Impact of diet counseling in thalassemic children and its response on nutritional status

OBJECTIVE: The objective of this study is to identify some nutritional deficiencies in thalassemic patients on regular transfusion therapy and to assess the improvement after dietetic modification. MATERIALS AND METHODS: This cross-sectional hospital-based study was conducted in thalassemia patients admitted to the Pediatric Ward of JSS Hospital, Mysore for 6 months. Those with any concurrent illnesses that could interfere with dietary intake were excluded. Dietary data were collected by 24 h recall method. The total amount of energy, protein, fat, calcium, iron, phosphorus, fiber, and carbohydrates consumed was estimated. Dietary counseling was then done to meet the recommended daily allowance of deficient nutrients for that specific age group during the next follow-up to the hospital. Using the similar 24-h recall method, the total amount of energy, protein, fat, calcium, iron, phosphorus, fiber, and carbohydrates consumed was again estimated and assessed after 6 months. ETHICAL CLEARANCE: Institutional Ethical Clearance was taken from the ethics committee before commencing the study. An informed written consent was taken from the parents before starting data collection. RESULTS: Before diet counseling, the study showed that all children consuming iron deficient diet suffered from deficiencies of calories, fiber, calcium, and phosphorus. All children seemed to consume adequate levels of protein, fat, and carbohydrates. On the 6-month review, these deficiencies continued to persist, but the nutritional value of the diet seemed to show an improvement when compared to their pre-counseled values. CONCLUSION: The emphasis on iron deficient diets in thalassemic children causes associated deficiencies. Emphasis on diet rich in these elements with follow-up dietary counseling during each visit is required to maintain a balanced nutrition.