Absorption of macronutrients and nitrogen balance in children with dysentery fed an amylase-treated energy-dense porridge

The aim of this study was to determine the absorption of macronutrients and energy from an energy, dense diet liquefied with amylase from germinated wheat (ARF) in children suffering from acute dysentery. Thirty male children aged 6-35 months presenting with acute dysentery were randomly assigned to receive either an ARF-treated porridge or a standard porridge liquefied with water to make its consistency similar to the ARF porridge. After 24-h stabilization a 72-h metabolic balance was performed. Sixteen children received an ARF-treated porridge and 14 received a standard porridge liquefied with water. The mean ± SD coefficients of absorption (%) of carbohydrate, fat, protein and energy (ARF porridge vs regular porridge) were 81.4 ± 11 vs 86.9 ± 7, 86.1 ± 10 vs 82.8 ± 15, 57.3 ± 12 vs 48.4 ± 24 and 81.4 ± 9 vs 83.1 ± 8, respectively. The stool loss of carbohydrate, protein, fat and energy was similar in the two groups. The net absorption of energy was substantially greater in the ARF-fed than regular porridge-fed children (by 28%, p = 0.01). The nitrogen balance was 6.9 ± 3.4 mg kg^-1 d^-1 in the ARF porridge group and 1.1 ± 6.7 mg kg^- d^-1 in the regular porridge group (p = 0.01). These results show that, despite being hyperosmolar, an amylase-treated liquefied energy-dense porridge is absorbed as well as a regular porridge by malnourished children with severe dysentery. Consequently, its use substantially increased the absorption of a net amount of macronutrients and resulted in a better nitrogen balance. These results further support this innovative approach of feeding sick children in developing countries.