The protein quality and digestibility of two high lysine (2.9-3.0 g/100 g protein) and tow conventional varieties (lysine content 2.1-2.2 g/100 g protein) of whole grain sorghum milled as flour were assessed through balance studies in 13 children 6-30 months of age. Sorghum protein provided 6.4 or 8.0% of dietary energy. Control diets contained 64% kcal protein as casein. Children consumed 100-150 kcal/kg body weight/day. Sorghum consumption was associated with weight loss or poor weight gain. We found no difference by variety in apparent nitrogen absorption or retention. Mean absorption and retention of nitrogen (+/- SD) from 26 six-day sorghum dietary periods were 46 +/- 17% and 14 +/- 10% of intake, respectively (corresponding preceding casein control values: 81 +/- 5% and 38 +/- 3%). Stool weight and energy losses during sorghum periods averaged 2.5 to 3 times control values. Plasma amino acids were determined in eleven children after 16 days of sorghum consumption. Fasting concentration of total amino acids (TAA) was similar to values previously obtained with wheat protein at similar levels of intake. Total concentration of essential amino acids (TEAA) was low as were concentrations of lysine (Lys) and threonine (Thr). Analysis of postprandial changes of the Lys/TEAA and Thr/TEAA molar ratios confirmed that Lys was the first limiting amino acid.
reflected the protein status rather than the composition of the diet associated with the development of the deficiency state. Whitehead developed two simplified techniques, usable in the field, to relate the concentration of some non-essential amino acids to that of a group of essentials, the ratio beinq-3 directly correlated with the severity of protein deficiency, gauged in part by the serum albumin levels. Arroyave has proposed the ratios of several essential amino acids, indivi dually, to qlycine, as positively correlated with nutritional history and proteLn status (5). Both authors feel that these ratios or indices arc usuful for the recognition of marginal or pre-clinical cases of protein malnutrition. In marasmus, however, they do not serve as a gaucge of severity (8). The present report analyses the relationship between serum total protein, serum albumin and plasma amino acid concentrations in 41 severely malnourished infants and child ren, in an effort to assess their usefulness aq clinical or field tools. Materials and Methods The patients studied represent 41 nearly consecutive unselected cases of severe malnutrition admitted under our care to the British American Hospital in Lima, Peru. In most of them chronologic age was verified by examination of birth or baptismal certificates. Along with anthropometric mea surements, physical examination, routine hematologic studies, serum electrolytes, and appropriate cultures, the initial evaluation included serum total protein, serum albumin, and plasma free amino acid determinations. In all but one case (when it-was drawn 1.5 hours later, after partial rehydration) venous blood samples were obtained wiLhin the first hour after admission. Although we have no reliable data on the * Tyrosine and Cystine have also been included as essentials.
Copper deficiency was often found in severely malnourished infants rehabilitated on exclusive milk diets. Marked, persistent neutropenia was its earliest and most constant manifestation.
The equivalent of 0.12% lysine enrichment of white wheat flour resulted in significant enhancement of its protein value for the rapidly growing human infant, as demonstrated by increased rates of weight gain and nitrogen retention, stability of serum albumin, and elevation of the molar ratio of plasma lysine when the flour was the only source of protein in the diet. Isonitrogenous and isocaloric casein diets were used as controls. Enrichment to the 0.2% level resulted in suggestive further increases in the rates of weight gain and N retention, a further elevation in the molar ratio of plasma lysine and a reduction in that of plasma threonine. Enrichment to the 0.4% level resulted in a suggestive further increase in N retention alone and in further elevation of plasma lysine and reduction of plasma threonine. Enrichment of white wheat flour with lysine to the 0.12% and possibly the 0.2% level is recommended for those areas in which this cereal serves as the main source of protein in the diet, particularly that of infants and children. The improvement in biological value to be expected is enough to make the difference between dietary protein adequacy and deficiency to the many, without adverse effects on the few who might not profit by such enrichment. 10. CONTROL NUMBER II. PRICE OF DOCUMENT PN-AAC-571 12. DESCRIPTORS 13. PROJECT NUMBER Diets Protein supplements Flours Wheat 14. CONTRACT NUMBER Lysine rqn-jI'i R e, Nitrogen metabolism 1s. TYPE OF DOCUMENT
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