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Luo B, Davidson ZE, O'Brien K, Volders E, Lu J, Dunlea K, Lazzari M, Billich N, Nguo K. Describing Energy Expenditure in Children with a Chronic Disease: A Systematic Review. Adv Nutr 2024; 15:100198. [PMID: 38432591 PMCID: PMC10987846 DOI: 10.1016/j.advnut.2024.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024] Open
Abstract
Understanding energy expenditure in children with chronic disease is critical due to the impact on energy homeostasis and growth. This systematic review aimed to describe available literature of resting (REE) and total energy expenditure (TEE) in children with chronic disease measured by gold-standard methods of indirect calorimetry (IC) and doubly labeled water (DLW), respectively. A literature search was conducted using OVID Medline, Embase, CINAHL Plus, Cochrane, and Scopus until July 2023. Studies were included if the mean age of the participants was ≤18 y, participants had a chronic disease, and measurement of REE or TEE was conducted using IC or DLW, respectively. Studies investigating energy expenditure in premature infants, patients with acute illness, and intensive care patients were excluded. The primary outcomes were the type of data (REE, TEE) obtained and REE/TEE stratified by disease group. In total, 271 studies across 24 chronic conditions were identified. Over 60% of retrieved studies were published >10 y ago and conducted on relatively small population sizes (n range = 1-398). Most studies obtained REE samples (82%) rather than that of TEE (8%), with very few exploring both samples (10%). There was variability in the difference in energy expenditure in children with chronic disease compared with that of healthy control group across and within disease groups. Eighteen predictive energy equations were generated across the included studies. Quality assessment of the studies identified poor reporting of energy expenditure protocols, which may limit the validity of results. Current literature on energy expenditure in children with chronic disease, although extensive, reveals key future research opportunities. International collaboration and robust measurement of energy expenditure should be conducted to generate meaningful predictive energy equations to provide updated evidence that is reflective of emerging disease-modifying therapies. This study was registered in PROSPERO as CRD42020204690.
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Affiliation(s)
- Bethany Luo
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia
| | - Zoe E Davidson
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
| | - Katie O'Brien
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia
| | - Evelyn Volders
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia
| | - Jeffrey Lu
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia
| | - Kali Dunlea
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia
| | - Matisse Lazzari
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia
| | - Natassja Billich
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics and Foods, Monash University, Melbourne, Victoria, Australia
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Ohmori H, Kato A, Shirai Y, Fukano R, Nagae A, Yamasaki M, Komenaka J, Imamura E, Kumode M, Miyachi T. The Effect of Vitamin K2 Supplementation on PIVKA-II Levels in Patients with Severe Motor and Intellectual Disabilities Undergoing Long-Term Tube Feeding. Nutrients 2023; 15:4525. [PMID: 37960177 PMCID: PMC10647752 DOI: 10.3390/nu15214525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/14/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Nutritional support is essential for patients with severe motor and intellectual disabilities (SMID) to ensure the smooth provision of medical care. These patients often require long-term tube feeding with enteral formulas, potentially leading to deficiencies in vitamins and trace elements. Additionally, frequent antibiotic use for infections often disrupts gut microbiota, inhibiting vitamin K2 production by intestinal bacteria. We assessed the serum protein induced by vitamin K absence or antagonists-II (PIVKA-II) and undercarboxylated osteocalcin (ucOC) levels to assess the vitamin K status in 20 patients with SMID (median age: 44.1 years, 11 men and 9 women) undergoing long-term tube feeding for durations ranging from 3 to 31 years. Thirteen (65%) and nine (45%) patients had elevated PIVKA-II (<40 mAU/mL) and serum ucOC levels (reference value < 4.50 ng/mL), respectively. Dietary vitamin K1 intake did not differ between patients with and without elevated PIVKA-II levels. Vitamin K2 supplementation for 3 months decreased serum PIVKA-II levels near those within the reference range. Approximately half of the patients with SMID on tube feeding had subclinical vitamin K deficiency. Further studies are needed to ascertain if long-term vitamin K2 supplementation effectively prevents vitamin K deficiency-induced hypercoagulation, osteoporosis, and vascular calcification in patients with SMID.
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Affiliation(s)
- Hiromitsu Ohmori
- Department of Pediatrics, National Hospital Organization Yanai Medical Center, 95 Ihonosho, Yanai 742-1352, Japan
| | - Akihiko Kato
- Blood Purification Unit, Hamamatsu University Hospital, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan;
| | - Yuka Shirai
- Clinical Nutrition Unit, Hamamatsu University Hospital, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan;
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube 755-8505, Japan;
| | - Akiko Nagae
- Department of Pediatrics, Biwako Gakuen Kusatsu Medical and Welfare Center for Children and Persons with Severe Motor and Intellectual Disabilities, 8-3-113 Kasayama, Kusatsu 525-0072, Japan; (A.N.); (M.K.)
| | - Masami Yamasaki
- Department of Neurology, National Hospital Organization Yanai Medical Center, 95 Ihonosho, Yanai 742-1352, Japan; (M.Y.); (E.I.); (T.M.)
| | - Junko Komenaka
- Department of Clinical Nutrition, National Hospital Organization Yanai Medical Center, 95 Ihonosho, Yanai 742-1352, Japan;
| | - Eiji Imamura
- Department of Neurology, National Hospital Organization Yanai Medical Center, 95 Ihonosho, Yanai 742-1352, Japan; (M.Y.); (E.I.); (T.M.)
| | - Masao Kumode
- Department of Pediatrics, Biwako Gakuen Kusatsu Medical and Welfare Center for Children and Persons with Severe Motor and Intellectual Disabilities, 8-3-113 Kasayama, Kusatsu 525-0072, Japan; (A.N.); (M.K.)
| | - Takafumi Miyachi
- Department of Neurology, National Hospital Organization Yanai Medical Center, 95 Ihonosho, Yanai 742-1352, Japan; (M.Y.); (E.I.); (T.M.)
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Jacinto M, Matos R, Monteiro D, Antunes R, Caseiro A, Gomes B, Campos MJ, Ferreira JP. Effects of a 24-week exercise program on anthropometric, body composition, metabolic status, cardiovascular response, and neuromuscular capacity, in individuals with intellectual and developmental disabilities. Front Physiol 2023; 14:1205463. [PMID: 37288435 PMCID: PMC10242032 DOI: 10.3389/fphys.2023.1205463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/28/2023] [Indexed: 06/09/2023] Open
Abstract
Introduction: The prevalence of overweight and obesity has increased in the last decades, including in people with Intellectual and Developmental Disabilities (IDD). This is even more concerning when it is globally accepted that a low physical condition contributes to the deterioration of functionality and increases the risk of developing chronic diseases during life, with effective implications for health and well-being. The aim of the present study is to investigate the effects of two physical exercise intervention programs on institutionalized individuals with IDD. Methods: Twenty-one adults with IDD (43.04 ± 11.18 years) were split by convenience into three groups: i) an indoor training group (IG; N = 7; 24-week machine-based gym intervention), ii) an outdoor training group (OG; N = 7; 24-week outdoor intervention with low-content materials), and iii) a control group (CG; N = 7). Assessed outcomes included indicators of health and neuromuscular capacity. The ShapiroWilk (n < 50) and Levene tests were used to verify data normality and homoscedasticity. A Kruskal-Walli test was performed to understand if there were differences between the groups. For comparison purposes and to assess hypothetical differences between groups, the Wilcoxon signed-rank test and the Friedman test were used. The respective effect size was calculated, and the significance level was defined at 0.05. Results/Discussion: There was a difference in fat mass in OG (initial ≠ intermediate; Bonferroni corrected: t = 2.405; p = 0.048; W = 0.08 and initial ≠ final moments; Bonferroni corrected: t = 2.405; p = 0.048; W = 0.08). Indoor intervention programs seem to be more effective than outdoor intervention programs for reducing heart rate rest (t = -2.912; p = 0.011; W = -0.104) when compared with CG. Conclusion: A low-cost outdoor intervention in contact with nature appears to be more effective for fat mass reduction. The results for heart rate variability are not clear and robust. Finally, an indoor intervention using weight-training machines appears to be a good method to promote neuromuscular capacity.
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Affiliation(s)
- Miguel Jacinto
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Rui Matos
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
| | - Diogo Monteiro
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal
| | - Raul Antunes
- ESECS—Polytechnic of Leiria, Leiria, Portugal
- Life Quality Research Centre (CIEQV), Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - André Caseiro
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
| | - Beatriz Gomes
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - Maria João Campos
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
| | - José Pedro Ferreira
- Faculty of Sport Sciences and Physical Education, University of Coimbra, Coimbra, Portugal
- Research Center for Sport and Physical Activity (CIDAF), Coimbra, Portugal
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Parents' Perspectives on Adaptive Sports in Children with Profound Intellectual and Multiple Disabilities. CHILDREN-BASEL 2021; 8:children8090815. [PMID: 34572247 PMCID: PMC8471413 DOI: 10.3390/children8090815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/06/2021] [Accepted: 09/15/2021] [Indexed: 11/18/2022]
Abstract
Children with profound intellectual and multiple disabilities (PIMD) need adaptations to participate in sports and it is more difficult for them to access these activities. We investigated the effects of adaptive sports in children with PIMD as perceived by their parents. The parents answered a postal questionnaire exploring the effects of adaptive sports during the 3 days following an activity. The questionnaire explored twelve domains of children’s daily lives, such as sleep and appetite. We calculated a composite score, including all of these domains, to assess whether the children globally benefited from adaptive sports. Of the families, 27/63 responded (participation 42.9%). Four domains improved after the sports activity in an important proportion of children (improvement in 64.0% of children for wellbeing, 57.6% for mood, 56.0% for comfort and 48.1% for sleep). Among the majority of children, the other eight domains remained mostly stable. Three quarters of parents reported a globally positive effect of adapted physical activities on their child. These findings support the further development and provision of adaptive sports for children with severe neurological impairments.
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