Malabsorption of carbohydrate from rice and child growth: a longitudinal study with the breath-hydrogen test in Burmese village children

Article Abstract:

In some developing countries, rice may provide as much as three quarters of the energy consumed by children. Thus it is very important that they be able to absorb the carbohydrate in rice and obtain its nutritional benefits. When most or all of the rice-flour carbohydrate is absorbed in the intestines, little hydrogen is released in the breath, but if it is poorly absorbed, breath hydrogen concentration will be high. The amount of breath hydrogen is measured with the breath-hydrogen test. Most of the research on absorption of rice-flour carbohydrate has been done with adults. A recent study with children in Burma found that two thirds of children aged 1 to 59 months had rice-carbohydrate malabsorption. This study related the malabsorption to growth of the children, who were measured at one point in time; this experimental design is known as a cross-sectional study. However, the most sensitive index of nutritional adequacy in children is growth velocity, or rate of growth over time. In the current study, growth velocity was determined by measuring the children at three time points which were three months apart. Seventy-five children aged 1 to 59 months were studied. Breath-hydrogen tests were also performed, and showed that the overall rate of rice-carbohydrate malabsorption was 47 percent. Children aged 36 to 59 months who were classified as rice malabsorbers had significantly slower linear growth (gains in height) than children who absorbed the rice efficiently. Therefore, rice-carbohydrate malabsorption did have an adverse effect on growth in these children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Children, Developing countries, Food and nutrition, Growth, Rice, Malabsorption syndromes, Intestinal absorption

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TPN-induced catch-up of growth in a 22-y-old male with radiation enteritis

Article Abstract:

Malnutrition in children can cause severe growth retardation and can also delay sexual maturation. Diseases that commonly have a major impact on growth and development from malnutrition include inflammatory bowel disease (colitis or Crohn's disease), gluten-induced enteropathy, and other intestinal malabsorption syndromes. Intensive nutritional therapy can support catch-up growth in these children, allowing their physical development to catch up to their chronological age. Important aspects of catch-up growth are skeletal growth, weight gain, and development of secondary sexual characteristics. The case of a 22-year-old man is discussed; he had experienced malnutrition caused by severe chronic radiation enteritis (inflammation of the intestines) and short bowel syndrome. These conditions were a result of treatment for bladder cancer diagnosed at age seven years. At age 22, he was very thin with severely stunted growth and had not yet undergone the changes of puberty. Home total parenteral nutrition (TPN), intravenous feeding used at home, was begun at age 22 and continued for four years. With this nutritional support, he experienced substantial increases in height and weight and matured sexually; secondary sexual characteristics appeared and his hormone levels normalized. This case shows that even at a late age, a dramatic growth spurt and the puberty process can still occur in individuals who were chronically malnourished as children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Case studies, Celiac disease, Parenteral feeding, Parenteral nutrition, Crohn's disease, Parenteral therapy

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Pneumonia, diarrhea, and growth in the first 4 y of life: a longitudinal study of 5914 urban Brazilian children

Article Abstract:

In infants and children, malnutrition and infectious diseases are known to be linked, but the interactions are complicated and are not yet fully understood. There are three main ways in which nutritional status and infectious illnesses such as diarrhea and pneumonia interact. Malnutrition appears to increase the risk of acquiring the illness, poor nutrition may cause the illness to be more severe, and the illness may worsen the nutritional status of the child. These relationships were investigated in a group of 5,914 urban Brazilian children followed from shortly after birth to age four years. The data consisted of records of hospital admissions for pneumonia and diarrhea, and weight and height taken at birth and at approximately age two and age four. Analysis of the data showed that malnutrition was a more significant risk factor for developing pneumonia than for developing diarrheal disease. However, admissions for diarrhea were better indicators of malnutrition than were admissions for pneumonia. These relationships between nutrition and illness were stronger from birth to age two than from age two to four years. Children who experienced serious episodes of pneumonia or diarrhea early in life still showed the adverse effects of these illnesses on their nutrition in the fourth year of life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Causes of, Pediatric diseases, Brazil, Pneumonia in children, Childhood pneumonia, Infection in children

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