Estimating Energy Needs for Children

There are several methods available to estimate energy requirements for children.  Below are descriptions of three commonly used approaches:

• Estimating Energy Requirements (EER) based on Dietary Reference Intakes (DRI)
• General recommendations for pediatric populations
• Estimated Energy Needs using rule-of-thumb formulas in conjunction with CDC Growth Charts

Estimated Energy Requirements (EER)

Energy is required to sustain the body’s basic functions, including respiration, circulation (heart beating), physical activity or movement, and protein synthesis (growth and repair of cells).  For children, energy is derived from dietary carbohydrates, proteins, and fats. Energy balance is achieved when dietary energy intake matches energy expenditure.

The DRI formulas, which have been widely adopted to guide energy intake for various life stages (pregnancy, lactation, and childhood from birth to 18 years), provide a structured approach to estimating energy needs.

The Estimated Energy Requirement (EER) is defined as the average dietary energy intake that is predicted to maintain energy balance in an individual of a defined age, sex, weight, height, level of physical activity, and life stage, consistent with maintaining health.  The original DRI formulas released in 2005 were updated in 2023.⁽¹⁾

• The formulas are provided in Table 5-15 Summary Table of EER Equations by Age, Sex, Physical Activity, and Energy Cost of Growth: Children and Adolescents.  The table includes the following age categories: 0-2.99 months, 3-5.99 months, 6 months-2.99 years,  3-13.99 years, and 14-18.99 years.
• National Academies of Sciences, Engineering, and Medicine. 2023. Dietary Reference Intakes for Energy. Washington, DC: The National Academies Press. https://doi.org/10.17226/26818.
• In the case of childhood (birth to 18 years of age), the equations have been formulated to allow for growth in addition to Total Energy Expenditure (TEE).
• Energy expenditure is also grouped into Physical Activity Levels (PAL) categorized as inactive, low active, active, and very active. The DRI formulas for EERs represent the TEE (for the US and Canada) plus growth allowance for each age group.

For example, the formulas below are provided for boys ages 3 to 13.99 years old in Table 5-15  Summary Table of EER Equations by Age, Sex, Physical Activity and Energy Cost of Growth:  Children and Adolsecents:⁽¹⁾

The footnote for the table explains table contents. 

Generalized energy needs in otherwise healthy children:

Evidence-based caloric intake ranges have been established for the pediatric population. For children between 2 and 3 years of age, the recommended daily caloric intake is 1000 to 1400 kcal/day.⁽²⁾ During periods of rapid growth, children may require additional calories to support their increased energy needs. It is important for parents to provide balanced nutrition while promoting a dietary pattern that allows children to recognize and respond to their hunger and fullness cues.⁽³⁾  Resources and tips to support these cues in preschool-aged children can be found here and shared with caregivers for guidance.

Faizan and Rouster created the following table of recommended energy intake in children.²

Estimated Energy Needs using rule of thumb formulas in conjunction with CDC Growth Charts²

Faizan and Rouster proposed using the following formulas while following patients' growth over time using the CDC Clinical Growth Charts. Dietitians are monitoring to ensure growth is progressive and follows the curve or percentile that is optimal for that individual.

References:

1. National Academies of Sciences, Engineering, and Medicine. 2023. Dietary Reference Intakes for Energy. Washington, DC: The National Academies Press. https://doi.org/10.17226/26818.  Accessed 7 Sep 2024.  Available at:  https://nap.nationalacademies.org/catalog/26818/dietary-reference-intakes-for-energy
2. Faizan U, Rouster AS. Nutrition and Hydration Requirements In Children and Adults. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Accessed 7 September 2024.  Available from: https://www.ncbi.nlm.nih.gov/books/NBK562207/
3. Hunger and Your Preschooler. Nemours Kids Health.  Accessed 9 September 2024.  Available at:  https://kidshealth.org/en/parents/hungry-preschooler.html.
4. Clinical Growth Charts.  Centers for Disease Control and Prevention (CDC).  Accessed 9 September 2024.  Available at:  https://www.cdc.gov/growthcharts/clinical_charts.htm