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## Background

Estimated Energy Requirement (EER):
Estimated Energy Requirement (EER) is the average dietary energy intake that is predicted to maintain energy balance in healthy, normal weight individuals of a defined age, gender, weight, height, and level of physical activity consistent with good health. In children and pregnant and lactating women, the EER includes the needs associated with growth or secretion of milk at rates consistent with good health.   [source: IOM].

The EER predictive equations developed by the Institute of Medicine Equation were released in September 2002 and were used to formulate the new dietary guidelines for the U.S. in 2005 when the revised food pyramid (MyPyramid) was released.   These equations were based on an extensive doubly labeled water database (considered the gold standard for Total Energy Expenditure measurement.)  Total Energy Expenditure (TEE) is the sum of the basal metabolic rate, TEF (thermic effect of food), physical activity, thermoregulation, and the energy expended in depositing new tissues and in producing milk.

When using the EER equations, it is important to distinguish between the 'Physical Activity Coefficients (PA)' and the 'Physical Activity Levels (PAL).'   The physical activity coefficients are used in the EER equations to estimate energy requirements and are based on ranges of  physical activity levels.  The Physical Activity Level (PAL) is the ratio of total energy expenditure to basal energy expenditure (TEE/BEE).   The Physical Activity Level categories were defined as sedentary (PAL 1.0-1.39), low active (PAL 1.4-1.59), active (PAL 1.6-1.89), and very active (PAL 1.9-2.5).

>Physical Activity Coefficients (PA) for the various age groups that are used in the EER equations can be found here.

This initial version will estimate energy requirements for individuals ≥ 9 years old:

Age     Gender:

Height

Weight

The  activity level below will be used along with the age-specific EER equation to calculate an estimate of the number of  calories needed per day (kcal/day)

Current daily activity level?

Sedentary: (Daily PAL range: 1.0 - 1.39):  Typical activities of daily living such as gardening (no lifting), household tasks, light activity while sitting, loading/unloading car,  mopping,  mowing lawn (power mower), etc.

Low Active: (Daily PAL range: 1.4 - 1.59):   Typical activities of daily living such as gardening (no lifting), household tasks, light activity while sitting, loading/unloading car,  mopping,  mowing lawn (power mower), etc.
PLUS
30 to 60 minutes of moderate activity daily such as calisthenics (no weight), cycling (leisurely), golf (without cart), swimming (slow), walking 3-4mph, etc.

Active: (Daily PAL range: 1.6 - 1.89):  Typical activities of daily living such as gardening (no lifting), household tasks, light activity while sitting, loading/unloading car,  mopping,  mowing lawn (power mower), etc.
PLUS
≥ 60 minutes of moderate activity daily such as calisthenics (no weight), cycling (leisurely), golf (without cart), swimming (slow), walking 3-4mph, etc.

Very Active: (Daily PAL range: 1.9 - 2.5):    Typical activities of daily living such as gardening (no lifting), household tasks, light activity while sitting, loading/unloading car,  mopping,  mowing lawn (power mower), etc.
PLUS
≥ 60 minutes of moderate activity daily such as calisthenics (no weight), cycling (leisurely), golf (without cart), swimming (slow), walking 3-4mph, etc.
60 minutes of vigorous activity such as chopping wood, climbing hills (no load), cycling (moderately),  jogging (10-min miles), rope skipping,  skating, swimming, tennis (doubles), walking (5 mph)  OR 120 minutes of additional moderate activity

## IOM - Estimated Energy Requirement (EER) Equations:

Estimated Energy Requirement (kcal/day) =
Total Energy Expenditure + Energy Deposition

Boy and Girl - Infants and Toddlers
0-3 months EER (kcal/d) = (89 x Wt [kg] - 100) + 175
4-6 months EER(kcal/d) = (89 x Wt [kg] - 100) + 56
7-12 months EER (kcal/d) = (89 x Wt [kg] - 100) + 22
13-36 months EER (kcal/d) = (89 x Wt [kg] - 100) + 20

Boys 3-8 years old
EER (kcal/d) = 88.5 - 61.9 x Age [y] + PA x (26.7 x Wt [kg] + 903 x Ht [m]) +20

Girls 3-8 years old
EER = 135.3 - (30.8 x age [y]) + PAx { (10.0 x weight [kg]) + (934 x height [m]) } + 20

Boys 9-18 years old
EER (kcal/d) = 88.5 - 61.9 x Age [y] + PA x (26.7 x Wt [kg] + 903 x Ht [m]) +25

Girls 9-18 years old
EER = 135.3 - (30.8 x age [y]) + PA x { (10.0 x weight [kg]) + (934 x height [m]) } + 25

Adults 19 years and older - Men
EER = 662 - (9.53 x age [y]) + PA x { (15.91 x weight [kg]) + (539.6 x height [m]) }

Adults 19 years and older - Women
EER = 354 - (6.91 x age [y]) + PA x { (9.36 x weight [kg]) + (726 x height [m]) }

Pregnancy (14-50 years old)
1st trimester EER = Non-pregnant EER + 0

2nd trimester EER = Non-pregnant EER + 340

3rd trimester EER = Non-pregnant EER + 452

Lactation
0-6 months postpartum EER = Non-pregnant EER + 330
7-12 months postpartum EER = Non-pregnant EER + 400

Overweight or obese children, 3-18 years old (maintenance)
Male TEE = -114 -50.9 x Age [y] + PA x (19.5 x Wt [kg] + 1161.4 x Ht [m])
Female TEE = 389 - 41.2 x Age [y] + PA x (15 x Wt [kg] + 701.6 x Ht [m])

These corrections for children and adolescents have been debated by S. J. Woodruff, R. M. Hanning, and S. I. Barr in a paper in Obesity Reviews published January 1 2009. The issue is whether or not the different formulae are actually necessary or possibly even harmful if overestimate occurs and thus contributes to an even higher and unhealthier body weight in these individuals.
[Source: Woodruff, S. J., Hanning, R. M., & Barr, S. I. (2009). Energy recommendations for normal weight, overweight and obese children and adolescents: are different equations necessary?. Obesity Reviews, 10(1), 103-108.

## Reference

Dietary Reference Intakes For Energy, Carbohydrate, Fiber, Fat, Fatty Acids,Cholesterol, Protein,and Amino Acids, Institute of Medicine of the National Academies, 2002 and 2005, THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001

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