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Diarrhea and Malnutrition pp 161–173Cite as

Diarrhea and Nutrient Requirements

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Abstract

Any discussion of protein and energy requirements arising from the occurrence of diarrhea is complicated by a number of factors, not the least of which is an incomplete understanding of these requirements in healthy individuals.1–8 Protein and energy requirements vary considerably as a function of age, sex, size of frame, rate of growth, activity, and genetic makeup.8 The variation in requirements is likely to increase considerably when the effects of disease, injury, and/or prior malnutrition become factors in the equation.9–12 Thus, it may not be possible, based on available knowledge, to establish absolutely the protein and energy requirements occasioned by diarrhea. However, it may still be feasible to develop operational guidelines for assessing the relative nitrogen and energy depletion in various forms of diarrhea as well as for judging the success of nutrient repletion.

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References

  1. Scrimshaw, N. S. Shattuck lecture—Strengths and weaknesses of the committee approach. An analysis of past and present recommended dietary allowances for protein in health and disease. N. Engl. J. Med. 294:136–142; 198–203, 1976.

    Article  CAS  Google Scholar 

  2. Rand, W. M., Scrimshaw, N. S., and Young, V. R. Determination of protein allowances in human adults from nitrogen balance studies. Am. J. Clin. Nutr. 30:1129, 1977.

    CAS  Google Scholar 

  3. Ghadimi, A., and Tejani, A. Protein and amino acid requirements. In: Total Parenteral Nutrition: Premises and Promises, A. Ghadimi (Ed.). pp. 213–230 John Wiley, New York, 1975.

    Google Scholar 

  4. Irwin, M. I., and Hegsted, D. M. A conspectus of research on protein requirements of man. J. Nutr. 101:385, 1971.

    CAS  Google Scholar 

  5. Swaminathan, M., and Parpia, H. A. B. Human protein requirements. Nutr. Rep. Int. 3:39, 1971.

    Google Scholar 

  6. Gentz, J., and Persson, B. Energy metabolism. In: Total Parenteral Nutrition: Premises and Promises, A. Ghadimi (Ed.), pp. 9–22 John Wiley, New York, 1975.

    Google Scholar 

  7. Food and Nutrition Board. Recommended Dietary Allowances, 9th ed., pp. 16–29. National Academy of Sciences/National Research Council, Washington, D.C., 1980.

    Google Scholar 

  8. Young, V. R., and Scrimshaw, N. S. Genetic and biological variability in human nutrient requirements. Am. J. Clin. Nutr. 32:486, 1979.

    CAS  Google Scholar 

  9. Wilmore, D. W. The Metabolic Management of the Critically III. Plenum Medical, New York, 1977.

    Google Scholar 

  10. Wilmore, D. W., and Kinney, J. M. Panel report on nutritional support of patients with trauma or infection. Am. J. Clin. Nutr. 34:1213, 1981.

    CAS  Google Scholar 

  11. Elwyn, D. H., Gump, F. E., Munro, H. N., Iles, M., and Kinney, J. M. Changes in nitrogen balance of depleted patients with increasing infusions of glucose. Am. J. Clin. Nutr. 32:1597, 1979.

    CAS  Google Scholar 

  12. MacLean, W. C, Jr., and Graham, C. G. The effect of energy intake on nitrogen content of weight gained by recovering malnourished infants. Am. J. Clin. Nutr. 33:903, 1980.

    CAS  Google Scholar 

  13. Mata, L. J., Kromal, R. A., Urrutia, J. J., and Garcia, B. Effect of infection on food intake and the nutritional state: Perspectives as viewed from the village. Am. J. Clin. Nutr. 30:1215, 1977.

    CAS  Google Scholar 

  14. McCaffery, T. D., Nasr, K., Lawrence, A. M., and Kirsner, J. B. Severe growth retardation in children with inflammatory bowel disease. Pediatrics 45:386, 1970.

    CAS  Google Scholar 

  15. Werlin, S. L. Growth failure in Crohn’s disease: An approach to treatment. JPEN 5:250, 1981.

    Article  CAS  Google Scholar 

  16. Heird, W. C., and Greene, H. L. Panel report on nutritional support of pediatric patients. Am. J. Clin. Nutr. 34:1223, 1981.

    CAS  Google Scholar 

  17. Colin, R., Hecketsweiler, P., Galmiche, J-P., Le Bihan, M., and Geffroy, Y. Etude de l’absorption intestinale dans la maladie de Crohn. Gastroenterol. Clin. Biol. 2:705, 1978.

    CAS  Google Scholar 

  18. Chen, K. M. Massive resection of the small intestine. Surgery 65:931, 1969.

    CAS  Google Scholar 

  19. Bodwell, C. E., Schuster, E. M., Kyle, E., Brooks, B., Womack, M., Steele, P., and Ahrens, R. Obligatory urinary and fecal nitrogen losses in young women, older men and young men and the factorial estimation of adult human protein requirements. Am. J. Clin. Nutr. 32:2450, 1979.

    CAS  Google Scholar 

  20. Cheng, A. H. R., Gomez, A., Bergan, J. G., Lee, T. C., Monckeberg, F., and Chichester, C. O. Comparative nitrogen balance study between young and aged adults using three levels of protein intake from a combination wheat-soy-milk mixture. Am. J. Clin. Nutr. 31:12, 1978.

    CAS  Google Scholar 

  21. Fomon, S. J., Thomas, L. N., Filer, L. J., Anderson, T. A., and Bergmann, K. E. Requirements for protein and essential amimo acids in early infancy. Acta Paediatr. Scand. 62:33, 1973.

    Article  CAS  Google Scholar 

  22. Holt, E., and Fales, H. L. The food requirements of children. II. Protein requirements. Am. J. Dis. Child. 22:371, 1921.

    CAS  Google Scholar 

  23. MacLean, W. C., Jr., and Graham, G. G. The effect of level of protein intake in iso-energetic diets on energy utilization. Am. J. Clin. Nutr. 32:1381, 1979.

    CAS  Google Scholar 

  24. Martorell, R., Yarbrough, C., Yarbrough, S., and Klein, R. E. The impact of ordinary illnesses on dietary intakes of malnourished children. Am. J. Clin. Nutr. 33:345, 1980.

    CAS  Google Scholar 

  25. Hoyle, B., Yunus, M., and Chen, L. C. Breast-feeding and food intake among children with acute diarrheal diseases. Am. J. Clin. Nutr. 33:2365, 1980.

    CAS  Google Scholar 

  26. Chung, A. W., and Viscorová, B. The effect of early oral feeding versus early oral starvation on the course of infantile diarrhea. J. Pediatr. 33:14, 1948.

    Article  CAS  Google Scholar 

  27. Briscoe, J. The quantitative effect of infection on the use of food by young children in poor countries. Am. J. Clin. Nutr. 32:648, 1979.

    CAS  Google Scholar 

  28. Wollaeger, E. E., Comfort, M. W., and Osterberg, A. E. Total solids, fat and nitrogen in the feces. III. A study of normal persons taking a test diet containing a moderate amount of fat; comparison with results obtained with normal persons taking a test diet containing a large amount of fat. Gastroenterology 9:272, 1948.

    Google Scholar 

  29. Holt, L. E., Courtney, A. M., and Fales, H. L. The chemical composition of diarrheal as compared with normal stools in infants. Am. J. Dis. Child. 9:213, 1915.

    Google Scholar 

  30. Wollaeger, E. E., Comfort, M. W., Weir, J. F., and Osterberg, A. E. The total solids, fat and nitrogen in the feces. I. A study of normal persons and of patients with duodenal ulcer on a test diet containing large amounts of fat. Gastroenterology 6:83, 1946.

    CAS  Google Scholar 

  31. Willimas, H. H., Endicott, E. N., Shepherd, M. L., Galbraith, H., and Macy, T. G. Fat excretion by normal children. J. Nutr. 25:379, 1943.

    Google Scholar 

  32. Stier, L. B., Taylor, D. D., Pace, J. K., and Eisen, J. N. Metabolic patterns in preadolescent children. IV. Fat intake and excretion. J. Nutr. 73:347, 1961.

    CAS  Google Scholar 

  33. Brown, K. H., Gilman, R. H., Khatun, M., and Ahmed, M. G. Absorption of macro-nutrients from a rice-vegetable diet before and after treatment of ascaris in children. Am. J. Clin. Nutr. 3:1975, 1980.

    Google Scholar 

  34. MacLean, W. C., Klein, G. L., de Romana, G. L., Massa, E., and Graham, G. G. Transient steatorrhea following episodes of mild diarrhea in early infancy. J. Pediatr. 92:562, 1978.

    Article  Google Scholar 

  35. Gomez, F., Galván, R. R., Cravioto, J., Frenk, S., Santaella, J. V., and De La Pena, C. Fat absorption in chronic severe malnutrition in children. Lancet ii:121, 1956.

    Article  Google Scholar 

  36. Carpenter, C. C. J. Cholera (Asiatic cholera). In: Cecil Textbook of Medicine, 15th ed., P. B. Beeson, W. McDermott, and J. B. Wyngaarden (Eds.), pp. 460–462, W. B. Saunders, Philadelphia, 1979.

    Google Scholar 

  37. Mahalanabis, D. Nitrogen balance during recovery from secretory diarrhea of cholera in children. Am. J. Clin. Nutr. 24:1548, 1981.

    Google Scholar 

  38. Gorbach, S. L. Typhoid fever. In: Cecil Textbook of Medicine, 15th ed., P. B. Beeson, W. McDermott, and J. B. Wyngaarden (Eds.), pp. 446–449, W. B. Saunders Co., Philadelphia, 1979.

    Google Scholar 

  39. Coleman, W., and DuBois, E. F. Clinical calorimetry. VII. Calorimetric observations on the metabolism of typhoid patients with and without food. Arch. Intern. Med. 15:887, 1915.

    Article  CAS  Google Scholar 

  40. Beisel, W. R., Sawyer, W. D., Ryll, E. D., and Crozier, D. Metabolic effects of intracellular infections in man. Ann. Intern. Med. 67:744, 1967.

    CAS  Google Scholar 

  41. Powanda, M. C. Changes in body balances of nitrogen and other key nutrients: Description and underlying mechanisms. Am. J. Clin. Nutr. 30:1254, 1977.

    CAS  Google Scholar 

  42. Beisel, W. R. Infectious diseases: Effect on food intake and nutrient requirements. In: Nutrition: Metabolic and Clinical Applications, R. E. Hodges (Ed.), pp. 329–346, Plenum, New York, 1979.

    Google Scholar 

  43. MacLean, W. C, Jr., de Romana, G. L., Massa, E., and Graham, C. G. Nutritional management of chronic diarrhea and malnutrition: Primary reliance on oral feeding. J. Pediatr. 97:316, 1980.

    Article  Google Scholar 

  44. Spady, D. W., Payne, P. R., Picou, D., and Waterlow, J. C. Energy balance during recovery from malnutrition. Am. J. Clin. Nutr. 29:1073, 1976.

    CAS  Google Scholar 

  45. Powanda, M. C., and Beisel, W. R., Hypothesis: Leukocyte endogenous mediator/ endogenous/pyrogen/lymphocyte-activating factor modulates the development of nonspecific immunity and specific immunity and affects nutritional status. Amer. J. Clin. Nutr. 35:762, 1982.

    CAS  Google Scholar 

  46. Walker, J., Roberts, S. L., Halmi, K. A., and Goldberg, S. C. Caloric requirements for weight gain in anorexia nervosa. Am. J. Clin. Nutr. 32:3196, 1979.

    Google Scholar 

  47. Pullar, J. D., and Webster, A. J. F. The energy cost of fat and protein deposition in the rat. Br. J. Nutr. 27:355, 1977.

    Article  Google Scholar 

  48. Holt, E., and Fales, H. L. The food requirements of children. I. Total caloric requirements. Am. J. Dis. Child. 21:1, 1921.

    CAS  Google Scholar 

  49. Jensen, K. B., Golterman, N., Jarnum, S., Weeke, B., and Westergaard, H. IgM turnover in Crohn’s disease. Gut 11:223, 1970.

    Article  CAS  Google Scholar 

  50. Kelts, D. G., Grand, R. J., Shen, G., Watkins, J. B., Werlin, S. L., and Boehme, C. Nutritional basis of growth failure in children and adolescents with Crohn’s disease. Gastroenterology 76:720, 1979.

    CAS  Google Scholar 

  51. Ladefoged, K., Nicolaidou, P., and Jarnum, S. Calcium, phosphorus, magnesium, zinc and nitrogen balance in patients with severe short bowel syndrome. Am. J. Clin. Nutr. 33:2137, 1980.

    CAS  Google Scholar 

  52. Aly, A., Barany, F., Kollberg, B., Monsen, U., Wisen, O., and Johansson, C. Effect of an H2-receptor blocking agent on diarrhoeas after extensive small bowel resection in Crohn’s disease. Acta Med. Scand. 207:119, 1980.

    Article  CAS  Google Scholar 

  53. Read, N. W., Miles, C. A., Fisher, D., Holgate, A. M., Kime, N. D., Mitchell, M. A., Reeve, A. M., Roche, T. B., and Walker, M. Transit of a meal through the stomach, small intestine and colon in normal subjects and its role in the pathogenesis of diarrhea. Gastroenterology 79:1276, 1980.

    CAS  Google Scholar 

  54. Mitchell, J. E., Breuer, R. I., Zuckerman, L., Berlin, J., Schilli, R., and Dunn, J. K. The colon influences ileal resection diarrhea. Dig. Dis. Sci. 25:33, 1980.

    Article  CAS  Google Scholar 

  55. Scrimshaw, N. S. Effect of infection on nutrient requirements. Am. J. Clin. Nutr. 30:1536, 1977.

    CAS  Google Scholar 

  56. Whitehead, R. G. Protein and energy requirements of young children living in the developing countries to allow for catch-up growth after infections. Am. J. Clin. Nutr. 30:1545, 1977.

    CAS  Google Scholar 

  57. Wilmore, D. W., Goodwin, C. W., Aulick, L. H., Powanda, M. C., Mason, A. D., Jr., and Pruitt, B. A., Jr. Effect of injury and infection on visceral metabolism and circulation. Ann. Surg. 192:491, 1980.

    Article  CAS  Google Scholar 

  58. Powanda, M. C., and Moyer, E. D. Plasma protein alterations during infection: Potential significance of these changes to host defense and repair systems. In: Infection: The Physiologic and Metabolic Responses of the Host, M. C. Powanda and P. G. Canonico (Eds.). Elsevier/North Holland, Amsterdam 1981, pp. 271–296

    Google Scholar 

  59. Powanda, M. C., and Moyer, E. D. Plasma proteins and wound healing. Surg. Gynecol. Obstet. 153:749–755, 1981.

    CAS  Google Scholar 

  60. Fuchs, R. J., Theis, C. F., and Lancaster, M. C. A nomogram to predict lean body mass in men. Am. J. Clin. Nutr. 31:673, 1978.

    CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Research Division, Cutter Laboratories, Berkeley, California, USA

    Elizabeth D. Moyer

  2. Department of the Army, Letterman Army Institute of Research, Presidio of San Francisco, California, USA

    Michael C. Powanda

Authors
  1. Elizabeth D. Moyer
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  2. Michael C. Powanda
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Editor information

Editors and Affiliations

  1. Ford Foundation, New Delhi, India

    Lincoln C. Chen

  2. Massachustts Institute of Technology, USA

    Nevin S. Scrimshaw (Institute Professor, Director, Senior Adviser) (Institute Professor, Director, Senior Adviser)

  3. MIT/Harvard International Food and Nutrition Program, USA

    Nevin S. Scrimshaw (Institute Professor, Director, Senior Adviser) (Institute Professor, Director, Senior Adviser)

  4. World Hunger Program, United Nations University, USA

    Nevin S. Scrimshaw (Institute Professor, Director, Senior Adviser) (Institute Professor, Director, Senior Adviser)

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© 1983 The United Nations University

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Moyer, E.D., Powanda, M.C. (1983). Diarrhea and Nutrient Requirements. In: Chen, L.C., Scrimshaw, N.S. (eds) Diarrhea and Malnutrition. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-9284-6_11

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  • DOI: https://doi.org/10.1007/978-1-4615-9284-6_11

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4615-9286-0

  • Online ISBN: 978-1-4615-9284-6

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