Branched-chain amino acid requirements in school-aged children determined by indicator amino acid oxidation (IAAO)

The current WHO/FAO/UNU recommendations for BCAA requirements in school-aged children are based on nitrogen balance studies that have tended to produce lower estimates of amino acid requirements that those determined using stable isotope methodologies. The new dietary reference intake (DRI) recommendations for total BCAA requirements in children were determined using a factorial approach that included adult BCAA requirements plus the additional needs for growth. The purpose of this study was to determine directly total BCAA requirements in school children aged 6-10 y using indicator amino acid oxidation (IAAO). Five children (8.5 +/- 1.2 y) were assigned. randomly to receive 7 graded intakes of total BCAA. Individual BCAA in the test diet were provided in the same proportions as those present in egg protein to minimize the potential interactive effects of individual BCAA on assessment of requirement. Total BCAA requirement was determined by measuring the oxidation of L-[1-C-13] phenylalanine to (CO2)-C-13 [(FCO2)-C-13 in mumol/(kg (.) h)], after a primed, continuous infusion of the labeled tracer and using a two-phase linear crossover regression analysis. The mean requirement and the population-safe intake level (upper limit of the 95% CI) of the total BCAA in healthy school aged children were 147 and 192 mg/(kg (.) d), respectively. The estimated mean requirements of the total BCAA as determined by IAAO is similar to48% higher than the current DRI recommendations, suggesting that these recommendations may be too low to meet the needs of school-aged children.