Wednesday, 18 February 2026

Beyond Estimates: Precision Measurement in Pediatric Energy Research.

 

Presenter: HPM Dabare

Affiliations: General Sir Joghn Kotelawala Defence University, Sri Lanka

Presentation Type: Oral Presentation (In-Person)

Title: Advancing the use of energy expenditure assessment through doubly-labelled water: global insights and applications in physical activity research in children and adolescents


🌍 Advancing Energy Expenditure Research Through Doubly-Labelled Water in Children and Adolescents

Understanding how much energy the human body expends under real-life conditions is fundamental to studying metabolism, physical activity, and overall energy balance. Accurate measurement of total energy expenditure (TEE) allows researchers to interpret growth, nutritional status, and long-term health outcomes more precisely.

Among available techniques, the doubly-labelled water (DLW) method has emerged as the global gold standard for assessing free-living energy expenditure. Its application has significantly strengthened the scientific foundation of pediatric metabolic and physical activity research.


🔬 The Gold Standard for Free-Living Energy Measurement

The DLW technique provides highly accurate estimates of total energy expenditure without restricting participants to laboratory settings. This makes it especially valuable in children and adolescents, where natural movement patterns and daily activity behaviors are essential to capture authentically.

Beyond measuring TEE, DLW has played a critical role in:

·         Validating self-reported dietary intake

·         Identifying systematic errors in physical activity questionnaires

·         Recalibrating global dietary surveillance tools

By revealing discrepancies between reported and actual energy expenditure, DLW has reshaped how researchers interpret behavioral data.


📊 Redefining Reference Standards in Youth Research

Recent international investigations have used DLW data to develop universal predictive equations capable of detecting under- or over-reporting of energy intake. These efforts have helped refine dietary reference standards used in public health monitoring.

Importantly, global findings demonstrate:

·         Developmental variability in energy expenditure during puberty

·         Significant sex-specific differences in TEE

·         The necessity for age- and sex-sensitive calibration models

Such evidence highlights that energy metabolism in growing individuals cannot be interpreted using generalized adult-based assumptions.


🌏 Expanding Methodological Advances Across Countries

The integration of DLW into international research networks has facilitated the validation of field-based assessment tools in diverse populations.

In Sri Lanka, our research applied the DLW method among 11–13-year-old children to evaluate both:

·         📋 Subjective tools (recall questionnaires and activity logs)

·         📱 Objective tools (accelerometers)

Findings revealed that commonly used accelerometer equations developed in Western populations systematically misestimated activity energy expenditure in Sri Lankan children. This discrepancy emphasized the importance of cultural and physiological specificity in prediction models.

Through population-specific calibration, a new predictive equation was derived, explaining more than 70% of the variance when compared with DLW. These results confirmed that aligning accelerometer outputs with local body composition and movement patterns substantially enhances validity.


🔄 Integrating Multidimensional Approaches

DLW becomes even more powerful when combined with:

·         Accelerometry

·         Behavioral assessments

·         Physical fitness measures

·         Growth and developmental indicators

This multidimensional integration allows researchers to examine metabolism and physical activity within broader biological and environmental contexts.

Precision in measurement is not merely a technical concern — it forms the foundation for credible public health recommendations.


🧠 Implications for Global Health Policy

As DLW-validated datasets expand across more than 30 countries, they are reshaping global energy expenditure models. These datasets reveal meaningful cross-cultural differences in energy balance that must be considered when developing international physical activity and nutrition guidelines.

High-quality metabolic evidence strengthens efforts to:

·         Design age-appropriate physical activity recommendations

·         Improve childhood nutrition strategies

·         Inform chronic disease prevention policies

·         Promote evidence-based global health standards


🎯 Conclusion: Precision as a Public Health Priority

The growing global application of doubly-labelled water underscores one essential principle: accurate measurement is the cornerstone of meaningful intervention.

By integrating DLW with behavioral and population-specific tools, researchers can move beyond estimation toward evidence-driven models that reflect real-world metabolic diversity.

As research networks continue to expand, the integration of high-fidelity metabolic data into public health frameworks may significantly advance global strategies for childhood physical activity, nutrition, and chronic disease prevention.


👩⚕️ About the Speaker

Dr. Prasangi Dabare is an academic and senior lecturer in physiotherapy, currently serving as the Head of the Department of Physiotherapy at the Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Sri Lanka. With a profound background in both clinical practice and academic research, Dr. Dabare has made significant contributions to the field of physiotherapy, particularly in pediatric and geriatric care, physical activity among children and adolescents, and body composition analysis methods.


🌍 Join the Global Conversation

Event: International Conference on Pediatrics, Neonatology & Child Health
📅 March 26–28, 2026
📍 Singapore & Online
🔗 Website: https://pediatrics.miconferences.com/
🔗 Register: https://pediatrics.miconferences.com/register
🔗 Abstract Submission: https://pediatrics.miconferences.com/abstract-submission

📩 Email: pediatrics@mathewsconference.com
📞 Phone: +1 (312) 462-4448
💬 WhatsApp: +1 (424) 377-0967

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