The associations between diet and physical activity with body composition and walking a timed distance in adults with Prader–Willi syndrome

Abstract

BackgroundResearch on aging in Prader–Willi syndrome (PWS) is limited, although people with PWS are living longer. Individuals with PWS present with high fat mass, low lean mass, and low levels of physical activity (PA). Previous reports in children and young adults with PWS show inadequate nutrient intake and body fat percentage indicating obesity. Previous studies in PWS rarely included individuals beyond young adulthood, especially studies conducted in the United States. This study includes adults from 18 to 62 years of age, and includes 19 of the estimated 60 adult individuals with PWS in Oklahoma. Because individuals with PWS are living longer, information must be provided on aging with PWS. This study is a report of the initial data for a planned longitudinal study on aging with PWS.ObjectiveDetermine associations between body composition, diet, PA, and a timed walk for adults with PWS, and to assess adequacy of dietary intake for those individuals aging with PWS.DesignThis cross-sectional investigation determined dietary habits, PA, and body composition of adults with PWS, and tested associations between these variables.ResultsParticipants ranged in age from 18 to 62 years. They had healthier body composition, at 26.8% body fat, than previously reported. Mean body mass index (BMI) was in the overweight range at 26.7. Those who consumed higher amounts of fat (as a percent of total kilocalories) had statistically significant lower body fat percentage, but this may simply reflect that individuals with lower body fat percentages felt freer to consume fat. Mean steps taken per day was 7631.7 steps but only 16% of participants met healthy PA recommendations despite participating in daily structured exercise. All participants’ diets met Dietary Guidelines for macronutrient distribution, but 80% were deficient in calcium, 100% were deficient in dietary vitamin D, and 87% were deficient in fiber. Sample size was small, so it was difficult to reach statistical significance, despite seeing clinical significance.ConclusionsRecommend working toward healthy PA recommendations for all age groups by decreasing time in sedentary activity. Recommend increasing vitamin A and D fortified dairy products and high-fiber foods, and consider dietary supplementation, especially for calcium, vitamin D, and fiber.

Association of Vitamin D Status with Chronic Disease Risk Factors and Cognitive Dysfunction in 50–70 Year Old Adults

“…The completed dietary record was then returned at the following visit and reviewed for completeness and portion sizes. The dietary record information was entered into FoodWorks nutrient analysis software [26] to obtain information regarding carbohydrate, protein, fat, as well as vitamin D intakes [27].…”

The Sun’s Vitamin in Adult Patients Affected by Prader–Willi Syndrome

“…However, body composition was not evaluated in the latter study, while in the Italian study the authors reported a negative correlation between 25OHD levels and fat mass in both groups, despite the youth PWS patients presenting a higher fat mass percentage than the controls. Similarly, Woods et al (2018) confirmed that there is inadequate dietary vitamin D intake in adulthood PWS, as they showed through a study of 19 PWS adults, none of whom met vitamin D recommendations from diet alone (25OHD levels were not provided) [9]. Of interest, the authors of this study showed that their PWS adults had lower body fat percentages than the percentages reported in most studies, especially in PWS adults of a younger age, likely due to earlier diagnoses and interventions in diet, exercise, and daily routines, as well as through use of rhGH replacement therapy.…”

“…The common treatments to counteracting the pathological characteristics of PWS-which include restricted caloric intake, increased physical activity, and rhGH therapy-are making it possible for PWS adults to live longer. Nevertheless, obesity-related comorbidities still remain the major contributors to morbidity and mortality in these patients, with the mortality rate reported up to 7% per year for those over 30 years of age [9]. Reduced intake of food containing vitamin D, less sunlight exposure, and scarce or absent physical activity (with preference given to indoor leisure activities) are all conditions that contribute to an increased risk of vitamin D deficiency in PWS adults.…”

“…All participants or their parents completed a three-day food record as accurately and thoroughly as possible using the serving sizes [8,9]. As we have already fully reported in previous studies [47][48][49][50].…”

“…Despite improved diagnoses and management of PWS and a relative preservation of insulin sensitivity in PWS youth, PWS adults usually tend to develop severe obesity-related comorbidities during their lifetimes [6]. In both PWS youths [7,8] and adults [9], low dietary vitamin D intake and low vitamin D status are commonly reported in the context of bone metabolism. To the best of our knowledge, the association of low vitamin D status with fat mass has not been extensively evaluated in PWS adults; however, vitamin D deficiency has been associated with obesity per se, along with the vast majority of obesity-related comorbidities and increased cardiovascular risk [10][11][12][13][14][15][16].…”