Nutrition is the study of nutrients found in food, its actual purpose in the body and the relationship it has on a person’s diet, health and disease. There are a lot of nutrients with the main nutrients being Proteins, Carbohydrates, Fats (macronutrients), and Vitamins, Minerals (micronutrients), Dietary fibre and Water. The evidence in support of nutritional deficiencies in people living with Sickle Cell Anaemia.

Nutrients are an important component to a person’s wellbeing. It is even more important to people living with a  chronic illness like sickle cell warriors as there is evidence to support that recommended dietary allowances (RDAs) for the general population are insufficient for the sickle cell patient. Micronutrient deficiencies have also been researched to less, including recent findings of vitamin D deficiency that may be associated with incomplete ossification and bone disease, which are well known complications of Sickle Cell Anaemia.

Nutrients meant for growth, repair and development are not used for their intended purposes in people with Sickle Cell Anaemia. Studies show that there is a low level of zinc, magnesium, folic acid, vitamin A, C, E and D, calcium, selenium, proteins and fatty acids. A good balanced diet is therefore cardinal to help carter for the required demand in order for body to get its needed nutrients to develop properly.

People with sickle cell often experience anemia, fatigue, have frequent pain (painful vaso-occlusive crisis,) and recurrent infections due to it being associated with some nutritional deficiency which causes low appetite resulting in delayed growth and development in sickle cell warriors. A sickle cell warrior’s diet must have a balanced diet from different food groups, this can help get the right levels of all important nutrients.

PROTEINS, CARBOHYDRATES AND FATTY ACIDS.

A good diet with foods rich in proteins, carbohydrates and fats is very essential because they help in repairing cells, tissues, fighting fatigue and reduce inflammation in the body. In sickle cell the lifespan of red blood cells which is 10-20 days compared to that of people without sickle cell which is 100-120 days, because of this the bone-marrow which makes red blood cells is always working in overdrive trying to produce more red blood cells to cater to the demands of the body. This requires a lot of energy and proteins because the oxygen-carrying protein in the hemoglobin is affected. Foods rich in proteins (made up of amino acids which act as building blocks) such as chicken, lean meat, eggs, fish, beans, lentils and nuts will help in the production of new cells, maintain and repair new tissues.

In sickle cell patients, during a crisis or an infection in the body there is a lot of inflammation and tissue breakdown going on. It’s extremely important during and after crisis to eat foods rich in nuts like almond, avocados, olives, fatty fish, canola oil, olive oil, coconut oil which will help lessen inflammation and repair tissues to and up recovery and reverse organ damage.

Fatigue which a common problem in sickle cell, due to the shape of red blood cells and them being rigid they can’t carry enough oxygen needed for the muscles and tissue resulting in low supply of energy in the body. Eating food such as brown rice, oatmeal, low fat yogurt, salmon, chicken, berries and bananas which are high in energy can help reduce fatigue. These foods have a steady level of energy which can last throughout the day.

Anemia is another common complication in people with sickle cell. Due to the 10-20 days lifespan of red blood cells, there is a rapid breakdown (Haemolysis) of the cells in the body which results in the shortage of the red blood. Low haemoglobin levels can very frightening as it can lead to shock and organ damage. It is very important for sickle cell patients to have a stable haemoglobin and eating foods rich in folate can help. Foods such as dark green leafy vegetables and beets. Organ meats like liver and kidney, almonds, tomatoes, chickpeas and kidney beans are a good source of folic acid. These will help in the production of the new rich blood cells which can help reduce pain crisis.

3d render of sickle cell anemia blood cells

VITAMINS AND MINERALS.

There is a significant low level of vitamins and minerals in sickle cell disease such as vitamin A, B, C, D and minerals like zinc, selenium, calcium, magnesium, that contribute to underlying problems in sickle cell like low levels of antioxidants, bone fractures, red cell destruction and infections which results in VOC pain crisis, acute chest syndrome and leg ulcers. Having foods rich in vitamins and minerals such as nuts, eggs, carrots, tomatoes, kiwi, green beans, bananas, mango, guava, bell peppers, apples, oranges, pomegranates, avocados, almond milk, broccoli and kale. Eating these will help with digestion, increase the low levels of zinc, selenium and vitamins which will help reduce crisis, infections, prevent cell damage, heal leg ulcers, maintain antioxidant enzyme, increase hemoglobin, reduce stress and overall reduce the many complications of sickle cell disease. (It’s important to avoid foods rich in iron because too much iron in sickle cell warriors is dangerous)

IMPORTANCE OF HYDRATION IN SICKLE CELL DISEASE

Hydration in sickle cell disease is very essential because it plays an important role in reducing sickle pain crisis. Hydration promotes increased blood flow, reduces the chance of sickled red blood cells sticking together and promotes supple easy movement in blood vessels. Sickle cell patients should drink at least 8 cups of water a day. Fruits and vegetables such as watermelon, strawberries, cucumbers, pineapples, celery, lettuce, peaches. Some of these fruits and vegetables can be mixed together to make tasty smoothies. It’s important to avoid drink with caffeine, carbonated and alcohol.

Having a balanced diet with 50% of plant based vegetables and fruits, 25% of proteins and 25% of fruits and whole grains in sickle cell will provide with enough nutrients to help reduce complications such as pain, infections, anemia, and improve organ function of the brain, heart, lungs, liver and kidneys which are often working in overdue which in turn will lower the chances of developing stroke, heart, liver and kidney disease.

Nutrition in sickle cell disease is still the least of things talked about in management of it sickle cell, its therefore important for people with sickle cell with the help of a professional dietician together with their haematologist to gather the right information on the right nutrition to take, how they can incorporate all the food groups in their diet, see how it works for their body, how the body responds and then stick by it. It is also important for caregivers to educate their young warriors on the importance of good nutrition, how having a rainbow diet can help minimize sickle cell complications while they are still young in order to inculcate good healthy eating habits. If nutritional deficiencies in sickle cell disease are not properly managed it can lead to more complications which will result in more hospital stays. ( Look out for my nutrition book for sickle cell warriors coming out soon…

References:

Hyacinth, H. I., Gee, B. E., & Hibbert, J. M. (2010). The Role of Nutrition in Sickle Cell Disease. Nutrition and metabolic insights, 3, 57–67. https://doi.org/10.4137/NMI.S5048