The effect of high-calorie diet on nutritional parameters of children with beta-thalassaemia major.
BACKGROUND
Impaired growth accompanying thalassaemia major poses diagnostic and therapeutic problems.


OBJECTIVE
To test the hypothesis that impaired growth of children with thalassaemia major might be corrected, partially or totally, by increasing their caloric intake.


METHODS
In a prospective controlled study, thirty selected children with thalassaemia major and 30 normal age and sex-matched controls were recruited. The dietary intake of both groups was evaluated. Nutritional status was assessed by measuring the weight, body mass index (BMI), mid-arm circumference (MAC), triceps skin fold thickness (SFT) and serum albumin and insulin-like growth factor-I (IGF-I) concentrations. The thalassaemic group was then, randomly divided into two equal groups. One group was given 8 weeks of high-caloric diet (130-150% of the caloric recommendation for age and sex) and the other was given the normal caloric requirement.


RESULTS
Initially the BMI, triceps SFT and MAC of children with thalassaemia were significantly decreased compared to those for the normal control group. IGF-I and albumin concentrations of thalassemic children before nutritional supplementation (69 +/- 20.5 ng/m and 3.65 +/- 0.67 g/dl, respectively) were significantly lower than those for normal age and sex-matched children (162.5 +/- 24 ng/ml and 4.29 +/- 0.66 g/dl, respectively). After nutritional supplementation for 8 weeks the MAC, SFT and BMI, IGF-I (88.4 +/- 27.3 ng/ml) and albumin concentrations (3.85 +/- 0.85 g/dl) increased significantly (P < 0.05) in the thalassaemic children given the supplementation compared to those without supplementation, however, they were still lower than normal children.


CONCLUSIONS
Increased caloric dietary intake increased significantly IGF-I levels in thalassaemic children. This was accompanied with increased BMI, mid-arm circumference and skin fold thickness. Growth impairment of children with thalassaemia major, without endocrinopathy and/or cardiomyopathy, can be partially corrected by increasing caloric intake.
Soliman
Ashraf T
AT
The Department of Pediatrics, University of Alexandria, Egypt. atsoliman@yahoo.com
El-Matary
Wael
W
Fattah
Mohamed M Abdel
MM
Nasr
Ibrahim S
IS
El Alaily
Rania K
RK
Thabet
M Alaa
MA
D000886:Anthropometry; D015992:Body Mass Index; D002648:Child; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006128:Growth; D006130:Growth Disorders / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D009751:Nutritional Requirements; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome; D017086:beta-Thalassemia / Q000503:physiopathology*
D012709:Serum Albumin; D007334:Insulin-Like Growth Factor I