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Body composition, energy expenditure and physical activity

Resting energy expenditure and adiposity accretion among children with Down syndrome: a 3-year prospective study

European Journal of Clinical Nutrition volume 67, pages 1087–1091 (2013)Cite this article

Subjects

Abstract

Background:

Children with Down syndrome (DS) have a higher prevalence of obesity than other children. Whether this increased risk for obesity is due to a lower resting energy expenditure (REE) is controversial. Our study assessed whether (1) the REE of children with DS adjusted for fat-free mass (FFM) was lower than that of sibling controls, and (2) the changes in fat mass (FM) over 3 years were associated with FFM-adjusted baseline REE.

Methods:

This study used cross-sectional and prospective cohort designs. Four annual measurement visits were conducted with 28 children with DS and 35 sibling controls aged 3–10years. REE and serum thyroxine (T4) were measured at baseline. Anthropometry, skinfold thickness measures, and, in a subsample, dual-energy x-ray absorptiometry (DXA) were used at each visit to calculate FM.

Results:

Children with DS had significantly lower REE adjusted for FFM (−78 kcal/day, 95% CI: −133 to −27, P=0.003). The difference remained significant after adjustment for FM, sex and African ancestry (−49 kcal/day, 95% CI: −94 to −4, P=0.03). In the longitudinal analysis, the baseline REE adjusted for baseline FFM was not predictive of FM accretion over time (P=0.8).

Conclusion:

Children with DS have lower REE than sibling controls, but REE was not associated with changes in FM over time. The results suggest that the lower REE of children with DS does not explain their increased risk for obesity.

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Acknowledgements

We thank the study participants and their families for their dedication and contribution to this research, as well as the following parent support groups: 21 Down, BUDS and the Down Syndrome Interest Group of Montgomery County. We also thank the CTRC staff and Kristen L O’Neill for their contribution to the data collection for this research. This research was supported by the National Institutes of Health (K23 RR16073), Clinical Translational Research Center and Nutrition Center at the Children’s Hospital of Philadelphia (UL1-RR-024134), and National Down Syndrome Society.

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Authors and Affiliations

  1. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    D L Hill, E P Parks, B S Zemel, J Shults & V A Stallings

  2. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    E P Parks, B S Zemel & V A Stallings

  3. Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    J Shults

  4. Exponent Inc., Washington, DC, USA

    N Stettler

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  1. D L Hill
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Correspondence to D L Hill.

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Contributors: The authors’ responsibilities were as follows: BSZ, JS, VAS and NS designed the study; BSZ, VAS and NS conducted the study; DLH, EPP, BSZ, JS and NS analyzed the data; DLH, EPP, JS, VAS and NS wrote the paper, and NS had primary responsibility for final content.

DISCLAIMER

The study sponsors had no role in the study design, data collection, data interpretation, preparation of the manuscript or decision to submit this paper for publication.

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Hill, D., Parks, E., Zemel, B. et al. Resting energy expenditure and adiposity accretion among children with Down syndrome: a 3-year prospective study. Eur J Clin Nutr 67, 1087–1091 (2013). https://doi.org/10.1038/ejcn.2013.137

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