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Calcaterra V, Magenes VC, Destro F, Baldassarre P, Silvestro GS, Tricella C, Visioli A, Verduci E, Pelizzo G, Zuccotti G. Prader–Willi Syndrome and Weight Gain Control: From Prevention to Surgery—A Narrative Review. CHILDREN 2023; 10:children10030564. [PMID: 36980122 PMCID: PMC10047227 DOI: 10.3390/children10030564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/01/2023] [Accepted: 03/12/2023] [Indexed: 03/19/2023]
Abstract
Severe obesity remains one of the most important symptoms of Prader–Willi Syndrome (PWS), and controlling weight represents a crucial point in the therapeutical approach to the syndrome. We present an overview of different progressive patterns of growth that involve controlling weight in PWS. Mechanisms involved in the development of obesity and in preventive and therapeutic strategies to control weight gain are discussed. Early diagnosis, a controlled diet regimen, regular physical activity, follow-up by multidisciplinary teams, and hormonal treatment improved the management of excessive weight gain. In selected cases, a surgical approach can be also considered. Controlling weight in PWS remains a challenge for pediatricians. The importance of consulting different healthcare specialists, starting from the neonatal and pediatric age, is also considered as a crucial approach to controlling weight, as well as to limiting and preventing the onset of obesity and its complications.
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Affiliation(s)
- Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Correspondence:
| | | | - Francesca Destro
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Paola Baldassarre
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | | | - Chiara Tricella
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Alessandro Visioli
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
| | - Elvira Verduci
- Pediatric Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Gloria Pelizzo
- Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
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Hirsch HJ, Benarroch F, Genstil L, Pollak Y, Derei D, Forer D, Mastey Ben-Yehuda H, Gross-Tsur V. Long-term weight control in adults with Prader-Willi syndrome living in residential hostels. Am J Med Genet A 2021; 185:1175-1181. [PMID: 33543526 DOI: 10.1002/ajmg.a.62101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/01/2021] [Accepted: 01/12/2021] [Indexed: 11/07/2022]
Abstract
Hyperphagia leading to severe obesity with increased morbidity and mortality is the major manifestation of Prader-Willi syndrome. Caring for these individuals in a home environment is challenging and stressful for caregivers and families. Residential hostels specifically for PWS adults offer programs of diet, exercise, and vocational opportunities, but long-term effects of PWS hostel living have not been reported. We studied long-term changes in body mass index (BMI) for PWS adults living in residential hostels compared with age-matched controls living with families at home. The study included all 34 individuals (18 men) aged >17 years with genetically confirmed PWS living in residential hostels. BMI was recorded at the time of yearly clinic visits and compared to 23 PWS adults (10 men) living at home. BMI on entering the hostel was 36.3 ± 11.0 kg/m2 and decreased to 27.0 ± 5.6 kg/m2 (p < 0.001) after 6.9 ± 3.9 years. For 21 residents, a slight rise of BMI to 28.8 kg/m2 was observed 5.1 ± 2.5 years after the lowest value was achieved. BMI of 23 PWS adults at home was 36.8 ± 12.7 kg/m2 versus 27.9 ± 7.1 kg/m2 for hostel residents in the same age range (p = 0.008). From 2008 to 2019, there were five deaths among PWS individuals aged 18-40 years living at home, compared with one death (a 43-year-old man) among hostel residents. Adults with PWS living in hostels lose weight, maintain BMI values in a normal to mildly overweight range, and have lower mortality in contrast to individuals in a family home environment.
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Affiliation(s)
- Harry J Hirsch
- Multidisciplinary Prader-Willi syndrome clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Fortu Benarroch
- Multidisciplinary Prader-Willi syndrome clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.,Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.,The Faculty of Medicine, The Hebrew University School of Medicine, Jerusalem, Israel
| | - Larry Genstil
- Multidisciplinary Prader-Willi syndrome clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Yehuda Pollak
- Seymour Fox School of Education, The Hebrew University, Jerusalem, Israel
| | - Dvorit Derei
- Multidisciplinary Prader-Willi syndrome clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Dorit Forer
- Multidisciplinary Prader-Willi syndrome clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Hadassa Mastey Ben-Yehuda
- Multidisciplinary Prader-Willi syndrome clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Varda Gross-Tsur
- Multidisciplinary Prader-Willi syndrome clinic, Neuropediatric Unit, Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel.,The Faculty of Medicine, The Hebrew University School of Medicine, Jerusalem, Israel
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Haseley A, Wallis K, DeBrosse S. Kleefstra syndrome: Impact on parents. Disabil Health J 2020; 14:101018. [PMID: 33189624 DOI: 10.1016/j.dhjo.2020.101018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 10/01/2020] [Accepted: 10/24/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Kleefstra syndrome (KS) is associated with developmental delay, autism, intellectual disability, psychosis, and regression. Research has not been conducted to assess the impact of KS on parents. OBJECTIVE/HYPOTHESIS A mixed-method study was conducted to assess the impact on parental well-being by evaluating parents' well-being, identifying factors of parental experience predicting well-being, and exploring the parental experience. METHODS Parents completed an online survey containing the PedsQL™ Family Impact Module (FIM) and a questionnaire created by the researchers. One-Way T-Test compared parents of children with KS to parents of children with Prader-Willi syndrome (PWS). Multiple linear regression used parents' total scale scores on PedsQL™ FIM to identify factors influencing parental well-being. Constant comparative analysis used open-ended responses to explore the parental experience of having a child with KS. RESULTS Parents of children with KS had statistically lower scores in daily activity and social functioning, but statistically higher scores in communication and emotional functioning compared to parents of children with PWS. However, the power was below 0.80, meaning additional research needs to be completed to confirm these findings. The linear multiple regression was not significant. Most importantly, the themes of establishing the diagnosis, importance of knowledge, sense of community, KS and relationships with others, how life changed, and what the future will hold, characterized the parental experience. CONCLUSIONS Knowledge and support were important to parents who had a child recently diagnosed with KS. Therefore, parents should be provided resources about KS and support groups at diagnosis.
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Affiliation(s)
- Alexandria Haseley
- Department of Genetics and Genome Sciences, Case Western Reserve University, Biomedical Research, 2109, Adelbert Rd Building, 6th FL, Cleveland, OH, USA.
| | - Kimberly Wallis
- Center for Human Genetics, University Hospitals Cleveland Medical Center, 11100 Euclid Ave #1500, Cleveland, OH, 44106, USA; Genetic Services, Akron Children's Hospital, 215 W Bowery St, Akron, OH, 44308, USA.
| | - Suzanne DeBrosse
- Department of Genetics and Genome Sciences, Case Western Reserve University, Biomedical Research, 2109, Adelbert Rd Building, 6th FL, Cleveland, OH, USA; Center for Human Genetics, University Hospitals Cleveland Medical Center, 11100 Euclid Ave #1500, Cleveland, OH, 44106, USA.
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Hamzaid NH, O’Connor HT, Flood VM. Observed Dietary Intake in Adults with Intellectual Disability Living in Group Homes. Nutrients 2019; 12:nu12010037. [PMID: 31877838 PMCID: PMC7020024 DOI: 10.3390/nu12010037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 12/31/2022] Open
Abstract
Background: There is limited information on the dietary intakes of people with intellectual disability (ID) living in group homes. Objective: To describe and evaluate dietary intake in people with ID. Method: Dietary intake was assessed in a convenience sample of people with ID living in group homes. Dietary assessment used three-day weighed food records and digital food photography. Intakes were compared to the Nutrient Reference Values (NRVs) and dietary recommendations. Results: A sample of 33 adults, (men (M): n = 14; women (W): n = 19), mean age 51 ± 14 years, was recruited from seven group homes. Mean daily energy intake was low (M: 7.4 MJ; W: 7.0 MJ; p = 0.46), similar to levels recommended for bed rest. Many participants had intakes below the estimated average requirements (EARs) for the nutrients, magnesium (M: 86%; W: 63%), calcium (M: 43%; W: 78%), iodine (M: 43%; W: 47%) and zinc (M: 43%). Less than half of the recommended daily servings were consumed for vegetables (men and women) and dairy foods (women). Conclusion: Nutrient intake and diet quality of the participants in the group homes studied was poor. Education and policy to support healthier diets is required to improve dietary intake of people with intellectual disability, living in group homes.
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Affiliation(s)
- Nur Hana Hamzaid
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Program of Dietetics, Kuala Lumpur 50300, Malaysia;
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe 2141, NSW, Australia;
| | - Helen T. O’Connor
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe 2141, NSW, Australia;
- Charles Perkins Centre, The University of Sydney, Camperdown 2006, NSW, Australia
| | - Victoria M. Flood
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe 2141, NSW, Australia;
- Westmead Hospital, Western Sydney Local Health District, Westmead 2145, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown 2006, NSW, Australia
- Correspondence: ; Tel.: +61-412-118-977
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Nutritional intervention with hypocaloric diet for weight control in children and adolescents with Prader-Willi Syndrome. Eat Behav 2016; 21:189-92. [PMID: 26970733 DOI: 10.1016/j.eatbeh.2016.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 02/25/2016] [Accepted: 03/01/2016] [Indexed: 11/21/2022]
Abstract
Prader-Willi Syndrome (PWS) is a genetic disorder caused by the lack of expression of paternal alleles in the proximal region of the long arm of chromosome 15. Low inhibitory control and hyperphagia are two of the most severe neurobehavioral symptoms of the syndrome. The aim of the present study was to assess the efficiency of nutritional training program with the use hypocaloric diet for weight control in a group of five children and adolescents with PWS. The intervention program consisted of 10 sessions for parents' orientation during 8months. Patients had their anthropometric measures assessed (weight, height and body mass index - BMI). The main results indicate weight maintenance, height increase, and BMI decrease after intervention. These results were considered indicators of the program's efficiency.
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