Search

Prolonged diarrhea is a major cause of infant mortality throughout the world, with US mortality at 45 percent of affected children. The cause of the disorder is unknown, but it is associated with intestinal malabsorption of nutrients and consequent malnutrition. Protracted diarrhea has been treated by total intravenous feeding, but this is not feasible in developing countries. The alternative of a semielemental diet, a formula containing basic food nutrients (amino acids, fatty acids and sugars) rather than whole foods, is more easily implemented in such areas. It has been thought that fat malabsorption may be one feature of protracted diarrhea; consequently, the fat content of semielemental formulas has usually been restricted. However, for infants at risk for malnutrition and poor growth, fats may provide an important source of calories. The effect of a high-fat semielemental diet was compared with that of a regular semielemental diet in 20 children with protracted diarrhea of infancy from Buffalo, New York and 30 similarly affected children from Bangkok, Thailand. Children in Buffalo given the experimental diet gained an average of 28 grams per day, while those on the standard diet gained only 20 grams per day. Two children from the experimental group and one from the regular group were rehospitalized for recurrent diarrhea and dehydration. Children in Bangkok on either diet improved, as indicated by growth in weight, height, and head circumference. However, the total weight gain of children who received the high-fat diet was significantly greater. These children also showed significant improvement in mid-arm muscle mass. These findings suggest that infants with protracted diarrhea benefit from a high-fat elemental diet. Further research is needed to determine the optimal fat sources and fat content for infants with persistent diarrhea. (Consumer Summary produced by Reliance Medical Information, Inc.)