NUTRITION IN SICKLE CELL DISEASE

CHOP儿童镰状细胞病的营养研究现状 揭示了一种生长和营养状况不佳的模式。慢性能源 缺陷可能是观察到的生长失败的一个原因。的研究 静息能量消耗表明能量需求增加 患有SCD的儿童与未受影响的对照组相比，有15-20%的比例。此外, 急性疾病期间能量摄入量低，记录在儿童 0~5岁，易造成能量缺乏。吸纳其他 营养素，特别是锌和钙，可能不足以满足 SCD儿童的特殊情况。拟议的研究包括三个项目 以确定营养补充剂和教育 干预改善儿童生长发育、骨密度和膳食摄入量 使用SCD。第一个项目是锌的双盲随机试验 补充以确定是否对生长和身体的改善 组成(肌肉、脂肪和骨骼的数量)在12个月内发生 口服锌补充剂对青春期前SCD儿童的影响 与接受安慰剂治疗的一组SCD儿童相比。第二 项目涉及补钙的双盲随机对照研究 确定钙摄入量增加是否与骨密度有关的试验 SCD儿童与对照组SCD儿童的比较 接受安慰剂治疗。第三项研究是一个开发和测试 营养教育干预计划。建立在我们的量化基础上 关于SCD儿童的饮食摄入和饮食问题的数据，以及 教育和行为改正计划将开发使用 书面和录像材料和教学会议与一项研究 营养师。多元文化(非裔美国人、加勒比人、西非人) 在制定和提交报告时，将考虑人口的各个方面 材料。该计划的目标将是增加卡路里的摄入量 并在参与干预计划的小组中增加体重。一个 对接受常规护理的对照组进行评估，以进行比较 目的。这三个项目将是第一个确定 营养干预是否改善生长、营养状况和 镰状细胞病儿童的膳食摄入量。

Current nutrition studies of children with sickle cell disease at CHOP reveal a pattern of poor growth and nutritional status. Chronic energy deficiency is a likely cause of the observed growth failure. Studies of resting energy expenditure indicate that energy requirements are increased 15-20% in children with SCD compared to unaffected controls. In addition, low energy intake during periods of acute illness, documented in children 0 to 5 years of age, contribute to energy deficiency. Intakes of other nutrients, particularly zinc and calcium, may not be adequate to meet the special of children of SCD. The proposed study consists of three projects to determine whether nutritional supplementation and educational intervention improves growth, bone density and dietary intake in children with SCD. The first project is a double blind randomized trial of zinc supplementation to determine whether improvements in growth and body composition (amount of muscle, fat and bone) occur in a twelve month period in pre-pubertal children with SCD given oral zinc supplements compared to a group of children with SCD receiving a placebo. The second project involves calcium supplementation in a double blind randomized trial to determine whether increased calcium intake involves bone density in children with SCD compared to a control group of children with SCD receiving a placebo. The third study is a program to develop and test a nutrition educational intervention program. Building on our quantitative data on dietary intake and eating problems in children with SCD, and educational and behavioral modification program will be developed using written and videotaped materials and teaching sessions with a research dietician. The multi-cultural (African-American, Caribbean, west African) aspects of the population will be considered in developing and presenting the material. The goal of the program will be to increase caloric intake and weight gain in the group participating in the intervention program. A control group receiving usual care will be assessed for comparative purposes. These three projects will be first of their kind in determining whether nutrition intervention improves growth, nutritional status and dietary intake in children with sickle cell disease.