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 MSc in Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran


BACKGROUND: Complications of chronic liver disease (CLD) in children play an important role in mortality
and disability. This disease is one of the health problems of the country and due to its chronic and irreversible
disease, it needs care and treatment education programs. Therefore, this study was performed to determine
the effect of nutrition adjustment training program on anthropometric indices in children with CLD.
MATERIALS AND METHODS: This clinical trial study was performed on 75 children
(45 in the intervention group and 30 in the control group) with CLD in the nutrition clinic of Ghaem
Educational‑Research Center in Mashhad. Children and caregivers with inclusion criteria entered
the study after completing written consent. Anthropometric indices (abdominal circumference, body
water level, body fat, height, weight, body mass index, arm circumference) were measured and
recorded in children at the beginning of the study. Children and their caregivers were randomly
divided into control and intervention groups. The intervention group underwent nutritional adjustment
(calculation of energy and carbohydrates, lipids and proteins, vitamins and minerals, calculation
and selection of diet) training (face to face) for 6 sessions (each session 90–120 min, three times
a week for 2 weeks). Twelve weeks after the start of the study, children in both intervention and
control groups were evaluated for anthropometric indices. The collected data were analyzed by SPSS
software version 16 and descriptive and analytical statistical tests (Mann–Whitney and Wilcoxon).
RESULTS: The results of Wilcoxon statistical test showed that children in the intervention group at
the end of the study compared to the beginning of the study had significant changes in scores around
the abdomen (P = 0.001), total body water (P = 0.009), total fat (0.001 > P), height (P = 0.001),
weight (P < 0.001), body mass index (P < 0.001), arm circumference (P < 0.001). The mean scores
at the end of the study increased compared to the beginning of the study, but the mean scores of
the studied indices in the control group did not change significantly.
CONCLUSION: The results of this study showed that diet adjustment training program can be effective
on anthropometric indices of children with CLD. For this purpose, the use of this educational method
is recommended to improve the anthropometric indices of these children.


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