Polfuss Michele, Bandini Linda G, Ravelli Michele N, Huang Zijian, Moosreiner Andrea, Schoeller Dale A, Huang Chiang-Ching, Ding Dan, Berry Cristen, Marston Emma, Hussain Azeem, Shriver Timothy C, Sawin Kathleen J
College of Nursing, University of Wisconsin - Milwaukee, Milwaukee, WI, United States.
Department of Nursing Research and Evidence-Based Practice, Children's Wisconsin, Milwaukee, WI, United States.
Front Pediatr. 2023 Jul 20;11:1151797. doi: 10.3389/fped.2023.1151797. eCollection 2023.
The consequences of obesity are ominous, yet healthcare professionals are not adequately preventing or treating obesity in youth with Down syndrome (DS). Total daily energy expenditure (TDEE) is the energy expended in 24 h through physical activity and life-sustaining physiologic processes. An individual's TDEE is essential for determining the daily caloric intake needed to maintain or change body weight. Successful prevention and treatment of obesity in youth with DS is severely compromised by the lack of data on TDEE and information on weight-related behaviors for this high-risk population. This manuscript describes the protocol for the federally funded study that is in process to determine daily energy expenditure in a large cohort of children with DS.
This observational cross-sectional study will include a national sample of 230 youth with DS, stratified by age (5-11 and 12-18 years of age) and sex. Doubly Labeled Water analysis will provide the criterion body fat%, fat-free mass, and TDEE. To increase accessibility and decrease the burden on participants, the entire study, including obtaining consent and data collection, is conducted virtually within the participant's home environment on weekdays and weekends. The study team supervises all data collection via a video conferencing platform, e.g., Zoom. This study will (1) examine and determine average TDEE based on age and sex, (2) develop a prediction equation based on measured TDEE to predict energy requirements with a best-fit model based on fat-free mass, sex, age, and height and/or weight, and (3) use 24-hour dietary recalls, a nutrition and physical activity screener, wearable devices, and sleep questionnaire to describe the patterns and quality of dietary intake, sleep, and physical activity status in youth with DS.
The lack of accurate information on energy expenditure and weight-related behaviors in youth with DS significantly impedes the successful prevention and treatment of obesity for this vulnerable population. The findings of this study will provide a further understanding of weight-related behaviors as obesity risk factors, currently not well understood for this population. This study will advance the science of weight management in individuals with disabilities and shift clinical practice paradigms.
肥胖的后果很严重，但医疗保健专业人员在预防和治疗唐氏综合征（DS）青少年肥胖方面做得并不够。每日总能量消耗（TDEE）是指通过身体活动和维持生命的生理过程在24小时内消耗的能量。个体的TDEE对于确定维持或改变体重所需的每日热量摄入至关重要。由于缺乏关于TDEE的数据以及该高危人群与体重相关行为的信息，DS青少年肥胖的成功预防和治疗受到严重影响。本手稿描述了一项由联邦政府资助的正在进行的研究方案，该研究旨在确定一大群DS儿童的每日能量消耗。
这项观察性横断面研究将纳入230名DS青少年的全国样本，按年龄（5至11岁和12至18岁）和性别分层。双标水分析将提供标准的体脂百分比、去脂体重和TDEE。为了提高可及性并减轻参与者的负担，整个研究，包括获得同意和数据收集，都在工作日和周末在参与者的家庭环境中以虚拟方式进行。研究团队通过视频会议平台（如Zoom）监督所有数据收集。本研究将（1）根据年龄和性别检查并确定平均TDEE，（2）基于测量的TDEE开发一个预测方程，以基于去脂体重、性别、年龄和身高和/或体重的最佳拟合模型预测能量需求，（3）使用24小时饮食回顾、营养和身体活动筛查工具、可穿戴设备以及睡眠问卷来描述DS青少年的饮食摄入、睡眠和身体活动状态的模式和质量。
缺乏关于DS青少年能量消耗和与体重相关行为的准确信息，严重阻碍了对这一弱势群体肥胖的成功预防和治疗。本研究的结果将进一步了解作为肥胖风险因素的与体重相关行为，目前这一人群对这些行为的了解并不充分。本研究将推动残疾人体重管理科学的发展，并改变临床实践模式。
