Total energy expenditure and body composition of children with developmental disabilities

Disabil Health J. 2018 Jul;11(3):442-446. doi: 10.1016/j.dhjo.2017.12.009. Epub 2017 Dec 28.


Background: Obesity prevalence is increased in children with developmental disabilities, specifically in children with spina bifida and Down syndrome. Energy expenditure, a critical aspect of weight management, has been extensively studied in the typically developing population, but not adequately studied in children with developmental disabilities.

Objective: Determine energy expenditure, fat-free mass and body fat percentile and the impact of these findings on recommended caloric intake in children with spina bifida and Down syndrome.

Methods/measures: This pilot study included 36 children, 18 with spina bifida, 9 with Down syndrome and 9 typically developing children. Half of the children with spina bifida were non-ambulatory. Doubly labeled water was used to measure energy expenditure and body composition. Descriptive statistics described the sample and MANOVA and ANOVA methods were used to evaluate differences between groups.

Results: Energy expenditure was significantly less for children with spina bifida who primarily used a wheelchair (p = .001) and children with Down syndrome (p = .041) when compared to children without a disability when adjusted for fat-free mass. However, no significant difference was detected in children with spina bifida who ambulated without assistance (p = .072).

Conclusions: Children with spina bifida and Down syndrome have a significantly decreased energy expenditure which directly impacts recommended caloric intake. No significant difference was detected for children with spina bifida who ambulated, although the small sample size of this pilot study may have limited these findings. Validating these results in a larger study is integral to supporting successful weight management of these children.

Keywords: Developmental disabilities; Down syndrome; Energy expenditure; Obesity; Spina bifida.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / metabolism
  • Adolescent
  • Analysis of Variance
  • Body Composition*
  • Body Fluid Compartments / metabolism
  • Child
  • Child, Preschool
  • Developmental Disabilities / complications
  • Developmental Disabilities / metabolism*
  • Disabled Children
  • Disabled Persons*
  • Down Syndrome / complications
  • Down Syndrome / metabolism*
  • Energy Intake
  • Energy Metabolism*
  • Female
  • Humans
  • Male
  • Obesity* / etiology
  • Obesity* / prevention & control
  • Pilot Projects
  • Spinal Dysraphism / complications
  • Spinal Dysraphism / metabolism*
  • Walking
  • Wheelchairs