Children With Sickle Cell Disease May Benefit from Improved Nutrition Practices

Abstract

LEARNING OUTCOME: To examine nutrition related factors that may contribute to poor growth in children with sickle cell disease.Children with sickle cell disease (SCD) have decreased height and weight when compared to their peers. Although exact reasons for poor growth have not been established, increased calorie and protein needs, and deficiencies in zinc, folic acid, and vitamins A, C, and E may be factors. To determine if inadequate nutrient intake contributes to this poor growth, we conducted a survey of SCD families’ nutrition knowledge and practices, and identified obstacles to obtaining adequate food. Sixty-one patients (median age 8 years, range 13 months- 17 years) from the Mid-South Sickle Cell Center and their caregivers participated in the study. During a patient's routine clinic visit, height and weight were measured and a 20 minute survey was administered. Thirteen percent of patients were below the 5th percentile for height, and 16% were below the 5th percentile for weight. Ninety percent were familiar with the food groups and could list most of them, but most patients failed to consume appropriate amounts from the groups. Although 2/3 of the patients ate the recommended number of servings daily from the meat group, only 20-31 % of the recommended servings from each of the other food groups were consumed. Patients ate an average of 2.6 servings of non-nutritive extra foods per day. Poor nutrient intake may be related to low socioeconomic status. The survey revealed that 59% had incomes below the poverty level and 79% participated in a food assistance program.We conclude that the nutrient intake of patients with SCD is often inadequate, and that this may contribute to poor growth in this population. Nutrition education for SCD patients should focus on specific nutrient needs with proper distribution of dietary intake among the food groups and ways to provide nutritious meals on a limited income.