Larger mass of high-metabolic-rate organs does not explain higher resting energy expenditure in children

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Abstract
Background: Children have a high resting energy expenditure (REE) relative to their body weight. The decline in REE during growth may be due to changes in body composition or to changes in the metabolic rate of individual organs and tissues. Objectives: The goals were to quantify body-composition components in children at the organ-tissue level in vivo and to determine whether the observed masses 1) account for the elevated REE in children and 2) account, when combined with specific organ-tissue metabolic constants, for children's REE. Design: This was a cross-sectional evaluation of 15 children (aged 9.3 ± 1.7 y) and 13 young adults (aged 26.0 ± 1.8 y) with body mass indexes (in kg/m2) < 30. Magnetic resonance imaging–derived in vivo measures of brain, liver, kidney, heart, skeletal muscle, and adipose tissue were acquired. REE was measured by indirect calorimetry (REEm). Previously published organ-tissue metabolic rate constants were used to calculate whole-body REE (REEc). Results: The proportion of adipose-tissue-free mass as liver (3.7 ± 0.5% compared with 3.1 ± 0.5%; P < 0.01) and brain (6.2 ± 1.2% compared with 3.3 ± 0.9%; P < 0.001) was significantly greater in children than in young adults. The addition of brain and liver mass significantly improved the model but did not eliminate the role of age. REEc with published metabolic coefficients underestimated REEm (REEc = 3869 ± 615 kJ/d; REEm = 5119 ± 769 kJ/d; P < 0.001) in children. Conclusion: The decline in REE during growth is likely due to both a decrease in the proportion of some of the more metabolically active organs and tissues and changes in the metabolic rate of individual organs and tissues.