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Nutritional assessment of children with juvenile chronic arthritis
A L Mortensen1, J R Allen, R C Allen
1Children's Hospital, Camperdown, NSW, Australia.
Insights
Nutritional assessment reveals children with juvenile chronic arthritis, especially systemic or polyarticular types, often have lower height and weight Z scores. Energy, calcium, and zinc intakes were frequently below recommended levels, highlighting the need for nutritional evaluation in JCA management.
Area of Science:
- Pediatric Rheumatology
- Nutritional Science
- Clinical Nutrition
Background:
- Juvenile chronic arthritis (JCA) encompasses various subtypes, including polyarticular, pauciarticular, and systemic forms.
- Nutritional status can be impacted by chronic inflammatory conditions in children.
- Previous research indicates potential nutritional deficiencies in pediatric rheumatic diseases.
Purpose of the Study:
- To conduct a nutritional assessment in children diagnosed with juvenile chronic arthritis.
- To identify specific nutritional deficits related to different subtypes of JCA.
- To evaluate the necessity of nutritional assessment in the comprehensive management of JCA.
Main Methods:
- Nutritional assessment involved anthropometric measurements (height, weight, mid-upper arm circumference, skinfolds) in 38 children with JCA.
- A 7-day weighed food record was utilized to quantify dietary intake.
- Children were categorized by current arthritis type: polyarticular (15), pauciarticular (13), and systemic (10).
Main Results:
- Children with systemic and polyarticular JCA exhibited significantly lower mean height Z scores compared to population norms.
- Mean weight Z scores were significantly lower in the polyarticular group.
- Energy intake was below recommended dietary intake (RDI) in systemic and polyarticular groups; calcium and zinc intakes were below RDI in the polyarticular group.
Conclusions:
- Nutritional assessment is crucial for managing children with JCA, particularly those with systemic or polyarticular disease.
- Suboptimal anthropometric measurements and dietary intakes highlight potential nutritional risks in these patient groups.
- The findings underscore the importance of integrating nutritional monitoring into the care of pediatric arthritis patients.
Abstract:
Nutritional assessment was performed in 38 children with juvenile chronic arthritis (polyarticular [15]; pauciarticular [13]; systemic [10]). This included anthropometric measurements (height, weight, mid-upper arm circumference and four skinfolds) and a 7 day weighed food record. The children were classified according to current type of arthritis which in some cases was not the same as the initial onset type. Mean height Z scores were significantly below the Z score population mean of 0 in the systemic (P = 0.02) and polyarticular (P = 0.009) groups. Mean weight Z scores were also below the mean in the polyarticular group (P = 0.001) but the systemic group did not reach significance. Mean energy intakes were significantly below the recommended dietary intake (RDI) in the systemic (P = 0.01) and polyarticular (P = 0.001) groups. Mean intakes of calcium and zinc were below the RDI of 100% in the polyarticular group (P = 0.0001). Thirteen (34%) of children were taking some form of self-prescribed vitamin and/or mineral supplement. Vitamin C was the most commonly used supplement, despite dietary intakes greatly exceeding the RDI. Nutritional assessment is essential in the management of patients with JCA, in particular those with systemic or polyarticular disease.