Examining differences in body composition between wheelchair users and non-impaired individuals

Body composition is a more sensitive indicator of disease risk than BMI, yet few studies have assessed body composition among individuals with disabilities. Wheelchair users represent a subsample of disabled individuals who experience substantial physical changes that may alter body composition. This study examined whether body composition differed between wheelchair users (WC) and a matched sample of non-impaired individuals. Investigators conducted DXA scans on 41 WC and compared results with an age, sex, and BMI matched sample from the National Health and Nutrition Examination Survey (NHANES). Participants were predominantly white (83%) women (54%) with average ages of 46.1 + 13.7 years (WC) and 48.3 + 16.2 years (NHANES). WC lived an average of 25.1 + 15.5 years with their impairment, which were primarily due to spinal cord injury (41.9%), cerebral palsy/spina bifida (23.0%), or other causes (35.4%, e.g., MS, fibromyalgia, or lupus). Despite matching on BMI, WC had significantly lower total mass (77,839g vs. 86,708g, p=0.02) and lean mass (44,925g vs. 54, 687g, p=0.00) than the NHANES sample. WC also had significantly greater total percent body fat (41.6% vs. 36.2%, p=0.02), percent leg fat (46.3% vs. 37.4%, p=0.00), and percent trunk fat (43.2% vs. 36.3%, p=0.00), but no difference in percent arm fat (32.8% vs. 36.82%, p=0.15). These results highlight that at the same BMI, WC users have less lean mass and greater body fat. Additionally, they point to the need to examine the impact of altered body composition on health and clinical importance of designing inclusive weight control interventions.