Dietary energy requirements in adolescents
- Nancy F Butte, PhD
Nancy F Butte, PhD
- Distinguished Emeritus Professor of Pediatrics
- Baylor College of Medicine
Nutritional needs during adolescence are influenced mainly by the onset of puberty with its associated increased growth rate and changes in body composition and organ systems. After age 11, girls accrue approximately 12 percent of their adult stature and 36 percent of adult weight, and boys approximately 20 percent of their adult stature and 50 percent of adult weight . Growth during adolescence is accompanied by an increased proportion of body fat for girls and an increased proportion of lean body mass and blood volume in boys. (See "Normal puberty".)
The recommended dietary energy requirements in adolescents are defined to maintain health, promote optimal growth and maturation, and support a desirable level of physical activity. Dietary energy recommendations must be accompanied by strong encouragement for physical activity compatible with health, prevention of obesity, and adequate social and psychologic development.
The recommended dietary energy requirements in adolescents are reviewed here. Dietary requirements for other nutrients in adolescents are discussed separately. (See "Dietary history and recommended dietary intake in children" and "Calcium requirements in adolescents" and "Iron requirements and iron deficiency in adolescents".)
Basal metabolism is the energy expended for cellular and tissue processes that maintain life. It is measured under standard conditions of thermoneutrality, immobility, and fasting. The basal metabolic rate (BMR) relative to weight increases from birth to two years and then gradually declines through adolescence (figure 1) .
The effect of age on BMR is a function of changes in body composition through childhood and adolescence. BMR is strongly correlated with the fat free mass that comprises the bulk of the active metabolic tissue. The marked sex differences in intensity and duration of the adolescent growth spurt and in the proportion of fat free mass dictate the energy and nutrient needs of boys and girls. The World Health Organization (WHO) has endorsed the Schofield equations for the estimation of BMR that take into account sex, age, and body weight [3,4].To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- CDC Growth Charts: United States. Centers for Disease Control and Prevention; US Department of Health and Human Services.
- Holliday MA. Metabolic rate and organ size during growth from infancy to maturity and during late gastation and early infancy. Pediatrics 1971; 47:Suppl 2:169+.
- Schofield WN. Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 1985; 39 Suppl 1:5.
- Schofield C. An annotated bibliography of source material for basal metabolic rate data. Hum Nutr Clin Nutr 1985; 39 Suppl 1:42.
- Henry CJ. Basal metabolic rate studies in humans: measurement and development of new equations. Public Health Nutr 2005; 8:1133.
- Herrmann SD, McMurray RG, Kim Y, et al. The influence of physical characteristics on the resting energy expenditure of youth: A meta-analysis. Am J Hum Biol 2016.
- Torun B, Davies PS, Livingstone MB, et al. Energy requirements and dietary energy recommendations for children and adolescents 1 to 18 years old. Eur J Clin Nutr 1996; 50 Suppl 1:S37.
- Wong WW, Butte NF, Ellis KJ, et al. Pubertal African-American girls expend less energy at rest and during physical activity than Caucasian girls. J Clin Endocrinol Metab 1999; 84:906.
- Tverskaya R, Rising R, Brown D, Lifshitz F. Comparison of several equations and derivation of a new equation for calculating basal metabolic rate in obese children. J Am Coll Nutr 1998; 17:333.
- McArdle WD, Katch FI, Katch VL. Essentials of exercise physiology, 3rd ed, Lippincott Williams & Wilkins, Baltimore, MD 2006. p.266.
- Haschke F. Body composition measurements in infants and children, Ross Laboratories, Columbus, OH p.76.
- Institute of Medicine (IOM). Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids, National Academies Press, Washington, DC 2002.
- Baumgartner RN, Roche AF, Himes JH. Incremental growth tables: supplementary to previously published charts. Am J Clin Nutr 1986; 43:711.
- International Dietary Energy Consulting Group. The Doubly-Labeled Water Method for Measuring Energy Expenditure: Technical Recommendations for Use in Humans. In: NAHRES-4, Prentice AM (Ed), International Atomic Energy Agency, Vienna, Austria 1990.
- Schoeller DA. Recent advances from application of doubly labeled water to measurement of human energy expenditure. J Nutr 1999; 129:1765.
- Treuth MS, Adolph AL, Butte NF. Energy expenditure in children predicted from heart rate and activity calibrated against respiration calorimetry. Am J Physiol 1998; 275:E12.
- Chen KY, Bassett DR Jr. The technology of accelerometry-based activity monitors: current and future. Med Sci Sports Exerc 2005; 37:S490.
- Corder K, Ekelund U, Steele RM, et al. Assessment of physical activity in youth. J Appl Physiol (1985) 2008; 105:977.
- Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc 2005; 37:S531.
- Lee JM, Kim Y, Welk GJ. Validity of consumer-based physical activity monitors. Med Sci Sports Exerc 2014; 46:1840.
- Zakeri I, Adolph AL, Puyau MR, et al. Application of cross-sectional time series modeling for the prediction of energy expenditure from heart rate and accelerometry. J Appl Physiol (1985) 2008; 104:1665.
- Torun B. Energy cost of various physical activities in healthy children. In: Activity, Energy Expenditure and Energy Requirements of Infants and Children, Schürch B, Scrimshaw NS (Eds), International Dietary Energy Consultancy Group, Lausanne 1990. p.139.
- Ainsworth BE, Haskell WL, Leon AS, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 1993; 25:71.
- Bar-Or O. Childhood and adolescent physical activity and fitness and adult risk profile. In: Physical Activity, Fitness, and Health. International Proceedings and Consensus Statement, Bouchard C, Shephard RJ, Stephens T (Eds), Human Kinetics Publishers, Champaign 1994. p.931.
- Byrne NM, Hills AP, Hunter GR, et al. Metabolic equivalent: one size does not fit all. J Appl Physiol (1985) 2005; 99:1112.
- Puyau MR, Adolph AL, Vohra FA, Butte NF. Validation and calibration of physical activity monitors in children. Obes Res 2002; 10:150.
- Ainsworth BE, Haskell WL, Whitt MC, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000; 32:S498.
- Harrell JS, McMurray RG, Baggett CD, et al. Energy costs of physical activities in children and adolescents. Med Sci Sports Exerc 2005; 37:329.
- McMurray RG, Butte NF, Crouter SE, et al. Exploring Metrics to Express Energy Expenditure of Physical Activity in Youth. PLoS One 2015; 10:e0130869.
- Trost SG, Drovandi CC, Pfeiffer K. Developmental Trends in the Energy Cost of Physical Activities Performed by Youth. J Phys Act Health 2016; 13:S35.
- Butte NF, Puyau MR, Vohra FA, et al. Body size, body composition, and metabolic profile explain higher energy expenditure in overweight children. J Nutr 2007; 137:2660.
- Zlotkin SH. A review of the Canadian "Nutrition recommendations update: dietary fat and children.". J Nutr 1996; 126:1022S.
- Cheng HL, Amatoury M, Steinbeck K. Energy expenditure and intake during puberty in healthy nonobese adolescents: a systematic review. Am J Clin Nutr 2016; 104:1061.
- Brooks GA, Butte NF, Rand WM, et al. Chronicle of the Institute of Medicine physical activity recommendation: how a physical activity recommendation came to be among dietary recommendations. Am J Clin Nutr 2004; 79:921S.
- The Surgeon General's Report on Nutrition and Health. US Government Printing Office; Department of Health & Human Services, Washington, DC 1988.
- U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at: http://health.gov/dietaryguidelines/2015/guidelines/ (Accessed on January 09, 2016).
- Gidding SS, Dennison BA, Birch LL, et al. Dietary recommendations for children and adolescents: a guide for practitioners: consensus statement from the American Heart Association. Circulation 2005; 112:2061.
- Gidding SS, Lichtenstein AH, Faith MS, et al. Implementing American Heart Association pediatric and adult nutrition guidelines: a scientific statement from the American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity and Metabolism, Council on Cardiovascular Disease in the Young, Council on Arteriosclerosis, Thrombosis and Vascular Biology, Council on Cardiovascular Nursing, Council on Epidemiology and Prevention, and Council for High Blood Pressure Research. Circulation 2009; 119:1161.
- Haddad EH, Sabaté J, Whitten CG. Vegetarian food guide pyramid: a conceptual framework. Am J Clin Nutr 1999; 70:615S.
- BASAL METABOLISM
- ENERGY COST OF GROWTH
- PHYSICAL ACTIVITY
- Patterns of activity
- Energy cost of physical activity
- - Measurement techniques
- - Energy equivalents of physical activity
- - Predictors
- Estimated daily energy expenditure
- TOTAL ENERGY REQUIREMENTS
- Prediction equations
- - Normal-weight children
- - Overweight and obesity
- Recommended composition of dietary energy intake
- SUMMARY AND RECOMMENDATIONS