Assessment of features of the nutritional status and nutrient requirements in children with cerebral palsy

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Abstract


The energy and nutrient requirements of children with cerebral palsy (СP) have always been discussed among domestic and foreign scientists. A wide range of physical characteristics such as state of muscle tone, dysphagia, pseudobulbar syndrome, hyperkinesia or the lack of physical activity determine individual features of the patients’ nutritional needs. Whereas, underestimation of these needs along with comorbid pathologies (frequent pneumonia, bronchitis, etc.), characterizing this group of patients, can easily lead to the emergence and rapid progression of protein-energy deficiency. In addition, there are also difficulties with the interpretation of indices of a patients’ physical development. In this regard, both special scales for physical development assessment and formulas for individual nutrient and energy requirements calculation have been developed for this category of patients. However, according to recent data, the use of these scales and formulas can lead to underestimation of the nutritional needs of CP children. This, in its turn, can cause protein-energy deficiency, frequently (in 29–66% of cases) found in these patients. Therefore, some principles of diet and nutritional support for CP children are being reviewed now. At the same time, the organization of adequate nutritional support based on modern clinical recommendations and a personalized approach is the key component of the comprehensive treatment of this complex patients’ category. This review contains the description of the current situation, as well as a broad discussion of different approaches based on the international, domestic guidelines and relevant recommendations of the European Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists — ESPGHAN, 2017).


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About the authors

S. G. Makarova

National Medical Research Center for Children’s Health; N.I. Pirogov Russian National Research Medical University; Lomonosov Moscow State University

Author for correspondence.
Email: sm27@yandex.ru
ORCID iD: 0000-0002-3056-403X

Russian Federation, Moscow

MD

L. A. Pak

National Medical Research Center for Children’s Health

Email: sm27@yandex.ru

Russian Federation, Moscow

MD, Ph.D., DSc.

A. P. Fisenko

National Medical Research Center for Children’s Health

Email: sm27@yandex.ru
ORCID iD: 0000-0002-7893-1863

Russian Federation, Moscow

MD, Ph.D., DSc., Prof.

L. M. Kuzenkova

National Medical Research Center for Children’s Health; N.F. Filatov Clinical Institute of Children's Health, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)

Email: sm27@yandex.ru
ORCID iD: 0000-0002-9562-3774

Russian Federation, Moscow

MD, Ph.D., DSc., Prof.

Irina Yu. Pronina

National Medical Research Center for Children’s Health

Email: sm27@yandex.ru
ORCID iD: 0000-0003-3306-6869

Russian Federation, Moscow, 119991, Moscow, Russian Federation

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