Studies in Protein-Calorie Malnutrition

Caddell, Joan L.; Goddard, D. R.

doi:10.1056/nejm196703092761001

Cited by 83 publications

(7 citation statements)

References 8 publications

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“…S-magnesium was above normal range in the majority of the children at admission, although there was a large variation which is in accordance with previous reports [23]. Some studies have reported normal S-magnesium in the presence of magnesium deficits (indicated by low levels of magnesium in muscle tissue and low urinary excretion of magnesium) in children with SAM [24, 25], whereas one study found low S-magnesium in severely malnourished children with history of diarrhoea [3]. S-magnesium could be falsely increased due to mild haemolysis of blood samples; however, the degree of haemolysis was highest in blood samples collected at admission, where magnesium levels were lowest.…”

Section: Discussionsupporting

confidence: 87%

Serum phosphate and magnesium in children recovering from severe acute undernutrition in Ethiopia: an observational study

et al. 2016

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BackgroundChildren with severe acute malnutrition (SAM) have increased requirements for phosphorus and magnesium during recovery. If requirements are not met, the children may develop refeeding hypophosphatemia and hypomagnesemia. However, little is known about the effect of current therapeutic diets (F-75 and F-100) on serum phosphate (S-phosphate) and magnesium (S-magnesium) in children with SAM.MethodsProspective observational study, with measurements of S-phosphate and S-magnesium at admission, prior to rehabilitation phase and at discharge in children aged 6–59 months admitted with SAM to Jimma Hospital, Ethiopia. Due to shortage of F-75, 25 (35 %) children were stabilized with diluted F-100 (75 kcal/100 ml).ResultsOf 72 children enrolled, the mean age was 32 ± 14 months, and edema was present in 50 (69 %). At admission, mean S-phosphate was 0.92 ± 0.34 mmol/L, which was low compared to normal values, but increased to 1.38 ± 0.28 mmol/L at discharge, after on average 16 days. Mean S-magnesium, at admission, was 0.95 ± 0.23 mmol/L, and increased to 1.13 ± 0.17 mmol/L at discharge. At discharge, 18 (51 %) children had S-phosphate below the normal range, and 3 (9 %) had S-phosphate above. Most children (83 %) had S-magnesium above normal range for children. Both S-phosphate and S-magnesium at admission were positively associated with serum albumin (S-albumin), but not with anthropometric characteristics or co-diagnoses. Using diluted F-100 for stabilization was not associated with lower S-phosphate or S-magnesium.ConclusionHypophosphatemia was common among children with SAM at admission, and still subnormal in about half of the children at discharge. This could be problematic for further recovery as phosphorus is needed for catch-up growth and local diets are likely to be low in bioavailable phosphorus. The high S-magnesium levels at discharge does not support that magnesium should be a limiting nutrient for growth in the F-100 diet. Although diluted F-100 (75 kcal/100 mL) is not designed for stabilizing children with SAM, it did not seem to cause lower S-phosphate than in children fed F-75.

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Section: Discussionsupporting

confidence: 87%

Serum phosphate and magnesium in children recovering from severe acute undernutrition in Ethiopia: an observational study

et al. 2016

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“…Protein refeeding stimulates anabolism and a lowered magnesium concentration, resulting in the magnesium deficiency syndrome of g r o~t h .~~~~ This abrupt dilution and redistribution of magnesium may precipitate clinical symptoms. 21 Dr. Abdulla pointed out the need for a sensitive, accurate diagnostic test to assess the magnesium stores of a patient during life. Both plasma and urinary magnesium values may be ~nreliable.~~ Erythrocytes are insensitive diagnostic tissues for magnesium deficiency.…”

Section: Replymentioning

confidence: 99%

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Caddell¹

2009

Nutrition Reviews

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“…Mg deficiency may occur in malnourished children with chronic or severe diarrhoea (Montgomery, 1960;Caddell & Goddard, 1967;Alleyne et al 1977). If signs of muscle twitching, hyperirritability or convulsions occur, and if they are not caused by hypoglycaemia or meningitis, Mg deficiency should be suspected and treated by intramuscular injection, for example by giving 0.5 ml MgS0,.7H20 (250 g/l)/kg .…”

Section: Vol 38mentioning

confidence: 99%

Progress in the Treatment of Protein–Energy Malnutrition

Ashworth

1979

Proc. Nutr. Soc.

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Studies in Protein-Calorie Malnutrition

Cited by 83 publications

References 8 publications

Serum phosphate and magnesium in children recovering from severe acute undernutrition in Ethiopia: an observational study

Serum phosphate and magnesium in children recovering from severe acute undernutrition in Ethiopia: an observational study

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Progress in the Treatment of Protein–Energy Malnutrition

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