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Energy expenditure and intake in children with sickle cell disease during acute illness.

Abstract

BACKGROUND

Children with sickle cell disease have frequent bouts of pain and infection which may increase energy expenditure, decrease energy intake and lead to a subsequent energy deficit.

METHODS

Two groups of African-American children with sickle cell disease-SS genotype were enrolled in this study upon hospital admission for a sickle cell disease related illness: a younger (<6 years, n=14, 7 M) and older group (> or =6 years, n=17, 8 M). Body composition and dietary intake were assessed, and sleeping (younger) or resting energy expenditure (older) were measured by indirect calorimetry at admission and one month later at steady state.

RESULTS

Energy expenditure was not different between the two timepoints for younger children, but was slightly elevated at steady state (+50 kcal/d, P=0.049) in the older group. After controlling for gender, changes in fat-free mass and dietary intake, the significance disappeared. Energy intake in both groups was significantly depressed at admission compared to follow-up (P<0.01).

CONCLUSIONS

These children and adolescents did not expend excess energy during their acute illness, however, an energy deficit was observed secondary to poor energy intake. Since 20% of patients with sickle cell disease have multiple hospitalizations per year, these results provide justification for the development and evaluation of nutrition care protocols to maintain adequate caloric intake during hospitalization and recovery.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, University of Pennsylvania School of Medicine and Divisions of Gastroenterology & Nutrition and Hematology, Children's Hospital of Philadelphia, PA 19104, USA.

    , , , , , ,

    Source

    MeSH

    Acute Disease
    Adolescent
    Adolescent Nutritional Physiological Phenomena
    Adult
    African Continental Ancestry Group
    Anemia, Sickle Cell
    Basal Metabolism
    Body Composition
    Calorimetry, Indirect
    Child
    Child Nutritional Physiological Phenomena
    Child, Preschool
    Eating
    Energy Intake
    Energy Metabolism
    Female
    Genotype
    Hospitalization
    Humans
    Infant
    Male
    Nutritional Status

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    11327740

    Citation

    Fung, E B., et al. "Energy Expenditure and Intake in Children With Sickle Cell Disease During Acute Illness." Clinical Nutrition (Edinburgh, Scotland), vol. 20, no. 2, 2001, pp. 131-8.
    Fung EB, Malinauskas BM, Kawchak DA, et al. Energy expenditure and intake in children with sickle cell disease during acute illness. Clin Nutr. 2001;20(2):131-8.
    Fung, E. B., Malinauskas, B. M., Kawchak, D. A., Koh, B. Y., Zemel, B. S., Gropper, S. S., ... Stallings, V. A. (2001). Energy expenditure and intake in children with sickle cell disease during acute illness. Clinical Nutrition (Edinburgh, Scotland), 20(2), pp. 131-8.
    Fung EB, et al. Energy Expenditure and Intake in Children With Sickle Cell Disease During Acute Illness. Clin Nutr. 2001;20(2):131-8. PubMed PMID: 11327740.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Energy expenditure and intake in children with sickle cell disease during acute illness. AU - Fung,E B, AU - Malinauskas,B M, AU - Kawchak,D A, AU - Koh,B Y, AU - Zemel,B S, AU - Gropper,S S, AU - Ohene-Frempong,K, AU - Stallings,V A, PY - 2001/5/1/pubmed PY - 2001/11/3/medline PY - 2001/5/1/entrez SP - 131 EP - 8 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 20 IS - 2 N2 - BACKGROUND: Children with sickle cell disease have frequent bouts of pain and infection which may increase energy expenditure, decrease energy intake and lead to a subsequent energy deficit. METHODS: Two groups of African-American children with sickle cell disease-SS genotype were enrolled in this study upon hospital admission for a sickle cell disease related illness: a younger (<6 years, n=14, 7 M) and older group (> or =6 years, n=17, 8 M). Body composition and dietary intake were assessed, and sleeping (younger) or resting energy expenditure (older) were measured by indirect calorimetry at admission and one month later at steady state. RESULTS: Energy expenditure was not different between the two timepoints for younger children, but was slightly elevated at steady state (+50 kcal/d, P=0.049) in the older group. After controlling for gender, changes in fat-free mass and dietary intake, the significance disappeared. Energy intake in both groups was significantly depressed at admission compared to follow-up (P<0.01). CONCLUSIONS: These children and adolescents did not expend excess energy during their acute illness, however, an energy deficit was observed secondary to poor energy intake. Since 20% of patients with sickle cell disease have multiple hospitalizations per year, these results provide justification for the development and evaluation of nutrition care protocols to maintain adequate caloric intake during hospitalization and recovery. SN - 0261-5614 UR - https://www.unboundmedicine.com/medline/citation/11327740/Energy_expenditure_and_intake_in_children_with_sickle_cell_disease_during_acute_illness_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(00)90367-4 DB - PRIME DP - Unbound Medicine ER -