Body Composition and Energy Expenditure in Youth with Spina Bifida

脊柱裂青少年的身体成分和能量消耗

• 批准号: 10529266
• 负责人: Michele Polfuss
• 金额: $ 71.5万
• 依托单位: UNIVERSITY OF WISCONSIN MILWAUKEE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2024-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10529266
• 关键词: Accelerometer; Address; Adult; Age; Age of Onset; Algorithms; Behavior; Biolectric Impedance; Body Composition; Body Height; Body Weight Changes; Body fat; Body mass index; Body measure procedure; Calories; Categories; Characteristics; Child; Childhood; Clinic; Clinical; Clinical Sciences; Clinical Trials; Cross-Sectional Studies; Data; Dietary Practices; Dietary intake; Economic Burden; Energy Intake; Energy Metabolism; Ensure; Environment; Equation; Equilibrium; Fatty acid glycerol esters; Frequencies; Funding; Future; General Population; Geographic Locations; Goals; Health; Health Promotion; Height; Individual; Intervention; Knee; Knowledge; Length; Literature; Measurement; Measures; Medical; Methods; Mission; Modeling; Morbidity - disease rate; National Institute of Child Health and Human Development; Obesity; Outcome Study; Participant; Physical activity; Pilot Projects; Population; Prevalence; Prevention; Productivity; Recommendation; Reporting; Research; Research Institute; Research Priority; Risk; Sampling; Science; Self Management; Self-Help Devices; Site; Spinal Dysraphism; Testing; Translational Research; Walking; Weight; Weight maintenance regimen; Wheelchairs; Youth; age stratification; arm; clinical practice; clinical research site; comorbidity; cost effective; disability; doubly-labeled water; feasibility testing; health management; healthy weight; high risk; high risk population; mortality; nutrition; obesity prevention; obesity risk; obesity treatment; peer; personalized medicine; population health; prevent; programs; psychologic; sex; total energy expenditure; waist circumference

Obesity prevalence in youth with spina bifida (SB) is reported as high as 74%, dramatically higher than their typically developing (TD) peers at 16.9%. Obesity is associated with life-long medical, psychological and economic burdens. In SB, obesity further limits one’s independence and ability to self-manage health as well as places them at risk for secondary obesity-related comorbidities. Accurate measurement of body fat is critical as higher levels are associated with increased health risks. Once body fat is established, knowledge of the individual’s total daily energy expenditure (TDEE) is essential to determine an individual’s recommended daily caloric intake needed to maintain or change body weight. Successful identification, prevention and/or treatment of obesity is severely compromised by the lack of: 1) a clinically feasible, cost-effective and valid method to measure body fat, and 2) data on TDEE of youth with SB. Inherent characteristics of SB complicate the ability to accurately measure height, to identify body fat and are associated with a decreased energy expenditure. In addition, a Body Mass Index (BMI), commonly used in clinics as a surrogate estimate of body fat to screen for obesity is inaccurate when used in SB. Proposals for alternative measures or methods to accurately identify body fat in individuals with SB have been made, but have yet to be tested in a sufficiently large sample. To address these gaps, we will develop two independent methods and/or algorithms for use in youth with SB, one to model body fat in a clinic environment and one to predict TDEE in order to determine daily caloric intake recommendations. This multisite, cross-sectional study will include 232 youth with SB, ages 5-18 (stratified by age and mobility status). Sites include four pediatric SB programs from different geographical regions. Participants will have four body composition measures (waist circumference, four-site skinfolds, bioelectrical impedance analysis, and Doubly Labeled Water [DLW]) and up to five height measures (standing [if able to stand independently], arm span, recumbent, knee height and ulnar length) performed. DLW analysis and calculations will provide the criterion body fat%, fat-free mass and TDEE. The body composition and/or height measures will be used to develop an algorithm that accurately models body fat% and categorizes weight status of youth with SB. Based on the average TDEE, an algorithm will be developed to predict energy requirements with a best-fit model based on fat-free mass, sex, age, ambulation status height and/or weight. In addition, a nutrition and physical activity screener will be employed to describe the dietary intake and patterns of physical activity in youth with SB. The proposed study aligns with the mission and research goals of NICHD by ensuring that all children have the opportunity for healthy and productive lives by optimizing independence and promoting the health of populations at an increased risk for obesity by generating findings to be used in the creation and testing of weight management interventions.

据报道，患有脊柱裂（SB）的年轻人的肥胖患病率高达74%，远远高于他们的年龄。 通常发展中（TD）同行为16.9%。肥胖与终生的医疗、心理和 经济负担。在SB中，肥胖进一步限制了一个人的独立性和自我管理健康的能力 这使他们面临继发性肥胖相关合并症的风险。准确测量身体脂肪是至关重要的 因为较高的水平与健康风险增加有关。一旦确定了身体脂肪， 个人的每日总能量消耗（TDEE）对于确定个人的每日推荐能量消耗至关重要 维持或改变体重所需的热量摄入。成功识别、预防和/或治疗 肥胖症的严重危害是缺乏：1）临床上可行的，成本效益和有效的方法， 测量身体脂肪，和2）关于SB青年TDEE的数据。SB的固有特征使测量身体脂肪的能力复杂化。 准确测量身高，识别身体脂肪，并与减少的能量消耗有关。在 此外，体重指数（BMI）通常在诊所用作筛查体脂的替代估计值 肥胖在SB中使用时是不准确的。关于准确识别肥胖的替代措施或方法的建议 SB个体的体脂含量已经确定，但尚未在足够大的样本中进行测试。到 为了解决这些差距，我们将开发两种独立的方法和/或算法用于青少年SB，一种是 在临床环境中对身体脂肪建模，以及预测TDEE以确定每日热量摄入 建议.这项多中心、横断面研究将包括232名5-18岁的SB青年（按年龄分层）。 年龄和流动性）。研究中心包括来自不同地理区域的四个儿科SB项目。 参与者将有四个身体组成的措施（腰围，四个网站皮褶，生物电 阻抗分析和双标记水[DLW]）和多达五个高度测量（站立[如果能够 独立站立]、臂展、横卧、膝高和尺骨长度）。DLW分析和 计算将提供标准体脂肪%、无脂肪质量和TDEE。身体成分和/或身高 测量将用于开发一种算法，该算法准确地模拟体脂%并对体重状态进行分类 基于平均TDEE，将开发一种算法来预测能量需求 使用基于无脂肪质量、性别、年龄、截肢状态、身高和/或体重的最佳拟合模型。另外还有按 将采用营养和体力活动筛选器来描述膳食摄入量和体力活动模式。 拟议的研究符合NICHD的使命和研究目标， 所有儿童都有机会通过最大程度的独立性，过上健康和富有成效的生活， 促进肥胖风险增加的人群的健康， 创建和测试体重管理干预措施。