Using an Allometric Equation to Accurately Predict the Energy Expenditure of Children and Adolescents With Nonalcoholic Fatty Liver Disease

BACKGROUND: Pediatric patients with nonalcoholic fatty liver disease (NAFLD) require targeted nutrition therapy that relies on calculating energy needs. Common energy equations are inaccurate in predicting resting energy expenditure (REE), influencing total energy expenditure (TEE) estimates. Equations based on allometric scaling are simple, accurate, void of subjective activity and/or stress factor bias, and they estimate TEE. OBJECTIVE: To investigate the predictive accuracy of an allometric energy equation (AEE) in predicting TEE of children and adolescents with NAFLD. METHODS: Retrospective study performed in a single institution. The allometric equation was used to calculate AEE, and the results were compared with TEE calculated using indirect calorimetry data (measured REE) multiplied by an activity factor (AF) of 1.5 or 1.7. RESULTS: Fifty-six patients with a mean age of 13 years were included in this study. The agreement between TEE (using an AF of 1.5) and AEE was -96 kcal/d (confidence interval, -29 to 221). The predictive accuracy of the allometric equation was not different between obese and nonobese patients. CONCLUSIONS: Allometric equations allow for accurate estimation of TEE in children with NAFLD.