Dietary supplementation with aromatic amino acids improves net protein synthesis in children with severe acute malnutrition during hospitalization

Abstract

The stress of infection in children with severe acute malnutrition (SAM) imposes a metabolic demand for increased synthesis of acute phase proteins which have a higher content of aromatic amino acids (AAA), phenylalanine (Phe), tyrosine and tryptophan. We investigated whether supplementation with an AAA cocktail (330 mg·kg−1·d−1 ) compared with isonitrogenous amounts of alanine (ALA) would improve measures of protein kinetics in 22 (11 with AAA, 11 ALA) children with SAM (age 4–31 mo) during treatment for SAM. Protein kinetics were assessed by measuring Phe kinetics in the fed state using a primed‐continuous infusion of 13C‐Phe. Supplementation started after the baseline experiment at the end of maintenance period (Phase 1) and continued to recovery. The 2nd and 3rd experiments were done at mid‐catch up growth when the children had replaced 50% of their weight deficit (Phase 2) and at recovery (Phase 3). Phase 1 Phase 2 Phase 3 AAA ALA AAA ALA AAA ALA Phe Kinetics μmol·kg−1·h−1 Total Intake 18±1 18±0.4 81±2 a 42±2 74±3a 35±2 Flux 48±4 53±5 60±5 47±6 81±15 72±13 NOD 7.5±2 9.8±1 32±5a 12±1 35±10a 23±3 Balance 12±2 10±2 49±5a 31±2 37±8a 11±3 Mean±SEM; NOD = Non‐oxidative disposal significantly different from ALA group in same phase, P < 0.05 We conclude that dietary supplementation with AAA improves net protein synthesis in children with SAM.Supported by NIH Grant # 5R01DK75018