The effect of high-calorie diet on nutritional parameters of children with beta-thalassaemia major

Clin Nutr. 2004 Oct;23(5):1153-8. doi: 10.1016/j.clnu.2004.03.001.


Background: Impaired growth accompanying thalassaemia major poses diagnostic and therapeutic problems.

Aim: To test the hypothesis that impaired growth of children with thalassaemia major might be corrected, partially or totally, by increasing their caloric intake.

Patients and methods: In a prospective controlled study, thirty selected children with thalassaemia major and 30 normal age and sex-matched controls were recruited. The dietary intake of both groups was evaluated. Nutritional status was assessed by measuring the weight, body mass index (BMI), mid-arm circumference (MAC), triceps skin fold thickness (SFT) and serum albumin and insulin-like growth factor-I (IGF-I) concentrations. The thalassaemic group was then, randomly divided into two equal groups. One group was given 8 weeks of high-caloric diet (130-150% of the caloric recommendation for age and sex) and the other was given the normal caloric requirement.

Results: Initially the BMI, triceps SFT and MAC of children with thalassaemia were significantly decreased compared to those for the normal control group. IGF-I and albumin concentrations of thalassemic children before nutritional supplementation (69 +/- 20.5 ng/m and 3.65 +/- 0.67 g/dl, respectively) were significantly lower than those for normal age and sex-matched children (162.5 +/- 24 ng/ml and 4.29 +/- 0.66 g/dl, respectively). After nutritional supplementation for 8 weeks the MAC, SFT and BMI, IGF-I (88.4 +/- 27.3 ng/ml) and albumin concentrations (3.85 +/- 0.85 g/dl) increased significantly (P < 0.05) in the thalassaemic children given the supplementation compared to those without supplementation, however, they were still lower than normal children.

Conclusions: Increased caloric dietary intake increased significantly IGF-I levels in thalassaemic children. This was accompanied with increased BMI, mid-arm circumference and skin fold thickness. Growth impairment of children with thalassaemia major, without endocrinopathy and/or cardiomyopathy, can be partially corrected by increasing caloric intake.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Anthropometry
  • Body Mass Index
  • Child
  • Energy Intake / physiology*
  • Female
  • Growth Disorders / etiology*
  • Growth Disorders / therapy
  • Growth*
  • Humans
  • Insulin-Like Growth Factor I / analysis
  • Male
  • Nutritional Requirements
  • Prospective Studies
  • Serum Albumin / analysis
  • Treatment Outcome
  • beta-Thalassemia / physiopathology*


  • Serum Albumin
  • Insulin-Like Growth Factor I