Assessment of Obesity of Children With Spina Bifida

Abstract

SUMMARY Percentage body fat of 35 children with spina bifida and 129 age‐matched normal children was measured by underwater weighing and skinfold thickness to assess obesity. Percentage body fat of patients below five years was similar to that of controls; however, 58 per cent of patients above six years had an increased percentage of body fat. The neurological level and ambulatory ability were associated with percentage body fat. A significant correlation between percentage body fat and hydrocephalus suggests that the metabolic and nutritional maladaptation is caused not only by these patients' physical inactivity but also by the condition itself. Appropriate nutritional and mobility programmes should be started early to prevent the development of obesity. RÉSUMÉ Evaluation de l'obesité chez les enfants spina‐bifida Le pourcentage de graisse sur poids total fut mesure chez 35 enfants spina bifida et 129 enfants normaux apparies, utilisant les techniques de poids sous l'eau et de pli cutané pour apprecier l'obesité. Le pourcentage graisse/poids total des enfants en dessous de cinq and était identique dans les deux groups mais 58 pour cent des enfants spina de plus de six ans présentaient un excés de graisse. Le niveau neurologique et l'aptitude au déplacement étaient reliés au pourcentage de graisse. Une correlation significative a été trouvé entre le pourcentage de graisse et l'hydrocéphalie, suggerant que la mauvaise adaption métabolique et nutritionnelle n'est pas causée seulement par l'inactivité physique de ces patients, mais aussi par la condition morbide elle‐meme. Des programmes appropries d'alimentation et de mobilisation devraient débutés précocement pour éviter l'obésite. ZUSAMMENFASSUNG Adipositas bei Kindern mit Spina bifida Bei 35 Kindern mit Spina bifida und 129 altersentsprechenden Kontrollen wurde zur Beurteilung der Adipositas der Korperfettanteil mit Hilfe der unter Wasser Wiegemethode und der Messung der Hautfalten bestimmt. Bei Patienten under funf Jahren war der Korperfettanteil ahnlich wie bei den Kontrollen; 58 Patienten jedoch. die alter als sechs Jahre waren, hatten einen hoheren Korperfettanteil. Der neurologische Befund und die Gehfahigkeit korrelierten mit dem Korperfettanteil. Eine signifikante Korrelation zwischen Korperfettanteil und Hydrozephalus deutet darauf hin, daB die metabolische und ernahhrungsmaBige Fehlanpassung nicht nur durch die korperliche Inaktivitat dieser Patienten bedingt ist, sondern auch durch die Krankheit selbst. Man sollte fruhzeitig mit entsprechenden Ernahrungs‐ und Beratungsprogrammen beginnen, urn der Entwicklung der Adipositas entgegenzuwirken. RESUMEN Evaluacion de la obesidad en ninos con espina bifida Se midió el porcentaje de grasa corporal en 35 ninos con espina bifida y en 129 controles de la misma edad, utilizando las téchnicas del pesaje en el agua y del groso del pliegue cutaneo con el objeto de evaluar la obesidad. El porcentaje de grasa corporal de pacientes de menos de cinco anos era similar a1 de los controles. En cambio el 58 por ciento de ...

Metabolic Syndrome in Adolescents With Spinal Cord Dysfunction

“…These results concur with those by Shurtleff and others that in adolescence, female subjects with SB have increased fat mass compared to male subjects with SB (36,37,71). Total body fat is approximately 18% in ambulatory SB in compared to !31% in nonambulatory SB (29,31,56), and 58% of SB are obese (30). The finding that paraplegic SCI subjects with greater amounts of total body fat had longer duration of injury agrees with those of Manns et al (59).…”

“…The values for obesity include a BMI z-score of !2.0 (97th percentile) adjusted for age and sex (45), 90th percentile BMI for age and sex, (46), total body fat mass as determined by DXA !30% in males and !35% in females (47), or a waist circumference of .90th percentile (13). Previously proposed criteria for obesity in adolescents with SB are 20% total body fat in males and 25% total body fat in females (48) and þ2 root mean square of the residual from the regression of skinfold thickness and hydrostatic weighing (30). Insulin resistance has been defined 3 ways; impaired glucose tolerance based on a 2-hour postprandial blood glucose between 140 and 200 mg/dL (45), fasting blood glucose !110 mg/dL (13,44,46), and fasting insulin !75th percentile (49).…”

“…These patients typically have reduced lean body mass in the lower extremities, with increased abdominal and lower extremity fat tissue accumulation (23)(24)(25)(26)(27)(28)(29)(30)(31). More than 50% of children with SB have body mass index (BMI) values greater than the 95th percentile (32).…”

Triad of physical activity, aerobic fitness and obesity in adolescents and young adults with myelomeningocele

“…Moreover, aerobic fitness of adolescents and young adults with MMC appeared to be 20-35% lower than in healthy comparison persons (17,18). Some studies have reported high prevalence of obesity in persons with MMC (19), up to 58% (20). Due to inconsistent results, it is unclear whether health-related conditions are worse in non-ambulatory persons than in ambulatory persons.…”

Evaluación de la musculatura inspiratoria en niños con antecedentes de Mielomeningocele

“…Los niños presentaban similares antecedentes mórbidos y/o secuelas que en otras series 2,7,8,9,22,23 , sin embargo, existía un mayor porcentaje de escoliosis (100%) y de invalidez (85%) 2,7,8,9,22,23 , lo que podría explicar en cierta forma el porcentaje marginalmente mayor de Pimax demostrada en el estudio de Sherman y colaboradores 10 . Los estudios sobre función pulmonar en pacientes con MMC son muy limitados, en especial cuando se hace mención a la capacidad inspiratoria 10,11 .…”