None listed
Conditions
Brief summary
Children with cerebral palsy (CP) show higher rates of physical inactivity and overweight and obesity than their typically developing peers– all likely contributors to the increased risk of health problems and chronic diseases in adulthood such cerebrovascular diseases and osteoporosis. Whilst low physical activity and high time spent in sedentary behaviours may contribute to overweight and obesity in young people with CP, dietary factors are also likely to play a major role for achieving healthy body composition for health and wellness. Interestingly, nutrition research in CP tends to describe high rates of malnutrition – yet there is a current lack of clear CP specific dietary guidelines for people across all functional levels. From the paucity of research that does exist on diet in CP, the focus is for children requiring assistance with their eating (though the majority of children with CP do not require assistance), and predominantly on energy requirements under the premise that (ambulatory) children with CP may have reduced energy requirements due to inactivity. However, this premise overlooks the fact that, owing to neuromuscular deficits and biomechanical inefficiencies, children with CP will typically have greater energy expenditure performing the same activities as their typically developing peers, even when at “rest”. Dietary guidance may need to be more targeted for children with CP dependant on their functional level, and not only take into consideration how much energy is consumed, but also take into consideration protein intake. This could be considered in the context of total daily protein intake and amount of protein consumed in relation to physical activity The aim of the “Eat, Sleep, Play-CP” study is to investigate the role that total energy, total protein and protein timing may have on supporting healthy body composition in children with CP, and to test the feasibility of a 12 week “Eat, Sleep, Play” dietary intervention. Children with CP between the ages of 5-12 years will be invited to take part in the study, and with the assistance of their parent/caregiver, will complete assessments of dietary intake and body composition, and questionnaires about their sleep and activity behaviours. Targeted feedback will be provided by the research team (supervised by a dietitian) to the child and parent/caregiver about their “Eat, Sleep, Play” profile, highlighting areas of their profile to target for improvement, and strategies on how to target changes will be co-developed between the child, the parent/caregiver and the research team. After 12 weeks, participants will complete repeated assessments to determine the feasibility of the intervention in changing a child’s “Eat, Sleep, Play” profile, and changes in variables of body composition. This study is the first of its kind, and the information gathered will advance our knowledge on the role of nutrition for supporting healthy a body composition for children with CP.
Interventions
This is a feasibility study for our 'Eat, Sleep, Play-CP' intervention.
The focus of the intervention primarily focuses on the child’s energy and protein intake, with the additional scope of the timing of protein intake in relation to the child’s activity patterns.
The nutritional information provided for the intervention has been developed based on the Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intake (NHMRC Ministry of Health and adaptations from T
This is a feasibility study for our 'Eat, Sleep, Play-CP' intervention. The focus of the intervention primarily focuses on the child’s energy and protein intake, with the additional scope of the timing of protein intake in relation to the child’s activity patterns. The nutritional information provided for the intervention has been developed based on the Nutrient Reference Values for Australia and New Zealand Including Recommended Dietary Intake (NHMRC Ministry of Health and adaptations from The American College of Sports Medicine Joint position statement: Nutrition and Athletic performance. The “Sleep” and “Play” components are developed from the “24 hour Activity Clinical practice guide” for children with CP. At T1, parent/caregiver and child will receive their “Eat, Sleep, Play” Profile, which will appear somewhat like a report card centred on 3 key areas. - Total energy intake: The NRV will be used which will be relevant to the age and physical activity level of the child - Total protein intake: As per the NR - Protein intake after physical activity: recommended as ~10% daily recommendation Total energy; if a participant is found to be consuming above the recommended energy intake, advice will be provided around how to decrease this. This advice will be personalised to the dietary intake of the individual and may include advice around a decrease in intake of high fat, sugar and salt foods for example chocolate, confectionary, potato chips, chocolate or cream-filled biscuits, fast food and sugary drinks. If a participant is found to be consuming below the recommended energy intake, advice will be provided on how to increase this. This will be personalised and may include advice around the increase of foods such as fruit, yoghurt, vegetable sticks with a low-fat dip (eg, hummus or yoghurt-based dips), mini-sandwiches, nuts and seeds, fresh fruit smoothie, plain popcorn, and unsweetened breakfast cereal with milk. Total protein: if a participant is found to be consuming below the recommended protein intake, personalised advice will be provide to increase their protein intake through an increase in food sources of protein which are meat, poultry, fish, milk, milk products, eggs, legumes, tofu, nuts and seeds. Protein after activity: If a participant is found not to consume adequate protein after activity, personalised advice will be provided and suggestions of protein rich foods will be given. Food sources of protein include meat, poultry, fish, milk, milk products, eggs, legumes, tofu, nuts and seeds. One Masters of Dietetics student will deliver the "intervention", which includes a ~30minute discussion about their current dietary intake, goal setting on where they can improve on their intake, and co-developed strategies on how this can be achieved. This discussion will primarily take place in person, however if the participant prefers (i.e due to time limitations or if the chlilds is tired) and/or if schedulling issues occur, the discussion will take place via videconfernce (the mode of the delivery will be recorded). The discussion points raised with the child/family will have been previously discussed with a NZ Registered Paediatric Dietitian and adjusted as needed. A checklist (developed for the study) will help guide the students’ discussion, and families will be provided with: their profile, a written summary of their goals and strategies, and an information pack to refer to over the following 12 weeks. The information pack has been developed for the study, Participants will receive up to four phone call/email/text check in (to the preference of the participant) to see how they are managing, and to provide advice and tips on how to follow the recommendations as needed. This will be spaced as follows: week 2, week 4, week 7, week 10, with the length of time varying depending on the families needs. It is anticiapted that this will be less than 10 minutes.
Sponsors
University of Auckland
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
5 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
i) Children with a confirmed diagnosis of CP aged 5-12 years. ii) All EDACS and GMFCS levels. iii) Living within the Auckland metropolitan region and/or able to travel to the University of Auckland, Grafton on two occasions. iv) At least one parent/caregiver understands written and verbal English and can speak English. v) Access to a phone/tablet and/or internet
Exclusion criteria
i) Dyskinesia preventing the ability to lie still for 10 minutes. ii) Inability to transfer from chair to bed (~60 cm high) without requiring a hoist. iii) Any implants, hardware, devices, or other foreign implanted material that may interfere with body composition assessment iv) Current, recent (3 months prior) or planned feeding tube (a percutaneous endoscopic gastrostomy (PEG), or similar) inserted through the study period. v) Under any specific clinical dietary guidance or textured modified foods and/or fluids vi) Uncontrolled epilepsy. vii) Planned orthopaedic surgery 6 months prior to or throughout the study period.
Outcome results
None listed