Background: Cerebral Palsy is usually divided into three subgroups: ataxic, spastic and dyskinetic, where children and adolescents can, because of misestimation in nutrition and energy intake, suffer from weight problems. Aim: To compare calculations with equations with the individual's measured RMR in the subgroups, to see if any equation is more suitable. This could be used as a tool to calculate the resting metabolism at times when it is not possible to perform clinical measurements. Method: The RMR has been measured in 37 children and adolescents aged 3-15 years through indirect respiratory calorimetry. Those values have been compared with calculations from five equations. The results were then analyzed in order to find if any equation is better to apply for calculating resting metabolism for each subgroup. Results: The ataxic group was overestimated by 56.5% of the calculated values. WHO/FAO/UNU’s equation indicates a significantly strong correlation between the measured and calculated values (r=0.85, p<0.05). The spastic group was underestimated by 53.3%. There is significance for all equations, however it is a relatively low correlation (r=0.63–0.66, p=0.02–0.03). The dyskinetic group was underestimated by 95%. There was no significant association between clinically measured values and the calculated resting metabolism (r=0.21–0.45, p=0.26–0.61). Conclusion: The equations are not reliable for calculation of energy need for all subgroups. There is a substantial risk of over- and underestimation, therefore awareness of the equations insufficiency is needed. Studies should be performed with additional basic data, and with more equations. Especially equations including further variables that involves the body composition. / Bakgrund: Cerebral Pares brukar delas in i undergrupper: ataktisk, spastisk och dyskinetisk, där barn och ungdomar kan, beroende på felskattningar av näringsintag och energiberäkning, lida av över- eller undervikt. Syfte: Att jämföra uträkningar med ekvationer med individernas uppmätta vilometabolism i de tre undergrupperna, för att se om någon ekvation lämpar sig bättre. Detta skulle kunna ge ett verktyg för att kunna räkna ut vilometabolismen vid de tillfällen då det inte är möjligt att utföra kliniska mätningar. Metod: Mätningar av vilometabolismen har utförts på 37 barn och ungdomar i åldern 3-15 år genom indirekt respiratorisk kalorimetri. Värdena har jämförts med uträkningar från fem ekvationer. Resultatet har sedan analyserats, för att hitta någon ekvation som är bättre lämpad för att räkna ut vilometabolismen, för respektive undergrupp. Resultat: Den ataktiska gruppen överskattades i 56,5% av uträkningarna av vilometabolism. WHO/FAO/UNUs ekvation påvisar ett signifikant starkt samband mellan det uppmätta och uträknade värdena (r=0,85, p<0,05). Den spastiska gruppen underskattades 53,3% av de uträknade värdena. Det föreligger signifikans för alla ekvationer, dock ett relativt lågt samband (r=0,63–0,66, p=0,02–0,03). Den dyskinetiska gruppen underskattades i 95 %. Det förelåg inget signifikant samband mellan kliniskt uppmätt och uträknad vilometabolism (r=0,21–0,45, p=0,26–0,61). Slutsats: Ekvationerna är inte tillförlitliga för uträkning av energibehov för alla undergrupper. Risk för över- och underskattning är överhängande, och en ökad medvetenhet om ekvationernas ofullständighet måste belysas. Studier bör göras med större underlag och med fler ekvationer. Framförallt ekvationer med fler variabler som tar hänsyn till kroppssammansättning.

Obesity in children and adolescents is on the rise and is a major risk factor for chronic disease, thus posing one of the greatest public health challenges for the 21st century. Although adolescent obesity is increasing in all ethnic groups, its prevalence is higher in non–Caucasian populations. A possible explanation for ethnic differences in the development of obesity could be ethnic differences in resting metabolic rate (RMR). A low RMR would pre–dispose an ethnic group to obesity. In South Africa limited research has been published with regards to body composition (BC) and RMR in adolescents and the possible association of RMR with BC. The first aim of this study, therefore, was to determine differences in BC and RMR between 14 year old black and Caucasian South African adolescents from the Tlokwe municipality of the North West Province, South– Africa. The second aim was to investigate whether significant relationships between the body composition characteristics body mass index (BMI), percentage body fat (%BF), fat free mass (FFM) and RMR exist in this group. The baseline data of participants in the Physical Activity and Health Longitudinal Study (PAHLS) was used. Anthropometric measurements included stature, body mass, triceps and subscapular skinfolds, and waist girth to determine BMI, %BF, FFM and waist–to–height ratio (WHTR). RMR was measured by the FitMate Pro Indirect Calorimetry (Cosmed). An independent t–test was used to compare the two groups (black vs. Caucasian, boys and girls respectively) with regards to body composition and RMR. Pearson correlation coefficients (adjusted for gender and ethnicity) were calculated, to study the relationship between RMR and body composition. Significant difference levels were set at p<0.05. The present cross–sectional results revealed significant differences in BC and RMR in black and Caucasian adolescents of the Tlokwe municipality, with Caucasian adolescents of both genders having a higher RMR and FFM compared to their counterpart black adolescents. The results further indicated that Caucasian adolescents were significantly (p<0.05) taller, heavier and had a higher %BF, WHTR, FFM and RMR than the black adolescents of both genders. Boys of both ethnicities had a higher RMR than the girls, with black girls having the lowest RMR. Both underweight and overweight/obesity were present in both ethnic groups and genders emphasizing the double burden of disease prevalent in South Africa. The overweight/obese group of both ethnicities had a higher FFM and RMR than the normal and underweight group. After adjusting for gender and ethnicity a high non–significant negative relationship was observed between RMR and FFM in the overweight group. The reasons for these persistent differences in ethnic groups for RMR in adolescents are not clear. A positive association between anthropometric indicators of BC and RMR influenced by gender and ethnicity was indicated. Whether the observed ethnic differences in RMR predict future weight gain and obesity awaits the results of longitudinal analyses. It is suggested that intervention programmes be implemented focusing on the prevention of obesity in adolescents, but especially black adolescent girls, as they are indicated to be the group more prone to obesity. These results supported the literature findings and identified the need for longitudinal data regarding RMR and BC in adolescents. The PAHL–Study will continue to follow–up these adolescents over a period of time as some of the conclusions made will further be cleared, including whether the observed ethnic differences in RMR predict future weight gain and obesity. / Thesis (M.Sc. (Biokinetics))--North-West University, Potchefstroom Campus, 2012.

Obesity in children and adolescents is on the rise and is a major risk factor for chronic disease, thus posing one of the greatest public health challenges for the 21st century. Although adolescent obesity is increasing in all ethnic groups, its prevalence is higher in non–Caucasian populations. A possible explanation for ethnic differences in the development of obesity could be ethnic differences in resting metabolic rate (RMR). A low RMR would pre–dispose an ethnic group to obesity. In South Africa limited research has been published with regards to body composition (BC) and RMR in adolescents and the possible association of RMR with BC. The first aim of this study, therefore, was to determine differences in BC and RMR between 14 year old black and Caucasian South African adolescents from the Tlokwe municipality of the North West Province, South– Africa. The second aim was to investigate whether significant relationships between the body composition characteristics body mass index (BMI), percentage body fat (%BF), fat free mass (FFM) and RMR exist in this group. The baseline data of participants in the Physical Activity and Health Longitudinal Study (PAHLS) was used. Anthropometric measurements included stature, body mass, triceps and subscapular skinfolds, and waist girth to determine BMI, %BF, FFM and waist–to–height ratio (WHTR). RMR was measured by the FitMate Pro Indirect Calorimetry (Cosmed). An independent t–test was used to compare the two groups (black vs. Caucasian, boys and girls respectively) with regards to body composition and RMR. Pearson correlation coefficients (adjusted for gender and ethnicity) were calculated, to study the relationship between RMR and body composition. Significant difference levels were set at p<0.05. The present cross–sectional results revealed significant differences in BC and RMR in black and Caucasian adolescents of the Tlokwe municipality, with Caucasian adolescents of both genders having a higher RMR and FFM compared to their counterpart black adolescents. The results further indicated that Caucasian adolescents were significantly (p<0.05) taller, heavier and had a higher %BF, WHTR, FFM and RMR than the black adolescents of both genders. Boys of both ethnicities had a higher RMR than the girls, with black girls having the lowest RMR. Both underweight and overweight/obesity were present in both ethnic groups and genders emphasizing the double burden of disease prevalent in South Africa. The overweight/obese group of both ethnicities had a higher FFM and RMR than the normal and underweight group. After adjusting for gender and ethnicity a high non–significant negative relationship was observed between RMR and FFM in the overweight group. The reasons for these persistent differences in ethnic groups for RMR in adolescents are not clear. A positive association between anthropometric indicators of BC and RMR influenced by gender and ethnicity was indicated. Whether the observed ethnic differences in RMR predict future weight gain and obesity awaits the results of longitudinal analyses. It is suggested that intervention programmes be implemented focusing on the prevention of obesity in adolescents, but especially black adolescent girls, as they are indicated to be the group more prone to obesity. These results supported the literature findings and identified the need for longitudinal data regarding RMR and BC in adolescents. The PAHL–Study will continue to follow–up these adolescents over a period of time as some of the conclusions made will further be cleared, including whether the observed ethnic differences in RMR predict future weight gain and obesity. / Thesis (M.Sc. (Biokinetics))--North-West University, Potchefstroom Campus, 2012.