Energy gain and energy gap in normal-weight children:: Longitudinal data of the KOPS

Population-based prevention of overweight needs evidence-based goals consistent with our present knowledge about energy gap ( i.e., daily imbalance between energy intake and energy expenditure resulting in overweight). Longitudinal data of normal-weight children ( 1,029 girls and 1,028 boys; Kiel Obesity Prevention Study, KOPS) were used to calculate energy gain ( i.e., increase in fat mass ( FM) and fat-free mass ( FFM)) in normal-weight children staying normal weight ( persistent children) or becoming overweight ( incident children). Taking into account weight gain in proportion to height gain ( normal development) energy gap was calculated from increases in FM and FFM exceeding normal development. Children were divided into two groups and were followed from age 6 to 10 ( group A) and 10 to 14 years ( group B). FM and FFM were measured. Medians of 4-year BMI- (kg/m(2))/ weight changes ( kg) were + 1.8/+ 13.2 ( A) and + 3.0/+ 18.7 ( B) in girls, and + 1.6/+ 12.8 ( A) and + 2.6/ 21.7 ( B) in boys. Corresponding data for FM/ FFM ( kg) were + 3.1/+ 10.2 ( A) and + 5.1/ 12.7 ( B) in girls, and + 2.3/ 10.8 ( A) and + 3.0/ 18.6 ( B) in boys. The 4-year-incidence of overweight (%) were 9.4 ( A) and 5.4 ( B) in girls, and 11.0 ( A) and 3.8 ( B) in boys, respectively. Mean energy gains ( kcal/ day) were 26.8 ( A) and 46.4 ( B) in girls, and 22.1 ( A) and 32.5 ( B) in boys. The 90th percentile of energy gap ( kcal/ day) in incident children were 58.1 ( A) and 72.0 ( B) in girls and 46.0 ( A) and 53.2 ( B) in boys. To prevent overweight in children energy gap should not exceed 46 - 72 kcal/ day.