Oral Presentation Australian and New Zealand Obesity Society Annual Scientific Conference 2024

Nutrition Quality of People with Prader-Willi Syndrome in Australia (#91)

Zoe Zhang 1 , Kyra A Sim 2 , Georgina Loughnan 2 , Alesha Southby 3 , Tania Markovic 2 , Nora Shields 3 , Janet Franklin 1 2 4
  1. Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
  2. Metabolism & Obesity Service, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  3. La Trobe University, Melbourne, Victoria, Australia
  4. Translational Health Research Institute, ENRG, Western Sydney University, Sydney, NSW, Australia

Background: Dietary management is essential to prevent obesity and related complications in people with Prader-Willi syndrome (PWS), a condition characterised by hyperphagia, reduced satiety and excessive food-seeking behaviours. Although PWS guidelines recommend tightly controlled, energy-restricted diets, little is known about diets of people with PWS in Australia.

Aims: To investigate nutritional adequacy and diet quality in people with PWS in Australia.

Method: The diets of 18 adolescents and 26 adults participating in the progressive resistance training in people with Prader-Willi syndrome (PRESTO) trial were assessed using the Australian Eating Survey Food Frequency Questionnaire. Diet alignment with Australian Dietary Guidelines was also determined. Energy requirements were calculated from height and calorie needs (weight loss: 7 kcal/cm; maintenance: 8-11 kcal/cm; gain: 11 kcal/cm), based on body mass index (BMI) or BMI z-score category. Diet quality was measured using the Australian Recommended Food Score. Statistical analyses compared outcomes between BMI categories, age groups and living arrangements.

Results: Most adolescents (59%) and adults (81%) had overweight or obesity. Diets exceeded recommended energy intakes by around 85-90% but aligned with Australian Dietary Guidelines. People above the healthy weight range were less likely to be within the PWS recommended energy intake (p < 0.01). Most met essential nutrient recommendations, except for saturated fat, calcium and sodium. Servings for most core food groups were generally met, except more than half did not meet grains and dairy, and exceeded discretionary recommendations. People in supervised residences showed a significantly higher vegetable intake but lower fruit variety. Overall diet quality and BMI distribution did not differ between living arrangements. 

Conclusion: There was a high prevalence of overweight and obesity in individuals with PWS despite strong adherence to Australian healthy dietary guidelines. PWS appropriate energy-restricted diets, including low-fat, calcium rich foods are recommended to enhance health outcomes.