Influence of the Basal Metabolic Profile on the Evolution of the Pediatric Patient with Obesity
Authors:   Department of Pediatric Endocrinology, Araba University Hospital-Txagorritxu, Spain, B Fernández Fernandez , Miranda Sarasua ,   Department of Pediatric Endocrinology, Araba University Hospital-Txagorritxu, Spain, I Lorente Blazquez ,   Department of Pediatric Endocrinology, Araba University Hospital-Txagorritxu, Spain, ID Diez López ,   Department of Pediatric Endocrinology, Araba University Hospital-Txagorritxu, Spain
Published: June 2021

Purpose: To study how basal metabolism influences the somatometric evolution of the child and adolescent population with obesity in a pediatric endocrinology clinic. Material and Methods: Study of the entire population diagnosed with childhood obesity in a tertiary hospital by means of a multichannel impedanceometry study, TANITA BF 430. Results: 100 patients were selected by chance and studied from a database with 1400 records. Most of the patients who attend to these consultations for obesity are girls, between 8 and 11 years old. All the patients studied had a basal metabolism lower than the calculated theoretical ideal. The group of boys at the beginning of their follow-up showed a higher basal metabolism and more similar than the group of girls. Girls had a higher amount of fat mass compared to boys at the beginning of their follow up. After their first year of follow-up, both groups achieved a decrease in the percentage of fat mass, double in the case of boys compared to girls. After three years of the study, it was observed that 54% of the boys achieved a reduction in their FM compared to 36% of the girls. In overall terms, weight reduction is not achieved in this pediatric population. However it is observed a decrease in fat content in the medium term (1-3 years). The reduction of this fat mass could be a protection factor against cardiovascular diseases in adults. Given the same adherence to nutritional programs, it is believed that physical exercise rates influence this reduction. It was also observed that the most relevant data in the evolution of obesity in these patients is the basal metabolism that they present at the beginning of their follow-up. Discussion: Childhood obesity is a problem of increasing importance in our society. Understanding its characteristics would allow different strategies to be taken for a better treatment and diagnosis of these cases. Boys, in general, achieve a greater reduction in fat mass in the same follow-up time. Due to sexual dimorphism, or a higher rate of physical activity. Bioelectrical impedanceometry measurement is a simple, cheap and easy to use method in clinical practice to evaluate the energy consumption and the body composition of the patient. In “healthy child” health programs and even in schools, an impedanceometry machine could be purchased to focus physical activity efforts on those boys and girls with a lower basal metabolism, adding a greater consumption factor such as physical exercise. Thus, it would be possible to increase the requirements and the basal metabolism of the patient would increase, favoring the loss of fat mass. Regarding the use of conventional scales, in this type of patients, if we only look at the weight variable, a bias could be created since it would not be noticed that there has been a decrease in fat content at the cost of an increase in muscle mass. Conclusion: We consider that it should be recommendable to supply with a multichannel impedanceometry every pediatric endocrine consultation room as it is a non-invasive, and easy-to-use test that can provide a great amount of information about the evolution of these patients, since we believe that focusing efforts on those boys and girls who have a worse basal metabolism could contribute to improving the efficiency and effectiveness of the scarce health resources that we have.