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Validation of energy requirement reference for exclusively breast-fed infants

Nielsen, SB and Wells, JCK and Fewtrell, MS and Eaton, Simon and Grinham, James and Reilly, John J. (2013) Validation of energy requirement reference for exclusively breast-fed infants. British Journal of Nutrition, 109 (11). pp. 2036-2043. ISSN 0007-1145

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Abstract

n paediatric practice, mean reference energy requirements for groups are often used to predict individual infant energy requirements. References from the FAO/WHO/United Nations University are based on infants not fed according to the current infant feeding recommendations. The objective of the present study was to measure total energy expenditure (TEE) and determine energy requirements using criterion methods, and validate the use of TEE prediction equation and mean energy requirement references for predicting individual TEE and energy requirements, respectively, in infants who were exclusively breast-fed (EBF) to 6 months of age. EBF infants were included from Greater Glasgow for measurements at 3·5 (n 36) and 6 (n 33) months of age. TEE was measured using doubly labelled water and energy requirements were determined using the factorial approach. TEE and energy requirements were also predicted using equations based on body weight. Relationships between criterion methods and predictions were assessed using correlations. Paired t tests and Bland–Altman plots were used to assess agreement. At the population level, predicted and measured TEE were similar. The energy requirement reference significantly underestimated energy requirements by 7·2 % at 3·5 months at the population level, but there was no bias at 6 months. Errors at individual levels were large and energy requirements were underestimated to a larger extent for infants with higher energy requirements. This indicates that references presently used in clinical practice to estimate energy requirements may not fully account for the different growth pattern of EBF infants. More studies in infants EBF to 6 months of age are needed to understand how growth of EBF infants influences energy requirements.

Item type: Article
ID code: 42016
Keywords: infants, infants nutrition, energy requirement, breast-fed infants, Public health. Hygiene. Preventive Medicine, Physical geography, Physiology
Subjects: Medicine > Public aspects of medicine > Public health. Hygiene. Preventive Medicine
Geography. Anthropology. Recreation > Physical geography
Department: Faculty of Humanities and Social Sciences (HaSS) > School of Psychological Science and Health > Physical Activity for Health
Related URLs:
Depositing user: Pure Administrator
Date Deposited: 13 Nov 2012 11:31
Last modified: 27 Mar 2014 10:41
URI: http://strathprints.strath.ac.uk/id/eprint/42016

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