Energy intake does not correlate with nutritional state in children with severe generalized cerebral palsy and intellectual disability

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 29; no. 5; pp. 617 - 621
• Main Authors: Calis, Elsbeth A.C, Veugelers, Rebekka, Rieken, Rob, Tibboel, Dick, Evenhuis, Heleen M, Penning, Corine
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-10-2010; Elsevier
• Subjects: Adolescent; Adult and adolescent clinical studies; Anthropometry; Biological and medical sciences; Cerebral palsy; Cerebral Palsy - physiopathology; Child; Child Nutritional Physiological Phenomena; Child, Preschool; Children; Cross-Sectional Studies; Diet Records; Dietary diary; Energy Intake; Energy Metabolism; Enteral Nutrition; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Intellectual deficiency; Intellectual disability; Intellectual Disability - physiopathology; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Nutritional assessment; Nutritional Status; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Skinfold Thickness; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Young Adult; Cerebral palsy; estimated average requirement; total energy expenditure; Dietary diary; adequate intake; energy expenditure; RDA; resting energy expenditure; DDS; Intellectual disability; energy intake as a percentage of estimated average requirement; Gross Motor Function Classification Scale; Children; ID; GMFCS; Energy intake; EE; Energy intake %EAR; AI; CP; Nutritional assessment; TE; recommended daily allowance; CV; REE; technical error; TEE; EAR; Dysphagia Disorders Survey; coefficient of variation; Human; Handicap; Nervous system diseases; Energy input; Metabolic diseases; Developmental disorder; Mental retardation; Generalized; Cerebral disorder; Central nervous system disease; Intellectual deficiency; Severe; Child; Nutritional status
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/j.clnu.2010.02.006

Summary Background & aims The majority of children with cerebral palsy and intellectual disability has a poor nutritional state compared with their healthy peers. Several studies have found reduced daily energy intake in this population. The hypothesis is tested that low daily energy intake correlates with poor nutritional state. Methods In a population-based sample of 176 children with severe generalized cerebral palsy and intellectual disability (mean age 10 years, SD 2 months; 16% GMFCS score 4; 84% GMFCS score 5) anthropometric parameters (weight, upper arm and tibia length, biceps, triceps, subscapular and suprailiacal skinfold thickness, mid upper arm circumference) were measured and dietary intake was registered. Results No correlation was found between energy intake%EAR and anthropometric Z -scores. Higher age, female gender, mobility, and to a lesser extent the absence of tube feeding predicted lower anthropometric Z -scores. Conclusions In children with severe generalized cerebral palsy and intellectual disability nutritional state is not primarily determined by energy intake. Differences in energy expenditure presumably play an important role, although more research is needed to clarify the complex association between energy intake and nutritional state. Individualized nutritional care is suggested, preferably based on energy expenditure, in order to avoid malnutrition, but also overweight.