Document Type : Original Article


1 MSc in Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran Department of Pediatrics, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Associate Professor of Pediatric Gastroenterology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Evidence Based Care Research Center, Instructor Pediatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran, Department of Pediatrics, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran

4 Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Graduate of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


BACKGROUND: Chronic liver disease (CLD) is one of the most common chronic diseases in the
world that threatens the health of children due to its many complications such as malnutrition and
problems related to growth and development. Paying attention to nutrition and lifestyle modification
in these children is of special importance. Therefore, the aim of this study was to determine the effect
of nutritional education program on micronutrient intake in children with CLD.
MATERIALS AND METHODS: The present study is a two‑group randomized clinical trial that was
performed by available sampling and referred to Ghaem Children’s Hospital in Mashhad in 2016. In
this study, 77 children with CLD who met the inclusion criteria (45 children in the intervention group and
32 children in the control group) were studied. The intervention included six workshops and training on
proper diet, post‑workshop phone calls, and regular face‑to‑face counseling sessions (first 4 weeks
once a week and second 4 weeks once every 2 weeks) on adherence to the above diet. Patients
in the control group received routine care. The collection tools in the study included demographic
information questionnaires, body composition device, and diet plan form in the form of 24‑h recall
forms. Data analysis was performed using descriptive statistical tests and Mann–Whitney and
Wilcoxon statistical tests using SPSS software version 16.
RESULTS: Based on the results of the study, the mean age of the research units was 7.8 ± 3.6 years.
The mean duration of CLD was 4.6 ± 1.8 years in the intervention group and 5.1 ± 1.9 years in the
control group. The mean crude intake of most minerals after the intervention was significantly higher
than before the intervention, except for the crude intake of retinol, thiamine, riboflavin, folate, Vitamin
C, iodine, and Vitamin B12. Furthermore, in relation to the modified intake of micronutrients, the
mean modified intake of most micronutrients after the intervention showed a significant increase
compared to before, except for retinol, Vitamin D, niacin, B12, and iodine.
CONCLUSION: Considering the effect of providing a nutritional education program to improve
micronutrient intake in children with CLD and emphasizing the importance of adequate micronutrient
intake in improving the health of children, special nutrition programs should be provided to these
children with special attention. In this regard, nurses can play an important role in improving the
quality of nutrition of children by providing nutrition programs with appropriate follow‑up.


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