Studies in water metabolism in clinical and experimental malnutrition

Changes in the Basal Metabolic Rate of the Malnourished Infant and Their Relation to Body Composition

“…If the body solid content of normal infants is taken as 35 to 45 per cent (19,29), the normal BMR range of 45 to 60 calories per kg body weight per day represents 100 to 170 calories per kg body solids. The range in nine malnourished infants studied soon after admission was 134 to 236 calories per kg body solids per day (mean 171) ( Table V).…”

“…The protein-depleted infant has an abnormally high content of body water, regardless of the degree of clinical edema, and most if not all of this excess is believed to be in the extracellular phase (18)(19)(20). As a basis of reference, therefore, the body solid mass, although it includes fat and minerals, may be preferable to the body weight.…”

Bromide Space Studies in Infants of Low Birth Weight

“…Clinical assumptions of fetal malnutrition with dehydration, hypovolemia, and hyperosmolality are, however, mutually contradictory. Abundant data concerning malnutrition in human infants [1,4,13,16,25,27,33,37,38,40,45,52,56] and in experimental animals [19,36,59] provide conclusive evidence for an expansion of fluid compartments (when expressed as percentage of body weight) in postnatal protein-calorie malnutrition, the extent of which is directly related to the severity of malnutrition [30,34].…”

Biochemical Effects of Protein-Calorie Malnutrition in Man

“…This suggests an excessive accumulation of water or a rel ative depletion of the major ions of the extracellular (N a, CI) and intracel lular (K, Mg, P) fluids, or both, relative to water. While the phenomenon has been related to impaired renal removal of water (88) or possibly to ex cessive antidiuretic hormone activity (112), balance and tissue studies are consistent with depletion of intracellular electrolytes. Depletion of extracel lular and intracellular electrolytes might be expected since recurrent bouts of severe diarrhea are characteristic of PCM.…”

“…Body water : Total body water is increased in relation to weight, sur face area, expected weight for height, or tissue solids in malnourished in fants and children with protein-calorie malnutrition or Kwashiorkor, when measured by TaO (88,89), D20 (90 chemical analysis of the body (80,92), or muscle (93)(94)(95)(96)(97). Total body water (TBW) as a percentage of body weight or of ideal weight for age in malnour ished preschool children is increased in proportion to the degree of weight retardation (87,89) .…”