Total energy expenditure measured by doubly labeled water method in children and adolescents: a systematic review

Total energy expenditure (TEE) is essential for understanding the growth, development, and physical activity of children and adolescents. This study aimed to summarize the existing evidence on TEE measured using the doubly labeled water (DLW) technique in children and adolescents aged 1–18 years. Furthermore, this review compared TEE between obese and normal-weight participants. This systematic review used the PubMed, ScienceDirect, Web of Science, and EBSCO databases. These studies were limited to those published in English between January 2000 and December 2021. Articles presenting objectively measured data on the TEE of children and adolescents aged 1–18 years measured using the DLW method were included. Physical activity level (PAL; TEE/basal metabolic rate [BMR]) and BMR data were also obtained. The search strategy identified 2,351 articles, of which 63 (n=4,283 children and adolescents; 45.4% male) met the selection criteria. The participants in the 10 studies were overweight or obese (n=413). In our study, TEE increased in male and female participants aged 1–18 years. PAL increased with age in males (y=0.0272x+1.3887, r(2)=0.511) and females (y=0.0199x+1.401, r(2)=0.335), and the slope of PAL with age did not differ between males and females. The TEE of obese and overweight participants was higher than that of normal-weight participants, but the slope of TEE did not differ between normal-weight (y=132.99x+702.24, r(2)=0.877) and obese individuals (y=136.18x+1,037.9, r(2)=0.842). In conclusion, this review provides convincing evidence that daily TEE progressively increases with growth in males and females aged 1–18 years.