New equations for calculating the components of energy expenditure in infants

Duro, Debora; Rising, Russell; Cole, Conrad R.; Valois, Sandra; Cedillo, Maribel; Lifshitz, Fima

doi:10.1067/mpd.2002.123308

Cited by 15 publications

(26 citation statements)

References 12 publications

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“…There are little data to support the scientific notion that energy expenditure and basic metabolic rate are the same in infants and in older children (16,17). Previous studies using an infant respiratory chamber directly quantitated energy expenditure and basal metabolic rates in infants from 3 to 4 mo of age and found some differences from World Health Organization figures, particularly in those with HIV or other causes of growth retardation (20,21). When measured over longer times (24 h) the energy expenditure in active infants was underestimated by the Schofield equation (16,20,21).…”

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confidence: 86%

“…Previous studies using an infant respiratory chamber directly quantitated energy expenditure and basal metabolic rates in infants from 3 to 4 mo of age and found some differences from World Health Organization figures, particularly in those with HIV or other causes of growth retardation (20,21). When measured over longer times (24 h) the energy expenditure in active infants was underestimated by the Schofield equation (16,20,21). However, there were no differences between inferred and directly measured resting metabolic rates (21).…”

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confidence: 87%

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Screening Newborns for Galactosemia Using Total Body Galactose Oxidation to CO2 in Expired Air

Barbouth

Velazquez

Konopka³

et al. 2007

Pediatr Res

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Classic galactosemia is caused by impaired galactose-1-phosphate uridyltransferase (GALT EC 2.7.712). If discovered and treated within the first days of life, the acute problems of hepatocellular damage, sepsis, and death are prevented. However, chronic problems such as ataxia, tremor, dyspraxic speech, and ovarian failure may occur. To determine whether screening newborns before discharge from the nursery for GALT deficiency is feasible and whether acute and chronic signs could be prevented by earlier intervention, we developed a simplified "breath test." We quantitated total body oxidation of 13 C-D-galactose to 13 CO 2 in expired air by normal newborns between 2 h and 2 mo of age and compared their results to older children with GALT deficiency. We found no differences in total body galactose oxidation (TBGO) among normal newborns up to 48 h of age, but a 2-fold rise in TBGO developed during their first 2 wk of life. Older children with galactosemia had significantly less oxidative capacity than normal newborns. We conclude that newborn breath testing for total body galactose oxidation is feasible before discharge from nursery. It has potential utility for both preventing acute neonatal toxicity and determining the mechanisms producing long-term complications such as ovarian failure, dyspraxia, ataxia, and tremors. C lassic galactosemia is an autosomal recessive disorder caused by a deficiency of galactose-1-phosphate uridyltransferase (GALT EC 2.7.7.12). The biochemical phenotype is characterized by accumulation of galactose, galactose-1-phosphate, and galactitol in cells, and of excess excretion of galactitol and galactose (1-4). The disease incidence is approximately 1:30,000 live births in the United States (2). If untreated in the first 2 wk of life, poor feeding, jaundice, hepatic failure, Escherichia coli sepsis, and death may occur. We have personal experience with families whose newborns had died (http://www.savebabies.org/diseasedescriptions/galactosemia. php, formally known as, "Tyler for Life Foundation" and personal experience).Despite population-based newborn screening and dietary intervention within 2-3 wk of life, the clinical outcome of patients with classic galactosemia is variable. Long-term complications include premature ovarian failure, dyspraxic speech, short stature, learning disabilities, and cataracts (5-7). In one ex post facto study, outcome was not related to time of treatment (5).Most states in the United States screen for galactosemia by the Beutler Method, which measures GALT in dried blood on filter paper through enzyme-linked fluorescence of NADPH production from glucose-1-phosphate. Some states use total galactose quantization (8,9). The median time for results to be received by a referring physician from public health laboratories is poorly documented nationally but from personal experience varies between 4 and 30 d (9).It is not clear whether this prolonged exposure to excess galactose-1-phosphate produces the chronic effects of galactosemia during fetal developm...

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confidence: 86%

mentioning

confidence: 87%

Screening Newborns for Galactosemia Using Total Body Galactose Oxidation to CO2 in Expired Air

Barbouth

Velazquez

Konopka³

et al. 2007

Pediatr Res

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“…Moreover, all metabolic measurements were conducted under standard conditions [4] at the same time in the morning between 9:00 AM and 1:00 PM. It is possible that variations in energy expenditure over the course of 24-hours, as shown by the presence of the metabolic circadian rhythm [6], might contribute to inherent inaccuracies when utilizing the World Health Organization [1], the Schofield [2] and the Oxford [3] prediction equations.…”

Section: Discussionmentioning

confidence: 99%

“…More specific, six of these equations (Table 2) were from a previous study in our laboratory [4] where 50 short-term metabolic measurements in infants of four-hours in the EMTAC were used in their derivation. These consisted of two equations for 24-hour EE based on both length and weight (EMTACEE-LWT) and weight (EMTACEE-WT), two equations for RMR based on both length and weight (EMTACRMR-LWT) and weight (EMTACRMR-WT) and finally, two equations for SMR based on both length and weight (EMTACSMR-LWT) and weight (EMTACSMR-WT).…”

Section: Methodsmentioning

confidence: 99%

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Twenty-four hour metabolic rate measurements utilized as a reference to evaluate several prediction equations for calculating energy requirements in healthy infants

Rising

2011

Nutr J

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Background: To date, only short-duration metabolic rate measurements of less than four hours have been used to evaluate prediction equations for calculating energy requirements in healthy infants. Therefore, the objective of this analysis was to utilize direct 24-hour metabolic rate measurements from a prior study to evaluate the accuracy of several currently used prediction equations for calculating energy expenditure (EE) in healthy infants. Methods: Data from 24-hour EE, resting (RMR) and sleeping (SMR) metabolic rates obtained from 10 healthy infants, served as a reference to evaluate 11 length-weight (LWT) and weight (WT) based prediction equations. Six prediction equations have been previously derived from 50 short-term EE measurements in the Enhanced Metabolic Testing Activity Chamber (EMTAC) for assessing 24-hour EE, (EMTACEE-LWT and EMTACEE-WT), RMR (EMTACRMR-LWT and EMTACRMR-WT) and SMR (EMTACSMR-LWT and EMTACSMR-WT). The last five additional prediction equations for calculating RMR consisted of the World Health Organization (WHO), the Schofield (SCH-LWT and SCH-WT) and the Oxford (OXFORD-LWT and OXFORD-WT). Paired t-tests and the Bland & Altman limit analysis were both applied to evaluate the performance of each equation in comparison to the reference data.

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Parenteral Nutrition in Infants and Children

Shulman,

Phillips

2003

J. pediatr. gastroenterol. nutr.

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New equations for calculating the components of energy expenditure in infants

Cited by 15 publications

References 12 publications

Screening Newborns for Galactosemia Using Total Body Galactose Oxidation to CO2 in Expired Air

Screening Newborns for Galactosemia Using Total Body Galactose Oxidation to CO2 in Expired Air

Twenty-four hour metabolic rate measurements utilized as a reference to evaluate several prediction equations for calculating energy requirements in healthy infants

Parenteral Nutrition in Infants and Children

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