Protein metabolism in chronic severe malnutrition (kwashiorkor)

Abstract

Absorption and retention of nitrogen from a typical poor Mexican diet BY F. GOMEZ, R. RAMOS-GALVAN, J. CRAVIOTO (Received 28 M a y 1956-Revised 26 February 1957 Variously known by such names as kwashiorkor (Africa), shibi gachaki (Japan), protein malnutrition (WHO), Mehlnahrschaden (Germany), chronic severe malnutrition is one of the most prevalent pathological conditions suffered by children living in underdeveloped countries. Surveys carried out in different parts of the world have shown that the diets of such children are very similar, not only in their nutritional value, but also in the foodstuffs actually eaten. A typical dietary history is as follows: (I) prolonged breast feeding on an inadequate lactation; (2) improper weaning with cereals (especially corn (maize) meal cooked by the action of quicklime), beans and peppers; ( 3 ) lack of milk, meat, fish and eggs after weaning. That is to say the diet after weaning is low in calories, fats and proteins, high in carbohydrates, and contains insufficient amounts of vitamins and minerals. The intake of most of the children meets no more than 50% of the caloric, and from 20 to 60% of the protein, requirement. Fats, usually vegetable fats, are consumed in amounts one-third below normal (Lozoya-

Delivery of oral doses of vitamin a to prevent vitamin a deficiency and nutritional blindness

“…These changes are likely to account for much of the fat malabsorption accompanying severe PEM (76). Since children with severe PEM are at greatly increased risk of developing blinding corneal xerophthalmia (3,77), improvement in their vitamin A status needs to be accomplished as quickly as possible.…”

Clinical Aspects of Protein Malnutrition

“…A number of investigators (Van der Sar, 1951 ;Jayasekera et al, 1951 ;Gómez et al, 1956c;Robinson et al, 1957) have noted varying degrees of steatorrhea and decreased fat absorption in kwashiorkor, which became normal with adequate diet therapy. A large percentage of the fecal fat is composed of fatty acids and neutral fats (Jayasekera et al, 1951).…”