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close this bookEnergy and Protein Requirements, Proceedings of an IDECG workshop, November 1994, London, UK, Supplement of the European Journal of Clinical Nutrition (International Dietary Energy Consultative Group - IDECG, 1994, 198 pages)
close this folderEnergy requirements and dietary energy recommendations for children and adolescents 1 to 18 years old
View the document(introductory text...)
View the documentIntroduction
View the documentTotal daily energy expenditure (TEE)
View the documentEstimates of basal metabolic rate to calculate total energy expenditure
View the documentTime allocation to different activities
View the documentPhysical activity levels of children and adolescents
View the documentDietary energy intake
View the documentGeneral conclusions and recommendations
View the documentReferences
View the documentDiscussion

Physical activity levels of children and adolescents

The occupational and habitual activities of adults are classified as light, moderate and heavy, and taken into account to calculate and recommend dietary energy intakes. The data presented in this document supports the suggestion that the same approach must be applied to children from 5 years of age onwards.

To do so, estimates must be made of the 24-hour PAL of children and adolescents with different lifestyles. This is usually associated with their geographic habitat (urban or rural, industrialized or developing country) and socioeconomic conditions.

An analysis of the PALs calculated in this review for children studied with doubly-labeled water, heart rate monitoring, time-motion/diary techniques and time allocation estimates allows making practical suggestions. Table 19 summarizes those calculations for industrialized countries and cities in developing countries, calculated as weighted means for the total number of boys or girls included in all studies with a specific technique. Studies with mean PAL < 1.40 for children over 5 years old were excluded, as well as those with PAL > 1.90 at all ages, as those figures are very unlikely to represent the habitual activity level of children in cities and industrialized countries. The mean PALS of normal and stunted children calculated from heart rate monitoring methods were combined as they were derived from otherwise healthy children, and in most cases they agreed within 4%.

There is hardly any information of TEE of children and adolescents living in rural developing countries. Therefore, we only estimated their PAL from time allocation data, as described in the preceding section and shown in Tables 15, 16 and 18.

The estimates of PALs from studies on time-motion/ diary records and time allocation data involve a series of assumptions on the energy cost of activities and tasks to calculate TEE. Thus, it seems more reasonable to use the data derived from doubly-labeled water and heart rate monitoring studies to suggest PALs to estimate the energy expenditure and requirements of children and adolescents from different populations. Such PALs, based on the data in Table 19, are shown in Table 20. Assuming that those levels of physical activity correspond to children and adolescents who are neither extremely sedentary nor active and are consuming dietary energy ad libitum, we suggest that they are equivalent to a moderate PAL.

The mean coefficient of variance (CV) of the studies with doubly-labeled water and heart rate monitoring in boys and girls 1-5, 6-13 and >14 years old shown in Tables 3 and 5 is 6%. We calculated the PAL of light and heavy lifestyles by subtracting or adding twice the CV (i.e. 12%) from the moderate PAL of children and adolescents over 5 years old (Table 20). It is unlikely that infants and preschoolers have a heavy physical lifestyle. Consequently, for that age group it is suggested that the mean of the PALs shown in Table 19 (measured by DLW or HR) be applied to a 'light' lifestyle, and the additional 12% (twice the mean CV) be applied to a 'moderate' PAL.

Table 20 Physical activity levels suggested to estimate total daily energy expenditure from the mean basal metabolic rate of children and adolescents



Habitual physical activity

Age (y)

Sex

Light

Moderate

Heavy

1-5

M, F

1.44

1.61


6-13

M

1.54

1.75

1.96

14-18

M

1.60

1.82

2.04

6-13

F

1.48

1.68

1.88

14-18

F

1.46

1.66

1.86

Table 21 Data from Table 20 rounded to the closest 0.05 PAL units



Habitual physical activity

Age (y)

Sex

Light

Moderate

Heavy

1-5

M, F

1.45

1.60

-

6-13

M

1.55

1.75

1.95

14-18

M

1.60

1.80

2.05

6-13

F

1.50

1.70

1.90

14-18

F

1.45

1.65

1.85

To facilitate remembering those PAL factors, it is further suggested to round them to the closest 0.05 PAL units, as shown in Table 21.

As more information on TEE and BMR of boys and girls with different lifestyles becomes available and the questions related to the mathematical equations to estimate BMR are cleared, the PALs shown in Table 21 may be modified. In the meantime, their use is suggested as a first approximation to estimate energy requirements in population groups where actual data is unavailable. Table 22 shows those estimates for boys and girls with median weights-for-age corresponding to the NCHS standards. Figure 7 compares them with measurements using doubly labeled water and heart rate monitoring, expressed as kcal/kg/day.

Table 22 Estimates of total daily energy expenditure from the physical activity levels suggested in Table 21 and basal metabolic rates calculated with Schofield's equations



Habitual physical activityb



Light

Moderate

Heavy

Age (y)

Weighta
(kg)

(kcal/d)

(kcal/kg/d)

(kcal/d)

(kcal/kg/d)

(kcal/d)

(kcal/kg/d)

Boys

1

10.4

854

82.1

942

90.6

c

c

2

12.3

1018

82.7

1123

91.3

c

c

3

14.6

1211

83.0

1337

91.6

c

c

4

16.7

1281

76.6

1413

84.6



5

18.7

1346

72.0

1486

79.4



6

20.7

1510

72.9

1704

82.3

1899

91.7

7

22.9

1587

69.3

1792

78.2

1996

87.2

8

25.3

1671

66.1

1887

74.6

2102

83.1

9

28.1

1770

63.0

1998

71.1

2227

79.2

10

31.4

1885

60.0

2126

67.7

2370

75.5

11

35.3

1988

56.3

2245

63.6

2501

70.9

12

39.8

2112

53.1

2384

59.9

2657

66.8

13

45.0

2254

50.1

2545

56.6

2836

63.0

14

50.8

2491

49.0

2803

55.2

3192

62.8

15

56.7

2659

46.9

2991

52.7

3406

60.1

16

62.1

2811

45.3

3163

50.9

3602

58.0

17

66.3

2930

44.2

3296

49.7

3755

56.6

18

68.9

3004

43.6

3379

49.1

3849

55.9

Girls

1

9.8

783

79.9

865

88.2

c

c

2

11.8

953

80.7

1051

89.1

c

c

3

14.1

1120

79.4

1236

87.6

c

c

4

16.0

1176

73.5

1297

81.1



5

17.7

1226

69.3

1352

76.4



6

19.5

1323

67.8

1499

76.9

1676

85.9

7

21.8

1393

63.9

1579

72.4

1764

80.9

8

24.8

1484

59.8

1682

67.8

1880

75.8

9

28.5

1597

56.0

1810

63.5

2023

71.0

10

32.5

1706

52.5

1933

59.4

2160

66.5

11

37.0

1783

48.2

2021

54.6

2259

61.0

12

41.5

1874

45.1

2123

51.2

2373

57.2

13

46.1

1966

42.6

2228

48.3

2490

54.0

14

50.3

1982

39.4

2256

44.8

2529

50.3

15

53.7

2048

38.1

2331

43.4

2613

48.7

16

55.9

2091

37.4

2379

42.6

2668

47.7

17

56.7

2107

37.2

2397

42.3

2688

47.0

18

56.6

2105

37.2

2395

42.3

2685

47.4

a Median weight for age, NCHS/WHO.
b PAL factors shown in Table 21.
c Assume values similar to moderate physical activity in children 1-3 years old.