Fat free mass explains the relationship between stunting and energy expenditure in urban Mexican Maya children

Abstract

15Background: Childhood stunting has been associated with an increased risk 16 of obesity in adulthood, but the causes are unclear. We hypothesize that stunting 17 significantly reduces both resting and activity energy expenditure. 18Aim: To assess and describe energy expenditure of low socio-economic 19 Maya children and to determine whether stunting is independently related to energy 20 expenditure after controlling for lean mass. 21Subjects and Methods: 33 urban Maya children, 17 boys, aged 7-9 years, 22 living in Merida, Mexico were measured for height, weight and bioelectrical 23 impedance analysis (BIA). Body composition was estimated from BIA. Energy 24 expenditure was measured for one week using the Actiheart (combined heart rate 25 and accelerometer). 26Results: Stunting affected 35% of these physically active children. Using 27 multiple linear regression analysis, greater lean body mass predicted higher resting 28 and activity energy expenditure. Stature was not a significant predictor of resting 29 energy expenditure. A lower height-for-age z-score, but not stunting as a categorical 30 variable, significantly predicted lower activity energy expenditure. 31 1 Conclusion: Our hypothesis that stunting reduces total energy expenditure 1 (resting + active) in children is not supported. Rather children with shorter stature 2 and less lean body mass have lower total energy expenditure. Complex interactions 3 between body size, body composition and metabolic activity appear to elevate the 4 risk for later life obesity in these Maya children. 5 6

Body fatness in relation to physical activity and selected socioeconomic parameters of adolescents aged 15–17 years in Merida, Yucatan

“…No comparable research has been done in Yucatan State, although some studies have been published on growth and nutrition in children and adolescents (Azcorra et al, , 2010Datta Banik et al, 2012;Dickinson et al, 1990;Valentín & Dickinson, 2005;Varela-Silva et al, 2009;Wilson et al, 2011Wilson et al, , 2012. These studies suggest that, over the last 20 years, rates of acute under-nutrition have declined, but both chronic under-nutrition and excess weight (OW + OB rates) have increased (Azcorra et al, , 2010Datta Banik et al, 2012;Dickinson, 1997;Valentín & Dickinson, 2005).…”

“…These studies suggest that, over the last 20 years, rates of acute under-nutrition have declined, but both chronic under-nutrition and excess weight (OW + OB rates) have increased (Azcorra et al, , 2010Datta Banik et al, 2012;Dickinson, 1997;Valentín & Dickinson, 2005). More recent studies have reported the existence of a nutritional dual burden of stunting combined with excess weight in Maya children in the city of Merida, Yucatan (Varela-Silva et al, 2009;Wilson et al, 2011Wilson et al, , 2012.…”

Maternal short stature does not predict their children's fatness indicators in a nutritional dual‐burden sample of urban Mexican Maya

“…Individuals with chronic under-nutrition (stunting) in early life seem to have reduced energetic demands through metabolic (Soares-Wynter and Walker, 1996;Frisancho, 2003;Grillo et al, 2005;Said-Mohamed et al, 2009 and behavioral shifts (Spurr and Reina, 1988;Hoffman et al, 2000;Wilson et al, 2012). Such reduced energetic demands may increase an individual's odds of immediate survival under conditions of energetic stress yet have negative longer-term consequences in health and survival.…”

Difference between Methods for Estimation of Basal Metabolic Rate and Body Composition in Pediatric Patients with Osteogenesis Imperfecta

“…However, a lower z-score for height and age was accompanied with lower lean mass, and this was predictive of a lower BMR [24]. In our study, BIA underestimated BMR compared to IC.…”