Grab my FREE NEURODIVERGENT FRIENDLY MEALS!

Grab my FREE Neurodivergent Friendly Meals!

Neurodivergent-Friendly 30 Minute Meals

Cerebral Palsy Nutrition Decoded: Your Comprehensive Guide

A girl with cerebral palsy in a wheelchair with text that says "Cerebral Palsy Nutrition Decoded: Your Comprehensive Guide"

“Cerebral Palsy Nutrition Decoded: Your Comprehensive Guide” was written by Yemina Goldberg and reviewed/edited by Gabi Abreu, BSc and Jackie Silver MHSc, RD

Medical Disclaimer: The information in this article is meant for educational purposes only. It is not intended to be personalized medical or nutrition advice. For a plan tailored to your needs, please consult with a Registered Dietitian or qualified healthcare professional.
Disclosure: This post may contain affiliate links with which I may earn a small commission but at no additional cost to you. Affiliate links help bloggers like me to provide you with free content. All opinions expressed here are genuine. 

Last updated: June 11, 2024

Cerebral Palsy Nutrition: A Personal Journey Advocating for Health

Growing up with cerebral palsy, I (Yemina) learned first hand about the importance of nutrition. I have always been a foodie. When I was two years old, my favorite food was London broil, if you can believe that. Yet, despite my love of food, I struggled to consume enough calories and had to go to a nutrition clinic. 

Throughout this journey, I learned about making food choices that were healthy for me and that helped me meet my caloric needs. Fast forward ten years, and I am now studying nutrition science in university and remain passionate about the importance of nutrition for everyone.I have also noticed a lack of practical information for people with cerebral palsy.

What is Cerebral Palsy?

Cerebral Palsy is the most common disability, affecting 1 in every 323 people. It happens early in life and generally impacts motor skills or a person’s ability to move and control their body. It doesn’t get worse, but never goes away

Cerebral Palsy presents in various forms, each unique in its impact on the body. One classification method is based on the extent of the condition’s effect on body parts. For instance, there’s hemi or hemiplegia, where half of your body is affected, and quadriplegia, where your whole body is affected. 

Another way to describe cerebral palsy is by its severity. This scale ranges from level 1 (least severe), characterized by very minor impacts on motor skills, to level 5 (most severe), having the most impact on mobility and function.

A boy with cerebral palsy on a wheelchair outside

Importance of Cerebral Palsy Nutrition

Nutrition plays an important role in maintaining your overall health. It is true for everyone, but can be a little more complex for people with cerebral palsy. People with cerebral palsy may often experience unique growth patterns and may face challenges in consuming the recommended amount of nutrients or calories. Research has shown that cerebral palsy nutrition can significantly improve survival, bone and brain health. 

Five Common Issues Related to Cerebral Palsy Nutrition

People with Cerebral Palsy may experience difficulties eating, moving, as well as being independent with those tasks. This can lead to additional health challenges and underscores the importance of nutrition. Listed below are five common issues related to cerebral palsy nutrition.

An infographic listing five common issues related to cerebral palsy nutrition
  1. Physical Challenges

People with Cerebral Palsy may have difficulties feeding themselves, preparing meals, and shopping due to physical challenges. Individuals may have to rely on another person to help with these tasks. By relying on others to get the food you need, it can become a barrier to meeting your caloric needs. 

Additionally, many people with cerebral palsy may experience difficulty speaking and therefore might not be able to ask for food when they need it. People with cerebral palsy also might not get enough food because they have difficulty chewing and eat very slowly.

  1. Exercise

Individuals with cerebral palsy may find it challenging to get enough exercise. Many people go to physical therapy, and while it is beneficial, it doesn’t often provide the same cardiovascular benefits d as a workout at the gym might. 

Surprisingly, research indicates that even among those with cerebral palsy who eat safely, 42% may still struggle with maintaining a healthy weight. An Eating and Drinking Ability Classification System with levels from 1 to 5 is used to assess how safely a person with cerebral palsy can eat. It includes elements of safety related to swallowing and choking as well as how efficiently a person eats and whether they rely on others to help them eat.

A level of 1 means a person eats completely safely, efficiently, and independently, while a level 5 means a person is likely completely dependent on others and cannot eat safely. Many people who are level 5 need to be tube fed.

Moreover, individuals with cerebral palsy may be more likely to develop heart disease or high blood pressure, which makes having proper nutrition even more important.

  1. Swallowing 

People with Cerebral Palsy may often experience difficulties with swallowing, which is medically referred to as dysphagia. Dysphagia can often increase the risk of choking on food and in severe cases, some food may go to the lungs. In addition to making it harder to eat, choking on your food can make eating a traumatic experience, increasing the likelihood of wanting to eat less. To learn more about food aversions, check out this blog!

  1. Constipation

People with cerebral palsy may often experience muscle spasms and poor mobility, which can lead to a higher chance of experiencing constipation. Being constipated can also make eating more unpleasant, and can result in wanting to eat less. To learn more about managing constipation, download our free Constipation Guide here!

  1. Bone Health 

As mentioned earlier, exercise can be challenging for individuals with cerebral palsy due to its impact on mobility and function. A lack of regular exercise, specifically weight bearing exercise, can lead to lower bone density.. In fact, 90% of people with cerebral palsy have low bone density, which leads to weaker bones that may fracture more easily. Overtime, this can increase the risk of developing osteopenia and osteoporosis

A close up of bones with osteoporosis

Building Balanced Meals for Cerebral Palsy Nutrition

Consuming a well-rounded diet is crucial for Cerebral Palsy nutrition, as it ensures your body receives all the necessary nutrients for long-term health by preventing and improving the health issues discussed above.

Did you know that Canada’s Food Guide was most recently updated in 2019? These new guidelines use a term called the “plate method,” which recommends filling half your plate with vegetables, one-quarter of your plate with starches, one-quarter with a protein source, and making water your drink of choice. 

Feel free to use our graphic below as a guideline or template when planning your meals to ensure they’re balanced. 

Please note that this is a guide, and not a hard rule. It can be particularly helpful when planning meals or modifying recipes to include more vegetables, as an example. Keep in mind that you will also have to modify this method for one-pot recipes. 

A graphic showing the plate method for building balanced meals for cerebral palsy nutrition

Cerebral Palsy Nutrition: Getting Enough Calories in a Healthy Way

As a general rule, if you should be gaining weight and you aren’t or if you are having difficulty maintaining a healthy weight, it may be helpful to eat 2g of protein for every kg you weigh and balance that with other healthy choices of fruits, vegetables and whole grains. 

If you have difficulty eating enough in one sitting, you may also find it helpful to consume smaller, more frequent meals. For example, by adding in healthy snacks, like yogurt, fruit and nuts in between meals. 

You may find it helpful to think about how to make higher calorie, yet healthy choices whenever possible. For example, can you drizzle a teaspoon of olive oil on top of what you are eating? That is a simple and easy way to add healthy calories to your food. Adding healthy fats such as olive oil is also good for your heart health.

Smoothies can also be a quick and easy way to meet your calorie goals. Try adding in some chia seeds, hemp hearts, or oats in addition to fruits or veggies to boost your fiber and calorie intake. Check out this blog post for some recipe inspiration! 

If you rely on others to help you eat, the more you can plan in advance by making a schedule and menu, the better. That way, you can take your time in preparing. It also makes it easier for others to help you, without you needing to communicate in the moment.

Please note that these are general tips based on research and you should always consult with your healthcare provider and a registered dietitian to meet your unique dietary needs. 

Tips for Increasing Protein Intake:

  • Aim to include a source of protein with each meal. Examples of proteins are meats, fish, eggs, tofu, greek yogurt, cottage cheese, protein powders, and beans
  • Add a high protein snack such as a protein shake, a handful of nuts, or a slice of cheese. As a bonus, these all are great sources of calcium too.
  • Swap a grain for a grain that has more protein. For example, quinoa has more protein than rice.
  • Have Greek yogurt instead of your usual yogurt. Greek yogurt has more protein.
  • Try out new high protein recipes, like this High Protein French Toast or these easy High Protein Meal Prep Recipes!

To learn more about the benefits of protein, check out this blog post!

Various high protein foods

Cerebral Palsy Nutrition: Swallowing Difficulties

We are not speech and language pathologists (SLPs), so if you have difficulties swallowing, make sure to talk to your doctor and get assessed for swallowing difficulties and textured diet recommendations from an SLP.

If you have swallowing difficulties, you may need to thicken food. Bananas can be a useful food to add to smoothies or to eat on their own. They are thick and soft and have a lot of potassium. 

One reason food may be hard to swallow is because it is dry. Adding moisture to what you are eating can help you chew. For example, you can add sauce to a dry piece of chicken. 

If difficulties swallowing makes it more tiring to eat and you end up eating less, consider eating smaller amounts more frequently.

Cerebral Palsy Nutrition: Dealing with Constipation

If you struggle with constipation, it is a good idea to increase both the liquid and the amount of fiber in your diet. 

Fiber is universally healthy. Insoluble fiber has the added benefit of improving constipation. Good sources of insoluble fiber include whole grains, nuts, and many vegetables. For example:

  • Wheat bran
  • All kinds of beans
  • Berries
  • Almonds or Walnuts
  • Spinach
  • Sweet potato

Getting enough fluids is also a big help for constipation. People with cerebral palsy sometimes drink less than they should due to swallowing difficulties or simply because finding an accessible washroom can be a big pain. This, again, may be something that planning ahead can help with. You can think about how to time your fluid intake and your washroom trips.

Tips for Increasing Fiber Intake:

  • Choose a high fiber breakfast cereal, such as one that includes wheat bran (check out this blog for more tips on How to Choose Cereals with Fiber
  • Switch as many of your grains to whole grains as you can, including in your baked goods
  • Add in high fiber snacks such as roasted chickpeas, a serving of popcorn or a handful of nuts
  • Add salad to your meals

Cerebral Palsy Nutrition: Bone Health

People with CP may often need more vitamin D and Calcium, especially if they cannot walk.Walking helps to strengthen leg bones by putting weight on them and making them work harder. So individuals who are unable to walk may benefit from additional support for their bone health. 

Milk can be an excellent option as it is a good source of vitamin D and calcium, which also provides lots of protein.However, you don’t need to drink milk to get enough calcium. You can also benefit from other calcium-rich foods like:

  • Other dairy products like cheese and yogurt
  • Nuts
  • Fish 
  • Legumes
  • Leafy greens
  • Fortified foods such as breakfast cereals with added nutrients

Tips for Increasing Intake of Calcium and Vitamin D:

An infographic listing tips for increasing intake of calcium and vitamin D for cerebral palsy nutrition
  • Add more calcium to your diet by choosing one food to swap, such as swapping your black coffee for one with milk or almond milk
  • Add a yogurt to your breakfast each day
  • Snack on a handful of almonds
  • Add a salad to your lunch
  • You can also get vitamin D from being in the sun. You only need a few minutes. After ten to fifteen minutes, make sure to put on your sunscreen. Please ask your doctor if a vitamin D supplement is recommended.

Cerebral Palsy Nutrition: A Weight-Inclusive Approach

In our practice at Jackie Silver Nutrition, we follow a weight-inclusive approach, which means that we shift our focus away from numbers or the scale as indicators of health status and focus on the many other health indicators that are not about weight. Research shows that using just BMI or body weight is not a good marker of overall health status.

Body weight and BMI alone does not consider how much fat vs. muscle someone has, the distribution of fat (fat around organs, also called visceral fat, has the most risk), and metabolic health. 

We focus on building sustainable habits that last rather than the number on the scale or calorie counting. When you make these healthy lifestyle changes, it is possible that the weight will go down if that’s what your body needs and wants. If not, that’s okay — continue to focus on the positive results in other important areas of your life! For more on body positivity and body neutrality, check out this blog post 65 Body Image Affirmations for Self-Love!

Summary

In conclusion, try following some of these gentle nutrition tips to support good good cerebral palsy nutrition:

  1. Do whatever works for you and fits into your daily life to get enough food – whether that be eating on a set schedule or adding in more snacks.
  2. If you are having trouble getting enough calories to maintain a healthy weight, adjust your protein to 2g for every kg of body weight.
  3. Consider choosing foods that are healthy and easy to swallow, such as bananas, and adding sauces and other moist to dryer food.
  4. Increase your intake of foods with insoluble fibre, such as whole grains and vegetables
  5. Drink enough fluid to stay hydrated and help with constipation
  6. Choose foods that are high in calcium and vitamin D to help with keeping your bones strong, especially if you cannot walk.

Remember that these Cerebral Palsy nutrition tips are general recommendations. Always consult with a registered dietitian before making any significant dietary changes, especially if you have specific medical conditions or dietary needs.

Links to similar blog posts 

References:

A healthy diet – up – the adult Cerebral Palsy Movement. UP. (2023b, August 7). https://upmovement.org.uk/live-well/a-healthy-diet/#:~:text=You%20want%20to%20eat%20lots,fat%2C%20sugar%2C%20or%20salt 

Brown, M. C., Marciniak, C. M., Garrett, A. M., & Gaebler‐Spira, D. J. (2021). Diet quality in adults with cerebral palsy: a modifiable risk factor for cardiovascular disease prevention. Developmental Medicine & Child Neurology, 63(10), 1221-1228.

Cerebral palsy fact sheet. INDI. (n.d.). https://www.indi.ie/diseases,-allergies-and-medical-conditions/disability/389-cerebral-palsy-meeting-nutritional-needs.html 

Eating, drinking and swallowing – up – the adult Cerebral Palsy Movement. UP. (2023c, August 8). https://upmovement.org.uk/live-well/eating-drinking-and-swallowing/ 

Harvard T.H. Chan: School of Public Health. (October 27, 2022). BMI a poor metric for measuring people’s health. Say experts. News. https://www.hsph.harvard.edu/news/hsph-in-the-news/bmi-a-poor-metric-for-measuring-peoples-health-say-experts/ 

Kamal, S., Kamaralzaman, S., Sharma, S., Jaafar, N. H., Chern, P. M., Hassan, N. I., … & Hamzaid, N. H. (2022). A review of food texture modification among individuals with cerebral palsy: the challenges among cerebral palsy families. Nutrients, 14(24), 5241.

Kuperminc, M. N., Gottrand, F., Samson-Fang, L., Arvedson, J., Bell, K., Craig, G. M., & Sullivan, P. B. (2013). Nutritional management of children with cerebral palsy: a practical guide. European journal of clinical nutrition, 67(2), S21-S23.

McAllister, A., Sjöstrand, E., & Rodby‐Bousquet, E. (2022). Eating and drinking ability and nutritional status in adults with cerebral palsy. Developmental Medicine & Child Neurology, 64(8), 1017-1024.

Rempel, G. (2015). The importance of good nutrition in children with cerebral palsy. Physical Medicine and Rehabilitation Clinics, 26(1), 39-56.

Vitrikas, K., Dalton, H., & Breish, D. (2020). Cerebral palsy: an overview. American family physician, 101(4), 213-220.

Yemina Goldberg

Yemina is a student in the Nutrition and Food Sciences program at Toronto Metropolitan University, where she is also pursuing a minor in disability studies. Born with cerebral palsy, Yemina has a mission to improve the accessibility of nutrition for people with disabilities. In her spare time Yemina enjoys reading, movies, and singing.

About Jackie

Jackie is a Registered Dietitian whose mission is to empower and support the neurodivergent and physically disabled communities through nutrition. Jackie runs a virtual private practice and blog which has simple recipes and health information tailored to these communities. She loves cooking, exercising, traveling, journaling, and spending time with family and friends.

Check out her full bio here →

A headshot of Gabi Abreu

About Gabi

Gabi Abreu, BSc, is a Nutrition & Dietetics graduate from Toronto Metropolitan University and the Blog & Social Media Manager at Jackie Silver Nutrition. She is also the founder of the Working Woman’s Health Collection. WWHC was created with the purpose of inspiring women to achieve a healthy relationship with food, while taking into consideration the busy lifestyles that we live today. Beyond her professional pursuits, she loves experimenting with new recipes, trying new workout classes, and indulging her love for adventure through travel!

Leave a Comment

Your email address will not be published. Required fields are marked *