[How much protein can our children, our economy and our conscience stand?].
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Biomedical subjects
Publications and source records attributed to G Sterky.
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Kwashkorkor is associated with malabsorption of energy and nutrients. Standard diets often initiate diarrhea and a high mortality is still prevalent. A synthetic monomolecular formula has been evaluated and compared with a standard diet in the early rehabilitation phase of 21 children with kwashiorkor. The formula group had significantly less vomiting and reached minimum weight faster than the group on standard diet. Weight gain and diarrhea were similar. The rise of albumin and BUN was faster on standard diet. A significant increase in haemoglobin was seen only in the formula group. A rise in body temperature after a meal was evident in most patients and significantly more pronounced in the formula group. The lower total nitrogen content of the formula may explain the observed slower rise in albumin and BUN but the ready utilization was indicated by the favourable weight changes as well as the rise in rectal temperature. As high energy per volume was desirable the formula was not diluted to isoosmolality. However, the high glucose concentration in the experimental diet probably caused some negative effects.
The authors report on the treatment of children with kwashiorkor, using Vivonex or Casilan. With Vivonex, all patients were bottle-fed as early as the 2nd or 3rd day, whereas Casilan had to be administered by stomach tube for about a week. Children fed Casilan vomited much more frequently than patients receiving Vivonex. When Casilan was given, the albumin level rose after 8 days, whereas with Vivonex, this did not occur unitl 15 days. On the other hand, only the Vivonex fed children showed an increase of hemoglobin in the first 3 weeks of treatment. With Vivonex, the patients reached their minimum weight much faster and at a lower albumin level than with Casilan. In both groups, the frequency of diarrhea was similar; the relatively high glucose concentration of Vivonex and the disturbance of resorption, even of monosaccharides, which is frequently observed in severe cases of kwashiorkor may be responsible for the diarrhea of the children receiving Vivonex.
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