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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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