Food intake of Tibetan children living in Kashin Beck disease endemic areas in Central Tibet

Introduction: Kashin-Beck disease (KBD) is a bone and joint pathology. KBD begins during childhood, causes deformities, pain, lack of mobility, and short stature.
The pathophysiology of the disease is unknown. Nutrition possibly plays a role. Children living in KBD endemic areas in Central Tibet present severe growth retardation, signs of chronic malnutrition and a high prevalence of rickets. A food consumption study was conducted. We have focused our attention on total energy intake, calcium, phosphorus and vitamin D.
Material and methods: Prospective food intake measurements have been performed. The investigation concerned children from 9 to 16 years old living in KBD endemic areas. All food and drinks have been measured during several days at the 4 seasons of the year. Anthropometric data were obtained.
Results: 30,5% of the children presented with stunting (height for age ratio below -2 z score); 13,8% of the cohort suffered from acute malnutrition (body mass index below -2 z score).
Mean total energy intake was 87% of the recommended value. Calcium and vitamin D intakes never covered the needs (44 % and 14 %, respectively). Phosphorus intake was high. Mean Ca / P ratio was 0.54.
Conclusion: Calcium and vitamin D deficiency may play a role in the etiology of bone and joint diseases in this population. To improve the nutritional status of the children, a large program of calcium and vitamin D supplementation among 0 - 5 years old children living in KDB endemic areas was started. Besides, chemical analyses of locally grown foods are performed, in order to have a more precise evaluation of nutrient intake. In the future, the effect of increased energy intakes will be evaluated.