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Protein deficiency, energy deficiency, and the oedema of malnutrition.

Abstract

The role of dietary protein deficiency in kwashiorkor is uncertain, although it has been shown not to be involved in the famine oedema of adults. A study of six different diets given to 103 children with oedematous malnutrition showed that the rate of loss of oedema was strongly correlated with the dietary energy intake (r = 0.75) but not with the protein intake (r = 0.03). 66 patients given a very-low protein diet (2.5% protein energy) lost oedema as fast as those given five times as much protein. The energy intake above which oedema resolved and below which oedema accumulated was 245-270 KJ/kg/day. Because energy deficiency is not invariably associated with oedema it cannot be the only factor involved, and the necessary dietary component(s) must therefore have been present in surfeit in all the therapeutic diets. This could be potassium together with factors necessary for its retention. The accessory ingredients must be low in foods associated with human and experimental nutritional oedema. It is suggested that protein deficiency is not the cause of the oedema of kwashiorkor and that there is no need to postulate a different pathogenesis for this oedema from starvation oedema of adults.

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  • Authors

    Source

    Lancet (London, England) 1:8284 1982 Jun 05 pg 1261-5

    MeSH

    Adult
    Age Factors
    Child
    Dietary Proteins
    Edema
    Energy Metabolism
    Humans
    Kwashiorkor
    Potassium Deficiency
    Protein-Energy Malnutrition
    Serum Albumin
    Starvation

    Pub Type(s)

    Clinical Trial
    Controlled Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    6123017

    Citation

    Golden, M H.. "Protein Deficiency, Energy Deficiency, and the Oedema of Malnutrition." Lancet (London, England), vol. 1, no. 8284, 1982, pp. 1261-5.
    Golden MH. Protein deficiency, energy deficiency, and the oedema of malnutrition. Lancet. 1982;1(8284):1261-5.
    Golden, M. H. (1982). Protein deficiency, energy deficiency, and the oedema of malnutrition. Lancet (London, England), 1(8284), pp. 1261-5.
    Golden MH. Protein Deficiency, Energy Deficiency, and the Oedema of Malnutrition. Lancet. 1982 Jun 5;1(8284):1261-5. PubMed PMID: 6123017.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Protein deficiency, energy deficiency, and the oedema of malnutrition. A1 - Golden,M H, PY - 1982/6/5/pubmed PY - 1982/6/5/medline PY - 1982/6/5/entrez SP - 1261 EP - 5 JF - Lancet (London, England) JO - Lancet VL - 1 IS - 8284 N2 - The role of dietary protein deficiency in kwashiorkor is uncertain, although it has been shown not to be involved in the famine oedema of adults. A study of six different diets given to 103 children with oedematous malnutrition showed that the rate of loss of oedema was strongly correlated with the dietary energy intake (r = 0.75) but not with the protein intake (r = 0.03). 66 patients given a very-low protein diet (2.5% protein energy) lost oedema as fast as those given five times as much protein. The energy intake above which oedema resolved and below which oedema accumulated was 245-270 KJ/kg/day. Because energy deficiency is not invariably associated with oedema it cannot be the only factor involved, and the necessary dietary component(s) must therefore have been present in surfeit in all the therapeutic diets. This could be potassium together with factors necessary for its retention. The accessory ingredients must be low in foods associated with human and experimental nutritional oedema. It is suggested that protein deficiency is not the cause of the oedema of kwashiorkor and that there is no need to postulate a different pathogenesis for this oedema from starvation oedema of adults. SN - 0140-6736 UR - https://www.unboundmedicine.com/medline/citation/6123017/Protein_deficiency_energy_deficiency_and_the_oedema_of_malnutrition_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0140-6736(82)92839-2 DB - PRIME DP - Unbound Medicine ER -