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Carbohydrate malabsorption in children with severe protein energy malnutrition

J J Tolboom, A P Ralitapole-Maruping, M Mothebe

    Tropical and Geographical Medicine
    |December 1, 1984
    PubMed

    Insights

    Severe Protein-Energy Malnutrition (PEM) in Basotho children is linked to increased carbohydrate malabsorption, especially lactose malabsorption. This suggests careful lactose use during PEM treatment is advisable.

    Area of Science:

    • Nutritional Science
    • Pediatric Gastroenterology
    • Public Health Nutrition

    Background:

    • Severe Protein-Energy Malnutrition (PEM) poses significant health challenges in children.
    • Understanding nutrient malabsorption is crucial for effective PEM treatment strategies.
    • Lactose malabsorption is a common concern in pediatric malnutrition.

    Purpose of the Study:

    • To investigate the incidence of carbohydrate malabsorption, specifically lactose malabsorption.
    • To assess malabsorption in Basotho children with severe PEM during treatment.
    • To evaluate the impact of a dry skim milk (DSM)-sucrose-oil mixture on malabsorption.

    Main Methods:

    • A Hydrogen Breath Test (HBT) was administered to 105 children with PEM.
    • Children received a dry skim milk (DSM)-sucrose-oil mixture.
    • Lactose-free challenges were used to confirm lactose malabsorption.

    Main Results:

    • Carbohydrate malabsorption was more frequent in children with kwashiorkor (48%) compared to marasmus (15%), marasmic kwashiorkor (20%), and controls (24%).
    • Lactose malabsorption accounted for at least two-thirds of carbohydrate malabsorption cases in kwashiorkor.
    • Carbohydrate malabsorption onset was earlier in PEM children (approx. 13 months) than in controls (approx. 22 months).
    • Diarrhea was more prevalent in PEM children with carbohydrate malabsorption.

    Conclusions:

    • Severe PEM is associated with a higher incidence of carbohydrate and lactose malabsorption.
    • Lactose malabsorption in PEM children occurs earlier than in healthy children.
    • Findings support the cautious use of physiological lactose doses in severe PEM treatment.

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