ResearchResearch and Professional BriefAdequacy of Dietary Intake Declines with Age in Children with Sickle Cell Disease
Section snippets
Methods
A sample of children with SCD-SS, aged 1 to 18 years from the Sickle Cell Center at The Children’s Hospital of Philadelphia, Philadelphia, PA, were enrolled in a prospective cohort study, and four annual assessments (year 1, 2, 3, and 4) of dietary intake and growth were performed. All patients who met the inclusion criteria and came to the clinic were invited to participate in the study. SCD-SS genotype was determined by standard methods. Exclusion criteria for enrollment included other
Results and Discussion
This is the first report of longitudinal nutrient intake patterns in a large contemporary sample of US children and adolescents with SCD-SS. Ninety-seven children (53 female), aged 1.5 to 18.7 years (mean age 8.7±4.7 years) completed year 1 dietary and growth evaluations. During the following 3 years, five subjects started chronic transfusion therapy due to stroke or risk of stroke, and 13 subjects were prescribed hydroxyurea medication and were included in the analysis as planned. By the final
Conclusions
Energy intake of children with SCD-SS was suboptimal, particularly for children 4 years of age and older. Nutrients of most concern were vitamins D and E, folate, calcium, magnesium, zinc, and fiber. The decline in the quality of the diet with age and over time likely contributes to their poor growth status particularly striking by adolescence.
Further attention should be given to maintaining appropriate energy intake and micronutrient adequacy in persons with SCD-SS. The dropoff in
D. A. Kawchak is a sickle cell research coordinator, J. I. Schall is associate director, Nutrition and Growth Laboratory, B. S. Zemel is director, Nutrition and Growth Laboratory, and V. A. Stallings is director, Nutrition Research Center, The Children⁎s Hospital of Philadelphia, Division of Gastroenterology, Hepatology, and Nutrition, Philadelphia, PA.
References (35)
- et al.
Total and resting energy expenditure in children with sickle cell disease
J Pediatr
(2000) - et al.
Some statistical methods for multiple endpoints in clinical trials
Control Clin Trials
(1997) - et al.
Is there an energy deficiency in homozygous sickle cell disease?
Am J Clin Nutr
(1997) - et al.
Low vitamin D status in children with sickle cell disease
J Pediatr
(2004) - et al.
Effect of zinc supplementation on growth and body composition in children with sickle cell disease
Am J Clin Nutr
(2002) - et al.
Sickle Cell Disease
(2001) - et al.
Distribution of hemoglobinopathy variants by ethnicity in a multiethnic state
Genet Epidemol
(1996) - et al.
Alterations in basal nutrient metabolism increase resting energy expenditure in sickle cell disease
Am J Physiol
(1998) - et al.
Nutritional factors and growth in children with sickle cell disease
Am J Dis Child
(1988) - et al.
Nutritional status and dietary intake of children with sickle cell anemia
Am J Pediatr Hematol Oncol
(1992)
Influence of sickle hemoglobinopathies on growth and development
N Eng J Med
Nutrition and sickle cell disease
Am J Hematol
Delayed adolescent growth in homozygous sickle cell disease
Arch Dis Child
A trial of folate supplementation in children with homozygous sickle cell disease
Br J Haematol
Selected indices of micronutrient status in adult patients with sickle cell anemia (SCA)
Am J Hematol
Zinc status of children with sickle cell disease: Relationship to poor growth
Am J Hematol
Cited by (48)
Bloodless management of significantly elevated transcranial Doppler velocity value in a Jehovah's witness child with sickle cell disease: A tertiary centre experience-A case report
2024, Journal of the National Medical AssociationFunctional foods: promising therapeutics for Nigerian Children with sickle cell diseases
2022, HeliyonCitation Excerpt :Its combination with anti-SCD therapeutic drugs has been reported to reduce the incidence and severity of sickle cell crisis [93]. In the findings of Kawchak and colleagues [94], functional foods containing vitamins E and C have the propensity to improve the health conditions of SCD children. The effects of these vitamins have been shown to decrease arterial blood pressure, mean corpuscular hemoglobin levels, and irreversible sicklde cells [2].
Impact of omega-3 fatty acids supplementation in children with sickle cell disease in Saudi Arabia
2022, Journal of King Saud University - ScienceCitation Excerpt :Therefore, safe alternatives apart from HU need to be researched, to alleviate the painful episodes and relieve the suffering of patients with SCD (Cannas et al., 2017). One of the factors impacting SCD is malnutrition, and the obvious need to correct the situation through wholesome nutrition is implied (Kawchak et al., 2007; Khan et al., 2016; Kirkham and DeBaun, 2004). The composition of phospholipids in the membranes of sickle cell erythrocytes exhibit irregularity, with replacement by saturated and certain unsaturated fatty acids.
Vitamin D Deficiency in Adult Sickle Cell Patients
2017, Journal of the National Medical AssociationCitation Excerpt :Concurrently, a large discrepancy in Vitamin D intake exists between white and black Americans, with blacks having lower intake, and is a difference that widens with age as intake by blacks declines further.6,34,35 Kawchak et al (2008) showed a decline in adequacy of Vitamin D intake associated with age in children with sickle cell disease.53 Winters et al (2014) confirmed a significant negative correlation between Vitamin D25(OH)D levels and age in a black American population of pediatric and adult SCD patients.18
Vitamin D in children and adolescents with sickle cell disease: An integrative review
2015, Revista Paulista de Pediatria
D. A. Kawchak is a sickle cell research coordinator, J. I. Schall is associate director, Nutrition and Growth Laboratory, B. S. Zemel is director, Nutrition and Growth Laboratory, and V. A. Stallings is director, Nutrition Research Center, The Children⁎s Hospital of Philadelphia, Division of Gastroenterology, Hepatology, and Nutrition, Philadelphia, PA.
K. Ohene-Frempong is director, Comprehensive Sickle Cell Center, The Children⁎s Hospital of Philadelphia, Hematology Division, Philadelphia, PA.