Effect of dietary viscosity on energy intake by breast-fed and non-breast-fed children during and after acute diarrhea

Marquis, Grace S; López, Teresa Torres; Peerson, Janet M; Brown, Kenneth H.

doi:10.1093/ajcn/57.2.218

Cited by 16 publications

(12 citation statements)

References 16 publications

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“…Our previous field trials found that the MCP diet was eagerly accepted by diarrheafree children in rural villages (unpublished data), so palatability was probably not an important factor. Although some investigators have suggested that children may consume more of a liquid diet than a semi-solid mixture of the same energy density, our studies in Peru found no positive impact of reduced viscosity of a weaning mixture on total energy intakes by children with diarrhea (27). Thus we do not believe that the distinct viscosities of the diets is the reason for the differences that were observed.…”

Section: Discussioncontrasting

confidence: 88%

Evaluation of a maize‐cowpea‐palm oil diet for the dietary management of Nigerian children with acute, watery diarrhea

Grange¹,

Santosham²,

Ayodele³

et al. 1994

Acta Paediatrica

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A randomized clinical trial was carried out to compare a locally available maize-cowpea-palm oil diet (group MCP) with a commercially produced lactose-free, soy protein isolate formula (group SF) for the dietary management of 69 Nigerian boys, 6-24 months of age, hospitalized for acute, watery diarrhea. Although the treatment groups were generally similar initially, the children in group SF had slightly lower mean weight-for-age z scores (p = 0.08), lower serum bicarbonate levels (p = 0.04) and greater stool outputs during the period of rehydration before the diets were initiated (p = 0.01). Rates of treatment failure in group MCP (5.7%) and group SF (8.8%) were similar (p = 0.67). There were no significant differences in the adjusted mean stool outputs by study group on days 1-5, but the children in group SF had slightly lower fecal weights on day 6 (p = 0.05). Children in group MCP had a substantially reduced duration of liquid stool excretion (estimated median duration 42 h versus 140 h; p < 0.001). On the other hand, children in group SF consumed considerably more of their diet, had greater net absorption of macronutrients and greater rates of weight gain than those in group MCP. We conclude that children can safely consume the MCP diet during acute, watery diarrhea without increasing their risk of treatment failure or augmenting stool output. However, the diet may not be adequate as a sole source of nutrients beyond the period of acute illness.

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Section: Discussioncontrasting

confidence: 88%

Evaluation of a maize‐cowpea‐palm oil diet for the dietary management of Nigerian children with acute, watery diarrhea

Grange¹,

Santosham²,

Ayodele³

et al. 1994

Acta Paediatrica

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“…The results of these studies are not consistent, some findings being positive 8,12,15 -19 and others not 5,9,20 . In all of the aforementioned studies but one 7 , amylase was used as a way to increase the density of energy and other nutrients while keeping the gruels' consistency at levels acceptable to both infants and mothers.…”

mentioning

confidence: 74%

Does the consumption of amylase-containing gruels impact on the energy intake and growth of Congolese infants?

Moursi

Mbemba

Trèche

2003

Public Health Nutr.

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Objective: To assess the effect of the incorporation of amylase in maize-based flours prepared as gruels on the energy intake and growth of Congolese infants. Design: A randomised controlled trial. At 18 weeks of age, infants were randomised into either an intervention group, where they were provided with a maize/soya-based flour that contained amylase, or a control group, where they were provided with a similar flour that did not contain amylase. Setting: Urban borough of Poto-Poto in Brazzaville, The Congo. Subjects: Eighty infants (40 in each group) were randomised into intervention and control groups. Three infants in the intervention group and two controls subsequently dropped out. Results: At 24 weeks, the addition of amylase resulted in a significant increase in energy intake (in kJ kg 21 day 21 ) from gruels ðP ¼ 0:02Þ without affecting breast milk consumption. In contrast, total energy intake (in kJ kg 21 day 21 ) did not differ significantly between groups ðP ¼ 0:08Þ: After adjustment for morbidity and previous growth, infants in the intervention group showed better growth in length during the trial (+0.22 cm month 21 ; P ¼ 0:04), especially between 24 and 31 weeks of age (+0.51 cm month 21 ; P , 0:01). There were no differences in weight velocity between groups. Conclusions: The findings of this study suggest that the consumption of amylasetreated gruels allows an increase in energy intake from these gruels without affecting breast milk consumption but has no impact on total daily energy intake. However, if started after 6 months, it could be effective in preventing faltering of infant linear growth. Keywords Amylases Energy density Complementary feedingBreast-feeding Energy intake Infant growthIn developing countries, the growth rates of infants who are exclusively breast-fed during the first 6 months are similar to those of their counterparts in affluent populations 1 -3 . After this period, most infants in developing countries deviate from the satisfactory growth pattern due to recurrent infections and a lack of nutrientdense complementary foods 4 . Mothers in most developing countries traditionally use gruels as the first special transitional food. These are generally prepared from a fermented dough or a flour or mixture of flours that are produced locally. These flours typically have high starch content and, when cooked in water, they swell considerably and thicken the gruels. In order to avoid this thickening, mothers reduce the proportion of flour to water and as a result the energy and nutrient densities of the gruels become insufficient. Low-nutrient-density complementary foods play an important role in children's dietary intake and growth performance 3 . Complementary foods with low nutritional value could displace breast milk and consequently have a detrimental effect on the nutritional status of infants 3 .Modification of the dietary characteristics of bulky gruels has been used as a way to improve children's dietary intake and several studies have been carried out to assess the ef...

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“…Anorexia in diarrheal neonates may reduce energy intake by 5 to 40% [27]; however, breast feeding usually remains unabated and intake may even increase during diarrhea [27], [28]. Therefore, lack of breast feeding during diarrhea further impacts nutrient and energy intake [27], [28]. However, the strong association of severe malnutrition with the cessation of breast feeding in early infancy has also been reported earlier [16].…”

Section: Discussionmentioning

confidence: 99%

Impact of Lack of Breast Feeding during Neonatal Age on the Development of Clinical Signs of Pneumonia and Hypoxemia in Young Infants with Diarrhea

et al. 2011

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BackgroundHypoxemia is a grave sequel of pneumonia, and an important predictor of a fatal outcome. Pneumonia in the neonatal period is often associated with lack of breast feeding. However, there is no published report on the impact of the cessation of breast feeding in the neonatal period on the development of pneumonia and hypoxemia. The purpose of our study was to assess the impact of non-breast feeding or stopping breast feeding during the neonatal period (henceforth to be referred to as non-breast fed) on clinical features of pneumonia and hypoxemia in 0–6-month-old infants with diarrhea admitted to an urban hospital in Bangladesh.MethodsWe prospectively enrolled all infants (n = 107) aged 0 to 6 months who were admitted to the Special Care Ward (SCW) of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research Bangladesh (ICDDR,B) with diarrhea and pneumonia from September 2007 through December 2007.We compared the clinical features of pneumonia and hypoxemia of breast fed infants (n = 34) with those who were non-breast fed (n = 73).ResultsThe median (inter-quartile range) duration of hypoxemia (hours) in non-breast-feds was longer than breast-fed infants [0.0 (0.0, 12.0) vs. 12.0 (0.0, 21.75); p = 0.021]. After adjusting for potential confounders such as inability to drink, fever, head nodding, cyanosis, grunting respiration, and lower chest wall in drawing, the non-breast-fed infants with pneumonia along with diarrhea had a higher probability of cough (OR 9.09; CI 1.34–61.71; p = 0.024), hypoxemia (OR 3.32; CI 1.23–8.93; p = 0.017), and severe undernutrition (OR 3.42; CI 1.29–9.12; p = 0.014).Conclusions and SignificanceNon-breast feeding or cessation of breast feeding during the neonatal period may substantially increase the incidence of severe malnutrition, incidence of cough, and both the incidence and duration of hypoxemia in young infants presenting with pneumonia and diarrhea. The findings emphasize the paramount importance of the continuation of breast feeding in the neonatal period and early infancy.

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Effect of dietary viscosity on energy intake by breast-fed and non-breast-fed children during and after acute diarrhea

Cited by 16 publications

References 16 publications

Evaluation of a maize‐cowpea‐palm oil diet for the dietary management of Nigerian children with acute, watery diarrhea

Evaluation of a maize‐cowpea‐palm oil diet for the dietary management of Nigerian children with acute, watery diarrhea

Does the consumption of amylase-containing gruels impact on the energy intake and growth of Congolese infants?

Impact of Lack of Breast Feeding during Neonatal Age on the Development of Clinical Signs of Pneumonia and Hypoxemia in Young Infants with Diarrhea

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