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

Purpose: 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. Materials and Methods: In this cross-sectional study, 25 children aged 1-18 years with CP underwent body composition assessment via bioelectrical impedance (InBody S10) and completed three-day food records analyzed using BeBiS software. Anthropometric z-scores were calculated based on WHO standards, and micronutrient adequacy was assessed using WHO Recommended Daily Allowances. Results: 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 (p < 0.05). Regarding dietary intake, children with GMFCS IV-V consumed significantly less energy (p = 0.036), protein (p = 0.015), and carbohydrates (p = 0.028). Micronutrient deficiencies were common, especially in calcium (p = 0.035), zinc (p = 0.046), vitamin B2 (p = 0.044). Magnesium intake showed positive correlations with anthropometric z-scores (p < 0.05). Conclusion: 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.