NUTRITION IN SICKLE CELL DISEASE

目前在CHOP对镰状细胞病儿童的营养研究 显示出生长不良和营养状况不佳的模式。慢性能量 缺陷是观察到的生长失败的可能原因。研究 静息能量消耗表明能量需求增加 与未受影响的对照组相比，SCD儿童中为15-20%。此外，本发明还提供了一种方法， 在儿童中记录的急性疾病期间的低能量摄入 0至5岁，导致能量缺乏。其他摄入量 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 以确定营养补充和教育是否 干预改善儿童的生长、骨密度和饮食摄入 关于SCD第一个项目是锌的双盲随机试验 补充，以确定是否改善生长和身体 组成（肌肉，脂肪和骨骼的量）发生在十二个月内 口服锌补充剂治疗青春期前SCD儿童 与接受安慰剂的SCD儿童组相比。第二 一个双盲随机的补钙项目， 一项确定钙摄入量增加是否与骨密度有关的试验 与对照组SCD儿童相比， 服用安慰剂。第三项研究是开发和测试一种 营养教育干预计划。基于我们的量化 SCD儿童的饮食摄入和饮食问题数据，以及 教育和行为矫正计划将使用 书面和录像材料和教学会议与研究 营养师多元文化（非裔美国人、加勒比海人、西非人） 人口的各个方面将被考虑在发展和提出 材料。该计划的目标将是增加热量摄入 和体重增加的影响。一 接受常规护理的对照组将被评估用于比较 目的这三个项目将首次确定 营养干预是否能改善生长、营养状况和 镰状细胞病儿童的饮食摄入量。

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.