Nutritional assessment of children with juvenile chronic arthritis

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.