Patients with sickle cell anemia have greater than average requirements for both calories and micronutrients. During sickle cell crises, energy intake can be especially poor. Children frequently hospitalized for sickle cell disease (SCD) commonly show poor linear growth, lean body mass, and reduced fat-free mass. For reasons that are poorly understood, many patients are deficient in essential micronutrients. A diet emphasizing fruits, vegetables, whole grains, and legumes will provide a greater proportion of essential nutrients and appropriate supplementation (1-3 times the recommended intakes for most essential nutrients) can prevent deficiency and may decrease the likelihood of disease exacerbation.
High-calorie, nutrient-dense diet: The average energy intake of sickle cell patients is typically below the suggested allowance for calories during the quiescent phase of the disease, and it drops to roughly half the recommended levels during times of illness requiring hospitalization. As a result, children with SCD are at risk for impaired growth and significantly lower fat and fat-free mass, though obesity is also a risk, especially in female adolescents. Standard nutritional assessment methods used to calculate energy needs typically underestimate resting energy expenditure in persons with SCD. A careful nutritional assessment and the possible addition of energy supplements are indicated.
Adequate fluid consumption to maintain hydration: Sickling of erythrocytes increases in SCD patients who exercise in the heat without consuming fluids, compared with those who maintain well-hydrated status.
Micronutrients: Blood levels of several vitamins and minerals, including vitamin A and carotenoids, vitamin B 6, vitamin C, vitamin E, magnesium, and zinc, are often low in individuals with SCD. These deficiencies cause a significant depreciation in blood-antioxidant status in these patients, and the resulting oxidative stress may precipitate vaso-occlusion–related acute chest syndrome. Studies indicate supplementation of zinc, magnesium; vitamins A, C, and E or treatment with a combination of high-dose antioxidants can reduce the percentage of irreversibly sickled cells. Antioxidant plant phenols, such as flavonoids, may also reduce the oxidative stress in SCD.
Source:https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition%20Guide%20for%20Clinicians/1342072/all/Sickle_Cell_Disease
