Intestinal malabsorption in malnourished children before and during recovery

Fe, Viteri; Jm, Flores; Alvarado, Jorge; Behar, Moisés

doi:10.1007/bf01071974

Cited by 53 publications

(22 citation statements)

References 21 publications

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“…Traditional weaning foods in Nigeria contain only 0.13 to 0.74 Cal% of linoleic acid [47], an amount that does not meet the requirements of the growing child [19]. In addition there is an impaired intestinal absorption of dietary lipids in the proteinenergy malnourished child [26,31,61,66,68]. Triglyceride digestion is hindered by premature bile salt deconjugation and thus impaired micellular solubisation of lipids [53,57] and by diminished production of pancreas lipase [3,57,62,67].…”

Section: Discussionmentioning

confidence: 99%

Fatty acid composition of plasma lipids in Nigerian children with protein-energy malnutrition

Koletzko

Laryea

et al. 1986

Eur J Pediatr

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The fatty acid (FA) composition of the main plasma lipids was analysed in eight well-nourished, generally healthy Nigerian children aged 14.1 +/- 7.2 months and in 17 malnourished children (8 marasmus, 9 kwashiorkor) aged 14.6 +/- 3.8 months within the first 2 days of admission at the Dept. of Child Health, University of Benin. In comparison to the control group, the malnourished children showed a marked decrease of polyunsaturated FA with low linoleic acid, mainly in sterol esters (STE), and severely reduced linoleic acid metabolites, including arachidonic acid, in all lipid fractions. omega-3-FA were not altered except for a reduction of docosapentaenoic and docosahexaenoic acids in phospholipids. Clearly increased values were found for saturated FA in STE and for the non-essential monoenoic FA in all lipid classes. This pattern indicates the presence of essential fatty acid deficiency in the malnourished children. There was no significant difference between marasmus and kwashiorkor. Eight malnourished children were followed up in the early phase of recovery during hospital treatment 14.0 +/- 3.1 days after obtaining the first sample. Linoleic acid had increased again in STE, but its metabolites were as low or even lower than before. An impaired activity of delta-6-desaturase, the rate limiting enzyme of linoleic acid metabolism, in suggested by elevated substrate-product-ratios of this enzyme in untreated children with protein energy malnutrition and in the early phase of recovery, which may be due to low insulin levels, protein and zinc deficiency. The trientetraen ratio (20:3 omega 9/20:4 omega 6) thus is not a reliable indicator of essential FA status in protein-energy malnutrition.

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Section: Discussionmentioning

confidence: 99%

Fatty acid composition of plasma lipids in Nigerian children with protein-energy malnutrition

Koletzko

Laryea

et al. 1986

Eur J Pediatr

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“…In a detailed study, Viteri et al [35] investigated intestinal absorption in children with protein-calorie malnutrition and edema prior to treatment, and at dif ferent stages of recovery. They noted that all of such children showed evidence of severe malabsorption of nitrogen, fat, purified 131 I-labeled triolein, oleic acid, vitamin A, glucose, D-xylose, and vitamin B 12 .…”

Section: Effects Of Protein-calorie Malnutrition and Chronic Illness mentioning

confidence: 99%

“…In nonindustrialized countries, protein-calorie malnutrition is a major public health issue, protein malnutrition leads to kwashiorkor, and calorie malnutrition to marasmus [31][32][33][34][35] malnutrition defined according to various criteria in different studies has been reported in up to 50% of hospitalized patients [1][2][3][4][5][6]36]. The clinical aspects of malnutrition in such patients are usually a mixed pic ture of kwashiorkor and marasmus.…”

Section: Albumin and Nutritionmentioning

confidence: 99%

The role of albumin in nutritional support.

Mobarhan

1988

Journal of the American College of Nutrition

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Hypoalbuminemia is considered one of the hallmarks of protein-calorie malnutrition and chronic liver disease. Recently, serum albumin has also been proposed as a critical predictor of the response to nutritional support and tolerance to enteral feeding in critically ill patients. Albumin is essential for maintenance of plasma colloidal osmotic pressure, prevention of edema, and transport of certain drugs and nutrients. Experimental studies have shown that rapid plasma expansion and reduced plasma protein concentration and osmotic pressure induce a net secretion of sodium and water into the small intestinal lumen. However, the effects of chronic hypoalbuminemia per se on intestinal absorption, independent of malnutrition, have not been fully studied. It is documented that both chronic illness and malnutrition may profoundly affect intestinal anatomical structure and function, inducing some degree of malabsorption. In the last few years, some have advocated albumin infusion to improve clinical response to patients with hypoalbuminemia receiving parenteral nutritional support or to reduce intestinal intolerance and diarrhea in patients receiving enteral tube feeding. A review of the literature shows that both clinical and experimental data to support these suggestions are scarce and further investigations are needed. Hypoalbuminemia is one of many parameters of malnutrition, and it is unlikely that correction of a single parameter for a short time would lead to major clinical benefits.

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“…La physiopathologie de la MPE se caractérise, entre autre, par la malabsorption des graisses qui porte à la fois sur les acides gras libres et sur les triglycérides, et qui ne saurait être expliquée par la seule diminution de l'activité lipolytique. L'enfant malnutri présente en effet un certain nombre d'autres anomalies susceptibles de perturber l'absorption intestinale des nutriments, notamment celle des lipides : des anomalies histologiques de la muqueuse gastrique et intestinale, une hypochlorhydrie et une pullulation microbienne avec une augmentation de la concentration des sels déconjugués (Viteri et al, 1973;King et Toskes, 1979;Wittman et al, 1987).…”

Section: Introductionunclassified

Digestibilité des graisses du lait de chèvre chez des enfants présentant une malnutrition d'origine digestive. Comparaison avec le lait de vache

Hachelaf¹,

Boukhrelda²,

Benbouabdellah³

et al. 1993

Lait

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Résumé -Liée dans les pays en développement à l'accès aux ressources, la malnutrition protéino-énergétique (MPE), requiert l'utilisation d'aliments disponibles localement à moindres frais. Caracté-risée notamment par la malabsorption des graisses, celle-ci peut être atténuée par des triglycérides à chaine moyenne (TCM). Les TCM étant 2 fois plus abondants dans le lait de chèvre que dans celui de vache, nos objectifs étaient de voir si le lait de chèvre améliorait le coefficient d'absorption intestinale des graisses (CAG), et d'étudier l'acceptabilité de cet aliment. Dans cette étude en double-aveugle 64 enfants de 9 à 72 mois, présentant une malabsorption intestinale et une malnutrition liées à une intolérance au gluten ont reçu durant 3 j une alimentation standardisée à base de lait et de beurre, soit de chèvre, soit de vache. Le CAG dans les selles des 3 j a été mesuré par la mé-thode Van de Kamer. Les résultats ont montré qu'entre les 2 groupes 1) il n'y avait pas de diffé-rences à l'admission, 2) le CAG du lait de chèvre était significativement supérieur (P< 0,04), et 3) la tolérance alimentaire, les prises alimentaires et caloriques ainsi que les modifications du poids corporel étaient identiques. Ainsi, le lait de chèvre, avec une meilleure absorption des graisses et une acceptabilité similaire par rapport au lait de vache, présente des avantages nutritionnels au moins équivalents et offre une perspective alternative digne d'être développée dans les zones endémiques de MPE.

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Intestinal malabsorption in malnourished children before and during recovery

Cited by 53 publications

References 21 publications

Fatty acid composition of plasma lipids in Nigerian children with protein-energy malnutrition

Fatty acid composition of plasma lipids in Nigerian children with protein-energy malnutrition

The role of albumin in nutritional support.

Digestibilité des graisses du lait de chèvre chez des enfants présentant une malnutrition d'origine digestive. Comparaison avec le lait de vache

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