title: Interdisciplinary approach improves nutritional status of children with heart diseases.
abstract: OBJECTIVE
  We evaluated the role of an interdisciplinary team in improving the nutrient intake and nutritional status of children with heart diseases.
  
  
  METHODS
  Thirty-five children 10.0 +/- 7.5 mo old were studied over a 6-mo period with regard to anthropometric measurements and dietary intake.
  
  
  RESULTS
  On admission, malnutrition prevalence was 57% and vitamin and mineral intakes were below estimated average requirement levels (dietary reference intakes) in the majority of patients. Stunting and wasting were more frequent among patients with pulmonary hypertension and/or uncompensated congestive heart failure. Follow-up analyses showed increased Z scores of weight for height (-1.17 +/- 1.03 versus -0.32 +/- 1.08, P < 0.01) and height for age (-1.09 +/- 0.96 versus -0.51 +/- 1.36, P < 0.01). In patients with pulmonary hypertension or uncompensated congestive heart failure, the height-for-age index remained unchanged. Energy intake did not differ (112.0 +/- 20.4 and 119.0 +/- 18.0 kcal.kg(-1).d(-1)) and significant increases were seen in intakes of micronutrients and minerals over the study period.
  
  
  CONCLUSIONS
  Intervention by an interdisciplinary team improved the nutrient intake and nutritional status of patients overall but was insufficient to improve growth in the subgroup with pulmonary hypertension or uncompensated congestive heart failure. Nutritional support should be made routine in the treatment of children with heart disease.
authors.affiliation: Department of Pediatrics, Discipline of Nutrition, Federal University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil.
authors.forename: Silvana G
authors.initials: SG
authors.lastname: Benzecry
authors.forename: Heitor P
authors.initials: HP
authors.lastname: Leite
authors.forename: Fernanda C
authors.initials: FC
authors.lastname: Oliveira
authors.forename: Juliana F
authors.initials: JF
authors.lastname: Santana E Meneses
authors.forename: Werther B
authors.initials: WB
authors.lastname: de Carvalho
authors.forename: Celia M
authors.initials: CM
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D002648:Child; D015362:Child Nutrition Disorders / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006128:Growth; D006331:Heart Diseases / Q000150:complications* / Q000628:therapy; D006333:Heart Failure / Q000150:complications / Q000628:therapy; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000628:therapy; D007223:Infant; D007228:Infant Nutrition Disorders / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D008297:Male; D008903:Minerals / Q000008:administration & dosage; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D018529:Nutritional Support; D010348:Patient Care Team; D011446:Prospective Studies; D014815:Vitamins / Q000008:administration & dosage
chemical_list: D008903:Minerals; D014815:Vitamins