Distribution of caloric intake by food groups according to the level of eating and drinking ability (EDACS) in children and adolescents with cerebral palsy in Argentina

Abstract

Introduction: The energy and nutritional contribution of food groups constitutes the dietary pattern. In children and adolescents (C/A) with cerebral palsy (CP), the level of impairment in eating or drinking abilities (EDACS) may influence this intake.

Objective: To determine consumption patterns by food groups and compare them according to EDACS levels in C/A with CP in Argentina.

Materials and Methods: This was an observational, cross-sectional study including C/A aged 2 to 19 years from six rehabilitation centers in Córdoba and Buenos Aires. A food frequency questionnaire covering 11 food or beverage groups was used. The percentage of total caloric intake contributed by each group was calculated. Group comparisons were performed using the Mann–Whitney test (p < 0.05).

Results: A total of 68 participants were included; 66% ([53.5; 77.06], n = 45) were adolescents. According to EDACS, 61.7% ([45.4; 76.2], n = 42) had mild to moderate impairment (levels I to III). Additionally, 82.4% were exclusively orally fed ([70.0; 91.3], n = 56). When analyzing the groups, C/A with severe EDACS showed lower energy contributions from cereals, grains, and pasta, with a median of 16.3% [IQR 6.9–25.9] (p = 0.0018); meats and processed meats, median 11.8% [IQR 9.0–16.4] (p = 0.0146); and dairy products, median 7.8% [IQR 4.4–11.9] (p = 0.0243). They had a higher contribution from supplements, with a median of 91.0% [IQR 50.5–100%] in 8 C/A (p = 0.04), showing significant differences. No significant differences were observed for eggs, fruits, vegetables, legumes, fats, sweets, or beverages. Fruit, vegetable, and legume intake was low across all EDACS levels, contributing less than 7% of total caloric intake.

Conclusion: The EDACS level influences the dietary pattern of C/A with CP. Greater functional impairment was associated with lower intake from food and higher intake from supplements. The consistently low consumption of fruits, vegetables, and legumes across all levels highlights the need for specific nutritional interventions.