Sickle cell disease is a genetic blood disorder inherited from one’s parents and characterised by the inheritance of two abnormal genes with one of the abnormal genes being haemoglobin “S.” It’s commoner in blacks’ although it is a global disease. It is said to have originated from Sub-Saharan Africa and #Nigeria still has the highest burden of sickle disease in the world.
#Sicklecelldisease (SCD) is one of the most common genetic diseases worldwide and its highest prevalence occurs in the #MiddleEast, Mediterranean regions, Southeast #Asia, and Sub-Saharan #Africa especially Nigeria.
Although significant progress has been made in the national prioritisation of SCD in a handful of these countries in the region, a larger population is still left behind. That goes even more so for those living in countries that lack equitable access to SCD care and for the vulnerable poor populations who bear the greatest inequities from the disease. They lack access to early diagnostics and care, education, financial and social protection, food security and opportunities to live their lives to the fullest potential.
The degeneration of untreated #SCD can be linked to organ damage. This is either caused by addiction to some pain relief medication (usually caused by self-medication) or untreated SCD. This makes #Nutrition of utmost importance in the management of SCD.
Nutrition is reported to impact many chronic health conditions associated with SCD, including chronic baseline inflammation, and vaso-occlusive crisis (VOC), which is accompanied by frequent pain and greater occurrence of stroke, particularly in young children. Other severe manifestations of SCD are pulmonary hypertension; cardiovascular and renal disease.
It is becoming more apparent that current dietary recommendations for SCD should include more emphasis on adequate amounts of macronutrients. Intervention with macronutrients, (proteins carbohydrates and fats) showed measurable improvement in clinical condition and reduced hospital admissions in growth-delayed children with SCA.
It was reported that adults and children with sickle cell anaemia have a relative energy shortage. In SCD patients, nutrients from the diet and amino acids from body protein catabolism channel towards rapid red cell production, are replacing hemolysed sickle red cells being constantly removed from the circulation. This metabolic irregularity drastically increases the energy requirement and reduces the availability of nutrients for growth and development in children and for maintaining adequate muscle mass in adults. The primary clinical manifestation of this relative nutrient deficiency is severe undernutrition.
Hydration plays an essential role in sickle cell anaemia. It is crucial to promote proper hydration by frequent intake of water and other fluids and to avoid physical activity and extreme weather that result in excessive sweating.
Note this! Avoiding dietary sodium intake can help to maintain appropriate hydration status by preventing water from leaving the erythrocytes (William-Hooker et. al., 2013). Dietary recommendations for maintaining good hydration status include limiting high sodium, processed foods, and snacks while consuming water and fluids throughout the day. (Umeakunne K, 2019).
Emphasis should be on high dietary requirements for macronutrients (protein-carbohydrate and fat). With the use of food sources of polyphenolic phytochemicals, flavanols and gut microbial required prebiotics these components in combination with the vitamins, minerals, and omega-3 fatty acids routinely use in standard treatment, may provide adjuvant therapy for the SCD-associated chronic disease burden, and promote sustainable health, quality of life and increase longevity for this patient population (Umeakunne K, 2019).
Courtesy; #Dietitian Unit, Rays of Hope Support Initiative