Dietary intake and anthropometric status of persons with severe physical and developmental disabilities

The dietary intakes and anthropometric status of 33 females and 33 males, aged 6 to 31 years, with severe developmental disabilities were assessed prior to and following a 6 month nutrition rehabilitation program. Dietary intake was based on 3-day weighed food records. Indices of growth and body composition were derived from weight, height, mid-arm circumference, triceps, biceps, subscapular, and suprailiac skinfold measurements. Reference data from NHANES I and NHANES II were used to compare and classify subjects according to anthropometric Z-scores of growth and body composition. Group 1 (n=34), goal to gain weight, consisted of residents with weight-for-height (WH) Z-scores < -1.650, (< 5th percentile WH); group 2 (n=21), goal to maintain the present rate of weight gain, had WH Z-scores ranging from -1.645 to +1.030 (5th to 85th percentile WH); group 3 (n=11), goal to slow down the rate of weight gain, had WH Z-scores > +1.036 (> 85th percentile). All subjects received individualized diets. Following the nutrition rehabilitation program, increases in mean height-for-age (p< 0.01) and upper-arm fat area (p< 0.05) Z-scores were evident in all groups. Group 1 showed an increase in mean weight-for-age Z-scores (p less than or equal to 0.01). Mean weight gain was 1.2 kg for group 1 (4%) and 1.1 kg for group 2 (3.1%). Increases were observed in Z-scores for triceps skinfolds (p less than or equal to 0.001) (group 1), mid-arm circumference and subscapular skinfolds (p less than or equal to 0.05) (group 2). Energy intake increased in group 1 (p< 0.001). At 6 months, the proportion of subjects with dietary intakes of all nutrients greater than or equal to 66.7% of recommended intakes increased from 78.8% to 90.9% for group 1, 90.5% to 95.2% for group 2, and 75.0% to 87.5% for group 3. These results provide information on the body composition of persons with severe disabilities and demonstrate that a nutritional rehabilitation program can effect weight gain in this population.