Assessment of the Nutritional Status, Bone Mineralization, and Anthropometrics of Children with Thalassemia Major

Abstract During the rehabilitation phase of burn injury, patient care transitions from critical care medicine to restorative treatment strategies that encompass physical and occupational therapies, nutrition repletion, and psychosocial support for community reintegration. As pediatric burn patients undergo rehabilitation, nutrition assessment remains ongoing to define nutritional status and any alterations in metabolism that may take place. For some, a persistent hypermetabolic state appears evident, and weight loss may continue. The severity and duration however varies among patients. Many patients enter their rehabilitative phase with visible lean body mass depletion, and the focus of nutritional therapy for them shifts to replenishing nutritional status, while supporting rehabilitative efforts. Over the past decade, we have conducted studies on energy and protein metabolism, body composition, including bone mineralization, and general wellness in over 130 patients to better understand changes in metabolism and nutritional status during the rehabilitative phase of recovery. This abstract summarizes our findings.

Download Full-text

Osteoporosis in childhood: related factors and prevention

Colombia Medica ◽

10.25100/cm.v42i1.758 ◽

2011 ◽

pp. 111-116

Author(s):

Emilio González-Jiménez ◽

Judit Álvarez-Ferre

Keyword(s):

Vitamin D ◽

Nutritional Status ◽

Bone Mass ◽

Physical Inactivity ◽

Bone Mineralization ◽

Related Factors ◽

Nutritional Factors ◽

Factors Associated ◽

Mechanical Factors ◽

Main Factors

Osteoporosis is defined as a reduction in bone mass. This loss is more important in states of malnutrition, physical inactivity, and with a poor dietary intake of vitamin D and calcium. Bone mineralization depends on both genetic and nutritional factors, as well as endocrine, metabolic, and mechanical factors. Several studies in children have shown that the development of osteoporosis in adulthood may be influenced by the nutritional status during childhood, especially with regard to the contributions of calcium and vitamin D. However, currently there are many questions regarding its pathogenesis and diagnosis and its treatment, some of which are reviewed in this paper. The aim of this work has been to provide an update on the main factors associated with the development of osteoporosis and its prevention in infancy.

Download Full-text

Bony density in adolescents after surgical repair of tetralogy of Fallot: a comparative study with healthy adolescents

Cardiology in the Young ◽

10.1017/s1047951102000963 ◽

2002 ◽

Vol 12 (6) ◽

pp. 531-536 ◽

Cited By ~ 5

Author(s):

Carla Rego ◽

António Guerra ◽

Micaela Guardiano ◽

Patricia Esteves ◽

Jorge Pereira ◽

...

Keyword(s):

Body Composition ◽

Bone Density ◽

Nutritional Status ◽

Tetralogy Of Fallot ◽

Sexual Maturity ◽

Surgical Repair ◽

Bone Mineralization ◽

Fetal Life ◽

Mineral Density ◽

Repaired Tetralogy Of Fallot

Background: Adverse influences arising in fetal life or immediately after birth have a permanent effect on body structure, physiology and metabolism. Evidence is now accumulating that programming of bone growth might be an important contributor to the later risk of osteoporosis. Long-term morbidity and mortality associated with tetralogy of Fallot is not completely known. The aim of the present study was to evaluate the state of the bones in adolescents after surgical repair of tetralogy of Fallot, so as to ascertain any possible repercussions of the disease on bone mineralization. Material and methods: We studied 34 adolescents with repaired tetralogy of Fallot, between the ages of 11 and 18 years, to establish their nutritional status, in terms of height, weight, and skinfolds, their body composition using an anthropometric method, their sexual maturity according to Tanner, and their food-habits as based on 24-hour recall. Bone density was evaluated by lumbar dual-energy X-ray absorptiometry. We included 34 healthy eutrophic adolescents, matched for gender and age, as controls. Results: No significant differences were observed between the patients and their controls concerning nutritional status, body composition, total energy intake and nutritional supply in macronutrients, calcium, phosphorus, magnesium and vitamin D. Bone mineral density, expressed in Z-score and g/cm2, was significantly higher in patients with tetralogy of Fallot (p < 0.01). The age at the time of the first surgical procedure, or at complete surgical repair, and the total number of surgical procedures, had no significant influence on nutritional status or bone mineralization. Gender, chronological age, sexual maturity and the index of body mass are the major determinants of bone density for both samples. Obese adolescents with repaired tetralogy of Fallot had a significantly higher bone density (p < 0.05) compared to undernourished or euthrophic patients. Conclusions: Being born with tetralogy of Fallot has no significant repercussion, by the stage of adolescence, on nutritional status, pubertal progression, and accretion of bone minerals subsequent to surgical repair. Nutritional status is the major influence on the accretion of bone mass.

Download Full-text

The Impact of Vitamin K2 (Menaquionones) in Children’s Health and Diseases: A Review of the Literature

Children ◽

10.3390/children9010078 ◽

2022 ◽

Vol 9 (1) ◽

pp. 78

Author(s):

Agnieszka Kozioł-Kozakowska ◽

Katarzyna Maresz

Keyword(s):

Vitamin K ◽

Bone Mineralization ◽

Thalassemia Major ◽

Developed Countries ◽

Vitamin K2 ◽

Bowel Diseases ◽

Joint Health ◽

History Of ◽

Effective Use ◽

The Impact

Vitamin K2 activates vitamin K-dependent proteins that support many biological functions, such as bone mineralization, the inhibition of vascular stiffness, the improvement of endothelial function, the maintenance of strong teeth, brain development, joint health, and optimal body weight. Due to the transformation of food habits in developed countries over the last five decades, vitamin K and, specifically, vitamin K2 intakes among parents and their offspring have decreased significantly, resulting in serious health implications. The therapeutics used in pediatric practice (antibiotics and glucocorticoids) are also to blame for this situation. Low vitamin K status is much more frequent in newborns, due to both endogenous and exogenous insufficiencies. Just after birth vitamin K stores are low, and since human milk is relatively poor in this nutrient, breast-fed infants are at particular risk of a bleeding disorder called vitamin K deficiency bleeding. A pilot study showed that better vitamin K status is associated with lower rate of low-energy fracture incidence. An ongoing clinical trial is intended to address whether vitamin K2 and D3 supplementation might positively impact the biological process of bone healing. Vitamin K2 as menaquinone-7 (MK-7) has a documented history of safe and effective use. The lack of adverse effects of MK-7 makes it the ideal choice for supplementation by pregnant and nursing women and children, both healthy and suffering from various malabsorptions and health disorders, such as dyslipidemia, diabetes, thalassemia major (TM), cystic fibrosis (CF), inflammatory bowel diseases (IBD), and chronic liver diseases. Additionally, worthy of consideration is the use of vitamin K2 in obesity-related health outcomes.

Download Full-text

Nutritional status of thalassemia major children and its impact of on their growth

International Journal of Academic Research ◽

10.7813/2075-4124.2014/6-1/a.22 ◽

2014 ◽

Vol 6 (1) ◽

pp. 166-177

Author(s):

Salwa M. Saleh ◽

Hoda A. Abdel Salam

Keyword(s):

Nutritional Status ◽

Thalassemia Major

Download Full-text

Biochemical indices and radiological examination to evaluate bone health in children with β-thalassemia major

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20190071 ◽

2019 ◽

Vol 6 (2) ◽

pp. 549

Author(s):

Madhu P. K. ◽

Bhagwan B.

Keyword(s):

Vitamin D ◽

Alkaline Phosphatase ◽

Bone Disease ◽

Bone Health ◽

Bone Mineralization ◽

Thalassemia Major ◽

Vitamin D Levels ◽

Significant Difference ◽

The Status ◽

Biochemical Indices

Background: β-Thalassemia major is a serious hematological problem requiring regular blood transfusions. In regularly transfused thalassemic patients, metabolic bone disease is an important cause of morbidity. Problems include bone pain, deformities, short stature, osteopenia/osteoporosis, rickets, osteomalacia, spinal deformities, nerve compression and fractures. This study was undertaken to evaluate the status of bone health in children with β-thalassemia major by selected biochemical indices and radiological examination.Methods: Fifty children with β- thalassemia major were enrolled. Detailed history, examination and anthropometry were done. Serum calcium, phosphorus, magnesium, alkaline phosphatase, and vitamin D levels were measured. X-ray of skull, wrist, and knee were studied for radiological changes. Biochemical indices were analysed with appropriate statistical tests.Results: Stunting and wasting was observed in 58% and 44% children respectively. Hypocalcaemia was seen in 22%, hyperphosphatemia in 56% and 24% children had raised alkaline phosphatase levels. Vitamin D levels were severely deficient in 12%, deficient in 50%, and insufficient in 38% of children. There was no significant difference between vitamin D levels of cases and controls. Radiologically almost all children had a range of osteopathy, like thinned out cortex (96%), medullary expansion (54%), loss of density (40%), diffuse osteoporosis (18%) and growth arrest lines were seen in 8% children.Conclusions: Vitamin D abnormalities and radiological features suggestive of decreased bone mineralization are seen in all the children with β-thalassemia major treated with periodic blood transfusion at this institute. No biochemical predictors of bone disease in these children were identified.

Download Full-text