C B Grogan1, S M Ekvall. 1. Children's Hospital Medical Center, University Affiliated Cincinnati Center for Developmental Disorders, University of Cincinnati, Ohio 45229, USA.
Abstract
OBJECTIVE: The purpose of this study was to develop a method to prevent obesity in myelomeningocele (MM) children by determining the effects of growth, calories and physical activity on body composition and to apply this data to clinical practice, specifically, to correlate lean body mass (LBM) with calorie needs and to correlate body fatness with anthropometry measures. METHODS: The body compositions of 14 children (four males and ten females) with MM were estimated from potassium content (40K), urinary creatinine and anthropometry measurements at the beginning and end of a six-month period. Three subjects who did not have MM were also evaluated as controls. Dietary and physical activity and dietary-goals estimates were taken from records kept by the patients after initial discussion of physical activity and dietary goals with the families. RESULTS: The study showed potassium content (40K), or LBM, in children with MM to be approximately 50% of the potassium content (40K) of children without MM. The percentage of LBM correlated with physical activity, but not with the location of neurological lesion. Lean body mass and creatinine excretion also were significantly correlated, indicating that creatinine excretion is a good measure of lean body tissue in these children. Thorax and abdominal skinfolds, as well as total circumferential measurements (waist being highest), showed significant correlations with the percent of body fat. The caloric intake requirement to maintain the growth of a child with MM was found to be approximately 50% of the recommended daily allowance (RDA) for a child without MM of the same age. Changes in LBM were observed in children with MM who increased physical activity over a six-month interval and were greater than in those who reduced calories alone, however not significantly, presumably due to the short duration of the study. CONCLUSION: To prevent obesity, physical activity should begin in infancy; this will increase LBM and thereby calorie needs. Skinfolds and circumferences (abdominal and thorax skinfolds and waist circumference) which significantly correlated with body fat should be used clinically. Calorie needs according to LBM should be reduced to 50% of the RDA or approximately nine cal/cm height for maintenance or seven cal/cm height for weight loss in MM children after age six (possibly at three to four years of age if nonambulatory).
OBJECTIVE: The purpose of this study was to develop a method to prevent obesity in myelomeningocele (MM) children by determining the effects of growth, calories and physical activity on body composition and to apply this data to clinical practice, specifically, to correlate lean body mass (LBM) with calorie needs and to correlate body fatness with anthropometry measures. METHODS: The body compositions of 14 children (four males and ten females) with MM were estimated from potassium content (40K), urinary creatinine and anthropometry measurements at the beginning and end of a six-month period. Three subjects who did not have MM were also evaluated as controls. Dietary and physical activity and dietary-goals estimates were taken from records kept by the patients after initial discussion of physical activity and dietary goals with the families. RESULTS: The study showed potassium content (40K), or LBM, in children with MM to be approximately 50% of the potassium content (40K) of children without MM. The percentage of LBM correlated with physical activity, but not with the location of neurological lesion. Lean body mass and creatinine excretion also were significantly correlated, indicating that creatinine excretion is a good measure of lean body tissue in these children. Thorax and abdominal skinfolds, as well as total circumferential measurements (waist being highest), showed significant correlations with the percent of body fat. The caloric intake requirement to maintain the growth of a child with MM was found to be approximately 50% of the recommended daily allowance (RDA) for a child without MM of the same age. Changes in LBM were observed in children with MM who increased physical activity over a six-month interval and were greater than in those who reduced calories alone, however not significantly, presumably due to the short duration of the study. CONCLUSION: To prevent obesity, physical activity should begin in infancy; this will increase LBM and thereby calorie needs. Skinfolds and circumferences (abdominal and thorax skinfolds and waist circumference) which significantly correlated with body fat should be used clinically. Calorie needs according to LBM should be reduced to 50% of the RDA or approximately nine cal/cm height for maintenance or seven cal/cm height for weight loss in MM children after age six (possibly at three to four years of age if nonambulatory).
Authors: Nicole M Mueske; Deirdre D Ryan; Alexander L Van Speybroeck; Linda S Chan; Tishya A L Wren Journal: Dev Med Child Neurol Date: 2014-09-23 Impact factor: 5.449
Authors: Michele Polfuss; Kathleen J Sawin; Paula E Papanek; Linda Bandini; Bethany Forseth; Andrea Moosreiner; Kimberley Zvara; Dale A Schoeller Journal: Disabil Health J Date: 2017-12-28 Impact factor: 2.554
Authors: Michele Polfuss; Bethany Forseth; Dale A Schoeller; Chiang-Ching Huang; Andrea Moosreiner; Paula E Papanek; Kathleen J Sawin; Kimberley Zvara; Linda Bandini Journal: J Pediatr Rehabil Med Date: 2021
Authors: Rungsinee Amanda Liusuwan; Lana M Widman; Richard Ted Abresch; Dennis M Styne; Craig M McDonald Journal: J Spinal Cord Med Date: 2007 Impact factor: 1.985