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%EARand 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.

Cerebral palsy, Children, Dietary diary, Energy intake, Intellectual disability, Nutritional assessment,
Clinical Nutrition
Erasmus MC: University Medical Center Rotterdam

Calis, E.A, Veugelers, R.J.G, Rieken, R, Tibboel, D, Evenhuis, H.M, & Penning, C. (2010). Energy intake does not correlate with nutritional state in children with severe generalized cerebral palsy and intellectual disability. Clinical Nutrition, 29(5), 617–621. doi:10.1016/j.clnu.2010.02.006