title: Effects of nutritional intake on disease severity in children with sickle cell disease.
abstract: Children with Sickle Cell Disease (SCD) may show growth failure in comparison to healthy peers. Many factors as hematological status, endocrine and/or metabolic dysfunction, and nutritional status, may play an important role in growth failure. The aim of this study was to assess whether impaired growth and nutritional intake can affect SCD severity during childhood.
  
  
  
  We conducted an observational study on children with SCD referring to our clinic for routine follow-up visits in a 6-month period. We collected information on weight, height and body mass index (BMI) and calculated their respective standardized scores (z). The nutritional intake was assessed through the last 24-h recall intake of total calories, macro- (proteins, lipids, carbohydrates) and micronutrients (calcium, iron, phosphorus, vitamins B1, PP, A, C, B2). Disease severity was assessed through total hemoglobin (Hb) and fetal hemoglobin (HbF), and lactic dehydrogenase (LDH) levels, and through the total number and days of hospitalizations, as well as the lifetime episodes of acute chest syndrome (ACS).
  
  
  
  Twenty nine children (14 males, 15 females) with SCD were enrolled; their mean age was 9.95 years (SD 3.50, min 3.72, max 17.18). Z-weight and z-BMI were significantly directly related to total Hb. Food intake resulted significantly unbalanced in terms of total calorie intake, macro- and micronutrients, especially calcium, iron, vitamin B1 and C. Low intake of calcium and vitamin B1 were significantly inversely correlated with number and days of hospitalizations per year. Protein, lipid, phosphorus, and vitamin PP intakes resulted adequate but were inversely correlated with number and days of hospitalizations. Carbohydrate, lipid, iron, phosphorus, vitamins B1 and B2 intakes were significantly inversely correlated to HbF levels.
  
  
  
  This study showed that, in our population, inadequate nutritional intake, weight and BMI have a significant impact on SCD severity indices.
authors.affiliation: School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, 41124, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Mandese
authors.affiliation: School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, 41124, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Marotti
authors.affiliation: School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, 41124, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Bedetti
authors.affiliation: Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, 41124, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Bigi
authors.affiliation: Oncology and Hematology Pediatric Unit, Department for Maternal and Child Integrated Activities, University Hospital of Modena, Modena, 41124, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Palazzi
authors.affiliation: School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, 41124, Italy. iughetti.lorenzo@unimore.it.|Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena, and Reggio Emilia, Via del Pozzo 71, Modena, 41124, Italy. iughetti.lorenzo@unimore.it.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Iughetti
mesh_terms: D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000503:physiopathology*; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D004032:Diet; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008297:Male; D011939:Mental Recall; D018977:Micronutrients / Q000008:administration & dosage; D009752:Nutritional Status
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins; D006454:Hemoglobins; D018977:Micronutrients
keywords: Diet; Disease severity; Macronutrient; Micronutrient; Nutritional intake; Sickle cell disease