Is Chewing Performance Related to Dietary Intake in Children with Cerebral Palsy?

ABSTRACT

To examine the relationship between chewing performance and dietary intakes in children with Cerebral Palsy (CP). Forty children with CP aged between 2 and 6 years were included. The Karaduman Chewing Performance Scale (KCPS) and the Mastication Observation and Evaluation (T-MOE) instruments were used to evaluate chewing performance. Daily dietary intakes were measured from a 24-h food record with digital photographs including the amount and textures of all foods consumed during the meal. Chewing function was impaired in 70% of children. There was a negative low-to-moderate correlation between KCPS scores and daily protein intake (r = -0.32, p = 0.04), but not with energy and other macronutrients. The percentage of daily dietary intakes from 'liquid-blenderized' foods were positively correlated with KCPS, and negatively correlated with T-MOE scores (p < 0.001). There was a significant negative association between the percentage of daily dietary intakes from 'easy to chew & regular solid' foods and KCPS scores, and a significant positive association was found with T-MOE scores. In conclusion, the amount of daily protein intake decreased, and daily intake ratios of energy and macronutrients from liquid-blenderized foods increased as chewing performance decreased in children with CP. Timely diagnosis and treatment of chewing dysfunction can serve as a useful treatment option to ensure adequate dietary intake in children with CP, and also to decrease the burden of their parents and improve their quality of life.