Children with spina bifida, a congenital condition of the spine and spinal cord, have a higher rate of obesity compared to typically developing peers. One barrier to better prevention of obesity is accurately assessing body fat.
Michele Polfuss is leading a research team in a $3.6 million federal grant to investigate methods of accurately measuring patients' body composition in a clinical setting.
Polfuss is the Joint Research Chair in the Nursing of Children at the University of Wisconsin-Milwaukee and Children's Hospital of Wisconsin. With an interdisciplinary team of professionals, she will determine methods of providing information on the amount of energy expended or calories used in children with spina bifida and determine an accurate assessment of their weight category.
Children with spina bifida are known to have a decreased level of energy expenditure, although we cannot specify how much less as compared to their typically developing peers. Our hypothesis is that the number of calories we currently recommend parents feed their children may be higher than it should be, inadvertently contributing to excess weight gain."
Michele Polfuss, Joint Research Chair in the Nursing of Children at the University of Wisconsin-Milwaukee and Children's Hospital of Wisconsin
For people who are not disabled, health providers can get a fairly accurate assessment of a person's weight status by measuring the person's height and weight, and then using this information to calculate a body mass index. That doesn't work well for children with spina bifida who may be unable to stand or have orthopedic complications that challenge their ability to have an accurate measure of height or weight performed, said Polfuss. If the measure of height or weight is not accurate, then the BMI is inaccurate.
The aim of the project is twofold, said Polfuss. "We want to find a feasible method of measuring body fat that can be conducted cost-effectively and accurately in the clinic – and to provide better guidance to the family on nutritional intake recommendations, with the ultimate goal of preventing and treating obesity."
The project team includes health professionals from four pediatric spina bifida programs at children's hospitals across the United States – Children's Hospital of Wisconsin, Children's Hospital of Los Angeles, Children's Hospital of Alabama-Birmingham and Children's Hospital of Pittsburgh – who are working with 232 children.
"We are happy to help lead the effort on this important and needed research," said Nancy Korom, chief nursing officer and vice president at Children's Hospital of Wisconsin. "Our mission is to have the healthiest children in the state, and through this multi-site initiative, we can improve the health of children across the nation."
The five-year grant comes from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, part of the National Institutes of Health. Additional support is provided by the Centers for Disease Control and Prevention, the National Spina Bifida Patient Registry and the Spina Bifida Association.
Global study reports significant decline in diarrheal disease mortality