The effect of high-calorie diet on nutritional parameters of children with β-thalassaemia major

Background: Impaired growth accompanying thalassaemia major poses diagnostic and therapeutic problems. Aim: To test the hypothesis that impaired growth of children with thalassaemia major might be corrected, partially or totally, by increasing their caloric intake. Patients and methods: In a prospective controlled study, thirty selected children with thalassaemia major and 30 normal age and sex-matched controls were recruited. The dietary intake of both groups was evaluated. Nutritional status was assessed by measuring the weight, body mass index (BMI), mid-arm circumference (MAC), triceps skin fold thickness (SFT) and serum albumin and insulin-like growth factor-I (IGF-I) concentrations. The thalassaemic group was then, randomly divided into two equal groups. One group was given 8 weeks of high-caloric diet (130–150% of the caloric recommendation for age and sex) and the other was given the normal caloric requirement. Results: Initially the BMI, triceps SFT and MAC of children with thalassaemia were significantly decreased compared to those for the normal control group. IGF-I and albumin concentrations of thalassemic children before nutritional supplementation (69±20.5 ng/m and 3.65±0.67 g/dl, respectively) were significantly lower than those for normal age and sex-matched children (162.5±24 ng/ml and 4.29±0.66 g/dl, respectively). After nutritional supplementation for 8 weeks the MAC, SFT and BMI, IGF-I (88.4±27.3 ng/ml) and albumin concentrations (3.85±0.85 g/dl) increased significantly (P<0.05) in the thalassaemic children given the supplementation compared to those without supplementation, however, they were still lower than normal children. Conclusions: Increased caloric dietary intake increased significantly IGF-I levels in thalassaemic children. This was accompanied with increased BMI, mid-arm circumference and skin fold thickness. Growth impairment of children with thalassaemia major, without endocrinopathy and/or cardiomyopathy, can be partially corrected by increasing caloric intake