NUTRITIONAL FACTORS AND THALASSEMIA MAJOR

Abnormal growth is a common feature of thalassaemia major in children. In an attempt to determine whether it has a nutritional cause, 12 chi ldren aged 1 to 3 years with thalassaemia major were studied under met abolic ward conditions. Nutritional status was assessed by anthropomet ry and biochemistry before and after an intensive nutrition regimen. F ive children had wasting or stunting on admission. As a result of the nutrition intervention, mean weight for height improved significantly. The mean height increase of 0.4 cm after one month was not significan t. Plasma zinc, depressed in half the children on admission, improved, as did alpha tocopherol, while copper decreased. Plasma insulin-like growth factor-I also increased commensurate with improved growth. Fat absorption was normal in all children. Undernutrition is an important cause of associated growth disturbances in children with thalassaemia major. Malnutrition was primarily caused by inadequate nutrient intake , as indicated by the capacity to gain weight appropriately when provi ded with nutrition support, and by the absence of intestinal malabsorp tion. While long term studies are required to determine if nutritional support will prevent stunting, these results underscore its central r ole in preventing nutritional deficiencies and in promoting normal gro wth in thalassaemic children.