Energy expenditure of children and adolescents with severe disabilities: a cerebral palsy model

• Published in: The American journal of clinical nutrition 1996-10, Vol.64 (4), p.627-634
• Main Authors: Stallings, VA, Zemel, BS, Davies, JC, Cronk, CE, Charney, EB
• Format: Article
• Language: English
• Subjects: ADIPOSE TISSUES; Adolescent; AGUA CORPORAL; ANTHROPOMETRIC DIMENSIONS; BALANCE DE ENERGIA; Basal Metabolism; BILAN ENERGETIQUE; Biological and medical sciences; Body Composition; BODY FAT; BODY LEAN MASS; BODY MEASUREMENTS; BODY WATER; BODY WEIGHT; Case-Control Studies; Cerebral palsy; Cerebral Palsy - metabolism; Child; Child, Preschool; Children & youth; DELAWARE; DIET; DIETA; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; EAU CORPORELLE; ENERGY BALANCE; ENERGY INTAKE; Energy Metabolism; ESPASMO; ESTADO NUTRICIONAL; ETAT NUTRITIONNEL; Female; Humans; INGESTION DE NUTRIENTES; INGESTION DE SUBSTANCES NUTRITIVES; Male; Medical sciences; MEDICION DEL CUERPO; MENSURATION CORPORELLE; Metabolism; MODELE; MODELOS; Models, Biological; Nervous system (semeiology, syndromes); Neurology; NUTRIENT INTAKE; NUTRITIONAL STATUS; PENNSYLVANIA; PENNSYLVANIE; PESO CORPORAL; Physical Exertion; POIDS CORPOREL; Reference Values; REGIME ALIMENTAIRE; Severity of Illness Index; SPASME; SPASMS; TEJIDO ADIPOSO; TISSU ADIPEUX
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/64.4.627

Spastic quadriplegic cerebral palsy (SQCP) is a severe disability that is associated with abnormal physical activity, body composition, and food intake and with frequent malnutrition. This study examined the pattern of dietary intake, anthropometry, and energy expenditure in a group of subjects with SQCP aged 2–18 y and a normal control group. The energy expenditure pattern was determined from resting energy expenditure (REE, n = 61 SQCP; n = 37 control group) by using indirect calorimetry and from total energy expenditure (TEE, n = 32 SQCP; n = 32 control group) by using the doubly labeled water method. Physical activity, including the chronic spasticity of SQCP, was estimated from the ratio of TEE to REE. Abnormal growth and body composition were common and dietary intake was markedly overreported in the children with SQCP. Children with SQCP were divided according to body fat stores determined by triceps-skinfold-thickness measurements. The children with low fat stores had a lower REE adjusted for fat-free mass compared with the SQCP and control groups with adequate fat stores. TEE was significantly lower for the SQCP group than for the control group. The ratio of TEE to REE, indicating energy for nonbasal needs, was significantly lower in the SQCP children than in the control group, with the adequately nourished SQCP children having lower ratios than the more poorly nourished SQCP group. The nonbasal energy expenditure, such as for physical activity and spasticity, of children with SQCP was low. The nutrition-related growth failure and abnormal pattern of REE are likely related to inadequate energy intake.