Protein Turnover, Synthesis and Breakdown before and after Recovery from Protein-Energy Malnutrition

1977 ◽  
Vol 53 (5) ◽  
pp. 473-477 ◽  
Author(s):  
M. H. N. Golden ◽  
J. C. Waterlow ◽  
D. Picou

1. Rates of total protein turnover, synthesis and breakdown were measured in five children before and after recovery from severe protein-energy malnutrition and while receiving 0·6 g of protein and 397 kJ day−1 kg−1. 2. These rates were calculated after giving doses of [15N]glycine every 2 h along with the feeds and measuring the rate of excretion of [15N]urea in urine. 3. Malnourished children had significantly lower rates of protein turnover, synthesis and breakdown than after they had recovered. 4. During recovery from protein-energy malnutrition, two children on a daily intake of 1·2 g of protein and 605 J/kg body weight, had rates of protein turnover, synthesis and breakdown that were twice as great as those found on admission and higher than after recovery. 5. On the study diet the malnourished children maintained their weight while the recovered children lost weight; the apparent nitrogen balance was more positive in the malnourished children. 6. In recovered children, the rate of protein synthesis was unchanged over a wide range of protein intake, whereas the rate of protein breakdown appeared to rise with a reduction in protein intake.

1985 ◽  
Vol 53 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Jacqueline M. Hibbert ◽  
Alan A. Jackson ◽  
Sally M. Grantham-Mcgregor

1. In rat studies, circulating concentrations of N-acetylneuraminic acid (NANA) have been shown to be an indicator of NANA concentrations in the brain and functional brain activity, in relation to nutritional state and stimulation. Abnormal behaviour can be improved with exogenous NANA. In the present study, the plasma NANA concentration has been measured in children with severe malnutrition and compared with that in controls.2. NANA was measured colorimetrically in the plasma of twenty-three severely malnourished children (mean age 11.43 (SD 6.05) months) before and after recovery, and in thirty-four controls (mean age 14.28 (SD 7.32) months). In thirteen of the malnourished children, NANA was measured after infections had been treated with a course of antibiotics.3. Mean plasma NANA concentration was significantly higher in protein-energy malnutrition (PEM)(2.89 (SD 0,58)μmol/ml; n 23) compared with controls (2.13(SD 0.37)μmol/ml; n 34, P < 0.001). The levels remained high in PEM after infections had been treated (2.87(SD 0.43) μmol/ml, n 13) but returned to control levels at recovery from PEM (2.14(SD 0.24)μmol/ml).4. In contrast to the findings in rats, in malnourished children plasma NANA concentrations were not reduced and did not relate directly to nutritional state or, by inference, brain function. These findings do not provide any support for the use of exogenous NANA supplements to improve brain function in humans.


2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 239-244
Author(s):  
Sung Hee Chung ◽  
Peter Stenvinkel ◽  
Bengt Lindholm ◽  
Avesani Carla Maria

Protein–energy malnutrition (PEM) is highly prevalent among peritoneal dialysis (PD) patients and is a strong predictor of morbidity and mortality. A wide range of factors can lead to PEM and associated wasting (PEM/W) in PD patients, but persistent inflammation and the presence of diabetes have been identified as the two main reasons. An important body of literature has been reporting studies of methods suitable for detecting malnutrition in its early phase so that appropriate intervention can be provided. Although assessment of nutrition status has been substantially improved, no definitive single method of assessing nutrition status has been decided. Rather, several different markers of nutrition should be evaluated together. Because of the complexity of treating malnutrition in PD patients, nontraditional strategies such as appetite stimulants, anti-inflammatory diets, and anti-inflammatory pharmacologic agents are recommended to be combined with more traditional forms of nutritional support, so as to provide a better chance of recovery. The present review briefly discusses the causes of PEM/W, the methods most commonly used to identify the condition, and the new management strategies available.


2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Aishat Oluwatoyin Saka ◽  
Mohammed Jamiu Saka ◽  
Lateefat Olayinka Sa’adu

Malaria and Protein-Energy-Malnutrition (PEM) are two major causes of childhood mortality in sub-Saharan Africa. Malaria can predispose a child to PEM and the reverse may also be true. Recent studies have presented inconsistent findings about nutritional status and the occurrence of malaria among the children. The goal of this study was to evaluate the association between PEM and malaria parasitemia if any. A case control study in which 90 children diagnosed for PEM (aged 6-59 months), and another well-nourished 90 children age and sex-matched controls were evaluated for malaria parasitemia. A semi-structured proforma was used to obtain relevant information on the children’s sociodemographic characteristics, nutritional indices amongst others. Venous blood sample was collected and thick and thin blood film were prepared and viewed under the microscope. Malaria parasitemia was present in 82 (91.1%) of malnourished group and 12 (13.3%) of the well-nourished group (P<0.05 OR=66.62). Malaria parasitemia was highest in those with kwashiorkor and marasmic kwashiorkor compared with underweight. These differences were statistically significant (P<0.05). The study demonstrates that malnourished children have higher degree of malaria parasitemia and are at risk of malaria. It also shows that severe forms of malnutrition are associated with heavier malaria parasitemia. It is therefore recommended that all malnourished children should have access to use of Insecticide Treated Nets (ITN), malaria chemoprophylaxis as well as empiric treatment of malaria in endemic areas where access to malaria parasite diagnosis is difficult.


2005 ◽  
Vol 26 (4) ◽  
pp. 323-329 ◽  
Author(s):  
M. Iqbal Hossain ◽  
M. A. Wahed ◽  
Shaheen Ahmed

Background In Bangladesh, as in other developing countries, protein–energy malnutrition is most prevalent among children during weaning. After weaning, children are often fed cereal-based diluted low-calorie porridge, resulting in growth-faltering. Objective To assess the effect on food intake of adding amylase-rich flour (ARF) from germinated wheat to supplementary food among children in nine rural Community Nutrition Centers under the Bangladesh Integrated Nutrition Project (BINP). Methods A total of 166 malnourished children of either sex, aged 6 to 24 months, received one of three diets randomly allocated to the Community Nutrition Centers. The composition of the diets was the same; however, the consistency and calorie density were altered by adding either ARF or water. Thirty-five children received the standard supplementary food of the BINP (S-SF), 65 received supplementary food with added ARF (ARF-SF), and 66 received supplementary food with added water (W-SF). The children were studied for six weeks. Results The mean ± SD intake of supplementary food from a single meal by children completing six weeks on the diets was higher for children receiving ARF-SF (33.91 ± 8.25 g) than for those receiving S-SF (25.66 ± 6.73 g) or W-SF (30.26 ± 8.39 g) (p < .05 for both comparisons). The weight of vomited food was significantly higher for children receiving W-SF than for children in the other two groups. Weight gain and increments in length and weight-for-height were higher for children who received ARF-SF than for children in the other two groups, but the differences were not statistically significant. The acceptability of ARF-SF was higher than that of the two other diets. The additional cost of adding 2 g of ARF to the diet was about Taka 0.25 (US$1 = Taka 48). Conclusions Addition of ARF to existing standard supplementary food, as used under the BINP program, is a simple and effective means to increase the intake of food by changing its consistency, thus making it easier for malnourished children to ingest.


2004 ◽  
Vol 11 (3) ◽  
pp. 577-580 ◽  
Author(s):  
Oralia Nájera ◽  
Cristina González ◽  
Guadalupe Toledo ◽  
Laura López ◽  
Rocío Ortiz

ABSTRACT Protein-energy malnutrition is the primary cause of immune deficiency in children across the world. It has been related to changes in peripheral T-lymphocyte subsets. The aim of the present study was to evaluate the effects of infection and malnutrition on the proportion of peripheral-lymphocyte subsets in well-nourished non-bacterium-infected (WN), well-nourished bacterium-infected (WNI), and malnourished bacterium-infected (MNI) children by flow cytometry. A prospectively monitored cohort of 15 MNI, 12 WNI, and 17 WN children was studied. All the children were 3 years old or younger and had only bacterial infections. Results showed a significant decrease in the proportion of T CD3+ (P < 0.05 for relative and P < 0.03 for absolute values), CD4+ (P < 0.01 for relative and absolute values), and CD8+ (P < 0.05 for relative values) lymphocyte subsets in WNI children compared to the results seen with WN children. Additionally, B lymphocytes in MNI children showed significant lower values (CD20+ P < 0.02 for relative and P < 0.05 for absolute values) in relation to the results seen with WNI children. These results suggest that the decreased proportions of T-lymphocyte subsets observed in WNI children were associated with infection diseases and that the incapacity to increase the proportion of B lymphocyte was associated with malnutrition. This low proportion of B lymphocytes may be associated with the mechanisms involved in the immunodeficiency of malnourished children.


2002 ◽  
Vol 8 (2-3) ◽  
pp. 290-297
Author(s):  
S. Y. Shaaban

To assess the role of enzymatic antioxidants in the pathogenesis of protein energy malnutrition [PEM] and the effect of nutritional rehabilitation, we studied 30 infants with PEM [mean age 10.63 +/- 4.39 months: 10 marasmic; 8 with kwashiorkor; 12 with marasmic kwashiorkor] and 15 controls. All underwent clinical examination and laboratory investigations, including superoxide dismutase [SOD] and glutathione peroxidase [GPx] estimation before and after nutrition rehabilitation. SOD and GPx were significantly lower in all malnourished infants compared to controls, and significantly increased after nutritional rehabilitation. These significant correlations suggest that antioxidants could be introduced during PEM nutritional rehabilitation to decrease morbidity and mortality.


Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2929
Author(s):  
Martin Röhling ◽  
David McCarthy ◽  
Aloys Berg

The aim of this study was to determine the changes in endurance performance and metabolic, hormonal, and inflammatory markers induced by endurance stress (marathon race) in a combined strategy of training and dietary protein supplementation. The study was designed as a randomised controlled trial consisting of regular endurance training without and with a daily intake of a soy protein-based supplement over a three-month period in 2 × 15 (10 males and 5 females per group) endurance-trained adults. Body composition (body mass, BMI, and fat mass) was determined, and physical fitness was measured by treadmill ergometry at baseline and after 3 months of intervention; changes in exercise-induced stress and inflammatory markers (CK, myoglobin, interleukin-6, cortisol, and leukocytes) were also determined before and after a marathon competition; eating behaviour was documented before and after intervention by a three-day diet diary. Although no significant influence on endurance performance was observed, the protein supplementation regime reduced the exercise-induced muscle stress response. Furthermore, a protein intake of ≥20% of total energy intake led to a lower-level stress reaction after the marathon race. In conclusion, supplementary protein intake may influence exercise-induced muscle stress reactions by changing cellular metabolism and inflammatory pathways.


2016 ◽  
Vol 45 (4) ◽  
pp. 166
Author(s):  
Boris Januar ◽  
Sri S Nasar ◽  
Rulina Suradi ◽  
Maria Abdulsalam

Background Although aggressive multimodal treatment programsin childhood cancer have significantly increased survival rates, themorbidity caused by protein energy malnutrition related to therapyis still high.Objective To describe nutritional status changes in children withmalignant solid tumors after 21 days of chemotherapy.Methods A descriptive prospective study with pre- and post-testdesign in children with malignant solid tumors was conducted inthe Department of Child Health, Medical School University of In-donesia/Cipto Mangunkusumo Hospital, Jakarta between Janu-ary and July 2004. Anthropometrics (body weight, BW and mid-upper-arm circumference, MUAC) and serum albumin measure-ments were performed before and after 21 days of chemotherapy.Results Twenty-two children were enrolled in this study. After 21days of chemotherapy, 8 children had decreased BW and 6 chil-dren had decreased MUAC, but 3 children gained weight and hadincreased MUAC. Based on MUAC-for-age, 7 children had de-creased nutritional status. Fifteen children had reduced serum al-bumin levels based on a 10% cut-off point. The number of childrenwho had reduced serum albumin was larger than those who hadreduced BW and MUAC. In the evaluation of average oral foodconsumption during 21 days, 7 out of 16 children could acceptmore than 2/3 portion of served food. All of the children who re-ceived enteral feeding could accept more than 2/3 portion of servedfood.Conclusion There was a decrease of nutritional status, BW,MUAC, and serum albumin in most of the subjects after chemo-therapy. Serum albumin level measurement was the more sensi-tive parameter in determining nutritional status changes. Enteralfeeding seems more appropriate to fulfill nutritional needs than oralfeeding


1981 ◽  
Vol 13 (1) ◽  
pp. 19-30 ◽  
Author(s):  
M. L. Sheffer ◽  
S. M. Grantham-McGregor ◽  
S. J. Ismail

SummaryThis investigation was part of a longitudinal study of mental development of seventeen Jamaican children who were admitted to hospital with severe protein energy malnutrition. The children were compared with 20 adequately nourished children who were admitted to hospital for other reasons.Previous research had shown that, 1 month after the children left hospital, both groups had similar scores on a modified Caldwell Inventory of Home Stimulation. When, in the present investigation, the inventory was repeated 24 months later, scores remained similar in both groups. When compared with data collected from a survey in a poor neighbourhood, again the scores of the neighbourhood children were similar to those of the malnourished group. The malnourished children were however living in poorer houses and had failed to catch up to the other groups in nutritional status.Comparison of these findings with those from other countries suggests that the ecology of malnutrition differs in different cultures and that Jamaican mothers of malnourished children are characterized by poverty rather than poor maternal–child relationships.It also appears that, at this age, poor levels of home stimulation were not a major factor in producing the deficit in development manifested by the malnourished group.


Author(s):  
Sumesh Prasad Sah ◽  
Manisha Aroral ◽  
Sudeep Kumar ◽  
Jyoti Batra ◽  
Imran Mustafa ◽  
...  

Objective: The objective of the study was to evaluate and compare serum total protein, serum albumin and thyroid hormones in children with Protein Energy Malnutrition (PEM) and in healthy controls.Methods: Present study was a cross sectional hospital based case control study, total 75 children of age group 1-5 years were included in this study. Triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) was estimated by electro-chemiluminescence immunoassay method, serum total protein by biuret method, albumin by BCG method and plasma hemoglobin by CMG method. Result: In malnourished children, there is significant decrease in serum total protein (4.76 gm %), albumin (2.24 gm %) and Hb (10.57 gm %) as compared to normal healthy children. Serum T3 (0.51 ng/ml), and T4 (3.93 µg/ml) levels were significantly decreased and non-significant changes in TSH (4.26 µUI/ml) levels in children with PEM was observed as compared to healthy controls. Conclusion: The reduction in protein is due to decreased intake of proteins and reduced biosynthesis. The decreased in T3 and T4 levels in malnourished children is probably due to a decrease in circulating plasma proteins.


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