Treatments & Research

Nourishing Healing

For patients with burn injuries, like Joelle, nutrition plays a role in recovery.

Research at Shriners Children’s leads to advances in nutrition for patients with burn injuries

Researchers at Shriners Children’s Ohio spent more than a decade looking at how vitamin D supplements can help prevent bone fractures in patients with burn injuries and discovered something extraordinary: The supplements made a huge difference. 

Shriners Children’s comprehensive wrap-around care model includes clinical nutritionists and dieticians who closely monitor patients during the acute and rehabilitative phases, particularly in children recovering from a severe burn. Years ago, they wondered if they could do anything to prevent bone fractures in recovering burn patients. 

Christina Sunderman, MS, RDN, LD

Discovering a special kind of healing

“Your skin is the largest organ in your body and requires a lot of calories and nutrients to help the healing process after a burn injury,” said Christina Sunderman, MS, RDN, LD, clinical dietician at Shriners Children’s Ohio.

Michele Gottschlich, Ph.D., RD, LD, CSP, CCRP

That healing process continues well after the acute phase, when children transition to rehabilitation and receive physical and occupational therapy. Shriners Children’s dietitian researchers, Michele Gottschlich, Ph.D., RD, LD, CSP, CCRP, and Theresa Mayes, RD, LD, CSP, CCRC, discovered that some patients started sustaining fractures in their long bones (femur, tibia, fibula) during their rehabilitative care. They further investigated each case and found low vitamin D levels to be one of the culprits that was weakening children’s bones.

Theresa Mayes, RD, LD, CSP, CCRC

“Vitamin D is key for growing and maintaining healthy bones,” Sunderman said. “Your body needs vitamin D in order to absorb calcium, the primary component of bone.” 

Gottschlich and Mayes launched a series of studies and clinical trials in 2003 and spent more than a decade comparing burn patients who received vitamin D supplements with those who received placebos. They found fractures significantly decreased in patients who received the vitamin D supplements. 

An incredible impact

“This was really groundbreaking research because very little was known about specific vitamin needs,” Sunderman said. “There’s been a lot of research about the importance of a high-calorie and protein diet, but we didn’t know how important vitamins and minerals were to the recovery process until this study.” 

Their findings were published in outlets like the Journal of Burn Care and Rehabilitation, Nutrition in Clinical Practice and the Journal of Parental and Enteral Nutrition. More important, the results were folded into clinical practice and are still used today. 

Clinical dieticians like Sunderman check vitamin D levels of children recovering from burns when they first arrive at the hospital, then weekly until they’re discharged. 

“It’s amazing when you think about the impact and long-term effects of this study,” Sunderman said. “The research at Shriners Children’s was groundbreaking in terms of how nutrition is so vital to better outcomes for our patients.”