title: Evaluation of nutritional status in children with refractory epilepsy.
abstract: BACKGROUND
  children affected by refractory epilepsy could be at risk of malnutrition because of feeding difficulties (anorexia, chewing, swallowing difficulties or vomiting) and chronic use of anticonvulsants, which may affect food intake and energy metabolism. Moreover, their energy requirement may be changed as their disabilities would impede normal daily activities. The aim of the present study was to evaluate nutritional status, energy metabolism and food intake in children with refractory epilepsy.
  
  
  METHODS
  17 children with refractory epilepsy (13 boys and 4 girls; mean age 9 +/- 3,2 years; Body Mass Index 15,7 +/- 3,6) underwent an anthropometric assessment, body composition evaluation by dual-energy X-ray absorptiometry, detailed dietetic survey and measurement of resting energy expenditure by indirect calorimetry. Weight-for-age, height-for-age (stunting) and weight-for-height (wasting) were estimated compared to those of a reference population of the same age.
  
  
  RESULTS
  40% of children were malnourished and 24% were wasted. The nutritional status was worse in the more disabled children. Dietary intake resulted unbalanced (18%, 39%, 43% of total daily energy intake derived respectively from protein, lipid and carbohydrate). Adequacy index [nutrient daily intake/recommended allowance (RDA) x 100] was < 60% for calcium iron and zinc.
  
  
  CONCLUSIONS
  many children with refractory epilepsy would benefit from individual nutritional assessment and management as part of their overall care.
authors.affiliation: International Centre for the Assessment of Nutritional Status (ICANS), University of Milan, Italy. simona.bertoli@unimi.it
authors.forename: S
authors.initials: S
authors.lastname: Bertoli
authors.forename: S
authors.initials: S
authors.lastname: Cardinali
authors.forename: P
authors.initials: P
authors.lastname: Veggiotti
authors.forename: C
authors.initials: C
authors.lastname: Trentani
authors.forename: G
authors.initials: G
authors.lastname: Testolin
authors.forename: A
authors.initials: A
authors.lastname: Tagliabue
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue; D000886:Anthropometry; D001823:Body Composition; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D015519:Bone Density; D002153:Calorimetry, Indirect; D002648:Child; D015930:Diet Records; D004351:Drug Resistance; D004435:Eating; D002149:Energy Intake; D004734:Energy Metabolism; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000150:complications; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology; D008903:Minerals / Q000008:administration & dosage; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D012146:Rest; D012885:Skinfold Thickness; D019282:Wasting Syndrome / Q000150:complications
chemical_list: D008903:Minerals