Author
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Abrams, Steven |
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Submitted to: Nutrition
Publication Type: Other Publication Acceptance Date: 9/20/2000 Publication Date: 3/20/2001 Citation: ABRAMS, S.A. WHERE DO ALL THE MINERALS GO? FINDING THE CAUSES OF LONG-TERM MINERAL DIFICIENCY IN CHILDREN WITH SERIOUS ILLNESS. NUTRITION: THE INTERNATIONAL JOURNAL OF APPLIED AND BASIC NUTRITIONAL SCIENCE. 2001. v. 17(3). p. 259-260. Interpretive Summary: Technical Abstract: One of the near certainties of caring for children with serious illnesses is that their condition predisposes them to deficiencies of minerals including calcium and magnesium. Sometimes these deficiencies are subtle, and their existence and significance controversial (such as in children with diabetes). In other clinical situations, bone mineral deficiency can be a major source of morbidity (such as in adolescents with anorexia nervosa who develop pathologic fractures). To understand the cause of these deficiencies, and ultimately to develop a rational approach to intervention, we must go beyond simplified assessments such as "they have a poor diet" to determine where abnormalities exist in the process of mineral intake, absorption, bone and tissue turnover, or excretion. Unfortunately, such research is easier to advocate than actually perform. This has led to relatively few data on how these deficiencies develop. The problems with identifying the cause and consequences of mineral deficiencies in children with serious illness are multifaceted. First, children with conditions such as malignancies are by their nature, very heterogeneous in terms of their baseline mineral statue, ethnic background, diet, and pre-diagnosis rates of mineral absorption or excretion. Second, it is impossible to perform baseline "pre-diagnosis" studies in most cases. Third, many of the techniques used to study bone mineral metabolism in adults, such as tetracycline bone labeling or radioisotope absorption studies, are either painful or potentially harmful for children and difficult to perform for research purposes. Finally, even when mineral metabolism studies are performed, it can be difficult to make comparisons with "normal" or healthy children. |
