Protein status in relation to linear growth faltering and environmental enteropathy.

Abstract

Children with linear growth faltering refractory to nutritional management show evidence of environmental enteropathy, which may compromise nutrient availability. Protein could be particularly affected, due to the possibility of sub-optimal digestibility and/or increase in requirement for immune response. This increase in protein requirement along with poor intake could potentially lead to increased breakdown of body protein sources and in turn a depleted protein state. The present review focuses on protein status in children at risk of linear growth faltering and environmental enteropathy. One pig study is also presented. There is consistent evidence of low circulating essential and conditionally essential amino acids, in children. One study showed no difference in protein synthesis/breakdown, and fat free mass (FFM) in children at risk of linear growth faltering and environmental enteropathy. Weanling pigs exposed to nutrient deprivation showed a decrease in plasma albumin, with a slower rate of weight and length accretion, and a lower FFM. These findings emphasize the need for improving intake of high-quality protein in children living in regions with a high prevalence of environmental enteropathy, with careful studies of the effect on growth rate and protein status.