Nutritional status, growth, energy expenditure and energy intake of children in the Netherlands between 0 and 18 years with dilated cardiomyopathy.
The aim of this cross-sectional study was to investigate the growth, nutritional status, Resting Energy Expenditure (REE), Total Energy Expenditure (TEE) and energy intake of children with DCM and to examine whether the division of the patient group into nutritional status caused differences in growth, energy demand and energy intake.
This study was based on a population-based cohort (CARS) of children diagnosed with DCM. Growth was determined using growth charts. Malnutrition was defined as standarddeviationscore (SDS) < -2 SD and/or by deflection in growth. REE was measured using indirect calorimetry and calculated with the Schofield formula. TEE was calculated using a physical activity factor according to Dutch Guidelines. Energy intake was calculated using preferably a food survey or when not avalilable a food diary.
A total of 69 children were included. The average height-for-age (-1.0 ± 1.2 SD) and average weight-for-length (-1.1 ± 0.9) were lower than the Dutch average (0 SD), independent of nutritional status. In 37 of the 69 children (54%) malnutrition was present, nearly half of them (18 of 37) based on deflection of growth. The mean average between measured and calculated REE was 0.36 kcal/kg bodyweight (SD ± 11 kcal/kg, limits of agreement -22, 23 kcal/kg). Energy intake was on average lower than the total measured and calculated energy requirement (80% and 77%, p<0.01). There was no significant difference between children with malnutrition or without (p<0.01).
Malnutrition, growth impairment, and an adequate energy intake are significant problems in both malnourished and not-malnourished children with DCM. Despite small differences between measured and calculated REE at grouplevel, considerable differences were found at individual level.