Nutritional status and growth in children with cerebral palsy: a review

Cerebral palsy is a disorder of posture and movement.[15] These children grow poorly throughout their lives.[2,16,17] They have significantly lower mean height,[18–20] weight,[7,18–20] skinfold thickness,[7,19] and mid upper arm circumference (MUAC)[7,18] as compared to general population. Communitybased cross-sectional surveys in Philippines,[21] Nigeria,[22] Bangladesh,[15] and India[19] have also reported similar findings [Table 1]. Overweight and obesity have also been reported by various researches conducted mostly in developed countries [Table 2]. Prevalence of overweight found to vary from 2% in Nigeria[18] to 16% in Norway.[9] Overweight and obesity are more prevalent among spastic bilateral CP than spastic unilateral CP.[9] This could be because children with spastic unilateral CP are more mobile as compared to those with spastic bilateral CP, and they have less feeding problems due to which they have a greater chance of gaining weight. The objective of this work was to review the studies conducted among developing and developed countries to assess the growth pattern and nutritional status of children with cerebral palsy. It also aimed at summarizing the key factors responsible for high prevalence of undernutrition among them. Significant reductions in the anthropometric parameters were found in children with cerebral palsy as compared to their nondisabled counterparts. This deviation from normal growth can be attributed to inadequate dietary intake, feeding problems, decreased weight bearing, and several nonnutritional factors including abnormal endocrine function, socioeconomic status, disease severity, and age. Also, it was seen that undernutrition was more prevalent among developing countries as compared to developed countries. Besides undernutrition, various studies conducted among developed countries have reported a high prevalence of overweight and obesity among this population. This could be attributed to a decrease in the motor function because of the underlying condition and an increase in the gastrostomy feeding owing to availability of better health care facilities.