A systematic review and quantitative analysis of resting energy expenditure prediction equations in healthy overweight and obese children and adolescents

Background: Resting energy expenditure (REE) estimates are often needed in young people and can be predicted using prediction equations based on body weight. However, these equations may perform poorly in those who are obese and overweight. The aim of this systematic review was to identify equations based on simple anthropometric and demographic variables that provide the most accurate and precise estimates of REE in healthy obese and overweight young people. Methods: Systematic searches for relevant studies in healthy obese and overweight young people aged ≤18 years were undertaken using PubMed, Scopus, Cinahl, OpenGrey and Cochrane Library (completed January 2018). Search terms included metabolism, calorimetry, obesity and prediction equation. Data extraction, study appraisal and synthesis followed PRISMA guidelines. Results: From 390 screened titles, 13 studies met inclusion criteria. The most accurate REE predictions (least biased) were provided by Schofield equations [+0.8% (3–18 years); 0% (11–18 years); +1.1% (3–10 years)]. The most precise REE estimations (percentage of predictions ± 10% of measured) for 11–18 years were provided by Mifflin equations (62%) and, for 7–18 years, by the equations of Schmelzle (57%), Henry (56%) and Harris Benedict (54%). Precision of Schofield predictions was 43% in both age groups. No accuracy data were available for those <3 years or for precision for those <7 years. Conclusions: No single equation provided accurate and precise REE estimations in this population. Schofield equations provided the most accurate REE predictions so are useful for groups. Mifflin equations provided the most precise estimates for individuals aged 11–18 years but tended to underestimate REE.