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Resting energy expenditure and body composition in children with myelomeningocele
Robyn A Littlewood1, Orrawin Trocki, Ross W Shepherd
1Queensland Paediatric Rehabilitation Service, Royal Children's Hospital, Herston, Queensland 4029, Australia. s310501@student.uq.edu.au
Insights
Children with myelomeningocele (MMC) have variable resting energy expenditure and lower total energy expenditure than predicted. Their body composition is also reduced, despite normal energy intake, highlighting metabolic complexities in MMC.
Area of Science:
- Pediatric Endocrinology
- Metabolic Research
- Neurology
Background:
- Myelomeningocele (MMC) is a complex congenital condition often associated with obesity.
- The underlying reasons for obesity in children with MMC are not fully understood.
- Understanding energy metabolism and body composition is crucial for managing health in this population.
Purpose of the Study:
- To determine the body composition of children with myelomeningocele (MMC).
- To assess the resting energy expenditure (REE) and total energy expenditure (TEE) in children with MMC.
- To compare energy intake (EI) with predicted values in children with MMC.
Main Methods:
- Measured resting energy expenditure (REE), body composition, and anthropometry in 19 children with MMC.
- Estimated total energy expenditure (TEE) using a 3-day activity record.
- Measured energy intake (EI) in seven children with MMC and compared data to predicted values.
Main Results:
- Resting energy expenditure (REE) in children with MMC was highly variable, averaging 96.1% of predicted values.
- Total energy expenditure (TEE) was significantly lower than predicted (73.3% of predicted TEE).
- Energy intake (EI) approximated normal requirements, while body cell mass (BCM) was lower than expected.
Conclusions:
- Resting energy expenditure (REE) in children with myelomeningocele (MMC) shows significant variability compared to predicted norms.
- Total energy expenditure (TEE) is reduced in children with MMC, suggesting altered energy utilization.
- Reduced body cell mass (BCM) in children with MMC indicates potential nutritional or metabolic challenges despite normal energy intake.
Purpose:
Myelomeningocele is a complex disease often complicated by obesity for reasons not well understood. The objectives of this study were to determine body composition and energy expenditure of children with MMC.
Methods:
Resting energy expenditure (REE), body composition and anthropometry were measured in 19 children with MMC (12 M, 7 F). Total energy expenditure (TEE) was estimated using a 3-day activity record. Energy intake (EI) was measured in seven children (5 M, 2 F) with MMC. Data were then compared with predicted values.
Results:
Mean REE (n = 19) was 4680 +/- 1452 kJ/day (96.1 +/- 18.1% of predicted REE). The range was large (45.8-125.7% of predicted REE). TEE (n = 7) was 4344 +/- 2376 kJ/day, hence only 73 34% of predicted TEE. EI (n = 7) was 6560 +/- 1329 kJ/day, approximating a normal energy requirement. Overall, BCM was lower than expected values.
Conclusions:
REE in children with MMC is variable when compared to predicted values. TEE was found to be lower in children with MMC than predicted values and EI was similar to predicted values in this group of seven children. BCM is reduced in children with MMC when compared to expected values.
