Weight-based nutritional diagnosis of Mexican children and adolescents with neuromotor disabilities

Springer Science and Business Media LLC - Tập 5 - Trang 1-7 - 2012
Rodrigo Vega-Sanchez1, Maria de la Luz Gomez-Aguilar2, Karime Haua3, Guadalupe Rozada3
1Department of Nutrition Research, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Mexico City, Mexico
2Nutrition Department, Centro de Rehabilitación Infantil Teletón, Estado de Mexico, Mexico
3Independent consultant, Mexico City, Mexico

Tóm tắt

Nutrition related problems are increasing worldwide but they have scarcely been evaluated in people with neuromotor disabilities, particularly in developing countries. In this study our aim was to describe the weight-based nutritional diagnoses of children and adolescents with neuromotor disabilities who attended a private rehabilitation center in Mexico City. Data from the first visit’s clinical records of 410 patients who attended the Nutrition department at the Teleton Center for Children Rehabilitation, between 1999 and 2008, were analyzed. Sex, age, weight and height, length or segmental length data were collected and used to obtain the nutritional diagnosis based on international growth charts, as well as disability-specific charts. Weight for height was considered the main indicator. Cerebral palsy was the most frequent diagnosis, followed by spina bifida, muscular dystrophy, and Down’s syndrome. Children with cerebral palsy showed a higher risk of presenting low weight/undernutrition (LW/UN) than children with other disabilities, which was three times higher in females. In contrast, children with spina bifida, particularly males, were more likely to be overweight/obese (OW/OB), especially after the age of 6 and even more after 11. Patients with muscular dystrophy showed a significantly lower risk of LW/UN than patients with other disabilities. In patients with Down’s syndrome neither LW/UN nor OW/OB were different between age and sex. This is the first study that provides evidence of the nutritional situation of children and adolescents with neuromotor disabilities in Mexico, based on their weight status. Low weight and obesity affect a large number of these patients due to their disability, age and sex. Early nutritional diagnosis must be considered an essential component in the treatment of these patients to prevent obesity and malnutrition, and improve their quality of life.

Tài liệu tham khảo

Olaiz-Fernández G, Rivera-Dommarco J, Shamah-Levy T, Rojas R, Villalpando-Hernández S, Hernández-Avila M, Sepúlveda-Amor J: Encuesta Nacional de Salud y Nutrición 2006. 2006, Instituto Nacional de Salud Pública, México Cunningham K, Gibney MJ, Kelly A, Kevany J, Mulcahy M: Nutrient intakes in long-stay mentally handicapped persons. Br J Nutr. 1990, 64 (1): 3-11. 10.1079/BJN19900004. Razagui IB, Barlow PJ, Izmeth MG, Taylor KD: Iron status in a group of long-stay mentally handicapped menstruating women: some dietary considerations. Eur J Clin Nutr. 1991, 45 (7): 331-340. Molteno C, Smit I, Mills J, Huskisson J: Nutritional status of patients in a long-stay hospital for people with mental handicap. S Afr Med J. 2000, 90 (11): 1135-1140. Troughton KEV, Hill AE: Relation between objectively measured feeding competence and nutrition in children with cerebral palsy. Dev Med Child Neurol. 2001, 43 (3): 187-190. Sánchez-Lastres J, Eirís-Puñal J, Otero-Cepeda JL, Pavón-Belinchón P, Castro-Gago M: Nutritional status of mentally retarded children in north-west Spain. I. Anthropometric indicators. Acta Paediatr. 2003, 92 (6): 747-753. 10.1111/j.1651-2227.2003.tb00612.x. Rimmer JH, Rowland JL, Yamaki K: Obesity and Secondary Conditions in Adolescents with Disabilities: Addressing the Needs of an Underserved Population. J Adolesc Health. 2007, 41 (3): 224-229. 10.1016/j.jadohealth.2007.05.005. Velez JC, Fitzpatrick AL, Barbosa CI, Diaz M, Urzua M, Andrade AH: Nutritional status and obesity in children and young adults with disabilities in Punta Arenas, Patagonia, Chile. (Int J Rehabil Res. 2008, 31 (4): 305-313. 10.1097/MRR.0b013e3282fb7d3c. Caram AL, Morcillo AM, Costa-Pinto EA: Nutritional status of children with cerebral palsy in a Brazilian tertiary-care teaching hospital. Dev Med Child Neurol. 2008, 50 (12): 956-10.1111/j.1469-8749.2008.03128.x. Proyecto de Norma Oficial Mexicana PROY-NOM-015-SSA3-2007, Para la atención integral a personas con discapacidad. México: Secretaría de Salud; 2009. XII Censo General de Población y Vivienda. México: Instituto Nacional de Geografía e Informática; 2000. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B: Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997, 39 (4): 214-223. Hung JW, Hsu TJ, Wu PC, Leong CP: Risk factors of undernutrition in children with spastic cerebral palsy. Chang Gung Med J. 2003, 26 (6): 425-432. Hurvitz EA, Green LB, Hornyak JE, Khurana SR, Koch LG: Body mass index measures in children with cerebral palsy related to gross motor function classification: a clinic-based study. Am J Phys Med Rehabil. 2008, 87 (5): 395-403. 10.1097/PHM.0b013e3181617736. UNICEF: The State of the World's Children 2007. 2006, UNICEF, New York Shepherd K, Roberts D, Golding S, Thomas BJ, Shepherd RW: Body composition in myelomeningocele. Am J Clin Nutr. 1991, 53 (1): 1-6. Mita K, Akataki K, Itoh K, Ono Y, Ishida N, Oki T: Assessment of obesity of children with spina bifida. Dev Med Child Neurol. 1993, 35 (4): 305-311. Liusuwan RA, Widman LM, Abresch RT, Styne DM, McDonald CM: Body composition and resting energy expenditure in patients aged 11 to 21 years with spinal cord dysfunction compared to controls: comparisons and relationships among the groups. J Spinal Cord Med. 2007, 30 (Suppl 1): S105-S111. Willig TN, Carlier L, Legrand M, Riviere H, Navarro J: Nutritional assessment in Duchenne muscular dystrophy. Dev Med Child Neurol. 1993, 35 (12): 1074-1082. Zanardi MC, Tagliabue A, Orcesi S, Berardinelli A, Uggetti C, Pichiecchio A: Body composition and energy expenditure in Duchenne muscular dystrophy. Eur J Clin Nutr. 2003, 57 (2): 273-278. 10.1038/sj.ejcn.1601524. Al Husain M: Body mass index for Saudi children with Down's syndrome. Acta Paediatr. 2003, 92 (12): 1482-1485. 10.1111/j.1651-2227.2003.tb00836.x. Amy L, Marjorie S, Dale AS, Nancy JMR: Nutrient Intake and Obesity in Prepubescent Children with Down Syndrome. J Am Diet Assoc. 1996, 96 (12): 1262-1267. 10.1016/S0002-8223(96)00330-6. Shabayek MM: Assessment of the nutritional status of children with special needs in Alexandria. Part II: Anthropometric measures. J Egypt Public Health Assoc. 2004, 79 (5–6): 363-382. van Schrojenstein Lantman-de Valk HM, Haveman MJ, Crebolder HF: Comorbidity in people with Down's syndrome: a criteria-based analysis. J Intellect Disabil Res. 1996, 40 (Pt 5): 385-399. Kuperminc MN, Stevenson RD: Growth and nutrition disorders in children with cerebral palsy. Dev Disabil Res Rev. 2008, 14 (2): 137-146. 10.1002/ddrr.14. Nelson MD, Widman LM, Abresch RT, Stanhope K, Havel PJ, Styne DM, McDonald CM: Metabolic syndrome in adolescents with spinal cord dysfunction. J Spinal Cord Med. 2007, 30 (Suppl 1): S127-S139. International Statistical Classification of Diseases and Related Health Problems. [http://apps.who.int/classifications/apps/icd/icd10online/] Stevenson RD: Use of segmental measures to estimate stature in children with cerebral palsy. Arch Pediatr Adolesc Med. 1995, 149 (6): 658-662. 10.1001/archpedi.1995.02170190068012. Habicht JP: Estandarización de métodos epidemiológicos cuantitativos sobre el terreno. Bol Oficina Sanit Panam. 1974, 76: 375-384. Ekvall SW, Ekvall VK, Beck C, Leonti G, Bigley B, Schwiegerhat L, Horn P, Jiang D: Growth charts for myelomeningocele. Pediatric Nutrition in Chronic Diseases and Developmental Disorders. Edited by: Ekvall SW, Ekvall VK. 2005, Oxford University Press US, New York, 532-2 Cronk C, Crocker AC, Pueschel SM, Shea AM, Zackai E, Pickens G, Reed RB: Growth Charts for Children With Down Syndrome: 1 Month to 18 Years of Age. Pediatrics. 1988, 81 (1): 102-110. Day SM, Strauss DJ, Vachon PJ, Rosenbloom L, Shavelle RM, Wu YW: Growth patterns in a population of children and adolescents with cerebral palsy. Dev Med Child Neurol. 2007, 49 (3): 167-171. 10.1111/j.1469-8749.2007.00167.x.