Identification of feeding risk factors for impaired nutrition status in paediatric patients with cerebral palsy

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Abstract
Aim:  To assess the nutrition status of children with CP, applying WHO growth standards, to indentify feeding risk factors and to evaluate their impact on the growth of children with CP.Methods:  In 42 paediatric patients (mean age 8.00 ± 4.00 years), anthropometry and food intake records were assessed. z‐scores were calculated using WHO Anthro software. Intake to requirements ratio (I/R) was calculated, and patients were classified according to their feeding ability (PFA). Overall diet quality was assessed using the Diet Quality Index International (DQI‐I).Results:  Based on WAz, 15 patients (38.1%) were undernourished. No association was found between I/R ratio and BMI z‐score, while PFA and DQI‐I displayed a significant correlation to both (p < 0.05). Diet Quality Index International was also correlated with macronutrient distribution (p < 0.05). Patients with CP were undernourished in a considerable proportion. Malnutrition in patients with CP is not associated with the intake of estimated energy requirements. Among the other feeding risk factors studied, PFA and DQI‐I represented important parameters associated with malnutrition.Conclusion:  WHO z‐scores represent accurate parameters for the assessment of malnutrition in patients with CP. Together with anthropometry and PFA evaluation, the use of the DQI‐I would add prognostic value to both the initial growth assessment and the patients’ growth monitoring.

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