BMI Is a Poor Predictor of Nutritional Status in Disabled Children. What Is the Most Recommended Method for Body Composition Assessment in This Pediatric Population?

摘要

Evidence shows the importance of nutritional assessment in clinical medicine especially in target groups at risk for nutrition imbalances, including children with disabilities in whom the cause of poor nutritional status can be multifactorial, such as decreased nutrient intake, oral motor dysfunction, increased nutrient losses, abnormal energy expenditure, and physical exertion (1). The body mass index (BMI), calculated as weight in kilograms divided by height in meters squared, is widely used for relating weight to height, defining body size, indicating nutritional status (2) and also for assessing the risk for mortality in the different BMI categories (3–6). Even though the relationship between BMI and mortality remains controversial, substantial data in the published literature have found a J-shaped association between BMI and overall mortality: excessively high or low body mass indexes have been linked to an increased risk of premature mortality (6). As reported by Bhaskaran et al. (4) for mental and behavioral, neurological causes, only a lower BMI was associated with increased mortality risk.