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. 2022 Jan 1;44(1):1-11.
doi: 10.1097/MPH.0000000000002291.

Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations

Elijah K Goldberg  1 , Ashutosh Lal  2 , Ellen B Fung  1   2
Affiliations

Nutrition in Thalassemia: A Systematic Review of Deficiency, Relations to Morbidity, and Supplementation Recommendations

Elijah K Goldberg et al. J Pediatr Hematol Oncol. .

Abstract

Background: Reports of nutritional deficiencies in patients with thalassemia (Thal) are common. Despite its importance, however, nutritionally focused research in Thal has been limited by inadequate sample size, inconsistent methodology, a lack of control comparisons, and few interventional trials. Due to these limitations, clinicians lack evidence-based nutrition recommendations to support clinical decision-making. This systematic review summarizes observed relationships between nutrition and morbidity in Thal published in the last 3 decades.

Methods: PubMed, Web of Science, and Embase were screened for articles pertaining to nutrition in Thal using comprehensive search terms. Studies performed in humans, written in English, and published between 1990 and 2020 were included. Over 2100 manuscripts were identified, from which 97 were included.

Results: Patients with Thal were most often deficient in vitamins A, C, D, selenium, and zinc. Prevalence of nutritional deficiency was positively correlated with age and iron overload. Evidence to support the role of vitamin D and zinc for bone health was observed; zinc was also found to improve glucose metabolism.

Conclusions: Due to the risk for multinutrient deficiency, nutritional status should be assessed annually in patients with Thal with prompt nutrient replacement when deficiency is detected. Routine supplementation with vitamin D and zinc is recommended.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1:
Figure 1:
PRISMA Flow Diagram of Study Assessment and Selection.
Figure 2:
Figure 2:
Summary of Nutritional Deficiency Prevalence Reported in Patients with Thalassemia. Only studies in which deficiency prevalence statistics were reported are included in this figure. See text for description of other studies not included herein. Histogram represents Mean + SD for studies reported, parentheses provide the total number of studies from which the data were generated. Manuscripts which reported elevated levels of a nutrient are not included in this graph.
See this image and copyright information in PMC

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