Biochemical aspects of malabsorption in marasmus: effect of dietary rehabilitation

1. Sixty marasmic children were investigated for the absorption of xylose, proteins and fats. Their duodenal juice samples were also analysed for bile salts and microflora. 2. The marasmic children were then studied in three groups of twenty by allocating them to three different dietary schedules: a high-protein diet (30% of the total energy from protein), a high-fat diet (40% of the total energy from fat) and a high-carbohydrate diet (70% of the total energy from carbohydrate) for 2 weeks and the previous measurements repeated. 3. Whereas the high-fat diet resulted in improved fat absorption, along with an increase in total and conjugated bile acids, and the high-carbohydrate diet led to improved xylose absorption, the diet rich in protein resulted in an improvement in the absorption of all three dietary ingredients. It appears that a high-protein diet improves the overall absorption process by improving the intestinal environment as a whole, while high-carbohydrate and high-fat diets bring about adaptive changes related to the respective absorptive processes.