PROTEIN AND ENERGY-REQUIREMENTS IN CHILDREN WITH SEVERE MALNUTRITION

Severe malnutrition is defined by a weight for height below 70% of int ernational standards or by presence of oedema in a clinically undernou rished child. Severe malnutrition associated with oedema is called kwa shiorkor. The origin of oedemas of kwashiorkor is still debated but it s relation with protein deficiency is strongly questioned. The same di etary management is now recommended for malnutrition with or without o edema. Present recommendations are based, as for well nourished childr en, on the separate estimation of nutritional requirements for mainten ance and growth. Total requirements van, between 0.7 g/kg/day in the f irst few days of treatment to 5 g/kg/day or more when weight gain is m aximum. As a result of high energy requirement during catch-rep growth , protein requirements never exceed 10 to 12% of total energy needs. ( C) 1998, Elsevier, Paris.