title: Energy expenditure and intake in children with sickle cell disease during acute illness.
abstract: BACKGROUND
  Children with sickle cell disease have frequent bouts of pain and infection which may increase energy expenditure, decrease energy intake and lead to a subsequent energy deficit.
  
  
  METHODS
  Two groups of African-American children with sickle cell disease-SS genotype were enrolled in this study upon hospital admission for a sickle cell disease related illness: a younger (<6 years, n=14, 7 M) and older group (> or =6 years, n=17, 8 M). Body composition and dietary intake were assessed, and sleeping (younger) or resting energy expenditure (older) were measured by indirect calorimetry at admission and one month later at steady state.
  
  
  RESULTS
  Energy expenditure was not different between the two timepoints for younger children, but was slightly elevated at steady state (+50 kcal/d, P=0.049) in the older group. After controlling for gender, changes in fat-free mass and dietary intake, the significance disappeared. Energy intake in both groups was significantly depressed at admission compared to follow-up (P<0.01).
  
  
  CONCLUSIONS
  These children and adolescents did not expend excess energy during their acute illness, however, an energy deficit was observed secondary to poor energy intake. Since 20% of patients with sickle cell disease have multiple hospitalizations per year, these results provide justification for the development and evaluation of nutrition care protocols to maintain adequate caloric intake during hospitalization and recovery.
authors.affiliation: Department of Pediatrics, University of Pennsylvania School of Medicine and Divisions of Gastroenterology & Nutrition and Hematology, Children's Hospital of Philadelphia, PA 19104, USA.
authors.forename: E B
authors.initials: EB
authors.lastname: Fung
authors.forename: B M
authors.initials: BM
authors.lastname: Malinauskas
authors.forename: D A
authors.initials: DA
authors.lastname: Kawchak
authors.forename: B Y
authors.initials: BY
authors.lastname: Koh
authors.forename: B S
authors.initials: BS
authors.lastname: Zemel
authors.forename: S S
authors.initials: SS
authors.lastname: Gropper
authors.forename: K
authors.initials: K
authors.lastname: Ohene-Frempong
authors.forename: V A
authors.initials: VA
authors.lastname: Stallings
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D000328:Adult; D000755:Anemia, Sickle Cell / Q000178:diet therapy / Q000378:metabolism*; D001481:Basal Metabolism; D044383:Black People; D001823:Body Composition; D002153:Calorimetry, Indirect; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004435:Eating; D002149:Energy Intake; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D005838:Genotype; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008297:Male; D009752:Nutritional Status; D001741:Black or African American