Protein-Calorie Malnutrition

Protein-Calorie Malnutrition reviews the state of knowledge of metabolic phenomena in the syndromes embraced by the general term protein-calorie malnutrition (PCM), and places this new knowledge in perspective with the traditional descriptions of kwashiorkar and marasmus. The clarification it provides constitutes a benchmark for design of future programs of prevention, therapy, rehabilitation, research, or teaching. Highly noteworthy are the new advances in amino acid and protein metabolism; the enlightening evidence concerning lysine and carnitine; the evidences of derangements or deficiencies of the broad spectrum of nutrients from carbohydrates to vitamins and minerals; and the implications of these for recovery and therapy. This book includes papers on the following: the impact of age on amino acid requirements; the mechanisms of adaptation to low-protein intakes; the metabolic consequences of essential amino acid deficiency in higher animals; carbohydrate metabolism; vitamin deficiencies associated with PCM; and mineral metabolism in PCM. Other studies deal with the effects of malnutrition on endocrine function; liver function in PCM; the synergistic interaction of malnutrition and infection; and the treatment and prevention of PCM.

List of ContributorsPrefaceAcknowledgmentsAmino Acid Requirements and Age Introduction Amino Acid Requirements and Protein Quality Practical Applications ReferencesDiscussionAdaptation to Low-Protein Intakes Introduction Albumin Metabolism Conservation of Nitrogen Oxidation of Essential Amino Acids Protein Metabolism in Muscle Control Mechanisms Conclusion ReferencesProtein Turnover in Various Nutritional States Text ReferencesDiscussionLysine Metabolism in Protein-Calorie Malnutrition with Attention to the Synthesis of Carnitine The Lysine/Carnitine-Precursor/Product Relationship Lysine Deficiency and Concomitant Impairment of Carnitine Biosynthesis: Nutritional Implications ReferencesDiscussionCellular Energy Metabolism in Protein-Calorie Malnutrition Introduction Results Discussion Summary ReferencesDiscussionBrain DNA Synthesis in Protein-Calorie Malnutrition Growth Retardation Mechanisms Controlling Cellular Growth Human Brain Growth Summary ReferencesElectroencephalograms, Learning, and Malnutrition Text ReferencesThe Relationship of Severe Marasmic Protein-Energy Malnutrition and Rehabilitation in Infancy to Subsequent Mental Development Subjects Methods Results Discussion ReferencesDiscussionCarbohydrate and Lipid Metabolism in Protein- Calorie Malnutrition Carbohydrate Metabolism Fat Metabolism Summary ReferencesDiscussionWater-Soluble Vitamins in Protein-Calorie Malnutrition Prevalence of Vitamin Deficiencies Associated with PCM Thiamine Status in PCM Riboflavin Status in PCM Folic Acid Status in PCM Vitamin B12 in PCM Pyridoxine in PCM Niacin in PCM Vitamin C in PCM Summary ReferencesNutritional Survey of Children in the Dominican Republic with Attention to Deficits in Water-Soluble Vitamins Text ReferencesDiscussionThe Fat-Soluble Vitamins and Protein-Calorie (Energy) Malnutrition Protein-Energy Malnutrition The Fat-Soluble Vitamins The Deficiency States in Relation to PEM Conclusion ReferencesDiscussionMineral Metabolism in Protein-Calorie Malnutrition Potassium Organ Analyses Significance of Changes in WBK and Organ Potassium Magnesium Sodium The Genesis and Significance of These Changes ReferencesMineral Metabolism in Protein Malnutrition Text ReferencesDiscussionEndocrines and Malnutrition Human Growth Hormone (HGH) in Kwashiorkor and Marasmus (PEM) Adrenal Function and Malnutrition Insulin and Protein-Energy Malnutrition Thyroid and Thyrotropin Antidiuretic Hormone (ADH) Conclusions ReferencesDiscussionErythropoiesis in Protein-Calorie Malnutrition Physiological Changes Pathological Changes Summary ReferencesThe Anemia of Protein-Calorie Malnutrition Text ReferencesThe Effect of Vitamin E on the Anemia of Protein-Calorie Malnutrition in Northern Thai Children Text ReferencesDiscussionThe Effect of Variations in Protein and Calorie Intake on the Rate of Recovery and Selected Physiological Responses in Thai Children with Protein-Calorie Malnutrition Design of the Study Materials and Methods Results Discussion Summary ReferencesThe Liver in Protein-Calorie Malnutrition: An Ultrastructural Study Text ReferencesDiscussionCalories in the Treatment of Protein-Calorie Malnutrition Text ReferencesProtein-Sparing Effect of Excess Calories during Adaptation to Low-Protein Intake Summary ReferencesDiscussionProtein versus Calories in the Treatment of Protein-Calorie Malnutrition: Metabolic and Population Studies in India Longitudinal Studies Cross-Sectional Studies Effect of Calorie Supplementation Clinical Studies ReferencesDiscussionInteractions of Malnutrition and Infection: Advances in Understanding Mechanisms of Interaction Epidemio