Progress in Nutrition in Cerebral Palsy Children – A Literature Review

Main Article Content

Ali Madi Almajwal
Iftikhar Alam


cerebral palsy, nutrition, growth, nutritional status, Saud Arabia


Cerebral palsy (CP) in children is highly prevalent. Despite this fact, however, nutritional care in
CP children has not been given much of the research attention. Nutrition is usually overlooked for many reasons, but mostly because the medical physicians are usually not skilled in nutritional care. This gap needs to be filled through numerous approaches. In this explanatory review, we present a brief overview on CP children
and their nutritional care; how is growth and nutritional status assessed in CP children? What are common
feeding problems of CP children? What is the status of CP in developing countries like Saudi Arabia? These
are important questions since the overall health of CP children depends mainly depends on how they are
nutritionally cared.


Download data is not yet available.
Abstract 646 | PDF Downloads 311


1. Huysentruyt K, Geeraert F, Allemon H, Prinzie P, Roelants M, Ortibus E, Vandenplas Y, De Schepper J. Nutritional red flags in children with cerebral palsy. Clinical Nutrition. 2019; 32:233
2. Hutton JL, Pharoah POD. Life expectancy in severe cerebral palsy. ArchDis Child. 2006;91(3):254–8.
3. Dias E and Dias A. Cerebral Palsy: A Brief Review. Acad J Ped Neonatol. 2017; 4(1)
4. Al-Hammad NS. Dietary practices in Saudi Cerebral Palsy Children. Pakistan journal of medical sciences. 2015;31(4):860.
5. Verschuren O, Smorenburg AR, Luiking Y, Bell K, Barber L, Peterson MD. Determinants of muscle preservation in individuals with cerebral palsy across the lifespan: a narrative review of the literature. Journal of cachexia, sarcopenia and muscle. 2018 Jun 1.
6. Verschuren O, McPhee P, Rosenbaum P, Gorter JW. The formula for health and well-being in individuals with cerebral palsy: physical activity,sleep, and nutrition. Dev Med Child Neurol. 2016;58(9):989–90.
7. Rempel G. The importance of good nutrition in children with cerebral palsy. Physical Medicine and Rehabilitation Clinics. 2015 Feb 1;26(1):39-56.
8. Mishra, A., Sheppard, J.J., Kantarcigil, C., Gordon, A.M. and Malandraki, G.A., 2017. Novel Mealtime Duration Measures: Reliability and Preliminary Associations With Clinical Feeding and Swallowing Performance in Self-Feeding Children With Cerebral Palsy. American journal of speech-language pathology, pp.1-9.
9. Benfer, K.A., Weir, K.A., Bell, K.L., Ware, R.S., Davies, P.S. and Boyd, R.N., 2017. The Eating and Drinking Ability Classification System in a population‐based sample of preschool children with cerebral palsy. Developmental Medicine & Child Neurology, 59(6), pp.647-654.
10. Stevenson RD, Conaway MR. Weight and Mortality Rates: " Gomez Classification & quot; for Children With Cerebral Palsy? Pediatrics.2011;128(2):e436–7. Disponible en:
11. Brooks J, Day S, Shavelle R, Strauss D. Low Weight, Morbidity, and Mortality in Children With Cerebral Palsy: New Clinical Growth Charts. Pediatrics. 2010;128:299–307.
12. Marks KP, LaRosa a. C. Understanding Developmental-Behavioral Screening Measures. Pediatr Rev. 2012;33(10):448–58.
13. Al-Asmari A, Al Moutaery K, Akhdar F, Al Jadid M. Cerebral palsy: incidence and clinical features in Saudi Arabia. Disability and rehabilitation. 2006 Jan 1;28(22):1373-7.
14. Al-Sulaiman, A. a, Bademosi, O. F., Ismail, H. M., Al-Quliti, K. W., Al-Shammary, S. F., Abumadini, M. S., Al-Umran, K. U. & Magbool, G. M. (2003). Cerebral palsy in Saudi children. Neurosciences, 8(1), 26–9.
15. Al‐Rajeh S, Bademosi O, Awada A, Ismail H, Al‐Shammasi S, Dawodu A. Cerebral palsy in Saudi Arabia: a case‐control study of risk factors. Developmental Medicine & Child Neurology. 1991;33(12):1048-52.
16. Pakula AT, Braun KV, Yeargin-Allsopp M. Cerebral palsy: classification and epidemiology. Physical Medicine and Rehabilitation Clinics. 2009; 20(3):425-52.
17. McIntyre S, Taitz D, Keogh J, Goldsmith S, Badawi N, Blair EV. A systematic review of risk factors for cerebral palsy in children born at term in developed countries. Developmental Medicine & Child Neurology. 2013;55(6):499-508.
18. Al Rajeh S, Bademosi O, Ismail H, Awada A, Dawodu A, Al-Freihi H, Assuhaimi S, Borollosi M, Al-Shammasi S. A community survey of neurological disorders in Saudi Arabia: the Thugbah study. Neuroepidemiology. 1993;12(3):164-78.
19. Alhammad NS, Wyne AH. Plaque and gingival health status among cerebral palsied children of Riyadh City. Pakistan Oral and Dental Journal. 2011;31(1).
20. Al Hammad NS, Wyne AH. Caries experience and oral hygiene status of cerebral palsy children in Riyadh. Odontostomatol Trop. 2010;33:5-9.
21. Wyne A, Saleem F, Khan N. Caries and oral hygiene status of cerebral palsy children in Riyadh area. Pediatr Dent J.1997;7:45-48.12.
22. Surman, G., Bonellie, S., Chalmers, J., Colver, A., Dolk, H., Hemming, K., Parkes, J. & Platt MJ. (2006). UKCP: a collaborative network of cerebral palsy registers in the United Kingdom. Journal of Public Health. 2006; 28(2), 148–56.
23. Marcström A, Hägglund G, Alriksson-Schmidt AI. Hip pain in children with cerebral palsy: a population-based registry study of risk factors. BMC musculoskeletal disorders. 2019;20(1):62
24. Armstrong RW. Definition and classification of cerebral palsy. Developmental Medicine & Child Neurology. 2007;49(3):166-.
25. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, Jacobsson B, Damiano D. Proposed definition and classification of cerebral palsy, April 2005. Developmental medicine and child neurology. 2005;47(8):571-6.
26. Rosenbaum P. Cerebral palsy: what parents and doctors want to know. BMJ Group; 2003; 326(7396):970–4.
27. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Dan B, Jacobsson B. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109(suppl 109):8-14.
28. Paulson A, Vargus-Adams J. Overview of Four Functional Classification Systems Commonly Used in Cerebral Palsy. Children. 2017; 24;4(4):30.
29. Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Developmental medicine and child neurology. 2000;42(5):292-6.
30. Andrew MJ, Sullivan PB. Growth in cerebral palsy. Nutrition in Clinical Practice. 2010; 25:357-361.
31. Norcliffe-Kaufmann L, Sarouk I, Dagan A, Ashkenazi M, Bezalel Y, Vilozni D, Lahad A, Efrati O. Resting Energy Expenditure in Patients With Familial Dysautonomia: A Preliminary Study. Journal of Pediatric Gastroenterology and Nutrition. 2019;68(3):422-7.
32. Schoendorfer NC, Vitetta L, Sharp N, DiGeronimo M, Wilson G, Coombes JS, Boyd R, Davies PS. Micronutrient, antioxidant, and oxidative stress status in children with severe cerebral palsy. Journal of Parenteral & Enteral Nutrition. 2013; 37:97-101.
33. Cooke RW, Foulder-Hughes L. Growth impairment in the very preterm and cognitive and motor performance at 7 years. Archives of Disease in Childhood. 2003 Jun 1;88(6):482-7.
34. Santoro A, Lang MBD, Moretti E, Sellari-Franceschini S, Orazini L, Cipriani P, Cioni G, Battini R. A proposed multidisciplinary approach for identifying feeding abnormalities in children with cerebral palsy. Journal of Child Neurology. 2012; 27:708-712.
35. Fung EB, Samson-Fang L, Stallings VA, Conaway M, Liptak G, Henderson RC, Worley G, O’DONNELL MA, Calvert R, Rosenbaum P, Chumlea W. Feeding dysfunction is associated with poor growth and health status in children with cerebral palsy. Journal of the American Dietetic Association. 2002;102(3):361-73.
36. Day SM, Strauss DJ, Vachon PJ, Rosenbloom L, Shavella R, Wu YW. Growth patterns in a population of children and adolescents with cerebral palsy. Dev Med Child Neurol. 2007;49:167–71.
37. Chad KE, McKay HA, Zello GA, Bailey DA, Faulkner RA, Snyder RE. Body composition in nutritionally adequate ambulatory and non-ambulatory children with cerebral palsy and a healthy reference group. Developmental medicine and child neurology. 2000;42(5):334-9.
38. Meyer-Heim AD, Khan Y. Nail dystrophy–a clinical sign of malnutrition in the disabled child. European Journal of Pediatrics. 2004; 163:567-568.
39. Vieira Pinto V, Anderson L, Alves C, Mendes FM, Ciamponi AL. The nutritional state of children and adolescents with cerebral palsy is associated with oral motor dysfunction and social conditions: a cross sectional study. BMC Neurol. 2016;16(55):1–7.
40. Karagiozoglou-Lampoudi T, Daskalou E, Vargiami E, Zafeiriou D. Identification of feeding risk factors for impaired nutrition status in paediatric patients with cerebral palsy. Acta Paediatr Int J Paediatr. 2012;101(6):649–54.
41. Araújo LA, Silva LR, Mendes FAA. Digestive tract neural control and gastrointestinal disorders in cerebral palsy. J Pediatr (Rio J). 2012;88(6):455–64.
42. Whitney DG, Miller F, Pohlig RT, Modlesky CM. BMI does not capture the high fat mass index and low fat-free mass index in children with cerebral palsy and proposed statistical models that improve this accuracy. International Journal of Obesity. 2019;43(1):82.
43. Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gómez JM, Heitmann BL, Kent-Smith L, Melchior J-C, Pirlich M. Bioelectrical impedance analysis—part I: review of principles and methods. Clinical Nutrition. 2004; 23:1226-1243.
44. Rieken R, Calis EA, Tibboel D, Evenhuis HM, Penning C. Validation of skinfold measurements and bioelectrical impedance analysis in children with severe cerebral palsy: a review. Clinical nutrition. 2010;29(2):217-21.
45. Ohata K, Tsuboyama T, Haruta T, Ichihashi N, Nakamura T. Longitudinal change in muscle and fat thickness in children and adolescents with cerebral palsy. Developmental Medicine & Child Neurology. 2009; 51:943-948.
46. Kuperminc MN, Stevenson RD. Growth and nutrition disorders in children with cerebral palsy. Developmental Disabilities Research Reviews.2008; 14:137-146.
47. Lark RK, Williams CL, Stadler D, Simpson SL, Henderson RC, Samson-Fang L, Worley G. Serum prealbumin and albumin concentrations do not reflect nutritional state in children with cerebral palsy. The Journal of Pediatrics. 2005; 147:695-697.
48. Hillesund E, Skranes J, Trygg KU, Bøhmer T. Micronutrient status in children with cerebral palsy. Acta Paediatrica. 2007; 96:1195-1198.
49. Singhi P, Sankhyan N. Co-morbidities of cerebral palsy and developmentally challenged children. Indian J Pract Pediatr. 2012;14:420-6.
50. Sullivan PB, Andrew MJ. Gastrointestinal problems in children with cerebral palsy. InCerebral Palsy 2018 (pp. 309-317). Springer, Cham.
51. Dahlseng MO, Finbråten A-K, Júlíusson PB, Skranes J, Andersen G, Vik T. Feeding problems, growth and nutritional status in children with cerebral palsy. Acta Paediatr 2012; 101(1):92–8.
52. Fung EB, Samson-Fang L, Stallings VA, Conaway M, Liptak G, Henderson RC, Worley G, O’DONNELL MA, Calvert R, Rosenbaum P, Chumlea W. Feeding dysfunction is associated with poor growth and health status in children with cerebral palsy. Journal of the American Dietetic Association. 2002;102(3):361-73.
53. Somerville H, Tzannes G, Wood J, Shun A, Hill C, Arrowsmith F, Slater A, O’Loughlin EV. Gastrointestinal and nutritional problems in severe developmental disability. Developmental Medicine & Child Neurology. 2008 Sep;50(9):712-6.
54. Almajwal A, Abulmeaty M, Alam I, Razzak S, Alqahtani A. Development of Food Frequency Questionnaire (FFQ) for the assessment of dietary intake among overweight and obese Saudi young children. Nutrire. 2018;43(1):29.
55. Alam I, Ng TP, Larbi A. Does inflammation determine whether obesity is metabolically healthy or unhealthy? The aging perspective. Mediators of inflammation. 2012;2012.
56. Alam I, Shivappa N, Hebert JR, Pawelec G, Larbi A. Relationships between the inflammatory potential of the diet, aging and anthropometric measurements in a cross-sectional study in pakistan. Nutrition and Healthy Aging. 2018. (Preprint):1-9.
57. Alam I, Pawelec G. Aging, nutrition and immunity–their relationship and interaction. Nutrition and Aging. 2012;1(3, 4):151-65.
58. Alam I, Goldeck D, Larbi A, Pawelec G. Aging affects the proportions of T and B cells in a group of elderly men in a developing country—a pilot study from Pakistan. Age. 2013;35(5):1521-30.
59. Alam I, Larbi A, Pawelec G. Nutritional status influences peripheral immune cell phenotypes in healthy men in rural Pakistan. Immunity & Ageing. 2012;9(1):16.