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Dietary supplementation and rapid catch-up growth after acute diarrhoea in childhood

Published online by Cambridge University Press:  09 March 2007

Simon Hoare ,
Sally D. Poppitt ,
Andrew M. Prentice  and
Lawrence T. Weaver
Simon Hoare
Affiliation:
MRC Dunn Nutrition Group, Keneba, The Gambia and Cambridge, CB4 1XJ
Sally D. Poppitt
Affiliation:
MRC Dunn Nutrition Group, Keneba, The Gambia and Cambridge, CB4 1XJ
Andrew M. Prentice
Affiliation:
MRC Dunn Nutrition Group, Keneba, The Gambia and Cambridge, CB4 1XJ
Lawrence T. Weaver
Affiliation:
MRC Dunn Nutrition Group, Keneba, The Gambia and Cambridge, CB4 1XJ
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Abstract

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Diarrhoea is a major cause of short-term growth faltering in children of the developing world. If catch-up weight gain is delayed by inadequate dietary intake, or by further bouts of diarrhoea, progressive growth failure occurs. To test the hypothesis that early refeeding is as effective as later feeding after acute diarrhoea with weight loss, we measured the effects of a timed dietary intervention on weight gain after acute diarrhoea in underweight Gambian children. Thirty-four children aged 4–22 months with weight loss following acute diarrhoea were given a high-energy-protein supplement for 14 d beginning either immediately after rehydration or a fortnight later. With a 50% increase in energy intake and a 100% increase in protein intake there was a rapid and highly significant (P < 0.001) gain in weight within a fortnight whether the supplement was given immediately or 2 weeks after presentation. Rates of weight increase were similar whether supplementation was provided early or late, but over the full 28 d (of intervention and non-intervention) children who received late supplementation had greater overall weight gain (P < 0.02) than those supplemented early. Vigorous and early feeding with a high-energy-protein supplement should be central to the management of malnourished children with acute diarrhoea in developing countries, and may be as important as control of diarrhoea in preventing malnutrition and growth failure. This may be achieved in the community using IocaUy available foods, in the face of continuing diarrhoea

Keywords

DiarrhoeaGrowthChildrenDietary supplementation
Type
Human and Clinical Nutrition
Information
British Journal of Nutrition , Volume 76 , Issue 4 , October 1996 , pp. 479 - 490
Copyright
Copyright © The Nutrition Society 1996

References

REFERENCES

Ashworth, A. & Millward, D. J. (1986). Catch-up growth in children. Nutrition Reviews 44, 157–163.CrossRefGoogle ScholarPubMed
Becker, S., Black, R. E. & Brown, K. H. (1991). Relative effects of diarrhoea, fever, and dietary energy intake on weight gain in rural Bangladeshi children. American Journal of Clinical Nutrition 53, 1499–1503.CrossRefGoogle ScholarPubMed
Black, R. E. (1991). Would control of childhood infectious diseases reduce malnutrition? Acra Paediatrica Scmdinavica 374, 135–140.Google ScholarPubMed
Briend, A.(1990). Is diarrhoea a major cause of malnutrition among the under fives in developing countries? A review of available evidence. European Journal of Clinical Nutrition 44, 611–628.Google Scholar
Briend, A., Aziz, K. M. A., Hasan, K. H. Zahid & Hoque, B. A. (1989). Are diarrhoea control programmes likely to reduce childhood malnutrition? Observations from rural Bangladesh. Lancet ii, 319–322.CrossRefGoogle Scholar
Brown, K. H. (1991 a). Appropriate diets for the rehabilitation of malnourished children in the community setting. Acta Paodiatric Scandinavica 374,Suppl.151–159.CrossRefGoogle ScholarPubMed
Brown, K. H. (1991 b). Dietary management of acute diarrhoea: optimal timing of feeding and appropriate use of milk and mixed diets. Journal of Pediatrics, 118, S92–S98.CrossRefGoogle ScholarPubMed
Brown, K. H. & MacLean, W. C. (1984). Nutritional management of acute diarrhea: an appraisal of the alternatives. Pediatrics 73, 119–125.Google ScholarPubMed
Chung, A. W. & Viscorova, B. (1948). The effect of early oral feeding versus early oral starvation on the course of infantle diarrhea. Journal of Pediatrics 33, 14–22CrossRefGoogle Scholar
Downes, R. M., Prentice, A. M., Coward, W. A., Whitehead, R. G. & Weaver, L. T. (1992). Effects of weaning food on breast milk intake in Gambin infants. Proceedings of the Nutrition Society 51, 78A.Google Scholar
Editorial (1991). Solving the weanling's dilemma: power flour to fuel the gruel. Lancet 338, 604–605.CrossRefGoogle Scholar
Feachem, R. G. (1983). Interventions for the control of diarrhoea1 diseases among young children: supplementary feeding programmes. Bulletin of the World Health Organisation 61, 967–979.Google Scholar
Fjeld, C. R., Schoeller, D. & Brown, K. H. (1989). Body composition of children recovering from severe protein-energy malnutrition at two rates of catch-up growth. American Journal of Clinical Nutrition 50, 1266–1275.CrossRefGoogle ScholarPubMed
Hamill, P. V. V., Drizd, T. A., Johnson, C. L., Reed, R. B., Roche, A. F. & Moore, W. M. (1979). Physical growth: National Center for Health Statistics percentiles. American Journal of Clinical Nutrition 32, 607–629.CrossRefGoogle ScholarPubMed
Heikens, G. T., Schofield, W. N., Dawson, S. & Grantham-McGregor, S. (1989). The Kingston project. 1. Growth of malnourished children during rehabilitation in the community, given a high energy supplement. European Journal of Clinical Nutrition 43, 145–160.Google Scholar
Hirschhorn, N. (1980). The treatment of acute diarrhea in children: an historical and physiological perspective. American Journal of Clinical Nutrition 33, 637–663.CrossRefGoogle ScholarPubMed
Hoyle, B., Yunus, M. D. & Chen, L. C. (1980). Breast feeding and food intake among children with acute diarrheal disease. American Journal of Clinical Nutrition 33, 2365–2371.CrossRefGoogle ScholarPubMed
Hudson, G. J., John, P. M. V. & Paul, A. A. (1980). Variation in composition of Gambian foods: the importance of water in relation to energy and protein content. Ecology of Food and Nutrition 10, 9–17.CrossRefGoogle Scholar
Jackson, A. A. (1990). Protein requirements for catch-up growth. Proceedings of the Nutrition Society 49, 507–516.CrossRefGoogle ScholarPubMed
Jackson, A. A. & Wootton, S. A. (1990). The energy requirements of growth and catch-up growth. In Activity, Energy Expenditure, and Energy Requirements of Infants and Children, pp. 185–214 [Schurch, B. and Scrimshaw, N. S. editors]. Lausanne, Switzerland: International Dietary Energy Consultancy Group.Google Scholar
Kennedy, E. & Knudsen, O. (1988). A review of supplementary feeding programmes and recommendations for their design. In Nutrition and Development, pp. 77–96 [Biswas, M. and Pinstrup-Anderson, P. editors]. Oxford:Oxford Medical Publications.Google Scholar
Lamb, W. H., Foord, F. A., Lamb, C. M. B. & Whitehead, R. G. (1984). Changes in maternal and child mortality rates in three isolated Gambian villages over ten years. Lancet i, 912–914.CrossRefGoogle Scholar
Lebenthal, E. (editor) (1989). Textbook of Gastroenterology and Nutrition in Infancy, 2nd ed. New York: Raven Press.Google Scholar
Lunn, P. G., Northrop-Clewes, C. A. & Downes, R. M. (1991). Intestinal permeability, mucosal injury, and growth faltering in Gambian infants. Lancet ii, 907–910.CrossRefGoogle Scholar
Lutter, C. K., Mora, J. O., Habicht, J. P., Rasmussen, K. M., Robson, D. S., Sellers, S. G., Super, C. M. & Herrera, M. G. (1989). Nutritional supplementation: effects on child stunting because of diarrhea. American Journal of Clinical Nutrition 50, 1–8.CrossRefGoogle ScholarPubMed
Molla, A. M., Molla, A., Sarker, S. A. & Rahaman, M. M. (1983). Food intake during and after recovery from diarrhea in children. In Diarrhea and Malnutrition. Interactions, Mechanisms, and Interventions, pp. 113–123 [Chen, L. C. and Scrimshaw, N. S. editors]. New York: Plenum Press.CrossRefGoogle Scholar
Moy, R. J. D., Choto, R., Booth, I. W. & McNeish, A. S. (1991). Diarrhoea and catch-up growth (letter). Lancet i, 600.Google Scholar
Prentice, A. M., Lucas, A., Vasquez-Velasquez, L., Davies, P. S. W. & Whitehead, R. G. (1988). Are current dietary guidelines for young children a prescription for overfeeding? Lancet ii, 1066–1069.CrossRefGoogle Scholar
Prentice, A. & Paul, A. A. (1990). Contribution of breast-milk to nutrition during prolonged breast-feeding. In Breastfeeding, Nutrition, Infection, and Infant Growth in Developed and Emerging Countries, pp. 88–101 [Atkinson, S. A., Hanson, L. A. and Chdndra, R. K. editors]. St. John's: ARTS Biomedical Publishers.Google Scholar
Prentice, A. M., Paul, A. A., Prentice, A., Black, A. E., Cole, T. J. & Whitehead, R. G. (1986). Cross cultural differences in lactational performance. In Human Lactation 2: Maternal and Environmental Factors, pp. 13–44[Hamosh, M. and Goldman, A. S., editors]. New York: Plenum Press.CrossRefGoogle Scholar
Rivera, J. A., Habicht, J. P. & Robson, D. S. (1991). Effect of supplementary feeding on recovery from mild to moderate wasting in pre-school children. American Journal of Clinical Nutrition 54, 62–68.CrossRefGoogle Scholar
Rowland, M. G. M., Cole, T. J. & Whitehead, R. G. (1977). A quantitative study into the role of infection in determining nutritional status in Gambian village children. British Journal of Nutrition 37, 441–450.CrossRefGoogle ScholarPubMed
Rowland, M. G. M. & Whitehead, R. G. (1978). Pattern of Growth of Keneba Children. The Epidemiology of Protein-Energy Malnutrition in Children in a West African Village Community, pp. 8–11. Cambridge: MRC Dunn Nutrition Unit.Google Scholar
Schorling, J. B. & Guerrant, R. L. (1991). Diarrhoea and catch-up growth. Lancet i, 599.Google Scholar
Sullivan, P. B., Lunn, P. G., Northrop-Clewes, C., Crowe, P. T., Marsh, M. N. & Neale, G. (1992). Persistent diarrhea and malnutrition - impact of treatment on small bowel structure and permeability. Journal of Pediatric Gastroenterology and Nutrition 14, 208–215.Google ScholarPubMed
Sullivan, P. B., Marsh, M. N., Mirakian, R., Hill, S. M., Milla, P. J. & Neale, G. (1991). Chronic diarrhoea and malnutrition: histology of the small intestinal mucosal lesion. Journal of Pediatric Gastroenterology and Nutrition 12, 195–203.Google Scholar
Truswell, A. S. (Chairman) (1983). Recommended dietary intakes around the world. Committee 1/5 of the International Union of Nutritional Sciences. Nutrition Abstracts and Reviews 53, 960.Google Scholar
Waterlow, J. C. (1992). Protein Energy Malnutrition. London: Edward Arnold.Google Scholar
Weaver, L. T., Austin, S. & Cole, T. J. (1991). Small intestinal length: a factor essential for gut adaptation. Gut 32, 1231–1233.CrossRefGoogle ScholarPubMed
Whitehead, R. G. (1977). Protein and energy requirements of young children living in developing countries to allow catch-up growth after infections. American journal of clinical Nutrition 30, 1545–1547.CrossRefGoogle ScholarPubMed
World Health Organization (1985). Energy and Protein Requirements. WHO Technical Report Series no. 724. Geneva: WHO.Google Scholar