Protein-energy malnutrition in Northern Sudan: clinical studies

Department of Tropical Paediatrics, Liverpool School of Tropical Medicine, England.
European Journal of Clinical Nutrition (Impact Factor: 2.71). 10/1988; 42(9):787-96.
Source: PubMed


The medical history, clinical features and investigations of 145 children with kwashiorkor were compared with 113 marasmic kwashiorkor, 158 marasmic children and 186 nutritionally normal controls of similar age admitted to hospital in Khartoum. Factors in the group with protein-energy malnutrition (PEM) which could relate to aetiology include: a history of prolonged illness and anorexia, frequent and prolonged episodes of diarrhoea and recent measles. The delay in achievement of developmental milestones in PEM children probably reflects the frequent and chronic illnesses in this group. An episode of previous oedema was reported in 22 per cent of marasmic kwashiorkor, 12 per cent of kwashiorkor and 12 per cent of marasmic children. Though hair and mucosal changes and enlarged liver were more common in the marasmic kwashiorkor and kwashiorkor groups, they were also common in marasmic children. There was no significant difference in behaviour (apathy, irritability, anorexia) between kwashiorkor and marasmic children. The classical skin changes of kwashiorkor were only seen in the oedematous children. The mortality was 19 per cent in kwashiorkor, 35 per cent in marasmic kwashiorkor, and 14.5 per cent in the marasmic group. The major differences between marasmus and kwashiorkor children were that the kwashiorkor children were reported larger at birth, achieved more normal developmental milestones, were taller and had larger head circumference than the marasmic children. The implications of these findings in relation to aetiology are discussed.

23 Reads
  • Source
    • "In most developing tropical countries the food situation is worsening owing to increasing population; shortage of fertile land, high prices of available staples and restrictions on the importation of food (Sadik, 1991; Weaver, 1994). This has resulted in a high incidence of hunger and malnutrition, a situation in which children and women, especially pregnant and lactating women, are most vulnerable (Coulter et al., 1988; Pelletier, 1994). Predictions of future rates of population increase and food production emphasize the seriousness of this problem (FAO, 1990). "
    [Show abstract] [Hide abstract]
    ABSTRACT: ‘Oze’ ( Bosqueia angolensis ) found in the tropical rain forest grows in thick humid forest of undisturbed land and belongs to the family Moracea . Wholesome ‘oze’ ( Bosqueia angolensis ) seeds were given different treatments, which included blanching, cooking, roasting and malting. Malting was carried out by soaking for 24 h, germinated for 3 weeks and then dried and milled. The samples obtained from these treatments were analyzed for their functional properties. The emulsion capacity of raw ‘oze’ seeds was 6.6 ml while the oil and water absorption capacities were 8.9 ml and 7.8 ml respectively. The ‘oze’ seed flour samples had reasonable increases in the proximate composition, amino acid profile and most of the functional properties. The high emulsion, oil and water absorption capacities of the malted samples showed that ‘oze’ seed flour would be good as sausage extenders.
    Preview · Article · Aug 2010 · Pakistan Journal of Nutrition
  • Source
    • "Studies pertaining to the search of alternative source of nutrition and protein quality are of great importance in tropical developing countries to alleviate hunger and malnutrition particularly in children and pregnant women, as they are most vulnerable (Coulter et al., 1988; Pelletier, 1994). It is known that the cereal diets in developing countries deprive humans from indispensable amino acids and energy (Young and Pellet, 1990). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Raw and processed (roasted and pressure-cooked) seeds of mangrove wild legume (Canavalia cathartica) of southwest coast of India were evaluated for nutritional and antinutritional qualities. The seeds consist of 28–32% proteins and 1600–1630 kJ/100 g of energy. A significant difference was seen between the proximate composition of raw and pressure-cooked seeds (P<0.05, t-test). Among the minerals, potassium was highest (240–828 mg/100 g) followed by phosphorus (84–120 mg/100 g) and sodium (21–41 mg/100 g). Globulins (18.2%) constituted the bulk of the seed proteins followed by albumins (7.3%) as in most of the legumes. Unlike the pressure-cooked seeds, SDS-PAGE revealed three protein bands in roasted seeds (51.4, 39 and 33.1 kDa) indicating partial or complete denaturation. The essential amino acids (EAA): cystine+methionine of processed seeds exceeded than that of rice; cystine+methionine, tyrosine+phenylalanine and lysine of the roasted seeds and cystine+methionine of pressure-cooked seeds were higher than FAO/WHO pattern. Threonine, valine and isoleucine of roasted seeds were comparable to FAO/WHO pattern, so also valine, isoleucine and lysine of pressure-cooked seeds. The carbohydrates, polyunsaturated/saturated fatty acid ratio and sulphur-amino acids were higher than soybeans. The raw seed flours were devoid of tannins and trypsin inhibitors, in addition, thermal processing decreased total phenolics and hemagglutinins. Growth and nitrogen balance studies in rats were performed to determine food efficiency ratio, protein efficiency ratio, net protein retention (NPR), protein retention efficiency (PRE), true digestibility, biological value (BV) and net protein utilization (NPU) of roasted and pressure-cooked seeds. Pressure-cooked seeds showed better biological indices than roasted seeds. Except for NPR, PRE, BV and NPU, rest of the parameters analyzed for protein quality was significantly different between roasted and pressure-cooked seed diet (P<0.05, t-test). Our study clearly indicated that Canavalia cathartica seeds of mangroves possess high protein and EAA. Even though domestic roasting and pressure-cooking partially detoxified con A-like lectins or hemagglutinins, improved methods of processing are essential to maximize the quality of protein with minimum loss of seed nutrients. This is the first study on the biochemical and protein quality evaluation of mangrove bean, Canavalia cathartica and warrants its conservation and utilization as a future potential protein source for humans and or livestock.
    Full-text · Article · Jun 2006 · Journal of Food Composition and Analysis
  • Source
    • "Malnutrition in children and lactating women in developing countries is common, due to inadequate supply of protein diets, and this is of great concern to scientists and governments (Coulter et al., 1988; Olsen, 1975; Pelletier, 1994). Such protein requirements, where animal protein is inadequate, can be compensated using wild legumes adapted to adverse conditions (Amubode & Fetuga, 1983; Rao, 1994; Siddhuraju, Vijayakumari, & Janardhanan, 1992; USNAS, 1975; Vadivel & Janardhanan , 2001). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Seeds of a wild legume, Canavalia cathartica collected from coastal sand dunes of the southwest coast of India were processed (roasted and cooked) and analyzed for proximate composition, mineral constituents, protein fractions, amino acid profiles, fatty acids and some antinutritional factors. Raw, roasted and cooked seeds contained 35.5%, 30.5% and 29.2% crude protein; 52.8%, 65.3% and 65.4% crude carbohydrates; 1.3%, 1.4% and 1.4% crude lipids; 1.7%, 1.6% and 1% crude fibre and 3.1%, 3% and 3.1% ash, respectively. Among the minerals, potassium was the highest (895, 821 and 190 mg/100 g), followed by phosphorus (137, 112 and 99 mg/100 g) and calcium (84, 70 and 44 mg/100 g). Among the true protein fractions of raw seeds, globulins (18.3 g/100 g) and albumins (7.3 g/100 g) were the major seed proteins. Essential amino acids, threonine, valine, methionine + cystine, isoleucine, leucine, phenylalanine + tyrosine and lysine, were above the FAO/WHO pattern in raw seeds. In roasted and cooked seeds, essential amino acid score ranged between 54 (threonine) and 224 (methionine). Essential amino acids, leucine, phenylalanine and lysine, in raw seeds were more than those of whole egg protein, soybean and rice. Total phenolics slightly declined in cooked seeds. Seeds did not possess tannins and trypsin inhibitors. Proteins of raw seeds possessed strong hemagglutination activity, which was lowered in processed seeds. The current study demonstrated that seeds of C. cathartica were high in protein, essential amino acids and low in saturated fatty acids and anti-nutritional factors.
    Full-text · Article · Sep 2005 · Food Chemistry
Show more