Nutrition support and growth es thalassemia major

Abnormal growth resulting in stunting and delayed or absent puberty is characteristic of children with thalassemia major, however the cause is largely unknown. 12 thalassemic children <3 yr old received nutritional support for one month, were discharged and followed for ten months. Anthropometry, bioelectrical impedance analysis, and dietary intake was longitudinally assessed. Energy intake exceeded the RDA during, but was less before and after, the period of nutrition support. Weight, but not height, significantly increased during the support period due to increases in both fat free mass (FFM) and fat mass (FM) in a pattern consistent with recovery from undernutrition. Growth (body weight, FFM, and FM) declined corresponding to reduced intake upon return home, however height velocity accelerated and exceeded normal before resuming a below-normal rate. Leg height increased concordantly while the truncal segment did not substantially change. We conclude that nutritional stunting due to reduced nutrient intake is an important cause of growth failure in thalassemic children and is responsive to nutritional support, and that the deficit in height velocity was due to retarded truncal height growth.