Resting energy expenditure and body composition in children with myelomeningocele

Littlewood, Robyn; Trocki, O.; Shepherd, Ross W.; Shepherd, K.; Davies, Peter S. W.

doi:10.1080/1363849031000097817

Cited by 29 publications

(30 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among patients with myelomeningocele, 43% were overweight/obese, which is consistent with what other authors, such as Fiore et al 17 and Littlewood et al, 6 have reported. This percentage is higher than the average 31% prevalence observed in different Argentine age groups according to the National Survey on Nutrition and Health (Encuesta Nacional de Nutrición and Salud, ENNyS), 18 but similar to what has been found by other national studies carried out in male and female adolescents.…”

Section: Discussionsupporting

confidence: 82%

“…I n a v e r a g e , o b e s i t y prevalence among patients with myelomeningocele is 42% due to an increased fat mass (FM) combined with an important lean mass (LM) deficit. Obesity may lead to worsening of comorbidities, such as restricted ability to move about, pressure ulcers, and a lower level of autonomy, compromising the quality of life, 6 and metabolic consequences, such as insulin resistance (IR), carbohydrate i n t o l e r a n c e , d i a b e t e s m e l l i t u s , fatty liver, dyslipidemia, arterial hypertension (HTN), obstructive sleep apnea syndrome, and increased cardiovascular risk, among others. 7,8 B e c a u s e o f t h e o r t h o p e d i c pathology described above, it is difficult to make accurate measures …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Body composition and energy expenditure in a population of children and adolescents with myelomeningocele

Caminiti

Sauré

Weglinski

et al. 2018

Arch Argent Pediatr

View full text Add to dashboard Cite

Introduction.Myelomeningocele is a congenital defect that occurs when the neural tube fails to close completely. It causes body composition alterations and a high prevalence of obesity. It is difficult to detect the most adequate indicator for a nutritional diagnosis due to the impossibility of recording accurate anthropometric measurements. Objective. To describe body composition, resting energy expenditure and metabolic disorders in a population of patients with myelomeningocele managed at "Hospital Garrahan" by comparing obese patients with myelomeningocele and a control population with multifactorial obesity. Population and methods. An anthropometry, an impedance analysis, skinfold equations, arm circumference equations, indirect calorimetry, and biochemical determinations were done to all patients with myelomeningocele between June 2013 and April 2014, once the informed consent had been signed. Results. 131 patients aged 0.7-18.6 years were assessed; they were classified according to their body mass index Z-score into low weight (15%), normal weight (42%), overweight (12%), and obese (31%). A high correlation (r: 20.74) was observed between the fat mass % measured by impedance analysis versus that estimated using skinfolds. Patients with a high fat mass % had a higher body mass index Z-score than those with a normal fat mass % (1.07 versus -0.27, p: 0.0001) although both values were within normal parameters. A lower resting energy expenditure was observed among obese patients with myelomeningocele than predicted and in comparison with multifactorial obese controls. Conclusions. A high percentage of overweight/ obesity was found in the population with myelomeningocele. Skinfold equations would be more adequate to detect obesity. Obese patients with myelomeningocele had a lower resting energy expenditure than predicted and in comparison with controls. Energy indication should be customized.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Body composition and energy expenditure in a population of children and adolescents with myelomeningocele

Caminiti

Sauré

Weglinski

et al. 2018

Arch Argent Pediatr

View full text Add to dashboard Cite

show abstract

“…This low lean body mass is primarily due to the absence of the large muscles about the hip and thigh in the LL1 group compared with their less paralyzed peers in groups LL2 and LL3. Investigators (4)(5)(6)(7)(8)(9) have demonstrated that from 40% to 50% of lean body mass is missing in this group with severe paralysis. The loss of lean body mass also helps explain why children with myelomeningocele and significant paralysis become overweight or obese despite low calorie intake (33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

“…Appropriate weight and low lean body mass causes the CDC/NCHS curves to indicate a low BMI, incorrectly suggesting an undernourished state. Studies using more accurate methods to estimate lean body mass are important to this discussion because they describe lean body mass of approximately 50% of ''normal'' among patients with high levels of paralysis and myelomeningocele (LL1 group) (4)(5)(6)(7)(8)(9). This low lean body mass is primarily due to the absence of the large muscles about the hip and thigh in the LL1 group compared with their less paralyzed peers in groups LL2 and LL3.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Obesity and Myelomeningocele: Anthropometric Measures

Shurtleff

Walker

Duguay

et al. 2010

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

Objective: To evaluate the appropriate use of arm span measurements as a substitute for height/linear length to evaluate obesity in people with myelomeningocele by comparing calculated body mass indices (BMIs) with recently published BMI graphs by the Centers for Disease Control and Prevention (CDC) and National Center for Health Statistics standards (NCHS) published in 2000. Study Design: Retrospective analysis of collected data on patients seen in the University of Washington Birth Defects Clinic from July 1, 1965, through June 1, 2008. Observations included degree of paralysis, presence of scoliosis, height (linear length), weight, and arm span. We compared published CDC/NCHS BMIs with our data using both height and arm span in place of height/linear length. There were 14,701 measures collected during 4,968 visits from 709 patients. Mean values were calculated using age, gender, and lesion level as independent variables. Results: Comparison of BMI means of patients with myelomeningocele suggests that our observations using arm span and height are comparable with the CDC/NCHS BMI means using height for the 2 least paralyzed groups but not for those groups with paralysis from high-level lesions that are more likely to exhibit lower extremity deformities or scoliosis. Conclusions: Published CDC/NCHS graphs, with their percentiles, are appropriate for estimating normal growth by BMI for children born with myelomeningocele when arm span is substituted for length if severe body differences due to high-level paralysis are taken into consideration.

show abstract

Feeding and swallowing dysfunction in genetic syndromes

Cooper-Brown

Copeland

Dailey

et al. 2008

Dev Disabil Res Revs

150

View full text Add to dashboard Cite

Children with genetic syndromes frequently have feeding problems and swallowing dysfunction as a result of the complex interactions between anatomical, medical, physiological, and behavioral factors. Feeding problems associated with genetic disorders may also cause feeding to be unpleasant, negative, or even painful because of choking, coughing, gagging, fatigue, or emesis, resulting in the child to stop eating and to develop behaviors that make it difficult, if not impossible, for a parent to feed their child. In addition, limited experiences with oral intake related to the medical or physical conditions, or other variables such as prematurity, often result in a failure of the child's oral motor skills to develop normally. For example, a child with Pierre Robin sequence may be unable to successfully feed orally, initially, due to micrognathia and glossoptosis. Oral-motor dysfunction may develop as a result of both anatomical problems, (e.g., cleft lip/palate), lack of experience (e.g., s/p. surgery), or oral motor abnormalities (e.g., brain malformation). Neuromotor coordination impairments such as those associated with Down syndrome (e.g., hypotonia, poor tongue control, and open mouth posture) frequently interfere with the acquisition of effective oral-motor skills and lead to feeding difficulties. Management of these phenomena is frequently possible, if an appropriate feeding plan exist that allows for three primary factors: (1) feeding program must be safe, (2) feeding program must support optimal growth, and (3) feeding program must be realistic. Researchers have demonstrated the utility of behavioral approaches in the treatment of feeding disorders, such as manipulations in the presentation of foods and drink and consequences for food refusal and acceptance (e.g., praise, extinction, contingent access to preferred foods). However, because a child's failure to eat is not frequently the result of a single cause, evaluation and treatment are typically conducted by an interdisciplinary team usually consisting of a behavioral psychologist, pediatric gastroenterologist, speech pathologist, nutrition, and sometimes other disciplines. This chapter provides an overview of some of the feeding difficulties experience by some of the more common genetic disorders including identification, interventions, and management.

show abstract

Resting energy expenditure and body composition in children with myelomeningocele

Abstract: REE in children with MMC is variable when compared to predicted values. TEE was found to be lower in children with MMC than predicted values and EI was similar to predicted values in this group of seven children. BCM is reduced in children with MMC when compared to expected values.

Cited by 29 publications

References 19 publications

Body composition and energy expenditure in a population of children and adolescents with myelomeningocele

Body composition and energy expenditure in a population of children and adolescents with myelomeningocele

Obesity and Myelomeningocele: Anthropometric Measures

Feeding and swallowing dysfunction in genetic syndromes

Contact Info

Product

Resources

About