Cerebral palsy is the most common cause of physical disability in childhood, occurring in one in 500 children. It is caused by a static brain lesion in the neonatal period leading to a range of activity limitations. Oral motor and swallowing dysfunction, poor nutritional status and poor growth are reported frequently in young children with cerebral palsy and may impact detrimentally on physical and cognitive development, health care utilisation, participation and quality of life in later childhood. The impact of modifiable factors (dietary intake and physical activity) on growth, nutritional status, and body composition (taking into account motor severity) in this population is poorly understood. This study aims to investigate the relationship between a range of factors - linear growth, body composition, oral motor and feeding dysfunction, dietary intake, and time spent sedentary (adjusting for motor severity) - and health outcomes, health care utilisation, participation and quality of life in young children with cerebral palsy (from corrected age of 18 months to 5 years).
Background: Body mass index (BMI) is used to diagnose obesity. However, its ability to predict the percentage fat mass (%FM) reliably is doubtful. Therefore validity of BMI as a diagnostic tool of obesity is questioned. Aim: This study is focused on determining the ability of BMI-based cut-off values in diagnosing obesity among Australian children of white Caucasian and Sri Lankan origin. Subjects and methods: Height and weight was measured and BMI (W/H2) calculated. Total body water was determined by deuterium dilution technique and fat free mass and hence fat mass derived using age- and gender-specific constants. A %FM of 30% for girls and 20% for boys was considered as the criterion cut-off level for obesity. BMI-based obesity cut-offs described by the International Obesity Task Force (IOTF), CDC/NCHS centile charts and BMI-Z were validated against the criterion method. Results: There were 96 white Caucasian and 42 Sri Lankan children. Of the white Caucasians, 19 (36%) girls and 29 (66%) boys, and of the Sri Lankans 7 (46%) girls and 16 (63%) boys, were obese based on %FM. The FM and BMI were closely associated in both Caucasians (r = 0.81, P<0.001) and Sri Lankans (r = 0.92, P<0.001). Percentage FM and BMI also had a lower but significant association. Obesity cut-off values recommended by IOTF failed to detect a single case of obesity in either group. However, NCHS and BMI-Z cut-offs detected cases of obesity with low sensitivity. Conclusions: BMI is a poor indicator of percentage fat and the commonly used cut-off values were not sensitive enough to detect cases of childhood obesity in this study. In order to improve the diagnosis of obesity, either BMI cut-off values should be revised to increase the sensitivity or the possibility of using other indirect methods of estimating the %FM should be explored.
Wide-ranging and inclusive, this text provides an invaluable review of an expansive selection of topics in human evolution, variation and adaptability for professionals and students in biological anthropology, evolutionary biology, medical sciences and psychology. The chapters are organized around four broad themes, with sections devoted to phenotypic and genetic variation within and between human populations, reproductive physiology and behavior, growth and development, and human health from evolutionary and ecological perspectives. An introductory section provides readers with the historical, theoretical and methodological foundations needed to understand the more complex ideas presented later. Two hundred discussion questions provide starting points for class debate and assignments to test student understanding.
11 February 2020 in European Journal of Clinical Nutrition
Stable isotopes have been used as tracers in human nutritional studies for many years. A number of isotopes have been used frequently to assess body composition, energy expenditure, protein turnover and metabolic studies in general, such as deuterium (2Hydrogen), 18Oxygen, 13Carbon and 15Nitrogen. Nevertheless, there is still occasional confusion and concern over their safety, which can hinder the appropriate use of these isotopes in human studies. This mini review aims, therefore, to consider the safety of the four stable isotopes mentioned above, and to reiterate and reaffirm their safety once again. It is hoped that these data will be of use to new researchers in the field, as well as those considering the ethical or other implications of using these stable isotopes in nutritional research. Undoubtedly some of the confusion arises as deuterium, especially, is associated with the nuclear industry. However, as their name implies, of course, none of these stable isotopes are radioactive, and no adverse biological or physiological effects have been reported at the very low levels of enrichment that are used in human studies. There are ample data to reaffirm the safety of stable isotopes at the levels used in nutritional research, and unnecessary concerns and/or confusion should not be a block to continued use of these important tracers.
Excessive physical activity is one of the most paradoxical features of anorexia nervosa (AN). However, there is individual variation in the degree of physical activity found in AN-patients. As a result, marked differences in energy expenditure may be expected. Furthermore, exercise has a positive impact on a variety of psychological disorders and the psychopathology may be different in AN displaying high exercise levels versus AN displaying low exercise levels. We analyzed the energy metabolism and psychological data in low-level exercise and high-level exercise AN-patients compared with healthy, age matched controls.