Diet, pancreatic function, and chronic pancreatitis in south India and France

The usual consumption of calories, fat, protein, and carbohydrate, and the exocrine pancreatic function estimated in duodenal juice after an intravenous injection of secretin and cholecystokinin (CCK), have been studied with the same method and by the same team in Kerala (South India) and in Marseille (France) in apparently normal children (7 Indians, 21 French), in normal adults (23 Indians, 17 French), and in patients presenting with chronic calcifying pancreatitis (8 Indian children, 28 Indian adults, 25 French adults). Although they had a low protein intake (children controls: 32.1 +/- 14 g/day (SM), children pancreatitis: 51.1 +/- 15, adult controls: 51.3 +/- 4.9, adult pancreatitis: 55.7 +/- 5.7), the exocrine secretion of Indian controls was not very much modified in comparison with Europeans. Therefore, Indians are less affected by the insufficient diet than the population of Ivory Coast previously studied by the same group. The diet of Indian patients is characterized by a moderately low protein intake and a very low fat intake (18.5 g/day +/- 2.3 (SM) for children 23.4 g/day + 2.7 for adult patients). Comparison between different series of patients studied in different countries with the same method suggests that kwashiorkor or cassava consumption have no evident role in the etiology of chronic tropical pancreatitis. The possible role of a low fat diet is suggested and needs further exploration.