Sickle Cell Disease: Nutritional Considerations
Patients with sickle cell disease have increased needs for calories
and micronutrients (e.g., vitamins and minerals). A diet emphasizing
fruits, vegetables, whole grains, and legumes will provide a greater
proportion of essential nutrients than a typical Western diet, and
appropriate supplementation (one to three times the recommended intakes
for most essential nutrients) can prevent deficiency.
- A high–calorie, nutrient–dense diet: The average
caloric intake of sickle cell patients is typically low, especially
during flare–ups of the disease. As a result, children with sickle
cell disease have impaired growth and significantly lower weight
compared with unaffected individuals. A careful nutritional assessment
and the addition of energy supplements are needed.
- Adequate fluid consumption to maintain hydration: Sickling
of red blood cells increases when patients become dehydrated. Thus,
it is important to maintain hydration by consuming adequate fluids.
In some cases, hospitalization to receive intravenous fluids may
- Vitamin and mineral supplementation: Blood levels
of several vitamins and minerals are often low in individuals with
sickle cell disease, including vitamin A and carotenoids, vitamin
B6, vitamin C, vitamin E, magnesium, and zinc.
This can result in a significant deficiency of antioxidants, which
may increase the risk of disease flare–ups. Studies indicate that
vitamin–mineral supplements of certain nutrients (vitamins C and
E, zinc, and magnesium) or treatment with a combination of high–dose
antioxidants can reduce the percentage of sickled red blood cells.
- Omega–3 fatty acid supplements: Supplementation
with omega–3 fatty acids can improve the membranes of red blood
cells and may decrease flare–ups of the disease. A small preliminary
study indicated that omega–3 fatty acid supplementation with fish
oil reduced the number of painful episodes requiring hospitalization.
However, this finding has not yet been confirmed in controlled