Nutritional status and dietary intakes in neurologically impaired children and adolescents

Neurologically impaired (NI) children are at increased risk of malnutrition due to non- nutritional and nutritional factors influencing dietary patterns and nutrient intakes. The present study evaluated dietary patterns, nutrient intakes and nutritional status of 48 subjects (aged 6-15 years) with various degrees of cognitive and/or motor dysfunction. Diagnosis were as follows: 29% (14/48) cerebral palsy (CP), 8.3% (4/48) epileptic encephalopathy, 18.7% (9/48) symptomatic epilepsy, 22.9% (11/48) idiopathic and genetic epilepsy, 14.6% (7/48) syndromes, 4.2% (2/48) other diagnosis. Half of subjects (47,9%, 23/48) presented difficulty feeding characterized by either prolonged feeding time, dependency on a caretaker or reduced ability of communicating hunger and/or satiety. Four percent (2/48) of subjects were gastrostomy fed. One third of subjects had a poor nutritional status with either body mass index (BMI) < 3° c.le (33,3%, 16/48) or triceps skinfold thickness (TST) < 10° c.le (33,3%, 16/48). Direct correlation was found between BMI z-score, TST (mm) and the degree of motor impairment, measured by Gross Motor Function Classification Scale (GMFCS) (p<0.0001). With regards to dietary intakes: 62.5% (30/48) and 50% (24/48) had an insufficient intake of energy and protein respectively. Micronutrient intakes were insufficient in 75% (36/48), 79,2% (38/48), 52,08% (25/48) and 90% (43/48) of subjects for calcium, iron, zinc and vitamin D respectively. The present study confirms a high prevalence of undernutrition in NI children, with a direct correlation between malnutrition and severity of motor impairment. Evaluation of nutritional status and nutritional intervention are crucial in clinical management and prognosis of NI patients.