Body Composition and Energy Expenditure in Youth with Spina Bifida

据报道，患有脊柱裂(SB)的青少年中肥胖率高达74%，大大高于他们的 通常开发(TD)同行的比例为16.9%。肥胖与终生的医学、心理和 经济负担。在某人身上，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 AS使他们面临与继发性肥胖相关的合并症的风险。准确测量身体脂肪是至关重要的 因为水平越高，健康风险就越大。一旦确定了身体脂肪，对 个人每日总能量消耗(TDEE)是决定个人每日推荐能量消耗的关键 保持或改变体重所需的卡路里摄入。成功识别、预防和/或治疗 由于缺乏：1)临床上可行的、经济有效的和有效的方法来 测量体脂，2)与某人一起测量青年TDEE数据。某人的内在特征使能力复杂化 准确测量身高，识别身体脂肪，都与能量消耗减少有关。在……里面 此外，身体质量指数(BMI)，在临床上通常用作身体脂肪的替代估计以进行筛查 肥胖症用在某人身上是不准确的。提出替代措施或方法以准确识别 患有SB的个体的体脂已经被制造出来，但还没有在足够大的样本中进行测试。至 为了解决这些差距，我们将开发两种独立的方法和/或算法与SB一起用于青年，一种 在临床环境中对体脂进行建模，并预测TDEE以确定每日卡路里摄入量 建议。这项多点横断面研究将包括232名患有SB的青年，年龄在5-18岁之间(按 年龄和活动状况)。网站包括来自不同地理区域的四个儿科SB项目。 参与者将接受四项身体组成测量(腰围、四点皮褶、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 站立]，手臂跨度，卧位，膝盖高度和尺骨长度)。DLW分析和 计算将提供标准体脂百分比、脱脂质量和TDEE。身体成分和/或身高 这些措施将被用来开发一种算法，准确地模拟身体脂肪百分比并对体重状况进行分类 与某人共度青春时光。基于平均TDEE，将开发一种算法来预测能源需求 以脱脂体重、性别、年龄、行走状态、身高和/或体重为基础的最佳模型。此外，a 营养和体力活动筛选将被用来描述饮食摄入量和体力活动模式 青年时期与某人在一起的活动拟议的研究符合NICHD的使命和研究目标，确保 所有儿童都有机会通过优化独立性和自主性获得健康和富有成效的生活 促进肥胖风险增加的人群的健康，通过产生用于 体重管理干预措施的创建和测试。

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.