Absorption of nutrients from an energy-dense diet liquefied with amylase from germinated wheat in infants with acute diarrhea

Abstract

Addition of a small amount of amylase rich flour (ARF) to a thick porridge instantly liquefy the porridge and increase the energy intake even by sick children. The present study examined the absorption of macronutrients and calorie from an energy dense diet liquefied with ARF in children aged 6-11 months with acute watery diarrhea. METHODS: After adequately hydrated with oral rehydration fluid over a period of 24 hours, children were randomly assigned to receive either an ARF treated liquefied porridge (test diet) or a porridge diluted with water (control diet). A 72-hour metabolic balance was performed to determine the absorption of carbohydrate, fat, protein, and calorie. RESULTS: Thirteen infants received the test diet, and 15 infants received the control diet. The intake of protein (g/kg/d), carbohydrate (g/kg.d), fat (g/kg.d) and calorie (kJ/kg.d) were 1.97, 20.6, 4.3 and 548 respectively in the test group and those in the control group were 1.12, 13.3, 2.8 and 356. The stool loss of protein, carbohydrate and fat were comparable in the two groups. The absorption coefficient (%) of carbohydrate, fat and energy were 69.6, 61.3 and 65.4 in the test group and were 73.2, 58.6 and 66.7 in the control group. The coefficient of absorption of protein was significantly higher in the test group (37.7% vs. 21.7%). The mean (95% CI) nitrogen balance (g/kg.d) in the test and control groups were 0.064 (0.026, 0.102) and -0.029 (-0.055, 0.003) respectively. CONCLUSIONS: The results suggest that energy dense diet liquefied with ARF was well absorbed in children with acute diarrhea and there was a positive nitrogen balance that may have a positive impact in preventing weight loss during acute illness.

PIP: A case-control study conducted in Bangladesh indicates that an energy-dense diet liquefied with amylase-rich flour (ARF) is well absorbed in children with acute diarrhea and may prevent weight loss. The addition of only 2 grams of ARF per 100 grams of porridge increases the cereal's osmolality without increasing its volume. 28 boys, 6-11 months old, with acute watery diarrhea, who were rehydrated at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) were randomly assigned to receive either ARF-treated liquefied porridge (test diet) (n = 13) or porridge diluted with water (control diet) (n = 15). A 72-hour metabolic balance indicated that mean intakes of protein, carbohydrate, fat, and energy were significantly greater (p 0.001) in the test group (1.97 gm/kg/d, 20.6 gm/kg.d, 4.3 gm/kg.d, and 548 kJ/kg.d, respectively) than among control infants (1.12 gm/kg/d, 13.3 gm/kg.d, 2.8 gm/kg.d, and 356 kJ/kg.d, respectively). The absorption coefficients of protein, carbohydrate, fat, and energy were 37.7%, 69.6%, 61.3%, and 65.4%, respectively, in the test group and 21.7%, 73.2%, 58.6%, and 66.7%, respectively, in the control group. The protein energy ratios in the test and control diets were 6.0 and 4.8, respectively. Stool losses of carbohydrate, fat, and nitrogen were comparable in both groups. The nitrogen balance was positive in the test group (0.064 gm/kg.d) and negative in the control group (-0.029 gm/kg.d). Finally, although the duration of diarrhea was similar in both groups, the median weight change was 0 in the test group and -12.4 gm/kg in the control group.