Nutritional Aspects of Spina Bifida Care: Optimizing Medical Management and Surgical Healing.

PURPOSE OF REVIEW: This review aims to highlight background of contributing factors for suboptimal nutrition in individuals with spina bifida and introduce strategies for amelioration.

RECENT FINDINGS: Recent studies demonstrate increased risk of metabolic syndrome by neurosegmental level, which is associated with truncal obesity and reduced mobility. From the neonatal intensive care stay, which may disrupt breast feeding and the developing microbiome of the gastrointestinal tract, to early childhood various insults may lead to suboptimal feeding practices, preferences and dietary intake. Family coping skills, financial stressors may lead to food insecurity and/or residence in an area with limited availability of fresh food. As children grow, weakness and challenging transfers may lead to more sedentary lifestyle and weight gain despite limited linear growth. Body habitus changes including atrophy of the lower extremities may lead to decreased muscle mass and reduced energy expenditure, with predisposition to truncal obesity and metabolic syndrome.