title: Body composition, diet, and physical activity: a longitudinal cohort study in preschoolers with cerebral palsy.
abstract: Altered body composition in children with cerebral palsy (CP) could be due to differences in energy intake, habitual physical activity (HPA), and sedentary time.
  
  
  
  We investigated the longitudinal relation between the weight-for-age z score (WZ), fat-free mass (FFM), percentage of body fat (%BF), and modifiable lifestyle factors for all Gross Motor Function Classification System (GMFCS) levels (I-V).
  
  
  
  The study was a longitudinal population-based cohort study of children with CP who were aged 18-60 mo (364 assessments in 161 children; boys: 61%; mean ± SD recruitment age: 2.8 ± 0.9 y; GMFCS: I, 48%; II, 11%; III, 15%; IV, 11%; and V, 15%). A deuterium dilution technique or bioelectrical impedance analysis was used to estimate FFM, and the %BF was calculated. Energy intake, HPA, and sedentary time were measured with the use of a 3-d weighed food diary and accelerometer wear. Data were analyzed with the use of a mixed-model analysis.
  
  
  
  Children in GMFCS group I did not differ from age- and sex-specific reference children with typical development for weight. Children in GMFCS group IV were lighter-for-age, and children in GMFCS group V had a lower FFM-for-height than those in GMFCS group I. Children in GMFCS groups II-V had a higher %BF than that of children in GMFCS group I, with the exception of orally fed children in GMFCS group V. The mean %BF of children with CP classified them as overfat or obese. There was a positive association between energy intake and FFM and also between HPA level and FFM for children in GMFCS group I.
  
  
  
  Altered body composition was evident in preschool-age children with CP across functional capacities. Gross motor function, feeding method, energy intake, and HPA level in GMFCS I individuals are the strongest predictors of body composition in children with CP between the ages of 18 and 60 mo.
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center, stinaoftedal@gmail.com.|Children's Nutrition Research Center, and.
authors.forename: Stina
authors.initials: S
authors.lastname: Oftedal
authors.affiliation: Children's Nutrition Research Center, and.
authors.forename: Peter Sw
authors.initials: PS
authors.lastname: Davies
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center.
authors.forename: Roslyn N
authors.initials: RN
authors.lastname: Boyd
authors.affiliation: Division of Developmental Pediatrics, Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, VA.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Stevenson
authors.affiliation: School of Population Health, The University of Queensland, Brisbane, Australia.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Ware
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center.|Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand; and.
authors.forename: Piyapa
authors.initials: P
authors.lastname: Keawutan
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Benfer
authors.affiliation: Queensland Cerebral Palsy and Rehabilitation Research Centre, University of Queensland Children's Health Research Center.|Dietetics and Food Services, Lady Cilento Children's Hospital, Children's Health Queensland, South Brisbane, Australia.
authors.forename: Kristie L
authors.initials: KL
authors.lastname: Bell
mesh_terms: D050154:Adiposity; D001724:Birth Weight; D001823:Body Composition; D002547:Cerebral Palsy / Q000628:therapy*; D002657:Child Development; D002675:Child, Preschool; D004032:Diet; D017097:Electric Impedance; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D057185:Sedentary Behavior
keywords: body composition; body fat; cerebral palsy; energy intake; fat-free mass; habitual physical activity; preschool children; sedentary behavior