Energy

Most energy recommendations for infants and children are based on the 1985 FAO/WHO/UNU report and are shown in Tables 2 and 3. The FAO/WHO data have been reviewed recently and it is likely that a number of revisions to the 1985 document are required in light of additional information and the development of new assessment techniques such as doubly labeled water. Energy requirements expressed in terms of body weight are highest during the first few months of life, decrease fairly sharply after the age of 1 year, and then show a gradual decline until the onset of puberty, when they increase. This mirrors the growth velocity seen at different ages.

Table 1 Terminology for nutritional recommendations

Authority Mean" 2SD Mean Mean+2SD Less evidence- Upper limit based data of intake

United Kingdom

European Union

USA/ Canada

Lower Reference Nutrient Intake (LNRI)

Lowest Threshold of Intake (LTI)

Estimated Average Requirement (EAR)

Average Requirement (AR)

Estimated Average Requirement (EAR)

Estimated Average Requirement (EAR)

Reference Nutrient Intake (RNI)

Population Reference Intake (PRI)

Recommended Dietary Allowance (RDA) Recommended Dietary Intake (RDI)

Estimated Safe + Adequate Dietary Intake (ESADI) Acceptable Ranges

Adequate Intake (AI)

Tolerable Upper Intake Level (TUL) Upper Tolerable Nutrient Intake (TUL)

The review suggests that the 1985 recommendations for dietary energy are too high for children younger than 5 years and possibly those younger than 7 years of age, whereas recommendations for adolescent boys and pubertal girls appear to be set too low, particularly in developing countries. The 1985 recommendations increased reported energy intakes by a factor of 5% to accommodate a 'desirable' level of physical activity. This may not be realistic in the increasingly sedentary environment seen in industrialized countries, and it has been suggested that recommendations for energy intake should be accompanied by recommendations for activity levels.

The proportion of dietary energy that is required to sustain normal growth varies according to the growth velocity at that particular age. Figure 2 shows the percentage of the energy requirement that is needed for maintenance and growth at different ages. When estimating the likely energy requirement for a child who is unusually inactive (e.g., children with mobility difficulties), the estimate, based on the Estimated Average Requirement for age, should be reduced by the percentage of dietary energy normally required for activity (e.g., 29% at age 4 or 5 years). There is evidence that formula-fed

Table 2 Recommended energy intakes for infants (kJ/kg body

weight/day)

Age

UK

Europe

USA

FAO/WHO

(months)

EAR

AR

EAR

EAR

0-3

480

465

450

480

4-6

420

440

450

420

7-9

400

410

410

400

10-12

400

405

410

400

Table 3 Recommended energy intakes for Children (MJ/day)

Age

Sex

UK

Europe

USA

FAO/

(years)

EAR

AR

EAR

WHO EAR

2

M

4.9

5.0

5.4

5.9

F

4.9

4.8

5.4

5.5

3

6.2

6.0

5.4

6.5

F

5.7

5.6

5.4

6.0

4

6.7

6.6

7.5

7.1

F

6.1

6.2

7.5

6.4

5

7.2

7.1

7.5

7.6

F

6.5

6.8

7.5

6.8

6

7.6

7.7

7.5

7.9

F

6.8

7.1

7.5

7.1

7

7.9

81

8.4

8.3

F

7.0

7.3

8.2

7.4

8

8.2

8.3

8.4

8.7

F

7.3

7.4

8.2

7.6

9

8.5

8.6

8.4

9.0

F

7.5

7.4

8.2

0.79

10

8.2

8.7

8.4

10.5

F

7.3

7.6

8.2

9.6

11

9.3

9.2

10.5

10.9

F

7.7

8.0

9.0

9.8

12

9.3

9.8

10.5

11.3

F

7.7

8.3

9.0

10.0

13

9.3

10.6

10.5

11.7

F

7.7

9.0

9.0

10.2

14

9.3

10.9

10.5

12.1

F

7.7

8.7

9.0

10.4

15

11.5

11.4

12.5

12.5

F

8.8

8.9

9.2

10.5

16

11.5

11.9

12.5

12.8

F

8.8

9.0

9.2

10.1

17

11.5

12.0

12.5

13.0

F

8.8

9.0

9.2

9.8

18

11.5

11.9-12.5a

12.5

13.0

F

8.8

8.3-10.6a

9.2

9.8

aDepends on physical activity level. F, female; M, male.

months months years years years

Figure 2 Energy required for maintenance and growth as percentage of total energy expenditure.

infants require a slightly increased energy intake to achieve the same growth velocity as breast-fed infants; children suffering from malnutrition have also been reported as having an increased energy expenditure and therefore may have a higher energy requirement than normal for their age.

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