SCI: Preventing Overweight (2007)
Citation:
Study Design:
Class:
- Click here for explanation of classification scheme.
Quality Rating:
Research Purpose:
To provide an overview of:
- prevalence of diseases associated with physical inactivity and obesity in SCI population,
- alterations in body composition following SCI,
- recommendations for assessing body composition of SCI individuals in clinical settings
Inclusion Criteria:
- None given.
Exclusion Criteria:
- None given.
Description of Study Protocol:
Recruitment
Methods of study inclusion not specified.
Design
Narrative Review.
Blinding Used (if applicable):
Not applicable.
Intervention (if applicable):
Not applicable.
Statistical Analysis:
Statistical analysis not performed.
Data Collection Summary:
Timing of Measurements
Not applicable.
Dependent Variables
Not applicable.
Independent Variables
Not applicable.
Control Variables
Description of Actual Data Sample:
Initial N: 87 references cited.
Attrition (Final N): 87
Age: not mentioned
Ethnicity: not mentioned
Other relevant demographics:
Anthropometrics:
Location: Worldwide studies
Summary of Results:
Disease Risk Factors higher in SCI
- Obesity
- Cardiovascular disease (lipid abnormality)
- Type 2 diabetes (glucose intolerance)
- Osteoporosis.
Fat-free composition changes following SCI
- Mineral (bone mineral content decreases 25-50% depending on level, completeness and direction of SCI)
- Protein (total body protein is reduced by 30%
- Water (total body water relative to body weight decreases by 15%)
Body Composition Assessment Techniques
- Hydrostatic weighting
- Dual-energy X-ray Absorptiometry
- Skinfold methods
- Bioelectrical impedance.
Author Conclusion:
- Obesity is a major risk factor for developing cardiovascular disease, hypertension, diabetes mellitus, obstructive pulmonary disease, hypercholesterolemia, osteoarthritis, renal disease, and certain cancers. NIH defines obesity as bodyweight exceeding 20% of the desirable for a given age, sex, skeletal frame (this definition does not take into account relative amounts of fat and fat-free mass). A more useful definition is an excessive amount of total body fat for a given bodyweight. Ideal = 15% for adult men and 23% for adult women. Obesity >25% for men and >32% for women.
- Cited studies found that fatness is related to level of spinal cord injury; that paraplegic athletics had lower fat mass;, and that sedentary SCI men had > 25% fat mass and physically active SCI men had 16-24% compared to 15% for able bodied males. Effect of physical activity on body fat in women is not well documented.
- Body fat needs to be routinely evaluated as a part of the health profile of SCI individuals.
- Methods for body composition assessment in SCI are problematic.
Funding Source:
| University/Hospital: | University of New Mexico |
Reviewer Comments:
- Comprehensive coverage of topic.
- Done in “traditional” review style without mention of method for search, selection, or critique of sources.
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Quality Criteria Checklist: Review Articles
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| Relevance Questions | |||
| 1. | Will the answer if true, have a direct bearing on the health of patients? | ??? | |
| 2. | Is the outcome or topic something that patients/clients/population groups would care about? | Yes | |
| 3. | Is the problem addressed in the review one that is relevant to dietetics practice? | Yes | |
| 4. | Will the information, if true, require a change in practice? | ??? | |
| Validity Questions | |||
| 1. | Was the question for the review clearly focused and appropriate? | Yes | |
| 2. | Was the search strategy used to locate relevant studies comprehensive? Were the databases searched and the search termsused described? | ??? | |
| 3. | Were explicit methods used to select studies to include in the review? Were inclusion/exclusion criteria specified andappropriate? Wereselectionmethods unbiased? | ??? | |
| 4. | Was there an appraisal of the quality and validity of studies included in the review? Were appraisal methodsspecified,appropriate, andreproducible? | No | |
| 5. | Were specific treatments/interventions/exposures described? Were treatments similar enough to be combined? | ??? | |
| 6. | Was the outcome of interest clearly indicated? Were other potential harms and benefits considered? | N/A | |
| 7. | Were processes for data abstraction, synthesis, and analysis described? Were they applied consistently acrossstudies and groups? Was thereappropriate use of qualitative and/or quantitative synthesis? Was variation in findings among studies analyzed? Were heterogeneity issued considered? If data from studies were aggregated for meta-analysis, was the procedure described? | ??? | |
| 8. | Are the results clearly presented in narrative and/or quantitative terms? If summary statistics are used, are levels ofsignificance and/or confidence intervals included? | Yes | |
| 9. | Are conclusions supported by results with biases and limitations taken into consideration? Are limitations ofthe review identified anddiscussed? | No | |
| 10. | Was bias due to the review's funding or sponsorship unlikely? | Yes | |