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Obesity is an even greater health problem for
people who have spina bifida than it is in the general population. Effects can
include:
- Further limits to mobility, leading to a
spiralling problem of decreased energy use and weight gain, making it harder for
the individual to keep up with peers in social and work situations.
- Additional pressure on skin, thus
increasing the already high risk of skin breakdown and pressure sores, particularly in areas
without sensation or those that become wet.
- Social rejection, which may already be a problem due to
others' lack of sensitivity and
understanding of disability, may be worsened.
- Negative effects on daily living, particularly independence in dressing, continence
management and hygiene, because of difficulties in moving a large, heavy body and reaching private areas of the
body.
Very young children with spina bifida usually grow at about the same rate
as their peers and are quite physically active, so they usually do
not become obese. However, as they grow older children who have spina bifida,
especially those who also have hydrocephalus, are at
very high risk for developing obesity: beyond age 6 at least 50% of children who
have spina bifida are overweight, and in
adolescence and adulthood over 50% are obese. There are many reasons for this.
- Mobility problems make it harder for individuals to
be physically active.
- Older children and adults are typically less
active due to the requirements
of school and work for sedentary activity, and due to the increasing difficulty
of moving a larger body.
- Individuals with spina bifida need fewer
calories each day, and must eat less than others to avoid gaining
weight and becoming obese, because:
- On average those who have
spina bifida are not as tall as their non-disabled peers, and therefore need
fewer calories for growth, and
- Studies
have shown that people with spina bifida have less lean body mass than their
peers, and even when other factors like physical activity are equal,
have a lower basic metabolic rate (fat cells have slower metabolic rates than
other cells like muscle cells).
Successful prevention of obesity depends upon
family commitment and involvement to changing behaviours that lead to weight
gain. The combination of aerobic exercise and a well-balanced diet will help
everyone to maintain a healthy weight.
- Nutrition education is
important, not just for the individual with spina bifida but for the whole
family. Check the Canada
Food Guide for information on eating a well-balanced diet.
- Exercise can include swimming,
rowing, and pushing distances in the wheelchair. Increasingly, there are
also opportunities to participate in athletics and at facilities that are
wheelchair accessible (such as Rotary
Challenger Park in Calgary). If nothing is readily available in your
community, there are books
and videotapes for wheelchair aerobics to get you going.
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