Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.

<h4>Background</h4>Cerebral palsy is an extremely severe brain injury associated with multiple nutritional and clinical issues, such as underweight, gastroesophageal reflux, constipation, and nutrient deficiency. Evidence-based dietary and nutritional interventions may improve the qualit...

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Main Authors: Fernanda Rebelo, Isabela Rodrigues Mansur, Teresa Cristina Miglioli, Maria Dalva Baker Meio, Saint Clair Gomes Junior
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0271993
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author Fernanda Rebelo
Isabela Rodrigues Mansur
Teresa Cristina Miglioli
Maria Dalva Baker Meio
Saint Clair Gomes Junior
author_facet Fernanda Rebelo
Isabela Rodrigues Mansur
Teresa Cristina Miglioli
Maria Dalva Baker Meio
Saint Clair Gomes Junior
author_sort Fernanda Rebelo
collection DOAJ
description <h4>Background</h4>Cerebral palsy is an extremely severe brain injury associated with multiple nutritional and clinical issues, such as underweight, gastroesophageal reflux, constipation, and nutrient deficiency. Evidence-based dietary and nutritional interventions may improve the quality of life of children with cerebral palsy.<h4>Aim</h4>Systematically review randomized clinical trials evaluating nutritional and dietary interventions in the clinical, nutritional, and neurodevelopmental aspects of children with cerebral palsy.<h4>Methods</h4>A search was performed in electronic databases (LILACS, Medline, Web of Science, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Database, OpenGrey) using keywords. The search was firstly performed in May 2020 and updated on June 18th, 2021. Eligible studies were randomized clinical trials, that included children between 2 and 12 years old, and evaluated the effect of nutritional or dietetic interventions on clinical, nutritional or neurodevelopmental outcomes. Risk of bias was investigated using the RoB-2 tool. The study was registered on PROSPERO (CRD42020181284).<h4>Results</h4>Fifteen studies were selected. Positive results included the use of whey-based or pectin-enriched enteral formulas for gastroesophageal reflux (n = 6); 25-hydroxy-vitamin D supplementation for hypovitaminosis D (n = 2); supplementation with lipid mixture or diet with high-density energy for improvements in anthropometric measures (n = 2); supplementation with probiotics, prebiotics, symbiotics or magnesium for constipation (n = 2); nutritional support system for gross motor function (n = 1); lactoferrin and iron hydroxide polymaltose for iron deficiency anemia (n = 1); and educational intervention to improve feeding skills (n = 1). The overall risk of bias was high for 60% of the studies, and some concerns were raised for the remaining 40%.<h4>Conclusion</h4>Some promising dietary and nutritional interventions may promote important clinical improvements for patients with cerebral palsy. However, evidence is weak, as few clinical trials have been published with many methodological errors, leading to a high risk of bias.
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spelling doaj.art-60c0c40831704059a4d4ca3e087ae8682022-12-22T01:33:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01177e027199310.1371/journal.pone.0271993Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.Fernanda RebeloIsabela Rodrigues MansurTeresa Cristina MiglioliMaria Dalva Baker MeioSaint Clair Gomes Junior<h4>Background</h4>Cerebral palsy is an extremely severe brain injury associated with multiple nutritional and clinical issues, such as underweight, gastroesophageal reflux, constipation, and nutrient deficiency. Evidence-based dietary and nutritional interventions may improve the quality of life of children with cerebral palsy.<h4>Aim</h4>Systematically review randomized clinical trials evaluating nutritional and dietary interventions in the clinical, nutritional, and neurodevelopmental aspects of children with cerebral palsy.<h4>Methods</h4>A search was performed in electronic databases (LILACS, Medline, Web of Science, Embase, Scopus, Cochrane Library, ClinicalTrials.gov, Brazilian Digital Library of Theses and Dissertations, ProQuest Dissertations and Theses Database, OpenGrey) using keywords. The search was firstly performed in May 2020 and updated on June 18th, 2021. Eligible studies were randomized clinical trials, that included children between 2 and 12 years old, and evaluated the effect of nutritional or dietetic interventions on clinical, nutritional or neurodevelopmental outcomes. Risk of bias was investigated using the RoB-2 tool. The study was registered on PROSPERO (CRD42020181284).<h4>Results</h4>Fifteen studies were selected. Positive results included the use of whey-based or pectin-enriched enteral formulas for gastroesophageal reflux (n = 6); 25-hydroxy-vitamin D supplementation for hypovitaminosis D (n = 2); supplementation with lipid mixture or diet with high-density energy for improvements in anthropometric measures (n = 2); supplementation with probiotics, prebiotics, symbiotics or magnesium for constipation (n = 2); nutritional support system for gross motor function (n = 1); lactoferrin and iron hydroxide polymaltose for iron deficiency anemia (n = 1); and educational intervention to improve feeding skills (n = 1). The overall risk of bias was high for 60% of the studies, and some concerns were raised for the remaining 40%.<h4>Conclusion</h4>Some promising dietary and nutritional interventions may promote important clinical improvements for patients with cerebral palsy. However, evidence is weak, as few clinical trials have been published with many methodological errors, leading to a high risk of bias.https://doi.org/10.1371/journal.pone.0271993
spellingShingle Fernanda Rebelo
Isabela Rodrigues Mansur
Teresa Cristina Miglioli
Maria Dalva Baker Meio
Saint Clair Gomes Junior
Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.
PLoS ONE
title Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.
title_full Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.
title_fullStr Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.
title_full_unstemmed Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.
title_short Dietary and nutritional interventions in children with cerebral palsy: A systematic literature review.
title_sort dietary and nutritional interventions in children with cerebral palsy a systematic literature review
url https://doi.org/10.1371/journal.pone.0271993
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