The 1985 FAO/WHO/UNU recommendations for dietary
energy intake of healthy infants seem too high based on reported measurements of energy
intake or energy expenditure and estimates of the energy deposited for growth. Because
observed energy intakes may not reflect desirable intakes, measurements of energy
expenditure are preferred as the basis for estimating energy requirements. Estimated
energy requirements of infants based on total energy expenditure and growth are 9-39%
lower than the 1985 FAO/WHO/UNU recommendations and provide strong evidence that current
estimates should be revised. However, confirmation of this observation will require
expansion of the available database on total energy expenditure of healthy infants, in
terms of sample size, age range and geographic distribution across the entire age range of
infancy. Data are particularly scarce in the second 6 months of infancy. Estimated energy
requirements should be consistent with the growth reference endorsed by WHO. To better
define the energy deposited during growth, changes in body composition during infancy must
be confirmed.
Given the relative uniformity of behavior, physical activity and growth of healthy infants from different geographic origins, estimates of energy requirements can be applied universally to healthy infants. It should be appreciated that energy requirements of infants are a function of age, gender, body size and feeding mode. Stipulation of estimated energy requirements by these factors will depend on the application.
More data must be sought on the energy expenditure of infants in populations at risk of high rates of infection and exposed to other environmental sources of stress to determine if energy requirements are altered under these circumstances. The energy needs for adequate catch-up growth also must be considered.
Table 6 Energy requirement estimated from total energy expenditure and energy cost of growth
Age |
Total energy expenditure |
Energy deposition |
||||||
ALL |
BFa |
FFa |
ALL |
BFa |
FFa |
(kcal/d) |
(kcal/kg/d) |
|
Boys |
||||||||
0-1 |
248 |
228 |
268 |
65 |
61 |
68 |
113 |
26 |
1-2 |
320 |
300 |
340 |
67 |
64 |
70 |
113 |
26 |
2-3 |
389 |
368 |
409 |
70 |
67 |
73 |
136 |
24 |
3-4 |
454 |
434 |
474 |
72 |
69 |
76 |
90 |
14 |
4-5 |
516 |
495 |
536 |
75 |
72 |
78 |
62 |
9 |
5-6 |
574 |
553 |
594 |
78 |
74 |
81 |
49 |
6 |
6-9 |
684 |
664 |
705 |
83 |
80 |
86 |
28 |
3 |
9-12 |
843 |
822 |
863 |
91 |
87 |
94 |
19 |
2 |
Girls: |
||||||||
0-1 |
241 |
220 |
261 |
65 |
61 |
68 |
102 |
22.5 |
1-2 |
306 |
286 |
326 |
67 |
64 |
70 |
102 |
22.5 |
2-3 |
369 |
349 |
389 |
70 |
67 |
73 |
108 |
20 |
3-4 |
431 |
411 |
451 |
72 |
69 |
76 |
79 |
13 |
4-5 |
492 |
472 |
513 |
75 |
72 |
78 |
65 |
10 |
5-6 |
552 |
532 |
573 |
78 |
74 |
81 |
56 |
8 |
6-9 |
666 |
645 |
686 |
83 |
80 |
86 |
26 |
3 |
9-12 |
820 |
799 |
840 |
91 |
87 |
94 |
21 |
2 |
Energy requirement |
|||||
Age |
BFa |
FFa |
ALL |
BFa |
FFa |
Boys |
|||||
0-1 |
341 |
381 |
91 |
87 |
94 |
1-2 |
413 |
453 |
93 |
90 |
96 |
2-3 |
504 |
545 |
94 |
91 |
97 |
3-4 |
524 |
564 |
86 |
83 |
90 |
4-5 |
557 |
598 |
84 |
81 |
87 |
5-6 |
602 |
643 |
84 |
80 |
87 |
6-9 |
692 |
733 |
86 |
83 |
89 |
9-12 |
841 |
882 |
93 |
89 |
96 |
Girls: |
|||||
0-1 |
322 |
363 |
88 |
84 |
90 |
1-2 |
388 |
428 |
90 |
86 |
92 |
2-3 |
457 |
497 |
90 |
87 |
93 |
3-4 |
490 |
530 |
85 |
82 |
89 |
4-5 |
537 |
578 |
85 |
82 |
88 |
5-6 |
588 |
629 |
86 |
82 |
89 |
6-9 |
671 |
712 |
86 |
83 |
89 |
9-12 |
820 |
861 |
93 |
89 |
96 |
a BF = breast-fed; FF = formula-fed infants.
Acknowledgements - I wish to
thank Drs PSW Davies, Cambridge, UK; KG Dewey, University of California-Davis; KF
Michaelsen, The Royal Veterinary and Agricultural University, Copenhagen,
Denmark; AM Prentice, Dunn Nutrition, Cambridge, UK;
AS Ryan, Ross Laboratories, Columbus, Ohio, and JE Stuff, Children's Nutrition Research
Center, Houston, Texas for their contribution of data used in this manuscript, as well as
Dr C Garza, Cornell University, Ithaca, New York, for his thoughtful review. I would also
like to thank I Tapper for manuscript preparation, and L Loddeke and R Klein for editorial
review.
This work is a publication of the USDA/ARS Children's Nutrition Research Center, Department of Pediatrics Baylor College of Medicine and Texas Children's Hospital, Houston, TX. Funding has been provided from the U.S. Department of Agriculture, Agricultural Research Service under Cooperative Agreement No. 58-6250-1-003. The contents of this publication do not necessarily reflect the views or policies of the U.S. Department of Agriculture, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.