ABSORPTION OF MACRONUTRIENTS FROM A CALORIE-DENSE DIET IN MALNOURISHED CHILDREN DURING ACUTE SHIGELLOSIS

A metabolic balance study was performed to determine the absorption of macronutrients and energy from different food items in 23 malnourishe d children aged 12 to 48 months with clinically severe acute dysentery due to shigellosis. In a 72-h balance period, the absorption of carbo hydrate, protein, fat, and total energy was determined. All the childr en received a standard hospital diet; 12 children in the test group we re offered an additional calorie-dense milk (5.0 kJ/ml with a protein- energy ratio of 11.0), and 11 children in the control group, on the ot her hand, received a milk formula with an energy of 2.5 kJ/ml with a p rotein-energy ratio of 11.0. The intakes (g/kg/day) of protein, fat, c arbohydrate, and energy between test and control groups were 4.25 vers us 2.32 (p = 0.01), 7.63 versus 3.00 (p = 0.01), 21.09 versus 11.14 (p = 0.01), and 711 kJ/kg/day versus 338 kJ/kg/day (p = 0.01), respectiv ely. The coefficients of absorption of protein, fat, carbohydrate, and energy between test and control groups were 61 versus 67%(p = 0.45), 69 versus 82% (p = 0.11), 77 versus 86% (p = 0.13), and 72 versus 82% (p = 0.13), respectively. The losses (g/kg/day) of protein, fat, carbo hydrate, and energy between the two groups were 1.61 versus 0.76 (p = 0.00), 2.44 versus 0.55 (p = 0.00), 5.0 versus 1.6 (p = 0.00), and 204 kJ/kg/day versus 60 kJ/kg/day, respectively. The results of this stud y indicate that during the acute stage of shigellosis (with a substant ially enhanced total intake of protein, fat, carbohydrate, and energy) , by adding calorie-dense meals in malnourished children younger than 5 years, the absorption of macronutrients is not significantly differe nt from that with the usual diet but suboptimal dietary energy intake, as is the case under ordinary treatment conditions.