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Protein quantity, not protein quality, accelerates whole-body leucine kinetics and the acute-phase response during acute infection in marasmic Malawian children

Published online by Cambridge University Press:  09 March 2007

M. J. Manary ,
K. E. Yarasheski ,
S. Smith ,
E. T. Abrams  and
C. A. Hart
M. J. Manary*
Affiliation:
College of Medicine, University of Malawi, Private Bag 360, Blantyre 3, Malawi Departments of Pediatrics and Internal Medicine, Washington University School of Medicine, St Louis, MO 63110, USA
K. E. Yarasheski
Affiliation:
Departments of Pediatrics and Internal Medicine, Washington University School of Medicine, St Louis, MO 63110, USA
S. Smith
Affiliation:
Departments of Pediatrics and Internal Medicine, Washington University School of Medicine, St Louis, MO 63110, USA
E. T. Abrams
Affiliation:
Department of Anthropology, University of Michigan, Ann Arbor, MI 48109, USA
C. A. Hart
Affiliation:
Department of Medical Microbiology, University of Liverpool, Liverpool, L69 3GA, UK
*
*Corresponding author: Dr Mark J. Manary, fax +1 314 454 4345, email [email protected]
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Abstract

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The present study compared leucine kinetics and acute-phase-protein concentrations in three groups of marasmic, acutely infected Malawian children fed one of three isoenergetic diets. These were: an enhanced-protein-quality diet (egg-white+tryptophan, providing 1.2 g protein/kg per d; n 14); an increased-protein-content diet (egg-white+tryptophan, providing 1·8 g protein/kg per d; n 14); a standard-protein diet (1·2 g milk protein/kg per d; n 25). The hypotheses tested were that children receiving a diet with more protein would have greater rates of non-oxidative leucine disposal and that children receiving an isonitrogenous diet with a higher protein quality would have lower rates of leucine oxidation. The children were studied after 24 h of therapy using standard [13C]leucine stable-isotope tracer techniques. The children receiving the higher-protein-content diet had greater leucine kinetic rates than those receiving the standard-protein-content diet; non-oxidative leucine disposal was 170 (SD 52) v. 122 (SD 30) μmol leucine/kg per h (P<0·01). Leucine oxidation was less in the children receiving the enhanced-protein-quality diet than in those receiving the standard-protein-quality diet; 34 (SD 12) v. 45 (SD 13) μmol leucine/kg per h (P<0·05). The children receiving the high-protein-content diet increased their serum concentration for five of six acute-phase proteins 24 h after starting therapy, while those receiving the standard-protein-content diet did not. These data suggest that there was greater whole-body protein synthesis, and a more vigorous acute-phase response associated with the higher-protein-content diet. The clinical benefits associated with a higher protein intake in marasmic, acutely infected children need further study.

Keywords

MalnutritionTherapyProteinAcute-phase response
Type
Research Article
Information
British Journal of Nutrition , Volume 92 , Issue 4 , October 2004 , pp. 589 - 595
Copyright
Copyright © The Nutrition Society 2004

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