# Body Composition and Energy Expenditure in Youth with Spina Bifida

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN MILWAUKEE · 2022 · $728,580

## Abstract

Obesity prevalence in youth with spina bifida (SB) is reported as high as 74%, dramatically higher than their
typically developing (TD) peers at 16.9%. Obesity is associated with life-long medical, psychological and
economic burdens. In SB, obesity further limits one’s independence and ability to self-manage health as well
as places them at risk for secondary obesity-related comorbidities. Accurate measurement of body fat is critical
as higher levels are associated with increased health risks. Once body fat is established, knowledge of the
individual’s total daily energy expenditure (TDEE) is essential to determine an individual’s recommended daily
caloric intake needed to maintain or change body weight. Successful identification, prevention and/or treatment
of obesity is severely compromised by the lack of: 1) a clinically feasible, cost-effective and valid method to
measure body fat, and 2) data on TDEE of youth with SB. Inherent characteristics of SB complicate the ability
to accurately measure height, to identify body fat and are associated with a decreased energy expenditure. In
addition, a Body Mass Index (BMI), commonly used in clinics as a surrogate estimate of body fat to screen for
obesity is inaccurate when used in SB. Proposals for alternative measures or methods to accurately identify
body fat in individuals with SB have been made, but have yet to be tested in a sufficiently large sample. To
address these gaps, we will develop two independent methods and/or algorithms for use in youth with SB, one
to model body fat in a clinic environment and one to predict TDEE in order to determine daily caloric intake
recommendations. This multisite, cross-sectional study will include 232 youth with SB, ages 5-18 (stratified by
age and mobility status). Sites include four pediatric SB programs from different geographical regions.
Participants will have four body composition measures (waist circumference, four-site skinfolds, bioelectrical
impedance analysis, and Doubly Labeled Water [DLW]) and up to five height measures (standing [if able to
stand independently], arm span, recumbent, knee height and ulnar length) performed. DLW analysis and
calculations will provide the criterion body fat%, fat-free mass and TDEE. The body composition and/or height
measures will be used to develop an algorithm that accurately models body fat% and categorizes weight status
of youth with SB. Based on the average TDEE, an algorithm will be developed to predict energy requirements
with a best-fit model based on fat-free mass, sex, age, ambulation status height and/or weight. In addition, a
nutrition and physical activity screener will be employed to describe the dietary intake and patterns of physical
activity in youth with SB. The proposed study aligns with the mission and research goals of NICHD by ensuring
that all children have the opportunity for healthy and productive lives by optimizing independence and
promoting the health of populations at an increased risk f...

## Key facts

- **NIH application ID:** 10178061
- **Project number:** 5R01HD096085-03
- **Recipient organization:** UNIVERSITY OF WISCONSIN MILWAUKEE
- **Principal Investigator:** Michele Polfuss
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $728,580
- **Award type:** 5
- **Project period:** 2019-07-01 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10178061

## Citation

> US National Institutes of Health, RePORTER application 10178061, Body Composition and Energy Expenditure in Youth with Spina Bifida (5R01HD096085-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10178061. Licensed CC0.

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