Basal metabolism accounts for more than half of daily energy expenditure and characterizes energy expenditure necessary to maintain the vital body functions at rest. The lean body mass makes the greatest contribution to the formation of basal metabolism. The «gold standard» for assessing basal metabolism is indirect respiratory calorimetry. This technique also evaluates, apart from basal metabolism, the rate of macronutrient oxidation, which is an important component of a personalized diet. In clinical practice, formulas for calculating basal metabolism are widely used, but their accuracy in children should be verified. Indirect calorimetry is characterized by a high variability of the measured parameters, which is related to the experimental peculiarities. This review briefly describes the main techniques for assessing basal metabolism and the methodology of indirect respiratory calorimetry in adults and its use in the child population. Also, we provide the literature data on the accuracy of assessing basal metabolism in obese children based on the most commonly used calculation formulas. Investigation of the energy metabolism features is necessary to elucidate the mechanisms of obesity pathogenesis and develop new techniques for its prevention and treatment.
Morbid obesity in children is associated with various metabolic complications, often persisting into adulthood and leading to reduced quality and duration of life. Conservative treatment of morbid obesity, often ineffective, and therefore, bariatric surgery in adolescents is becoming more common throughout the world. This review presents an analysis of international clinical guidelines for patient selection for bariatric surgery, assessed the efficiency and safety of different types of bariatric operations and identified the main problems of the widespread use of metabolic surgery as a method of treatment of morbid obesity in adolescents.
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