Validation of dietary reference intakes for predicting energy requirements in elementary school-age children

Eun Kyung Kim, Didace Ndahimana, Kazuko Ishikawa-Takata, Sangjik Lee, Hyungryul Kim, Kiwon Lim, In Sook Lee, Shigeho Tanaka, Ye Jin Kim, Yeon Jung Choi, Mun Jeong Ju, Jonghoon Park

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


BACKGROUND/OBJECTIVES: Dietary Reference Intakes (DRI) for energy are derived from total energy expenditure (TEE) measured using the doubly labelled water (DLW) method. The objective of this study was to assess the validity of DRI for predicting the energy requirements of elementary school-age children. SUBJECTS/METHODS: The present study involved 25 elementary school-age children aged between 9 and 11 years. TEE was assessed by the DLW method, and the results were compared with the TEE predicted by the DRI equations in order to evaluate accuracy. RESULTS: The subjects’ TEE measured by the DLW method was 1,925.2 ± 380.9 kcal/day in boys and 1,930.0 ± 279.4 kcal/day in girls, whereas resting energy expenditure was 1,220.2 ± 176.9 kcal/day in boys and 1,245.9 ± 171.3 kcal/day for girls. The physical activity level was 1.58 ± 0.20 in boys and 1.55 ± 0.13 in girls. The mean bias between the predicted and measured TEE was 12.6% in boys and-1.6% in girls, and the percentage of accurate predictions was 28.6% and 63.6%, respectively. In boys, the equation resulted in underprediction of TEE among the subjects having low TEE values, whereas there was overprediction among subjects having high TEE values as shown by the Bland-Altman plot. On the contrary, this proportional bias was not observed in girls. CONCLUSIONS: The findings of this study suggest that the DRI equation for energy could result in the overestimation of energy requirements in elementary school-age boys. In the case of girls, the equations could be accurate at the group level. However, the DRI appears to be invalid for individual girls, as more than one third of girls had their TEE inaccurately predicted. We recommend more studies for confirmation of these results.

Original languageEnglish
Pages (from-to)336-341
Number of pages6
JournalNutrition Research and Practice
Issue number4
Publication statusPublished - 2018 Aug

Bibliographical note

Funding Information:
1Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung 25457, Korea 2Department of Nutrition and Metabolism, National Institutes of Biomedical Innovation, Health and Nutrition, 3Division of Physical Education, Uiduk University, Gyeongju 38004, Korea 4Department of Physical Education, Konkuk University, Seoul 05029, Korea 5Division of Food Service Industry, Uiduk University, Gyeongju 38004, Korea 6Department of Physical Education, Korea University, 145 Anam-Ro, Seongbuk-Gu, Seoul 02841, Korea

Publisher Copyright:
© 2018 The Korean Nutrition Society and the Korean Society of Community Nutrition.


  • Child
  • Energy expenditure
  • Nutrition requirements

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics


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