Diet, feeding practices, and anthropometry of children and adolescents with cerebral palsy and their siblings

Objective: We investigated growth and nutrition in children and adolescents with cerebral palsy (CP) in comparison with their healthy siblings. Methods: This was a case-control, single observational investigation of 16 pairs of children with CP and their healthy siblings. Stature, weight, skinfolds, and selected circumferences were measured, and Z-scores, percentage of body fat (calipers), and body mass index were calculated. Diet and feeding practices were recorded for 3 d. Results: No differences were observed in the macronutrient distribution of energy intake, with participants with CP covering 75% of their energy requirements. Subjects with CP demonstrated low vitamin A, biotin, folate, vitamin K, and copper intakes. The healthy siblings inadequately consumed vitamin E and both groups followed diets low in zinc. Iron was marginal for the CP group, but calcium was consumed adequately by all. The participants with CP demonstrated lower body weight, body mass index, percentage of body fat, weight-for-age Z-score, and triceps skinfold (P <= 0.001), decreased height-for-age Z-score (P <= 0.008), lower body mass index Z-score (P <= 0.002), and smaller circumferences. Praise rewards were more often used in children with CP (P <= 0.049) but threats to withdraw food were applied only to the healthy siblings (P <= 0.021). When usual intakes were considered, participants with a greater degree of motor impairment were closer to meeting their energy needs. Conclusion: The diets of participants with CP were in the majority energy deficient. The highest energy intakes were demonstrated by the most severely impaired subjects. A tendency was recorded within each household for the adequacy/inadequacy in energy intake, concerning both siblings. (c) 2009 Published by Elsevier Inc.