LMBBS Conference Houston 2006 Dr. Kathleen Motil Nutrition
Disclaimer: These notes were taken by Ruth Dameron at the LMBBS Conference in Houston, June 17, 2006. There has been no attempt to verify accuracy. Do not quote the speakers based on these notes!
Kathleen Motil, M.D., Ph.D., Associate Professor of Pediatrics, USDA/ARS Children’s Nutrition Research Center
Obesity: The new social epidemic
Most common and costly health problem in the U.S.
1. 22% of U.S. 6-18 years old are obese
2. 38% of Texan children obese
Growth and Weight
Higher prevalence of obesity in BBS: 52% in BBS vs 20% in general population
obesity is defined as BMI greater than 30 kg/m^2 (BMI is Body Mass Index; kg is weight in kilograms; m is the square of the person’s height in meters)
Obesity is associated with other issues that can shorten lifespan such as:
A. Diabetes
B. High blood pressure
C. Hyperfibrinogenemia – tendency to blood clotting
D. Heart disease
Obesity leads to poor quality of life.
Cause in BBS – we don’t really know
For the general population and many with BBS, they eat more than they should.
Excessive intake of food in absence of good level of activity – gain weight. (This is not true of certain cases in BBS – babies in particular where weight gain is inexplicable)
BMR – Basal Metabolic Rate
Everything your body does to make it work
A. Expend energy to process the food we eat
B. Physical activity expends energy
C. Growth expends energy
The big players are dietary intake and physical activity.
One study she found how BBS people burn their energy:
1500 to 1600 calories of food a day is not so much. But when people write down what they eat, they cheat. Still, this is a pretty low reported intake.
When we measure the resting metabolic rate – it’s pretty normal. People with BBS are not victims of a low metabolic rate.
Physical activity of people with BBS was, however, lower than normal. If you keep up less activity, you end up with more body fat. (RHD note: the afternoon panel on personal experiences with weight management emphasized the value of exercise as well as eating meals that are high in nutrition, high in volume so you feel full, but low in calories – yes, that’s possible.)
Intake and output have to balance better.
Calculating BMI varies with age and gender; measures proportionality of height and weight.
There is probably a hypothalamus issue for some. (RHD note: Dr. Nico said we still don’t know if cilia have messed up the hypothalamus, if cilia have messed up the body in a way that the BBS patient does not sense the energy expended in consumption or the energy produced by the food. Clearly, something prevents the sensation of satisfaction – not sure what yet. This is why Vickie Weir recommends the Joanna Lund Healthy Exchanges recipes for large portions of food that taste good but have relatively few calories. This is one of the toughest areas for parents – children who are crazily persistent to find food when they clearly do not need it; babies who are not eating but are still gaining weight excessively; etc. )
Walking is a very important component of exercise.
