Fjeld C R, Schoeller D A, Brown K H
Instituto de Investigación Nutriciońal, Lima, Perú.
Pediatr Res. 1989 May;25(5):503-8. doi: 10.1203/00006450-198905000-00016.
Energy partitioned to maintenance plus activity, tissue synthesis, and storage was measured in 41 children in early recovery [W/L (wt/length) less than 5th percentile] from severe protein-energy malnutrition and in late recovery (W/L = 25th percentile) to determine energy requirements during catch-up growth. Metabolizable energy intake was measured by bomb calorimetry and metabolic collections. Energy expended (means +/- SD) for maintenance and activity estimated by the doubly labeled water method was 97 +/- 12 kcal/kg FFM (fat-free mass) in early recovery and 98 +/- 12 kcal/kg FFM in late recovery (p greater than 0.5). Energy stored was 5-6 kcal/g of wt gain. Tissue synthesis increased energy expenditure by 1 +/- 0.7 kcal/g gain in both early and late recovery. From these data a mathematical model was developed to predict energy requirements for children during catch-up growth as a function of initial body composition and rate and composition of wt gain. The model for predicting metabolizable energy requirements is [(98 x FFM + A (11.1 B + 2.2 C)], kcal/kg.d, where FFM is fat-free mass expressed as a percentage of body wt, A is wt gain (g/kg.d), B and C are percentage of wt gain/100 as fat and FFM, respectively. The model was tested retrospectively in separate studies of malnourished children.
对41名严重蛋白质-能量营养不良早期恢复阶段（体重/身长比[W/L]低于第5百分位数）和晚期恢复阶段（W/L =第25百分位数）的儿童，测量分配于维持加活动、组织合成及储存的能量，以确定追赶生长期间的能量需求。通过弹式热量测定法和代谢物收集来测量可代谢能量摄入量。用双标记水法估算的维持和活动所消耗的能量（均值±标准差）在早期恢复阶段为97±12千卡/千克去脂体重（FFM），在晚期恢复阶段为98±12千卡/千克FFM（p＞0.5）。储存的能量为每克体重增加5 - 6千卡。在早期和晚期恢复阶段，组织合成使能量消耗每克增加1±0.7千卡。根据这些数据建立了一个数学模型，以预测儿童追赶生长期间的能量需求，该模型是初始身体组成以及体重增加速率和组成的函数。预测可代谢能量需求的模型为[（98×FFM + A（11.1B + 2.2C）]，千卡/千克·天，其中FFM是以体重百分比表示的去脂体重，A是体重增加量（克/千克·天），B和C分别是体重增加量/100中脂肪和FFM的百分比。该模型在营养不良儿童的单独研究中进行了回顾性检验。
