Obesity in children and adolescents with acquired brain injury

Abstract

Objectives: To measure the prevalence of obesity and to assess associated clinical factors in children and adolescents with acquired brain injury (ABI). Study design: This cross-sectional study included 88 subjects aged between 2.4-17.7 years attending the Brain Injury Clinic at a tertiary paediatric hospital. Body mass index (BMI) and BMI z-scores were calculated. Obesity and overweight were defined using the International Obesity Taskforce cut-points. Associations were examined between BMI z-scores and the following: ABI severity, mobility level, duration from injury and presence of radiological injury. Results: The prevalence of obesity in this population (obese =15%) was higher than those in Australian children and adolescents (1995 National Nutrition Survey) while the prevalence of overweight (19.3%) was comparable. There was a linear trend for the participants to have a higher BMI z-score with increasing level of mobility (F=6.91, df 1.70, p = 0.011). Conclusion: There is no data about obesity in children and adolescents with ABI. The study with limited statistical power suggests that obesity is prevalent in this population and increases with increasing level of mobility. Further studies are required to address the issue of obesity and related complications in this population. Keywords: Traumatic brain injury, overweight, body mass indexObjetivos: Medir la prevalencia de la obesidad y evaluar los factores clinicos asociados en ninos y adolescentes con lesion cerebral adquirida (ABI). Diseno del estudio: Este estudio transversal incluyo a 88 sujetos con edades entres los 2.4 y los 17.7 anos, que asisdan a la Clinica de Trauma Cerebral en un hospital pediatrico de tercer nivel. Se calcularon el indice de masa corporal (BMI) y las calificaciones-z del BMI. La obesidad y el sobrepeso se definieron usando los puntos de corte de la Fuerza de Tarea de Obesidad Intemacional. Se examinaron las asociaciones entre las calificaciones-z del BMI y los siguientes puntos: la severidad de la ABI, el nivel de movilidad, la duracion de la lesion y la presencia de la lesion radiologica. Resultados: La prevalencia de la obesidad en esta poblacion (Obeso =15%) fue mas alta que aquella encontrada en los nifios y adolescentes australianos (Encuesta de Nutricion Nacional 1995), mientras que la prevalencia del sobrepeso (19.3%) fue comparable. Hubo una tendencia lineal para los participantes en tener calificaciones-z del BMI mas altas conforme al aumento en el nivel de la movilidad (F=6.9l, DF 1,70, p = 0.01l). Conclusion: No hay datos acerca de la obesidad en ninos y adolescentes con ABI. Nuestro estudio con un poder estadistico limitado, sugiere que la obesidad prevalece en esta poblacion y que aumenta con el aumento en el nivel de la movilidad. Se requieren mas estudios que se dediquen al tema de la obesidad y a las complicaciones relacionadas en esta poblacion.

Avaliação da composição corporal de crianças e jovens com deficiência

“…A literatura aponta que o excesso de peso é um problema significativo de saúde entre crianças e adolescentes com deficiência (4,11,12) . Em populações selecionadas, alguns pesquisadores relataram uma maior prevalência de sobrepeso entre crianças e adolescentes com mielomeningocele, paralisia cerebral, síndrome de Prader-Willi, síndrome de Down, distrofia muscular, lesão cerebral, deficiência visual, transtorno do déficit de atenção e hiperatividade (TDAH) e transtornos do espectro do autismo (1,4,(13)(14)(15)(16) .…”

Interventions for managing weight change following paediatric acquired brain injury: a systematic review

“…10 Questions can be raised as to the applicability of these guidelines to the paediatric ABI population. Given the propensity for adverse weight change in this population, 2 clinical recommendations should include the routine collection of anthropometric data. 45 Given the range of aetiologies present in patients with paediatric ABI, it is imperative that future research is aetiologically sensitive.…”

“…1 There are a range of physical and neuropsychological sequelae following ABI associated with lasting impact on quality of life and survival. 2 One such consequence is on appetite and weight, with the latter being frequently gained or lost significantly as a result of ABI and/or interventions. 2 In addition to correlation with mortality, obesity and low body weight are associated with type 2 diabetes mellitus, cardiovascular disease, hypertension, and an increased risk of chronic respiratory diseases.…”

“…2 One such consequence is on appetite and weight, with the latter being frequently gained or lost significantly as a result of ABI and/or interventions. 2 In addition to correlation with mortality, obesity and low body weight are associated with type 2 diabetes mellitus, cardiovascular disease, hypertension, and an increased risk of chronic respiratory diseases. 3 Impaired stamina is a wellrecognized feature post-ABI, with disordered appetite and inadequate nutrition compounding this effect.…”

“…4 Children with ABI face greater risk of developing obesity than the general population. 2 In one study investigating adverse effects in survivors following childhood low grade glioma, cumulative incidence of being overweight (body mass index [BMI] <30 but ≥25) or obese (BMI ≥30) at 5, 10, and 15 years was 18%, 35%, and 53% respectively. 5 Similarly, weight gain in children during the first year following TBI was demonstrated to be 'rapid and excessive', with males being at a higher risk of excessive weight gain than females.…”