Dose, timing, and source of protein intake of young people with spastic cerebral palsy.

Since the dose, timing and source of dietary protein intake are important for muscle growth and development, the aim of this study was to examine the dose, timing and source of protein intake of young people with cerebral palsy. Dietary intake was assessed in 19 children with spastic cerebral palsy (Gross Motor Function Classification System levels I-V; Eating and Drinking Classification System levels I-V; 10 males, 9 females; mean [SD] age 11 years 2 months [3 years 3 months]) using a 3-day food diary. The data were analyzed for three age categories (4-8, 9-13, and 14-17 years). Average 3-day protein intake (62.1 g [27.9 g]) was within the recommended boundaries with a minimum of 1.0 g/kg body weight/day and a maximum of 4.1 g/kg body weight/day. However, dinner was the only mealtime that provided at least 25 g of protein, which is needed for optimal muscle maintenance. The main food groups that contributed to protein intake were 'milk and milk products', 'meat, meat products and poultry', and 'bread'. These observations suggest timing of protein intake can be improved with higher intakes during breakfast and lunch to better support skeletal muscle growth and development.IMPLICATIONS FOR REHABILITATIONRecent studies have shown that smaller muscles and early atrophy are already present at young age in individuals with cerebral palsy.Besides physical training, adequate protein intake (with optimal dose, timing and source of protein) may be a key factor in the prevention and treatment of loss of muscle mass in children with cerebral palsy.In a relatively small sample this study shows that overall protein intake (dose) was in line with recommendations and also that the source of the protein seemed sufficient to contain all essential amino acids.Improvement of the timing of protein intake throughout the day, with higher intakes during breakfast and lunch, seems important to better support skeletal muscle growth and development.