SAME GROWTH AND DIFFERENT ENERGY-INTAKE OVER 4 YEARS IN CHILDREN SUFFERING FROM CHRONIC NONSPECIFIC DIARRHEA

An increase in energy intake often occurs at weaning and this may depe nd on the current practice of offering energy-dense foods ad libitum. In two-year-old lean infants suffering from chronic non-specific diarr hoea (CNSD), the offering of food was evaluated by care-givers at ever y meal on the basis of food need expressions and non-starchy vegetable acceptance, taking into account the maintenance of good temper and no rmal activity between meals. The purpose was to avoid diarrhoea recurr ence. This form of regulation was continued in a prospective, controll ed, randomized investigation to explore: (i) familial pre-determinatio n of growth and (ii) the existence of an 'unnecessary' fraction of ene rgy intake, i.e. a fraction which may habitually be excluded while sti ll maintaining the same normal inter-meal behaviour, intellectual and physical achievements, growth, skinfold thicknesses and blood paramete rs. Seven-day intake home diaries and clinical assessments were perfor med every 6 to 12 months. Growth records were investigated in siblings . Eighty-two of 91 experimental subjects and 32 of 41 randomized ones in the control group were followed for up to four years. The control g roup maintained a significantly higher (15-30%) energy intake than the experimental children, without any fattening or growth acceleration, or any improved results in inter-meal behaviour, intellectual and phys ical achievements or blood parameters for four years. The normal media n weight was reached in the experimental and control children in the s ixth year of life and in the siblings in the fourth year of life. Fami lial predetermination of growth and pre-determination of thin subcutan eous tissues were found in CNSD children despite the possibility of a substantially higher energy intake than necessary. The current early p ractice of offering energy-dense food ad libitum was responsible for t he increased intake.