Peer-reviewed article
The nutritional status according to anthropometric indexes and growth patterns in children and adolescents with cerebral palsy: A scoping review of the literature.
Andrea A García-Contreras, Lucía Vázquez-Rocha, Carlos García-Contreras ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examines how nutritional status is measured in children and adolescents with cerebral palsy by analyzing 63 studies. The review found that different growth measurement standards produce very different results: when using WHO or CDC standards, most children appear undernourished, but when using cerebral palsy-specific growth charts, most appear normal. Body mass index (BMI) was the most commonly used measurement across studies. The findings suggest that using standard growth charts designed for typically developing children may overestimate malnutrition in children with cerebral palsy.
Key points
- Prevalence of undernutrition was 93.3% with WHO growth standards but only 7.5% with US cerebral palsy-specific growth charts
- Stunting prevalence ranged from 4.3% (CP charts) to 97.7% (WHO standards), showing major variation by measurement tool
- WHO growth standards were used in 50.8% of studies, followed by CDC charts (22.2%) and CP-specific charts (12.7%)
- BMI was addressed in 77.8% of studies, making it the most frequently used anthropometric index
- Using standard growth patterns for typically developing children produces higher prevalence estimates of undernutrition and stunting compared to CP-specific charts
Limitations
As a scoping review synthesizing methodologies rather than a meta-analysis, this work cannot determine which measurement standard is actually most appropriate for assessing health outcomes in children with cerebral palsy. The review does not establish which growth pattern best predicts clinical outcomes or long-term health.
Abstract
Background: Determining the nutritional status of children with cerebral palsy (CP) presents numerous challenges. Accurate nutritional assessment is crucial in this population to ensure the provision of appropriate and effective nutritional interventions. Aim: This scoping review aimed to analyze the most frequently used anthropometric indexes and growth patterns to determine the nutritional status of children and adolescents with CP. Methods: The literature search was performed in six databases Scopus, Cochrane Library, Web of Science, SciELO, Medline and PubMed. It was conducted on studies that included children aged 0 to 18 years. Sixty-three publications met the inclusion criteria. Results: The prevalence of undernutrition was higher when WHO growth standards and CDC growth charts were used (93.3% and 56.8%, respectively), whereas the prevalence of normal nutritional status was higher when US CP growth charts were used (92.5%). The prevalence of stunting was higher with the WHO growth standards (97.7%) and lowest with the US CP growth charts (4.3%). The WHO growth standards were the most frequently used (50.8%), followed by the CDC growth charts (22.2%) and the US CP growth charts (12.7%). Conclusion: The index with more relevance in this scoping review was BMI since it was addressed in 77.8% of the studies. When assessing the nutritional status with typically developed children's patterns, there was a higher prevalence of undernutrition and stunting. When using US CP growth charts, more children were included in the normal range. More studies are needed to determine which growth pattern is a better indicator of health.