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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
become necessary.
- 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
trials.
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