Interest of Nutritional Care of Children With Sickle Cell Disease on Bone Mineral Density and Body Composition (NUTRIDREP)

Interest of Nutritional Care of Children With Sickle Cell Disease on Bone Mineral Density and Body Composition

Interest of Nutritional Care of Children With Sickle Cell Disease on Bone Mineral Density and Body Composition

This study is design to assess the effects of an increase in nutritional intake on the bone mineral density of children with sickle cell disease, for 12 months.

Sickle cell disease is the most common inherited disease of the red blood cell During sickle cell disease, the decrease in Bone Mineral Density (BMD) in children is very common: 19 and 56% depending on the studies children with sickle cell disease have an increase in resting energy expenditure of 15-20% children with sickle cell disease have a significant decrease in muscle mass there are no specific nutritional recommendations for sickle cell disease in children Our main purpose is to assess the effects of an increase in nutritional intake on the bone mineral density of children with sickle cell disease, for 12 months Our secondary objectives are : / Evaluate the effects of an increase in nutritional intake on: body composition, height and weight growth, frequency of complications of sickle cell disease, school absenteeism, cardiac function, cerebral vasculopathy, biological parameters follow-up, and the relationship with the treatment started / Creation of a sero-type blood bank for future research

Sickle cell disease, Osteoporosis, Osteopenia, bone mineral density, Nutrition, body composition, Oral nutritional supplement

Randomization of patients included in 2 groups Group 1: receiving an oral nutritional supplement to increase calorie intake by around 20% Group 2: "controls" receiving normal calorie intake without oral nutritional supplement Randomization will take into account age, gender and severity of disease in order to create two homogenous groups Monitoring by biphotonic absorptiometry, dietetic, clinical and biological Creation of a sero-type blood bank for the 2 groups

We will propose to the patients of group 1 several different oral nutritional supplements according to taste, and consistency of each child in order to optimize observance. Each of those different oral nutritional supplements will be adapted to the nutritional survey and the age of children without exceeding recommended intake of proteins, carbohydrates, lipids and micronutrients. Those patients will consume the Oral Nutritional Supplement during 12 months.

The change in the mean Bone Mineral Density Z-score of the two randomized groups will be measured by biphotonic absorptiometry

The change in the mean Bone Mineral Density Z-score of the two randomized groups will be measured by biphotonic absorptiometry

Complications such as chronic pain, chronic and acute anemia, infections justifying hospitalization, multi visceral involvement.

The presence or not of impaired cardiac function and / or cardiac anatomy related to sickle cell disease

The presence or not of impaired cardiac function and / or cardiac anatomy related to sickle cell disease determined by echocardiography

Inclusion Criteria: Homozygous sickle cell disease SS, SC, SE, Sbeta + or Sbeta0 Ages 3 to 16 years old Exclusion Criteria: Overweight at the start of the study Child for whom one of the 2 parents refuses his child's participation in the study

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