COMPARATIVE DIGESTIBILITY OF GOATS VERSUS COWS MILK FATS IN CHILDREN WITH DIGESTIVE MALNUTRITION

Proteino-energetic malnutrition (PEM), currently prevalent in developi ng countries, is linked to the basic question of resource availability , and use of locally available foods at lower cost should be encourage d. PEM physiopathology is notably characterized by malabsorption of fa ts, which can be partially counteracted by medium-chain triglycerides (MCTs) absorbed by the intestine without pancreatic lipase and biliary salts. However, industrial formula are expensive, and MCTs are presen t in goat's milk in a proportion twice as great as in cow's milk. The aim of our study was first to check whether the higher rate of MCTs in goat's milk was likely to trigger a positive clinical effect as regar ds intestinal fat absorption rate (FAR), and second, to assess whether goat's milk could constitute a valuable clinical alternative to cow's milk. The double-blind study included 64 children aged 9 to 72 months , with intestinal malabsorption and malnutrition due to gluten intoler ance. After an initial observation period to determine which subjects met the inclusion criteria, the children were given standardized food based on either goat's or cow's milk and butter for 3 d. The daily die t comprised 2 milk meals with milk diluted at 14%, 2 gluten-free and m ilk-free flour meals, and 2 vegetable meals enriched with 12% butter. Thus each child received 160 kcal/kg body weight/24 h, more than the a mount required for measuring FAR. Stool fat was measured over the 3-d period according to Van de Kamer's method. Food acceptability and tole rance were estimated according to food intake and body weight changes. Results were as follows: 1) no difference appeared between the 2 grou ps upon inclusion; 2) there was a significant difference in FAR rate b etween the 2 groups (P < 0.04) in favor of the goat's milk fed group; 3) food tolerance, food and caloric intake as well as body weight chan ges were similar in the 2 groups. To conclude, goat's milk and butter appear to have a nutritional value which is at least similar to those of cow's milk and butter as regards the clinical status of malnutritio n, with the additional factor of greater availability in the many regi ons with prevalent proteino-energetic malnutrition.