The resting energy expenditure (REE) and the respiratory quotient (R) were measured in 8 malnourished infants admitted for diarrheal dehydration and associated common infections. Mean body weight deficit for age was more than 35%. Ages ranged from 3 to 12 months. They were studied by indirect calorimetry with a closed system on admission (Adm) and after recovery (Rec) which lasted a mean of 37 days. VO2 and VCO2 were analyzed by gas chromatography, Physical activity was evaluated by the Scopes and Ahmed score. Paired data show that REE per kg of body weight by age was similar on Adm = 70.4 ± 17,4 kcal/kg and at Rec = 79.4 ± 14.7 kcal/kg. When REE was calculated using body weight by length, significant differences were observed between Adm = 44.5 ± 7.3 kcal/kg and Rec = 55.3 ± 9.5 kcal/kg (p < 0.05). Increased physical activity was associated to a similar (20%) and significant increase (p < 0.05) in energy expenditure on Adm and after Rec. R on Adm = 0.76 ± 0.09 was significantly lower than after Rec = 0.03 ± 0.16 (p < 0.05). Decreased weight/height - REE on Adm may be due to reduced body mass. We conclude that R is an appropiate parameter to monitor metabolic activity of malnourished patients during nutritional recovery.
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