Beyond BMI: functional-level based nutritional and body composition assessment in children with cerebral palsy.

Abstract

This cross-sectional study aimed to evaluate the nutritional status and body composition of children with CP by Gross Motor Function Classification System (GMFCS) levels and to examine the relationship between nutrient intake and anthropometric indicators. In this cross-sectional study, 25 children aged 1-18 years with CP underwent body composition assessment <i>via</i> bioelectrical impedance (InBody S10) and completed three-day food records analyzed using BeBiS software. Anthropometric <i>z</i>-scores were calculated based on WHO standards, and micronutrient adequacy was assessed using WHO Recommended Daily Allowances. Children in the GMFCS IV-V group had significantly lower fat-free mass, skeletal muscle mass, and body mineral content compared to those in GMFCS I-III (<i>p</i> < 0.05). Regarding dietary intake, children with GMFCS IV-V consumed significantly less energy (<i>p</i> = 0.036), protein (<i>p</i> = 0.015), and carbohydrates (<i>p</i> = 0.028). Micronutrient deficiencies were common, especially in calcium (<i>p</i> = 0.035), zinc (<i>p</i> = 0.046), vitamin B2 (<i>p</i> = 0.044). Magnesium intake showed positive correlations with anthropometric <i>z</i>-scores (<i>p</i> < 0.05). Children with CP, particularly those with greater motor impairment, exhibit significant nutritional challenges. Standard measures like BMI may not adequately reflect their nutritional risk. A comprehensive assessment, including body composition and dietary intake, is essential to guide individualized, function-based nutritional strategies. IMPLICATIONS FOR REHABILITATIONStandard anthropometric tools like Body Mass Index (BMI) may overlook malnutrition in children with cerebral palsy (CP); thus, body composition analysis and GMFCS-based evaluation should be integrated into routine nutritional assessments.Rehabilitation professionals should collaborate closely with dietitians to develop individualized nutritional strategies based on motor function levels to prevent muscle loss and support healthy growth.Micronutrient deficiencies, especially in children with severe motor impairment, highlight the need for targeted dietary interventions and potential supplementation to optimize neuromuscular and skeletal health.Using function-based assessments can guide more tailored rehabilitation plans that include both nutritional and physical therapy components to address the complex needs of children with CP.