Factors affecting nutritional status among pediatric patients with transfusion-dependent beta thalassemia

  • Naghmeh Zahra Mirhosseini
  • Suzana Shahar
  • Majid Ghayour-Mobarhan
  • Noor Azmi Kamaruddin
  • Abdullah Banihashem
  • Noor Aini Mohd Yusoff
  • Habib Alah Esmaili
  • Shima Tavallaei
Original Article


Malnutrition affects the growth, efficacy of treatments and quality of life in children suffering from thalassemia. This study was conducted to assess the nutritional status of thalassemic patients and to determine the factors involved. Data were obtained from 140 thalassemic patients aged 8–18 years in Mashhad, Iran, on anthropometry, food record and biochemical profile. The prevalence of malnutrition was 44.3 % for boys and 19.6 % for girls, as determined by low body mass index. Furthermore, 44.3 % of boys and 37.7 % of girls were found to be of short stature. Sum of triceps and subscapular skinfold thickness and arm muscle area (AMA) calculation showed the incidence of 7.4 % leanness and 60.7 % wasting among thalassemic children and adolescents. The average of energy intake met 74 % of recommended dietary allowance, although more than 71 % under-reporting was calculated for food records. The intake of energy, macronutrients, zinc, iron and vitamin E was positively correlated (P < 0.05) with anthropometric measures. Age, age at first transfusion, age of starting chelation and serum alkaline phosphatase were considered as positive predictors for nutritional status, whereas puberty, gender and fasting blood sugar as negative predictors. Nutritional status of thalassemic children and adolescents should be monitored, focusing on their nutrition education and supplementation, treatment protocol and control on blood sugar. These may play important roles in enhancing the quality of life in thalassemic children and adolescents.


Malnutrition Short stature Diet Children Thalassemia 



This research project was financially supported by the Mashhad University of Medical Science Research Council, Iran National Science Foundation. The contribution of the staff of the Avicenna (Bu-Ali) Research Institute, Biochemistry and Nutrition Department of the Mashhad University of Medical Science, Iran National Science Foundation (INSF), Pharmacy faculty, Noor bone densitometry center, Sarvar clinic and lab, Sadra lab and Nutrition and Dietetics Department of the Universiti Kebangsaan Malaysia is gratefully acknowledged. The contribution of Professor Gordon Fern for edition of this manuscript is highly appreciated.

Conflict of interest



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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Naghmeh Zahra Mirhosseini
    • 1
    • 2
  • Suzana Shahar
    • 1
  • Majid Ghayour-Mobarhan
    • 2
  • Noor Azmi Kamaruddin
    • 3
  • Abdullah Banihashem
    • 4
  • Noor Aini Mohd Yusoff
    • 5
  • Habib Alah Esmaili
    • 6
  • Shima Tavallaei
    • 2
  1. 1.Dietetic Programme, Centre for Health Care SciencesUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia
  2. 2.Faculty of Medicine, Biochemistry and Nutrition Research CenterMashhad University of Medical Sciences (MUMS)MashhadIran
  3. 3.Department of Internal MedicineHospital of University Kebangsaan MalaysiaKuala LumpurMalaysia
  4. 4.Department of Hematology-OncologyDr. Sheikh Hospital, Mashhad University of Medical ScienceMashhadIran
  5. 5.Faculty of Therapeutic SciencesMasterskill University College of Health SciencesKuala LumpurMalaysia
  6. 6.Department of Statistics, Faculty of MedicineMUMSMashhadIran

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