American Journal of Clinical Nutrition, Vol 68, 950S-955S, Copyright © 1998 by The American Society for Clinical Nutrition, Inc

REVIEW ARTICLES

Role of energy expenditure in the development of pediatric obesity

JP DeLany
Pennington Biomedical Research Center, Louisiana State University, Baton Rouge 70808-4124, USA. delanyjp@mhs.pbrc.edu

The role that energy expenditure plays in pediatric obesity was somewhat confused by early research purporting to show that, as a group, obese children have lower energy intakes than do lean children. On the basis of this intake data, the conclusion was drawn that obese persons are somehow energy efficient, leading to weight gain. More recent research examining energy expenditure has shown clearly that, as a group, obese children have higher energy expenditures than do their lean counterparts. With the advent of the doubly labeled water method for determining free-living energy expenditure, it has been shown that obese children underreport intake significantly more than do lean children. When measurements are properly adjusted for differences in body size, there are generally no major differences in energy expenditure between lean and obese groups. However, in some cross- sectional studies, a low level of physical activity has been shown to be related to current body fatness. In addition, longitudinal studies have shown that a low level of energy expenditure, particularly energy expended in physical activity, is associated with both body fatness and weight gain.

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