Diet, nutrition and CP
Everyone is influenced by their diet, including people with Cerebral Palsy (CP). What we eat and drink has a major effect on how our brain and body function.
Most people understand that diet and lifestyle play an important role in health and general well-being. The dietary guidelines from the Danish Veterinary and Food Administration (Fødevarestyrelsen) are a sensible framework for us all to follow. For people with CP, it’s particularly important to pay close attention to diet and nutrition.
Why is diet important for people with CP?
There are many good reasons to focus on diet and nutrition in relation to CP. Both undernutrition and overnutrition are more common among people with CP compared to the general population.
Undernutrition and stunted growth are challenges for many people with CP. They often have difficulty chewing, swallowing, and absorbing food, and some people have no appetite. This can mean that they don’t get the energy and nutrients their brain needs to develop and function optimally. For others, the challenge is obesity, often resulting from motor challenges that make physical activity difficult. This is especially true among young people and adults with CP. Like undernutrition, overnutrition or obesity can also result from an improper diet due to difficulties with chewing and swallowing. There is no single "correct" diet for people with CP, but focusing on energy content and essential food groups is a good strategy for ensuring sufficiently healthy and 'brain-friendly' meals.
Is the role of diet and nutrition different for children and adults with CP?
Age and lifestyle affect how efficiently the body utilizes different nutrients. In the early years, the brain develops more rapidly and flexibly, which means that young children need a more energy-dense diet compared to older children and adults.
Eating habits of children and adults are also typically different. Children gradually learn to eat different foods with new appearances, textures, smells, and tastes. Some children are curious, while others are more cautious. Genetics and previous experiences play an important role in this process. As the child grows, the environment, including the influence of parents, becomes increasingly important.
All children go through a phase early on where they want to taste everything. During this phase, they build a foundation of experiences that will influence their dietary choices later in life, both positively and negatively. Because taste is 'plastic,' it can change throughout a person's life.
The way children and adults experience meals is shaped by a complex social interaction between child and parents, subconscious coping mechanisms, and genetics. Fortunately, it’s relatively easy to make meals more enjoyable and achieve a more balanced diet.
How to eat for brain health
An optimal diet is structured to meet the brain's needs. It should be varied and rich in vitamins, minerals, fats, and other beneficial nutrients. By getting to know the main food groups, you can make sure your brain gets the nutrients it needs. This method also simplifies grocery shopping and meal planning, making them more flexible than focusing on individual foods.
The following five food groups contain key nutrients that benefit the brain:
FISH
Many studies indicate that people who eat a lot of fish live longer and have a lower risk of cardiovascular diseases and other serious health issues. Fish are rich in omega-3 fatty acids, particularly DHA, which are vital for brain function and development. Note that children under the age of three should not eat large predatory fish such as tuna or halibut because of the higher mercury content.
VEGETABLES
Vegetables are rich in polyunsaturated fatty acids, vitamins, and minerals, all of which are important for brain function. They also provide dietary fiber, which is necessary for proper intestinal function. Varying the types of vegetables you eat helps ensure you get a wide range of vitamins and minerals.
FRUITS AND BERRIES
Fruits are among the best sources of vitamins and minerals for the brain and also contain fiber for the intestines. Research suggests that fruit consumption positively impacts the brain’s ability to learn and remember new information. This also applies to cocoa/chocolate in moderate amounts.
NUTS/SEEDS/BEANS
Rich in protein and energy, this food group also offers various vitamins, minerals, and amino acids important for brain function. Just like other food groups, it's beneficial to include a variety of nuts, seeds, and similar foods in your diet.
DAIRY PRODUCTS
Dairy products offer numerous health benefits and contain calcium and vitamin D, which are important for brain function. Children have a particularly high need for calcium. However, adults also require calcium, especially after the age of 30, when bones start to weaken. Research shows that people with CP generally need more calcium because their bones are more fragile.
Tips for handling mealtime challenges
People with CP often encounter different challenges during meals. Since CP affects each person individually, and age influences their needs, different approaches are needed to improve the mealtime experience.
Generally, even small adjustments can make a big difference. For example, you can experiment with different plate sizes and colors, and try adding some calming background music. It's also important to remember that diet is part of a bigger picture. Physical activity and sleep are also key components that affect appetite, energy balance, and overall health.
Below is a selection of tips for children and adults that we hope will inspire further experimentation.
TIPS FOR CHILDREN
Chewing time
Begin with 10 minutes of silent eating, focusing solely on chewing and not talking. A quiet setting can be helpful for people who need to concentrate to carefully chew and swallow their food. Talking while eating makes this challenging.
Three safe foods
Keep at least three safe food choices on the table - enough for the child to feel full. Try to vary these options daily. This can create a feeling of safety and can encourage some children to try new foods.
Full return policy
Place a 'spit-out' bowl next to the child's plate. This gives them reassurance when trying new foods, knowing they can get rid of anything they don’t like. This goes for any food they’re handling or tasting.
TIPS FOR ADULTS
Be prepared
A good dining experience begins before you sit down at the table. Will you be eating alone or with others? If you're eating with others, it can be more comforting and relaxing to have a helper with you. Consider having a small snack beforehand to make sure you have enough energy to socialize during the meal. It's also a good idea to start the meal 10 minutes before quiet eating.
Create a pleasant environment
It’s important to stimulate your senses and encourage the desire to try new foods, whether you're cooking alone or with others. Getting involved in the shopping and cooking process is a great start. Cooking classes or clubs are excellent opportunities to experiment with new ingredients and dishes.
Have a say in what you eat
If you live in a residential care facility, for example, the presentation of food can make a big difference. Do you have the option to choose what you want to eat? If food is all blended into one mixture for safety reasons, it often looks unappetizing, and all the flavors and aromas blend together. When the food is blended separately, you can clearly identify what's on your plate, and it looks and tastes better.
When are dietary supplements necessary?
If you eat a varied diet and eat enough, dietary supplements aren’t necessary. A regular healthy diet can easily meet the nutritional needs of both the brain and body, including people with CP.
Most Danes occasionally need additional vitamin D, since it's common to be deficient because of the lack of sunlight in winter. If you don’t eat fish regularly, taking fish oil supplements can help as fish is the main source of the important omega-3 fatty acid DHA.
Those who have major difficulties chewing and swallowing and are on a modified diet may be at risk for vitamin and mineral deficiencies, so it’s essential to supplement these nutrients when needed. To ensure the best approach, you should consult with a dietitian.
