Relationships between Dietary Intake and Body Composition according to Gross Motor Functional Ability in Preschool-Aged Children with Cerebral Palsy

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Abstract

Background/Aims: We aimed to determine the relationships between energy intake, macronutrient intake and body composition in preschool-aged children with cerebral palsy (CP) according to gross motor functional ability in comparison with typically developing children (TDC). Methods: Seventy-three children with CP (70% male) of all functional abilities and 16 TDC (63% male) aged 2.8 ± 0.9 years participated in this study. Dietary intake was measured via a validated 3-day weighed food record. Body composition was determined via isotope dilution techniques. Results: There was a significant relationship between energy intake and fat-free mass index, which was stronger in TDC compared to children with CP. There were no significant correlations between other dietary intake and body composition variables, despite differences in body composition as ambulatory status declined. Non-ambulant, tube-fed children had significantly lower protein intakes compared to orally fed children. No other differences in macronutrient intake between children with CP and TDC were apparent. Conclusions: Results suggest that relationships between dietary intake and body composition are not evident in this population, but develop over time. Physical activity levels may have a greater impact on body composition at this age. Longitudinal research is required to examine these factors.

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Dietary risk factors for development of childhood obesity.

Rosa L Moreno, Gerardo Rodriguez-Araujo (2007)

Controversial information exists on the contribution of several dietary factors for overweight development in childhood, but there is no doubt that obesity prevalence is increasing. We review the most up-to-date information in order to clarify the evidence-based dietary aspects influencing obesity development in children and adolescents. Longitudinal studies are the preferred method for analysing the relationship between dietary factors and obesity development. With the exception of infants, there are no conclusive associations between energy intake or diet composition and later overweight development in children. Among formula or mixed-fed infants, the increase in energy intake has been associated with an increased risk of being overweight during childhood. Breastfeeding seems to be a protective factor for later obesity development. In terms of food intake, longitudinal studies have only found a clear and positive association between obesity development and sugar-sweetened beverage consumption; this is not the case with snacking, fast food or food portion sizes. Cross-sectional studies have found correlations between being overweight in childhood and buying lunch at school, eating supper while watching television or without family supervision, consuming less energy at breakfast or more at dinner, and missing breakfast. Results from longitudinal studies must be taken into account in order to design preventive strategies to counteract the increased prevalence of obesity and its consequences in children. Lack of breastfeeding, high early energy intake and high intake of sugar-sweetened beverages seem to be the main dietary factors contributing to obesity development.

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Dysphagia in children with severe generalized cerebral palsy and intellectual disability.

Rebekka Veugelers, Heleen M Evenhuis, Corine Penning … (2008)

This study assessed the clinical indicators and severity of dysphagia in a representative sample of children with severe generalized cerebral palsy and intellectual disability. A total of 166 children (85 males, 81 females) with Gross Motor Function Classification System Level IV or V and IQ<55 were recruited from 54 daycare centres. Mean age was 9 years 4 months (range 2 y 1 mo-19 y 1 mo). Clinically apparent presence and severity of dysphagia were assessed with a standardized mealtime observation, the Dysphagia Disorders Survey (DDS), and a dysphagia severity scale. Additional measures were parental report on feeding problems and mealtime duration. Of all 166 participating children, 1% had no dysphagia, 8% mild dysphagia, 76% moderate to severe dysphagia, and 15% profound dysphagia (receiving nil by mouth), resulting in a prevalence of dysphagia of 99%. Dysphagia was positively related to severity of motor impairment, and, surprisingly, to a higher weight for height. Low frequency of parent-reported feeding problems indicated that actual severity of dysphagia tended to be underestimated by parents. Proactive identification of dysphagia is warranted in this population, and feasible using a structured mealtime observation. Children with problems in the pharyngeal and esophageal phases, apparent on the DDS, should be referred for appropriate clinical evaluation of swallowing function.

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Growth and nutrition disorders in children with cerebral palsy.

Michelle Kuperminc, Richard Stevenson (2008)

Growth and nutrition disorders are common secondary health conditions in children with cerebral palsy (CP). Poor growth and malnutrition in CP merit study because of their impact on health, including psychological and physiological function, healthcare utilization, societal participation, motor function, and survival. Understanding the etiology of poor growth has led to a variety of interventions to improve growth. One of the major causes of poor growth, malnutrition, is the best-studied contributor to poor growth; scientific evidence regarding malnutrition has contributed to improvements in clinical management and, in turn, survival over the last 20 years. Increased recognition and understanding of neurological, endocrinological, and environmental factors have begun to shape care for children with CP, as well. The investigation of these factors relies on advances made in the assessment methods available to address the challenges inherent in measuring growth in children with CP. Descriptive growth charts and norms of body composition provide information that may help clinicians to interpret growth and intervene to improve growth and nutrition in children with CP. Linking growth to measures of health will be necessary to develop growth standards for children with CP in order to optimize health and well-being. (c) 2008 Wiley-Liss, Inc.

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Author and article information

Journal

Journal ID (publisher-id): ANM

Journal ID (nlm-ta): Ann Nutr Metab

Journal ID (doi): 10.1159/issn.0250-6807

Title: Annals of Nutrition and Metabolism

Publisher: S. Karger AG

ISSN (Print): 0250-6807

ISSN (Electronic): 1421-9697

Publication date Subscription-year: 2012

Publication date (Print): December 2012

Publication date (Electronic): 03 December 2012

Volume: 61

Issue: 4

Pages: 349-357

Affiliations

^aChildren’s Nutrition Research Centre and ^bQueensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, ^cQueensland Children’s Medical Research Institute, University of Queensland, and ^dDepartment of Paediatric Rehabilitation, and ^eSpeech Pathology Department, Royal Children’s Hospital, Brisbane, Qld., Australia; ^fDivision of Developmental Pediatrics, Department of Pediatrics, University of Virginia, School of Medicine, Charlottesville, Va., USA

Author notes

*Jacqueline L. Walker, Children’s Nutrition Research Centre, Department of Paediatrics and Child Health, University of Queensland, Level 3, Foundation Building, Royal Children’s Hospital, Herston Road, Herston, QLD 4029 (Australia), E-Mail j.walker3@uq.edu.au

Article

Publisher ID: 342557 Other ID: Ann Nutr Metab 2012;61:349–357

DOI: 10.1159/000342557

PubMed ID: 23208164

SO-VID: 9df77647-f0c3-4529-a765-4cf09b75ac95

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date received : 17 July 2012

Date accepted : 10 August 2012

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Figures: 1, Tables: 2, Pages: 9

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Relationships between Dietary Intake and Body Composition according to Gross Motor Functional Ability in Preschool-Aged Children with Cerebral Palsy

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Abstract

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Karger: Nutrition and Dietetics

Most cited references 30

Dietary risk factors for development of childhood obesity.

Dysphagia in children with severe generalized cerebral palsy and intellectual disability.

Growth and nutrition disorders in children with cerebral palsy.

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