Intake and Absorption of Nutrients in Children With Cholera and Rotavirus Infection During Acute Diarrhea and After Recovery

Molla, Ayesha; Molla, A; Rahim, Ali Abdel

doi:10.1097/00005176-198302010-00028

Cited by 5 publications

(10 citation statements)

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“…In Peruvian infants with diarrhea or fever, breast-milk intake was unaffected; however, caloric intakes of non-breastmilk food decreased by 20-30%, resulting in an overall decrease in caloric intake of 5-6% (65). Infection-related caloric suppression results in both decreased macro-and micronutrient intake (63,64).…”

Section: Current Status Of Knowledgementioning

confidence: 99%

“…Although breast-milk intake appears to be unaffected, food intake is suppressed in children during the APR according to the magnitude of infection. Caloric intake decreases between 8% and 22% in children with diarrheal diseases, malaria, and acute respiratory infection (62)(63)(64). During more severe infections, such as cholera and measles, decreases in caloric intake were reported to be 44% and 75%, respectively.…”

Section: Current Status Of Knowledgementioning

confidence: 99%

“…Gut helminths and diarrheal diseases can impair nutrient absorption by damaging epithelial cells (20,63,66). The extent of malabsorption corresponds to the severity of enteric infection and diarrheal output (20).…”

Section: Current Status Of Knowledgementioning

confidence: 99%

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Undernutrition, the Acute Phase Response to Infection, and Its Effects on Micronutrient Status Indicators

Bresnahan

Tanumihardjo

2014

Advances in Nutrition

106

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Infection and undernutrition are prevalent in developing countries and demonstrate a synergistic relation. Undernutrition increases infectionrelated morbidity and mortality. The acute phase response (APR) is an innate, systemic inflammatory reaction to a wide array of disruptions in a host's homeostasis, including infection. Released from immune cells in response to deleterious stimuli, proinflammatory cytokines act on distant tissues to induce behavioral (e.g., anorexia, weakness, and fatigue) and systemic effects of the APR. Cytokines act to increase energy and protein requirements to manifest fever and support hepatic acute phase protein (APP) production. Blood concentrations of glucose and lipid are augmented to provide energy to immune cells in response to cytokines. Additionally, infection decreases intestinal absorption of nutrients and can cause direct loss of micronutrients. Traditional indicators of iron, zinc, and vitamin A status are altered during the APR, leading to inaccurate estimations of deficiency in populations with a high or unknown prevalence of infection. Blood concentrations of APPs can be measured in nutrition interventions to assess the time stage and severity of infection and correct for the APR; however, standardized cutoffs for nutrition applications are needed. Protein-energy malnutrition leads to increased gut permeability to pathogens, abnormal immune cell populations, and impaired APP response. Micronutrient deficiencies cause specific immune impairments that affect both innate and adaptive responses. This review describes the antagonistic interaction between the APR and nutritional status and emphasizes the need for integrated interventions to address undernutrition and to reduce disease burden in developing countries. Adv Nutr 2014;5:702-711.

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Section: Current Status Of Knowledgementioning

confidence: 99%

Section: Current Status Of Knowledgementioning

confidence: 99%

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Undernutrition, the Acute Phase Response to Infection, and Its Effects on Micronutrient Status Indicators

Bresnahan

Tanumihardjo

2014

Advances in Nutrition

106

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“…To determine nutrient absorption, a 72 h balance study was carried out with the previously-mentioned diet after a 24 h pre-balance period following admission. Details of the method of balance study have been described previously (Molla et al 1982;Roy et al 1990).…”

Section: Patients a N D Methodsmentioning

confidence: 99%

“…Stools from patients with persistent diarrhoea indicate severe malabsorption of nutrients (Roy et af. 1990) which is much higher than that occurring in patients with acute diarrhoea (Molla et al 1982). Management of persistent diarrhoea has always remained problematical, especially because patients had malnutrition and significant digestive and absorptive derangement.…”

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confidence: 98%

Persistent diarrhoea: efficacy of a rice-based diet and role of nutritional status in recovery and nutrient absorption

Akramuzzaman

Haider

et al. 1994

Br J Nutr

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A diet based on rice powder, soya-bean oil, glucose, egg-white and salts was given to twenty-six patients of different nutritional status aged 4–18 months with persistent diarrheoa and twenty-five age-matched controls without diarrhoea. Clinical response was monitored during 1 week of dietary treatment and absorption of macronutrients was estimated during a 72 h balance study. Twenty-one patients (81 %) recovered from diarrhoea within 7 d. There were significant relationships between nutritional indices, recovery, and absorption of total energy, fat and N. The absorption of fat, protein and carbohydrate in the better nourished controls without diarrhoea was significantly higher than in patients with persistent diarrhoea with better nutrition or malnutrition. The duration of diarrhoea was significantly longer in lighter patients (weight-for-age < 65% NCHS (1976) standard), in wasted patients (weight/height < 80% of NCHS) and those with mid upper arm circumference (MUAC) less than 110 mm. There were negative relationships between the period of recovery and the coefficient of absorption of fat (P < 0·001), total energy intake (P < 0·01) and MUAC (P < 0·05). Weight-for-age and MUAC showed most effective discriminative power for absorption of nutrients. However, the coefficients of absorption for carbohydrate were not different for any pair of nutritional groups. Absorption of all nutrients was also correlated negatively with severity of persistent diarrhoea on admission. The results of the present study indicate that a rice-based diet is highly effective in the management of persistent diarrhoea, while malnutrition aggravates nutrient malabsorption, increases duration and severity of diarrhoea and less severely malnourished patients do not absorb nutrients as well as healthy controls. Malnutrition and the initial severity of diarrhoea are significant determinants of clinical prognosis and nutrient absorption in persistent diarrhoea.

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Pathogenesis of rotavirus-induced diarrhea

1984

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The pathogenesis of diarrhea caused by rotavirus infection was studied in miniature swine piglets. The animals were inoculated orally with 2 X 10(7) plaque-forming units of porcine rotavirus (OSU strain). During the height of diarrhea, intestinal function was investigated by in vivo perfusion of a 30-cm segment of proximal jejunum and a 30-cm segment of distal ileum. Absorption of Na+ and water decreased and 3-O-methylglucose transport was markedly reduced, P less than 0.01 compared to control animals. Mucosal lactase and sucrase levels were depressed in both the jejunum and ileum, P less than 0.001. Na+,K+-ATPase activity was significantly depressed only in the ileum, P less than 0.001. These changes were associated with a marked reduction in villous height, suggesting that the diarrhea could be an osmotic diarrhea due to nutrient (carbohydrate) malabsorption. Fresh stool samples were obtained and analyzed immediately for NA+,K+, osmolarity, glucose, and lactose; the osmotic gap was also determined. Stool osmolarity continually increased from 248 +/- 20 mosm/liter prior to inoculation to 348 +/- 20 mosm/liter at 75 +/- 1 hr postinoculation (P less than 0.005); the majority of the fecal osmotic gap could be accounted for by the amount of lactose present in the stools. Stool sodium increased from 34 +/- 6 mM prior to inoculation to a maximum of 65 +/- 4 mM at 53 +/- 1 hr postinoculation, P less than 0.001. There was no significant change in potassium concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

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Intake and Absorption of Nutrients in Children With Cholera and Rotavirus Infection During Acute Diarrhea and After Recovery

Cited by 5 publications

References 0 publications

Undernutrition, the Acute Phase Response to Infection, and Its Effects on Micronutrient Status Indicators

Undernutrition, the Acute Phase Response to Infection, and Its Effects on Micronutrient Status Indicators

Persistent diarrhoea: efficacy of a rice-based diet and role of nutritional status in recovery and nutrient absorption

Pathogenesis of rotavirus-induced diarrhea

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