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Objective: The pediatric obesity epidemic has created an urgent need for improved treatment and prevention plans. Clinicians often rely on metabolic equations to predict resting energy expenditure (REE), as other direct measures of REE are often impractical for use in a clinical setting. However, few equations have been validated for use in overweight and obese adolescents. The purpose of this research was to assess whether REE equations have comparable validity for overweight and obese versus healthy weight adolescents.

Methods: Ten equations were used to predict REE for 109 adolescents (n = 77 males; 36.7% overweight or obese). Nine equations were age specific, and the tenth, non-age specific equation was included due to its widespread use on adolescent populations. 95% equivalence testing was used to assess how well each equation agreed with the criterion measure of indirect calorimetry.

Results: For healthy weight adolescents, all ten equations were significantly equivalent to the criterion measure within ±8.4% (p < 0.05), whereas for overweight or obese participants only three equations were equivalent within the same range (p < 0.05).

Summary: Prediction equations tend to be biased toward higher accuracy in healthy weight versus overweight/obese adolescents, unless the original sample specifically included overweight/obese participants. The findings of this research underscore the importance of sample diversity in original development procedures for prediction equations. Clinicians should carefully consider the characteristics of the individual or group being assessed when choosing a prediction equation as commonly utilized equations may not be valid for adolescents across all weight status groups.

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Resting Energy Expenditure Equations Have Lower Validity For Overweight And Obese Versus Healthy Weight Adolescents