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Higher Total Energy Expenditure Contributes to Growth Faltering in Breast-Fed Infants Living in Rural Mexico¹

USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX ^* Division de Crecimiento y Desarrollo, Instituto Mexicano del Seguro Social, Mexico City, DF, Mexico

To investigate the energy requirements of infants living under unfavorable environmental conditions in rural Mexico, we measured the total energy expenditure (TEE) of 40 Otomi infants at -4 or -6 mo of age. Total energy expenditure was estimated by the doubly labeled water method: 100 mg ²H₂O/kg and 250 mg ¹⁸O/kg were administered orally, after which urine was collected serially for 7 or 10 d. Isotopic enrichment of urine samples was analyzed by gas-isotope-ratio mass spectrometry. Weight and length were measured monthly from birth to 6 mo. Fat free mass was estimated from ¹⁸O dilution spaces. Total energy expenditures (mean ± SD) were 310 ± 58 and 318 ± 29 kJ·kg^-1·d^-1 at -4 and -6 mo, respectively. Total energy expenditure was higher than that previously observed for breast-fed infants reared under more protected environments (268 ± 29 kJ·kg^-1·d^-1). Weight, length and weight gain were 5.9 ± 0.8 kg, 60 ± 2 cm and 2.9 ± 2.4 g·kg^-1·d^-1 at 4.25 mo and 7.1 ± 0.8 kg, 65 ± 2 cm and 1.0 ± 1.2 g·kg^-1·d^-1 at 6.27 mo. Growth faltering was evident at 6 mo by clinically significant declines in growth velocities and National Center for Health Statistics Z-scores. Body fat of the Otomi infants averaged 21 ± 6 and 18 ± 5 g/100 g at -4 and -6 mo, respectively. Higher rates of TEE narrowed the margin of energy available for growth and thereby contributed to growth faltering in the Otomi infants.

KEY WORDS: • energy expenditure • infants • Mexico • breast feeding

¹ This work is a publication of the USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX. Funding was provided from the USDA/ARS under Cooperative Agreement no. 58-6250-1-003. The contents of this publication do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products or organizations imply endorsement by the United States government.

² To whom correspondence should be addressed.

Manuscript received 4 August 1992. Revision accepted 27 January 1993.

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