Nutritional support and growth in thalassaemia major

Abstract

Twelve thalassaemic children under 3 years of age received intensive nutritional support for one month and were discharged on a prescribed diet of locally available foods. Anthropometry, bioelectrical impedance analysis and dietary intake were longitudinally assessed. Mean energy intake was 20% greater than the recommended daily allowance during nutritional supplementation as compared with below the recommended daily allowance before and after the period of nutritional support. Weight, but not height, significantly increased during the support period and was due to increases in both fat free mass and fat mass. Body weight, fat free mass and fat mass declined in line with the reduced intake upon return home; however, height velocity accelerated and exceeded normal through the fourth month before resuming a below normal rate. It can be concluded that (1) nutritional stunting as the result of reduced nutrient intake is an important cause of growth failure in young children with thalassaemia and is responsive to nutritional support, (2) the deficit in height velocity was due to retarded truncal height growth, and (3) the bioelectrical impedance analysis method is suitable for body composition analysis of thalassaemic children. (Arch Dis Child 1997;76:509-512)

Guidelines for the Standard Monitoring of Patients With Thalassemia

“…Many early reports and interventional studies conducted outside the United States have shown that nutritional inadequacy may contribute to growth failure in some patients [35, 36]. In a recent TCRN study, 12% of pediatric, non-chronically transfused patients were underweight for height [37].…”

Relationship between Chronic Transfusion Therapy and Body Composition in Subjects with Thalassemia

“…Fuchs et al provided intensive nutrition support for one month in 12 young children (1 to 3 years) with Thal from Thailand and observed improvements in weight, height and body fat, which declined when nutrition support was removed [11,20]. Another group provided a high calorie diet to 15 children with Thal major from Egypt for 8 weeks [12].…”

Body Composition in Adult Patients with Thalassemia Major

“…The major side effect of multiple transfusions is iron overload leading to secondary hemochromatosis that affects multiple organs such as heart, liver, and endocrine glands and is responsible for deficits in bone mineral acquisition [3–8]. Various studies have shown that children with thalassemia major suffer from growth retardation, impaired immune function, and low body mass index [8–10]. The above treatment-related complications disrupt the balance between osteoblasts and osteoclasts by interfering with various molecular mechanisms leading to osteoporosis and increased fracture risk during adulthood [11, 12].…”