Arthritis

Updated 16 September 2014

JA and diet

All children need proper nutrition; those with juvenile arthritis (JA) need it more than most.

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All children need proper nutrition; those with juvenile arthritis (JA) need it more than most. This can make life difficult, because children with JA often have poor appetites, leading to weight loss and poor growth. The occasional use of steroid treatment may result in weight gain.

Chronic disease places inordinate demands on a child’s growing body, creating a need for an increased caloric intake. But JA may leave them feeling nauseous, weak, or simply too tired to eat.

Encourage your child to eat a balanced diet, with regular meals and snacks, even if her or she may not feel like eating. Reducing the amount of food, but increasing its nutritional value and taste will make things easier.

You can try mixing melted cheese into cooked foods or offering whole milk, yoghurt and dips. Bear in mind that excess weight gain brings as many problems as being underweight. Some children with JA do pick up too much weight because they don’t exercise enough. This puts strain on joints such as knees, hips and ankles, aggravating the arthritis.

Consider getting a dietician to compile an eating plan for your child. Combine this with a sensible exercise programme that will help your child feel healthy and comfortable.

Many children with JA need their diets supplemented with calcium and vitamin D to help strengthen their bones. While a vitamin supplement will usually take care of these needs, it’s worth reading up about how vitamins and minerals interact with each other. For instance, Vitamin D is really a hormone produced in the body by the action of ultraviolet light (sunlight) on the skin. The vitamin is converted to its active form by the body in two steps - first in the liver and then in the kidneys. In its active form, vitamin D acts as a hormone to regulate calcium absorption from the intestine and to regulate levels of calcium and phosphate in the bones.

When the body is deficient in vitamin D, it’s unable to regulate calcium and phosphate levels. If the blood levels of these minerals become low, the other body hormones may stimulate release of calcium and phosphate from the bones into the bloodstream. This can lead to a loss of bone.

A supplement of calcium and magnesium can be particularly helpful.

Most youngsters have favourite foods, which are often unhealthy. A small portion of say, fries, is unlikely to do any harm if combined with plenty of fresh fruit and vegetables, steamed fish or chicken and moderate amounts of red meat.

Because your child will benefit from eating a balanced, sensible diet, it would be unfair to subject him or her to a green salad while the rest of the family tucks into pizza. As far as possible, serve the same foods to the whole family, following the nutritional guidelines outlined in the food pyramid, with occasional treats such as pizza or burgers.

In this way your child won’t feel ostracized by the rest of the family and his or her siblings won’t resent what they see as special treatment. Obviously there are exceptions to this, such as when the child is feeling ill. This may be the time to revert to favourites or comfort foods such as soups.

In sickness or in health, your kids should drink plenty of fluids. Monitor their intake of fruit juice – it’s healthy, but can pack on the kilograms.

 

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Arthritis expert

Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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