The Indian Journal of Pediatrics

, Volume 85, Issue 1, pp 15–19 | Cite as

Subjective Global Nutritional Assessment: A Reliable Screening Tool for Nutritional Assessment in Cerebral Palsy Children

  • Priyanka Minocha
  • Sadasivan Sitaraman
  • Anita Choudhary
  • Rajiv Yadav
Original Article



To determine the prevalence of undernutrition in children with cerebral palsy and to compare subjective and objective methods of nutritional assessment.


This was a hospital based analytical observational study in which 180 children of cerebral palsy, aged 1–12 y, attending tertiary level hospital, Jaipur from March, 2012 through March, 2013 were included. Subjective assessment was done by questionnaire (Subjective Global Nutritional Assessment; SGNA) in which questions related to nutrition history and physical examination, signs of fat, muscle wasting and edema was done while objective assessment was done by weight, height and triceps skinfold thickness (TSFT) measurements.


In this study prevalence of undernutrition by subjective method (SGNA) was 76.67% while by objective measurement (weight, height, TSFT) was 48.89%, 77.78% 35.18% respectively. There was fair to moderate agreement between the SGNA and objective assessments including weight and height (k = 0.341, p = 0.000; k = 0.337, p = 0.000 respectively) while for TSFT agreement between both methods was poor (k = 0.092, p = 0.190). In the index study, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of SGNA was for weight was 95%, 37%, 56%, 90%; for height 84%, 50%, 85%, 47%; for TSFT 81%, 30%, 38%, 75% respectively.


The prevalence of undernutrition is high in cerebral palsy children. SGNA can be a reliable tool for assessing nutritional status in children with cerebral palsy and is a simple, comprehensive, noninvasive, and cost-effective tool for screening undernutrition in children of cerebral palsy.


Cerebral palsy Malnutrition Nutritional assessment Objective assessment Subjective global nutrition assessment 



Cerebral palsy


Negative predictive value


Positive predictive value


Subjective global nutrition assessment


Triceps skinfold thickness



PM and AC wrote the manuscript. SS is consultant of incharge and will act as guarantor for this paper. RY interpreted the results. All authors critically reviewed the manuscript.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding


Supplementary material

12098_2017_2501_MOESM1_ESM.docx (682 kb)
ESM 1 (DOCX 682 kb)


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Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  • Priyanka Minocha
    • 1
  • Sadasivan Sitaraman
    • 1
  • Anita Choudhary
    • 1
  • Rajiv Yadav
    • 2
  1. 1.Department of PediatricsSMS Medical College and HospitalJaipurIndia
  2. 2.Department of Preventive and Social MedicineSMS Medical College and HospitalJaipurIndia

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