Serum Amino Acids of Children on High and Low Protein Intakes

I T IS generally accepted that kwashiorkor arises from the use of starchy foods un-supplemented by sufficient protein in the diets of children after weaning. The diets may be deficient in total protein, in essential amino acids, or in both. In some regions, caloric intakes may be adequate; ‘ in others, as in South India, weaning diets are often deficient in calories as well as in protein.2’3 In populations in which kwashiorkor affects a small percentage of children, many others, without demonstrable signs of the syndrome, are in a suboptimal state of protein nutrition, as is evident from their retardation of growth. In India, as in a number of developing countries, the growth rate of children is considerably below western standards. The growth of rural children lags behind that of urban children, and both grow at rates considerably below those of Indian children from well to do families.4 Such data suggest strongly that frank kwashiorkor is the obvious expression of widespread protein-calorie deficiency. Biochemical indices (particularly serum al-bumin concentration) are readily available to document protein deficiency of the child with overt kwashiorkor. However, serum protein levels in the moderately undersized child may differ only slightly from those in well nourished children, and are not necessaril