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Body Composition and Physical Activity in Pediatric Intestinal Failure On and Off Parenteral Nutrition
Dianna Yanchis1,2, Stephanie So1,2,3, Catherine Patterson1,2,3
1From Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Insights
Children with intestinal failure (IF) show significantly lower physical activity (PA) and altered body composition (BC). Promoting PA is crucial for their rehabilitation and improving health outcomes.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Pediatric Physical Therapy
Background:
- Limited data exist on physical activity (PA) and body composition (BC) in children with intestinal failure (IF).
- Understanding these factors is crucial for optimizing management and rehabilitation in this vulnerable population.
Purpose of the Study:
- To collect data on PA and BC in children with IF, including those on parenteral nutrition (PN) and enteral feeding.
- To assess the relationship between PA and BC in these children.
Main Methods:
- A cross-sectional study involving 58 children (ages 5-18) with IF.
- PA was measured using accelerometry, and BC by dual-energy X-ray absorptiometry.
- Data were compared to age- and sex-matched population norms; regression analysis explored PA-BC relationships.
Main Results:
- Children with IF exhibited significantly fewer daily steps compared to literature controls (7,972 vs. 11,749).
- No significant differences in PA were found between PN and enterally fed groups, but both were less active than controls.
- IF patients had higher fat mass and lower fat-free mass; PA significantly influenced BC (r²=0.32, P<0.001).
Conclusions:
- Children with IF, regardless of feeding method (PN or enteral), are at risk for reduced PA and altered BC.
- Incorporating PA into rehabilitation programs is recommended to optimize outcomes for children with IF.
Objectives:
Data on the relationship between body composition (BC) and physical activity (PA) in children with intestinal failure (IF) are lacking. The objectives were to collect data on PA and BC in children with IF, both parenterally and enterally fed, and to assess the relationship between PA and BC.
Methods:
Cross-sectional study in children 5-18 years with IF including those receiving parenteral nutrition (PN) and those fully enterally fed. PA levels were measured using accelerometry. BC was measured by dual-energy X-ray absorptiometry. Data were compared to age- and sex-matched population norms using t tests. Regression analysis assessed the relationship between BC and PA.
Results:
Fifty-eight children with IF (38 males), mean (SD) age of 10.0 (3.5) years, 20 dependent on PN were included. Patients with IF had significantly fewer steps per day ( P ≤ 0.001) compared with literature controls, with a mean (SD) of 7,972 (3,008) and 11,749 (1,106), respectively. There were no significant differences between patients receiving PN and those enterally fed, but both groups were significantly less active than literature controls ( P < 0.001). Patients with IF had higher fat mass and lower fat-free mass compared to literature controls ( P = 0.008). PA had a significant effect on BC ( r2 = 0.32, P < 0.001).
Conclusions:
Children with IF, those receiving PN and those fully enterally fed, are at risk of decreased PA and altered BC. PA should be part of ongoing rehabilitation and management to optimize outcomes.
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