Protein Metabolism in Chronic Infantile Malnutrition (Kwashiorkor)

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Abstract
In trying to explain the causes for plasma hypoalbuminemia in severely malnourished children, increased rate of degradation and disturbances of protein absorption or retention can reasonably be eliminated. The deficient protein synthesis seems to be due to the low ingestion of a poorly absorbed and poorly retained diet. “Diarrhea” causes in some children diminution of the nitrogen absorption, but it appears that it is the common practice of reducing the food intake to a minimum during the bouts of diarrhea which lead to an acute lack of precursors superimposed on an already chronically depleted organism. Preliminary experiences show that supplements of lysine and tryptophan improve the biologic value of the corn and bean diet. No beneficial effect on the absorption or retention of nitrogen could be demonstrated when cow's milk was supplemented with l-lysine. Data on free amino acids of blood plasma seem to support the hypothesis that phenylalanine hydroxylase is deficient in children with chronic severe malnutrition of the kwashiorkor type.