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Arch Dis Child 1997;76:509-512 ( June )

Nutritional support and growth in thalassaemia major

G J Fuchs,a b c P Tienboon,a M A Khaled,c d S Nimsakul,a S Linpisarn,a A S G Faruque,c Y Yutrabootr,a M Dewier,a R M Suskindb

a Research Institute for Health Sciences, Chiang Mai University, Thailand, b Department of Pediatrics, Louisiana State University School of Medicine, New Orleans, USA, c International Centre for Diarrhoeal Disease Research, Bangladesh, d University of Alabama in Birmingham, USA

Correspondence to: Dr G J Fuchs, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box 128, Dhaka 1000, Bangladesh.

Accepted 30 January 1997

Twelve thalassaemic children under 3 years of age received intensive nutritional support for one month and were discharged on a prescribed diet of locally available foods. Anthropometry, bioelectrical impedance analysis and dietary intake were longitudinally assessed. Mean energy intake was 20% greater than the recommended daily allowance during nutritional supplementation as compared with below the recommended daily allowance before and after the period of nutritional support. Weight, but not height, significantly increased during the support period and was due to increases in both fat free mass and fat mass. Body weight, fat free mass and fat mass declined in line with the reduced intake upon return home; however, height velocity accelerated and exceeded normal through the fourth month before resuming a below normal rate. It can be concluded that (1) nutritional stunting as the result of reduced nutrient intake is an important cause of growth failure in young children with thalassaemia and is responsive to nutritional support, (2) the deficit in height velocity was due to retarded truncal height growth, and (3) the bioelectrical impedance analysis method is suitable for body composition analysis of thalassaemic children.

Keywords: thalassaemia; malnutrition; bioimpedance; anthropometry


© 1997 by Archives of Disease in Childhood






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