)	(kJ/kg/d)
Sexes combined
1-2	12	927	4.17	0.82	375	74	90	18	1.54	4.80	439	- 13.1	- 14.6
			(Range 3.39-4.96)		(Range 325-451)				(Range 1.38-1.79)
2-3	11	835	4.92	1.08	367	81	88	19	1.51	5.70	418	-13.7	-12.2
			(Range 4.03-5.80)		(Range 310-407)				(Range 1.30-1.76)
3-5	22	2460	5.76	1.15	345	67	82	16	1.53	6.50	397	-11.4	-13.1
			(Range 4.60-6.90)		(Range 277-408)				(Range 1.31-1.80)
Boys
5-6	6	273c	7.06	1.05	363	53	87	13	1.80	7.57	385	- 6.7	- 5.7
			(Range 5.36-8.09)		(Range 312-395)				(Range 1.44-2.02)
6-7	4	544	7.82	1.88	360	87	86	21	1.90	7.94	368	-1.5	-2.2
			(Range 7.17-8.91)		(Range 320-438)				(Range 1.92-2.22)
7-8	6	436	8.41	2.29	352	100	84	24	1.94	8.32	347	+ 1.1	+ 1.4
			(Range 6.97-9.58)		(Range 293-401)				(Range 1.62-2.14)
8-9	7	996	8.13	1.79	289	62	69	15	1.72	8.66	322	-6.1	- 10.2
			(Range 7.45-9.43)		(Range 248-375)				(Range 1.64-2.11)
9-10	7	1085	8.75	1.81	314	66	75	16	1.83	8.99	301	-2.7	+4.3
			(Range 7.10-9.74)		(Range 280-364)				(Range 1.64-2.08)
Girls
5-6	6	288	6.64	0.96	349	50	83	12	1.72	6.81	368	-2.5	-5.2
			(Range 5.36-8.09)		(Range 312-395)				(Range 1.44-2.02)
6 7	4	556	7.21	1.52	342	66	82	16	1.78	7.11	347	+1.4	-1.4
			(Range 6.80-7.86)		(Range 320-416)				(Range 1.70-2.04)
7-8	6	402	8.05	2.13	343	93	82	22	1.88	7.40	318	+8.8	+7.9
			(Range 6.08-8.25)		(Range 255-398)				(Range 1.41-2.04)
8-9	7	1026	7.47	1.69	266	62	64	15	1.58	7.65	268	-2.4	-0.7
			(Range 6.92-8.21)		(Range 236-358)				(Range 1.50-1.92)
9-10	6	469	8.14	1.75	283	67	68	16	1.68	7.86	259	+3 6	+9.3
			(Range 7.62-8.38)		(Range 220-321)				(Range 1.43-1.83)

^a Energy intake data (MJ/d, kJ/kg/d, × BMR) expressed as weighted means. s.d. estimated from

(ⁿ = number of studies). For studies where s.d. was not reported the mean CV of other studies in that group was assumed.

^b Percentage difference = (energy intake - FAO/WHO/UNU estimated requirement)/estimated requirement × 100.
^c Sample sizes for 5-10 year olds include studies listed in Table 30 and assume equal numbers of boys and girls.

Table 32 Energy intakes of boys aged 10-18 years compared with current FAO/WHO/UNU (1985) estimated requirements

			Energy intakea
			(MJ/d)		(kJ/kg/d)		(kcal/kg/d)		× BMR	FAO/WHO/UNU (1985) requirements			Percentage difference (%)b
Age (y)	Studies n	Subjects n	Mean	s.d.	Mean	s.d.	Mean	s.d.	Mean	(MJ/d)	(kJ/kg/d)	× BMR	(MJ/d)	(kJ/kg/d)	× BMR
10-11	10	1981	8.86	2.62	255	76	61	18	1.68	8.95	278	1.76	-1.0	-8.3	-4.5
			(Range 7.38-10.58)		(Range 222-344)				(Range 1.41-2.12)
11-12	7	1203	8.74	1.97	220	58	53	14	1.55	9.37	254	1.73	-6.7	-13.4	-10.4
			(Range 7.74-10.26)		(Range 205-305)				(Range 1.43-1.96)
12-13	9	1167	10.47	2.59	240	61	57	15	1.76	9.66	237	1.69	+8.4	+1.3	+4.1
			(Range 9.49-11.0)		(Range 216-305)				(Range 1.60-2.12)
13-14	10	1023	11.37	3.28	233	64	56	15	1.80	10.20	217	1.67	+11.5	+7.4	+7.2
			(Range 10.00-12.10)		(Range 190-267)				(Range 1.53-1.97)
14-15	8	1268	11.11	2.50	208	50	50	12	1.70	10.83	206	1.65	+2.6	+0.1	+2.4
			(Range 10.40-12.20)		(Range 187-249)				(Range 1.54-1.94)
15-16	7	795	12.34	3.25	212	57	51	14	1.75	11.29	195	1.62	+9.3	+8.7	+8.0
			(Range 11.33-13.10)		(Range 198-225)				(Range 1.66-1.87)
16-17	10	3143	11.49	3.51	184	55	44	13	1.57	11.71	187	1.60	-1.9	-1.6	-1.9
			(Range 10.10-14.00)		(Range 163-219)				(Range 1.40-1.90)
17-18	5	968	11.22	3.53	179	56	43	13	1.55	12.00	184	1.60	-6.5	-2.7	-3.1
			(Range 10.38-13.20)		(Range 169-207)				(Range 1.45-1.79)

^a Energy intake data (MJ/d, kJ/kg/d, × BMR) expressed as weighted means. s.d. estimated from

(n = number of studies). For studies where s.d. was not reported the mean CV of other studies in that group was assumed.
^b Percentage difference = (Energy intake - FAO/WHO/UNU estimated requirement)/estimated requirement × 100.

Table 33 Energy intakes of girls aged 10-18 years compared with current FAO/WHO/UNU (1985) estimated requirements

			Energy intakea
			(MJ/d)		(kJ/kg/d)		(kcal/kg/d)		× BMR	FAO/WHO/UNU (1985) requirements			Percentage difference (%)b
Age (y)	Studies n	Subjects n	Mean	s.d.	Mean	s.d	Mean	s.d.	Mean	(MJ/d)	(kJ/kg/d)	× BMR	(MJ/d)	(kJ/kg/d)	× BMR
10-11	9	1750	7.94	2.46	226	72	54	17	1.60	7.99	237	1.65	-0.6	-4.6	-3.0
			(Range 7.09-9.02)		(Range 197-300)				(Range 1.44-1.93)
11-12	8	1254	7.81	2.16	194	45	46	11	1.51	8.28	215	1.63	-5.7	-9.8	-7.4
			(Range 6.54-9.16)		(Range 175-274)				(Range 1.41-1.88)
12-13	11	2142	8.41	2.16	186	53	44	13	1.55	8.57	196	1.60	-1.9	-5.1	-3.1
			(Range 7.80-9.80)		(Range 168-253)				(Range 1.42-1.88)
13-14	9	1005	8.88	2.39	179	48	43	11	1.58	8.87	181	1.58	0.0	-1.1	0.0
			(Range 7.83-9.65)		(Range 159-213)				(Range 1.40-1.73)
14-15	8	1669	8.47	2.19	166	42	40	10	1.49	9.03	176	1.57	-6.2	-5.7	-5.1
			(Range 7.85-9.60)		(Range 146 191)				(Range 1.34-1.67)
15-16	7	818	8.72	2.39	161	45	38	11	1.48	8.95	169	1.54	-2.6	-4.7	-3.9
			(Range 7.60-9.50)		(Range 143-187)				(Range 1.31-1.62)
16-17	8	3789	8.62	2.53	156	46	37	11	1.46	8.91	166	1.53	-3.3	-6.0	-4.6
			(Range 7.80-9.30)		(Range 145-178)				(Range 1.34-1.58)
17-18	3	399	8.55	3.32	156	61	37	15	1.45	8.95	165	1.52	-4.4	-5.4	-4.6
			(Range 8.10-9.80)		(Range 150-169)				(Range 1.38-1.62)

^a Energy intake data (MJ/d, kJ/kg/d, × BMR) expressed as weighted means. s.d. estimated from

(n = number of studies). For studies where s.d. was not reported the mean CV of other studies in that group was assumed.
^b Percentage difference = (energy intake - FAO/WHO/UNU estimated requirement)/estimated requirement × 100.

Figure 11a Energy intake compared with expenditure estimated by doubly labeled water and heart rate monitoring, including stunted and underweight children, and current recommendations: boys (solid line: mean energy intake; interrupted line: FAO/WHO/UNU recommendations).

Figure 11b Energy intake compared with expenditure estimated by doubly labeled water and heart rate monitoring, including stunted and underweight children, and current recommendations: girls (solid line: mean energy intake; interrupted line: FAO/WHO/UNU recommendations).

Figure 12 Comparison of average dietary energy intakes of boys and girls.