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Vol. 58. Núm. 4.
Páginas 316-321 (abril 2003)
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Vol. 58. Núm. 4.
Páginas 316-321 (abril 2003)
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Influencia del gasto energético en la obesidad infantil
influence of energy expenditure on childhood obesity
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M. Paz Cerezo, C. Sierra Salinas*, L. del Río Mapelli, A. Barco Gálvez, C. Delgado Utrera, A. Jurado Ortiz
Unidad de Gastroenterología y Nutrición Pediátrica. Departamento de Pediatría. Hospital Materno-Infantil. Málaga. España
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Objetivos

Estudiar las diferencias en el gasto energético en reposo (GER) en función de sus determinantes (sexo, peso, masa grasa, masa magra) y la oxidación de los sustratos energéticos entre niños obesos y no obesos.

Pacientes y métodos

Se ha estudiado una muestra de 71 niños, 39 obesos y 32 controles, con rango de edad entre 4,1 y 13,6 años, de los cuales 37 eran mujeres y 34 varones, a los que se realiza medida del gasto energético mediante calorimetría indirecta de circuito abierto. La oxidación de sustratos se calculó a partir del consumo de oxígeno, producción de anhídrido carbónico y excreción de nitrógeno ureico uri-nario. Se determinó la composición corporal por antropometría.

Resultados

El GER (kcal/día) ajustado en función de los parámetros antropométricos y de composición corporal es superior en niños que en niñas. El GER en valor absoluto es significativamente superior en los obesos (1.512,82 234,47 frente a 1.172,59 190,20), y al expresarlo en función de sus determinantes, sigue siendo mayor en los obesos o se iguala en ambos grupos. Los obesos presentan mayor porcentaje de oxidación de grasas (57,15 10,68 frente a 51,08 13,61; p 0,04), menor porcentaje de oxidación dehidratos de carbono (30,10 9,85 frente a 36,34 13,61 p 0,03) y menor cociente respiratorio (0,79 0,03 fren-te a 0,82 0,04; p 0,02). No existen diferencias en los porcentajes de oxidación de hidratos de carbono, grasas y proteínas según el sexo.

Conclusiones

Del estudio se han extraído las siguientes conclusiones: a)el GER ajustado en función de los parámetros antropométricos y de composición corporal es significativamente superior en el sexo masculino que en el femenino;b)el GER es superior en los obesos, y sigue siéndolo al estan darizarlo en función de la masa corporal magra, yc)los niños obesos presentan mayor porcentaje de oxidación de grasas, menor porcentaje de oxidación de hidratos de car-bono y un cociente respiratorio menor que los niños no obesos.

Objectives

To study differences in resting energy expenditure (REE) according to its determining factors (sex, weight, body fat mass, lean body mass) and in the oxidation of energy substrates in obese and non obese children.

Patients and methods

We studied 71 children (39 obese and 32 non-obese) aged from 4.1 to 13.6 years. The male/female ratio was 34/37. Energy expenditure (EE) was measured by usingopen circuit indirect calorimetry. The oxidation of energy substrates was calculated from oxygen consumption, car-bon dioxide production, and urinary nitrogen excretion from urea. Body composition was determined by anthro-pometry.

Palabras clave:
Gasto energético
Gasto energético en reposo
Cociente respiratorio
Oxidación de sustratos
Results

REE (kcal/day), adjusted for anthropometric parameters and body composition, was higher in boys than in girls. The absolute REE was significantly higher in obese than in nonobese children (1512.82 234.47vs1172.59 190.20) and was higher or the same when adjusted for its determinants. Compared with the non-obese group, the obese group presented a significantly higher percentage of fatoxidation (57.15 10.68vs51.08 13.61, p 0.04), a lo wer percentage of carbohydrate oxidation (30.10 9.85vs36.34 13.61, p 0.03) and a lower respiratory quotient (0.79 0.03vs0.82 0.04, p 0.02). No differences were found between male and female subjects in the percenta-ges of carbohydrate, fat, and protein oxidation.

Conclusions

We obtained the followings conclusions:a)When ad-justed for anthropometric measurements and body composition, REE was significantly higher in boys than in girls;b)REE was higher in obese than in non-obese children, after adjustment for lean body mass; andc)Compared with the control group, obese children presented a higher percentage of fat oxidation, a lower percentage of carbohydrate oxidation, and a lower respiratory quotient.

Key words:
Energy expenditure
Resting energy expenditure
Respiratory quotient
Substrate oxidation
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Copyright © 2003. Asociación Española de Pediatría
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