Body Composition of Children with Myelomeningocele, Determined by⁴⁰K, Urinary Creatinine and Anthropometric Measures

Abstract

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).

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

“…8 In turn, a correlation was established between absolute LM by impedance analysis and arm circumference and skinfold equations, so both measurements would be adequate to assess body composition alterations in these patients. Grogan et al 25 found 50% less LM in children with myelomeningocele compared to controls.…”

Composición corporal y gasto energético en población de niños y adolescentes con mielomeningocele

“…8 A su vez, se encontró correlación entre MM absoluta con impedanciometría y fórmula por perímetro braquial y pliegues cutáneos, por lo que ambas serían medidas apropiadas para evaluar la alteración de la composición corporal en estos pacientes. Grogan et al 25 encontraron 50% menos de MM en niños con mielomeningocele vs. controles.…”

Obesity and Myelomeningocele: Anthropometric Measures

“…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).…”

“…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.…”

“…Since then a number of articles have described a high prevalence of obesity ranging from 29% to 74%, with an average of 42.4% (1)(2)(3)(4)(5)(6)(7)(8)(9). The results vary according to the number, age, and sex of the patients, as well as the methods of assessment.…”