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Trace mineral balance during acute diarrhea in infants
C Castillo-Duran1, P Vial, R Uauy
1Institute of Nutrition and Food Technology, University of Chile, Santiago.
Insights
Infants with acute diarrhea experience significant copper and zinc losses, leading to depletion. Recovery improves zinc retention, but copper balance may remain abnormal even after a week.
Area of Science:
- Pediatric Nutrition
- Gastroenterology
- Mineral Metabolism
Background:
- Acute diarrhea is a common pediatric illness.
- Diarrhea can lead to significant fluid and electrolyte disturbances.
- Nutrient losses during diarrhea, particularly minerals like copper and zinc, are a concern for infant health.
Purpose of the Study:
- To quantify copper and zinc losses in infants hospitalized with acute diarrhea.
- To compare these losses with those in healthy infants.
- To assess the recovery of copper and zinc balance and plasma levels post-diarrhea.
Main Methods:
- Metabolic balance studies were conducted in 14 infants with diarrhea and 15 healthy controls.
- Fecal and urinary losses of copper and zinc were measured using atomic absorption spectrophotometry.
- Plasma copper and zinc levels were monitored during recovery.
Main Results:
- Infants with diarrhea showed significantly higher fecal losses of copper and zinc compared to controls.
- Zinc retention improved markedly by day 6-7, while copper balance remained negative in the diarrhea group.
- Fecal weight and mineral losses were positively correlated; plasma zinc levels correlated negatively with fecal zinc losses.
Conclusions:
- Acute diarrhea causes significant depletion of copper and zinc in infants.
- While zinc status improves with recovery, copper balance may remain abnormal for at least a week.
- Monitoring and potentially supplementing copper and zinc may be crucial for infants recovering from severe diarrhea.
Abstract:
To evaluate the magnitude of copper and zinc losses during acute diarrhea requiring hospitalization, we studied 14 infants, 3 to 14 months of age, and compared them with a control group of 15 infants of similar age, birth weight, and nutritional status. Metabolic balance studies were conducted in the study group during an initial 48 hours (period 1) and on days 6 and 7 after admission (period 2). The control group was studied after recovery from respiratory disease. Copper and zinc content of feces, urine, and food samples was measured by atomic absorption spectrophotometry. Mean (+/- SD) fecal losses were higher for period 1 in the diarrhea group than in control subjects: Cu 55.7 +/- 21.2 versus 28.8 +/- 6.7 micrograms/kg/body weight/day (p less than 0.01); Zn 159.4 +/- 59.9 versus 47.4 +/- 6.4 micrograms/kg/day (p less than 0.0001). For period 2, Zn losses were similar in both groups, but Cu balance remained negative only in the study group. Retention of Zn for the study group went from -21.2 +/- 46.7 in period 1 to 204.5 +/- 103.0 micrograms/kg/day in period 2 (p less than 0.0001), and fecal weight decreased from 70.5 +/- 20.6 in period 1 to 36.8 +/- 20.0 gm/kg/day in period 2. Fecal weight and fecal losses were correlated: r = 0.71 (p less than 0.01) for Cu and r = 0.81 (p less than 0.001) for Zn. Plasma mean Cu and Zn levels were low in period 1 but rose in period 2, especially for Zn. A negative correlation was found between fecal Zn losses and plasma Zn: r = 0.74 (p less than 0.001). We conclude that acute diarrhea leads to Cu and Zn depletion and that plasma levels and Cu balance remain abnormal a week after admission.