Nutritional Status
muscle mass
DISEASE
Although most children did not consume sufficient calories according to their food diaries, growth was comparable to healthy peers. Body fat measured over the control period (by both skinfold and BODPOD; body composition system, COSMED, Ltd, Concord, CA) decreased, leading to a significantly higher body fat percentage measured by skinfold over the exercise period compared to the control period. It has to be noted that one patient experienced an exacerbation of disease during the control period and lost 20 kilograms; she gained weight again during the exercise period. Whether children also gained muscle mass, is uncertain; REE as percentage of predicted tended to increase, indicating a higher muscle mass, but did not reach significance. Both the BODPOD and skinfold caliper only measure fat mass and fat-free mass; further studies may need to use dual X-ray absorptiometry to investigate training effects on muscle mass.