Fat absorption in malnutrition
fat and malnutrition Janet-Marie Huddle 19.06.97
fat and malnutrition André Briend 24.06.97

From: Janet-Marie_Huddle/CANO/WorldVision_at_WVCAN-NOTESatWorldvision.CA

Date: Thu, 19 Jun 97 08:51:06 EST

Subject: fat and malnutrition


Is there any evidence for impaired fat absorption during recovery from malnutrition among children under 5?

Tue, 24 Jun 1997 12:01:56 +0200 (METDST)

From: briendatext.jussieu.fr (Andre' BRIEND)

Subject: fat and malnutrition


A few word to respond to Janet's query re: fat absorption in malnutrition.

There is indeed a pancreatic dysfunction in severe malnutrition leading to malabsorption. Apparently, lipase production is more depressed than amylase production which makes fat malabsorption presumably more common than CHO malabsorption. (see Am J Clin Nutr 1988; 48: 1233-8 Exocrine pancreatic function and protein-calorie malnutrition in Dakar and Abidjan (West Africa): silent pancreatic insufficiency). This is the rationale for giving low fat high CHO diets at the first few days of the treatment of severe malnutrition.

In practice though, fat malabsorption is indeed a problem only in most severe cases and during the first few days of treatment. F100 diet (and its ancestors) with 50-55% energy coming from fat have been used for the last 20 years or more to successfully feed hundreds of thousands (if not millions) of malnourished children in the recovery phase without major problem. Breast milk too brings 55% of its energy from fat. Actually, fat is convenient because it raises energy density of feeds without having any effect on their osmolarity.

Dr. André Briend