PD902 - DEFINING MALNUTRITION IN CHILDREN WITH NEUROLOGICAL IMPAIRMENT: A GLOBAL COLLABORATION

PD902

DEFINING MALNUTRITION IN CHILDREN WITH NEUROLOGICAL IMPAIRMENT: A GLOBAL COLLABORATION

K. Huysentruyt^1,*, S. Vermilyea², J. Wolff³, R. D. Stevenson⁴, J. M. Hulst⁵, M. Neudecker⁶, D. Kennedy⁷, V. Marchand⁸, L. Lourens⁹, E. Ochoa-Ortiz¹⁰, M. R. Conaway¹¹, T. S. Desai¹², M. Ruiz Brunner¹³, N. Sanchez Vargas¹⁰, V. Martinez Tenorio¹⁴, K. L. Bell¹⁵, C. Romano¹⁶, R. Grossberg¹⁷, G. Rempel¹⁸

¹UZ Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium, ²Saint Joe’s, Cincinnati, ³Baxter Healthcare, Illinois, ⁴UVA Health Children’s, Charlottesville, United States, ⁵The Hospital for Sick Children, Toronto, Canada, ⁶UH Rainbow Babies and Children's Hospital, Cleveland, United States, ⁷First Community Health and Care, Surrey, United Kingdom, ⁸Ste-Justine UHC, Montreal, Canada, ⁹Neuro-nutrition, George, South Africa, ¹⁰Centro de Investigación y Educación en Nutrición (CIENutrition), Bogotá, Colombia, ¹¹University of Virginia, Charlottesville, United States, ¹²Schulich School of Medicine & Dentistry, London, Canada, ¹³Instituto Universitario de Ciencias Biomédicas de Córdoba (IUCBC), Córdoba, Argentina, ¹⁴Indiana University Health, Indianapolis, United States, ¹⁵Children’s Health Queensland Hospital and Health Service, Brisbaine, Australia, ¹⁶University of Messina, Messina, Italy, ¹⁷UH Rainbow Babies and Children's Hospital, Ohio, United States, ¹⁸University of Manitoba, Winnipeg, Canada

Rationale: In children with neurological impairment (CNI), challenges in acquiring reliable anthropometric data, as well as severity-specific variations in body composition, restrict the applicability of conventional nutritional indicators. This international multidisciplinary expert panel aimed to agree on standard criteria for recognizing malnutrition in CNI.

Methods: A scoping review was done in Medline, EBSCO, Elsevier Scopus and LILACS (2012-2025). Domain experts synthesized key findings and formulated recommendations which were refined and anonymously voted on via a 10-point Likert scale (scores of ≥7 indicating agreement) using a modified Delphi process. All experts (n=18) voted, and all recommendations reached consensus (≥80% of votes scoring ≥7) in the initial round.

Results: This consensus paper highlights the importance of using a multimodal approach to identify malnutrition in CNI. Statements regarding anthropometrics and growth all had median agreement scores of 10. Statements said that 1) no single measure is adequate as an unequivocal indicator of nutritional status; 2) Growth metrics should be interpreted in the context of motor impairment, joint contractures, and scoliosis and additional anthropometrics should be added when needed; 3) Weight and measured or estimated length/height should be plotted on general reference charts and CP-specific growth charts. Five referral criteria for detailed nutritional evaluation were agreed on with a median agreement score of 10 among experts.

Conclusion: These expert recommendations provide pediatricians and other nutrition care practitioners with a framework for identifying malnutrition in CNI. Implementing our expert recommendations across global healthcare facilities could potentially improve patient outcomes, reduce morbidity and mortality, and provide consistent data for future research endeavors.

Disclosure of Interest: K. Huysentruyt Grant / Research Support from: Beneo, Danone, Nestlé Health Science, Biogaia (grants made to institution), Other: study was supported by a Global Nestle unrestricted grant, S. Vermilyea Speakers Bureau of: Nutricia, Other: study was supported by a Global Nestle unrestricted grant, J. Wolff Other: employee of Baxter Healthcare; study was supported by a Global Nestle unrestricted grant, R. Stevenson Other: study was supported by a Global Nestle unrestricted grant, J. Hulst Grant / Research Support from: Nestle Health Sciences, Canada (grant made to institution), Consultant for: Danone, Nutricia, Abbott Nutrition and Nestle Health Sciences, Other: study was supported by a Global Nestle unrestricted grant, M. Neudecker Other: study was supported by a Global Nestle unrestricted grant, D. Kennedy Speakers Bureau of: Nutricia, Other: study was supported by a Global Nestle unrestricted grant, V. Marchand Speakers Bureau of: Nestle and Abbott, Other: study was supported by a Global Nestle unrestricted grant, L. Lourens Other: study was supported by a Global Nestle unrestricted grant, E. Ochoa-Ortiz Speakers Bureau of: Opella, Carnot, Stendhal, Nutricia, Danone México, Abbott México, Nestlé México., Other: study was supported by a Global Nestle unrestricted grant, M. Conaway Other: study was supported by a Global Nestle unrestricted grant, T. Desai Other: study was supported by a Global Nestle unrestricted grant, M. Ruiz Brunner Other: study was supported by a Global Nestle unrestricted grant, N. Sanchez Vargas Other: study was supported by a Global Nestle unrestricted grant, V. Martinez Tenorio Other: study was supported by a Global Nestle unrestricted grant, K. Bell Other: study was supported by a Global Nestle unrestricted grant, C. Romano Other: study was supported by a Global Nestle unrestricted grant, R. Grossberg Other: study was supported by a Global Nestle unrestricted grant, G. Rempel Consultant for: Nutricia, Speakers Bureau of: Cardinal, Other: study was supported by a Global Nestle unrestricted grant