Nutritional status of children with undernutrition

Abstract

Objective. To assess nutritional status of children with undernutrition without chronic diseases.Patients and methods. Eighty one children without chronic diseases and with undernutrition aged 3 months to 17 years and 2 months, 41 boys (50.6 %), 40 girls (49.4 %), were examined. The anthropometry was assessed by WHO criteria. The complete blood count (n = 69), blood biochemistry (n = 62), insulin level and vitamin status were examined. Bioelectric impedance analysis (n = 58) and indirect respiratory calorimetry (n = 28) were performed. The food intake was assessed in 28 patients.Results. Mild undernutrition was diagnosed in 35 (43.2 %) children, moderate - in 30 (37 %), severe - in 16 (19,8 %) children. The stunting (Z-score height to age < -2) was revealed in 3 (3,7 %) children. Anemia was found in 4 (5.8 %) children, absolute lymphopenia - in 2 (2.9 %), hypoproteinemia in 8 (12.9 %), hypoalbuminemia - in 1 (1.5 %), hypocholesterolemia - in 7 (11.3 %), hypercholesterolemia - in 6 (9.7 %) children. None of children had hypoglycemia. Insulin was decreased in 9 (15.5 %) children. Deficiency of vitamin D was found in 11 (13.6 %) patients. Decrease of fat mass was found in 52 (89,7 %) patients, muscle mass - in 42 (72.4 %), active cell mass - in 18 (31 %), protein - in 37 (63.8 %), minerals - in 41 (70.7 %), total body water - in 36 (62.1 %) patients. Decrease of the phase angle (<4.4) was recorded in 13 (22,4 %) children. Resting energy expenditure was normal in 12 (42,8 %) patients. Carbohydrate oxidation rate was decreased in 20 (71,4 %) children, fat oxidation rate was increased in 15 (53,6 %), protein oxidation rate was normal in 15 (53,6 %) children. The food intake was characterized by low energy intake in 21 (75 %) children. Deficiency of protein, fat and carbohydrate intake were found in 42.9, 60.7 and 82.1 % patients, respectively. Low energy intake due to all macronutrients deficiency was revealed in 35.7 % children.Conclusion. Most children with undernutrition without chronic diseases have a decrease in fat and muscle body components, low energy value of diet and imbalance of macronutrients. Changes in resting metabolism were also revealed.