Nutritional survey of children and adolescents with myelomeningocele (MMC): overweight associated with reduced energy intake.

Abstract

In patients affected by MMC both neurological and systemic dysfunctions may cause obesity and malnutrition. The aim of this study is a nutritional survey, with anthropometric assessment and dietary evaluation, of patients affected by MMC. Anthropometric assessment, dietary evaluation, and a comprehensive assessment of motor impairment degree (MID) were performed in 100 patients (54 males, 46 females) affected by MMC aged from 6 to 228 months (median 91 months). Fifty-five/100 children and adolescents with MMC were classified as normal or wellnourished and 5 at risk of malnutrition or malnourished, while another 40/100 patients were classified as marked overweight (weight-for-height or BMI above the 95th percentile). Deficit in height-for-age was observed in 34/100 patients; 12 of these patients presented with obesity. Dietary assessment evidenced that the majority of wellnourished patients (48/55) were consuming less than 80% or between 80% to 100% of recommended daily allowances (RDA) of energy. Overweight patients had an energy intake lower than their own RDA: 5 below 80%, 25 between 80% to 100%, and only 10 over 100% of RDA of energy for age and sex. No statistical correlation was found between nutritional status and MID, while there was a statistically significant difference between nutritional status and dietary intake (p = 0.005). Overweight is the most frequent nutritional disease in patients affected by MMC. Since in our experience on correlation with MID was found, we can speculate that childhood and adolescent obesity in patients with MMC occurs as a result of complex interactive factors, not strictly related to energy intake and MID. Nutritional surveillance and specific treatment programs for overweight MMC patients are essential to enhance their quality of life.