Sickle cell disease and macronutrients

Please note: Foods mentioned on this page may not be appropriate for all ages. Please speak to your health-care provider for more information.

All the food we eat contains nutrients, the substances that help the body function. There are two main types of nutrients:

1. Micronutrients: Micronutrients are nutrients that we only eat in small quantities ("micro" means very small). They include vitamins such as vitamins A, C and D, and minerals such as calcium, iron and magnesium, just to name a few.
2. Macronutrients: Macronutrients are the big building blocks of our diet—we eat these nutrients in large quantities ("macro" means large).

There are three macronutrients:

1. Fat
2. Protein
3. Carbohydrates

Each of them plays an important role in your body.

Fat

Among other things, fat:

• gives your child energy while they are resting or doing low-intensity exercise
• helps your child's body absorb vitamins A, D, E and K (these vitamins need fat to transport them around the body)
• provides essential fatty acids. These are fats that your child's body needs from their diet to keep their heart healthy, help their brain function properly, make hormones and build healthy cells and skin.

Over the years, you might have heard to avoid “fatty foods”. However, not all foods that are high in fat are bad. This is because there are good fats and bad fats.

Good fats

Fish such as salmon, for example, are generally a source of good fat, especially omega-3 fatty acids. Other sources of good fats include nuts and seeds, vegetable oils and avocados.

You may hear that fish can contain high levels of mercury. It is true that, over time, mercury can build up in some larger fish like white tuna, shark and swordfish. It is better to avoid these larger fish, but it is safe to eat most others, including salmon, cod, haddock and sole.

Bad fats

Unhealthy fats include trans-fat and saturated fat. These fats should be limited because they can increase the risk of heart disease. To reduce the amount of unhealthy fats in your child's diet, limit foods such as butter, margarine, lard and shortening (found in pastries), fatty cuts of meat and chicken with the skin on.

Pay attention to nutrition claims

Be careful of food products advertised as “low fat”. Often, food manufacturers will add extra sugar, sweeteners or salt to make the food taste better. Over time, these added ingredients may be worse for your child than the fat the manufacturer removed from the food.

Talk to your health-care team or a registered dietitian about how to make healthy choices about low-fat food products.

Protein

Protein plays a number of roles in the body, including:

• building and repairing muscles, blood cells, organs, bones, skin, hair and nails
• helping muscles work
• helping to make enzymes to digest food
• helping to make hormones to control things such as appetite, sleep and mood
  

People with sickle cell disease may need more protein to help make extra red blood cells.

Another benefit of protein is that it helps you feel full for longer. Starting the day with a good source of protein, such as eggs, and including protein in every meal will help to keep your child's hunger at bay and make them less likely to snack mindlessly. It will also help them concentrate at school or work.

The food groups richest in protein are:

• meat and alternatives, which includes chicken, beef, eggs, tofu, beans, peas and lentils
• milk and alternatives, which includes dairy, almond and rice milk, yogurt and different types of cheese
  

Carbohydrates

Carbohydrates play two main roles in the body. 

1. They are the body’s main source of fuel (energy).
   
2. They provide fibre to help food pass through the digestive system and help keep you fuller longer.

The food groups richest in carbohydrates are:

• grain products, such as bread, pasta, rice, barley and oats
• vegetables and fruit
  

Some people might fear certain “high-carb foods” (usually made from grain products) because they believe that they lead to weight gain or bloating. But this belief ignores the different types of carbohydrates and how they behave in the body. It also ignores the fact that many people can have healthy amounts of carbohydrates for their individual needs without any problems.

There are two main types of carbohydrates:

1. Simple carbohydrates (sugars) are those in foods such as fruit, fruit juice, honey, sugar and candy. These foods tend to cause blood sugar levels to "spike" (rise very quickly) and then fall quickly, which can leave your child feeling hungry soon afterwards.
2. Complex carbohydrates (starches) are found in grains, vegetables and legumes (beans, peas and so on), and whole fruit. These foods are filled with fibre and are digested more slowly, meaning that they will keep your child full for longer.

There is a place for simple and complex carbohydrates in your child's diet. For example, many fruits (such as strawberries, cherries, grapes and raisins) can help ease inflammation. Apples also boost acetylcholine in the brain, a chemical that helps with memory, concentration and energy. That said, it is best not to rely on simple carbohydrates for your energy. This includes juices and soft drinks, which often contain high amounts of sugar and sweeteners.

When it comes to choosing complex carbohydrates, aim for whole grains such as barley, wholewheat pasta and wholegrain bread, and encourage your child to eat a wide range of vegetables.