Malnourished children treated in day-hospital or outpatient clinics exhibit linear catch-up and normal body composition.
The nutritional programming hypothesis proposes that early life malnutrition is related to an increase in body fat later in life. Brazilian boys and girls (n = 94; 4-14 y old) were studied. Malnourished children treated in a Nutrition Recovery Center, were followed up and divided into 2 groups: the Outpatient group (recovered after outpatient care, n = 28), and the Day-hospital group (recovered after day-hospital care, n = 38). They were compared with a Control group (healthy individuals without intervention, n = 28). Nutritional recovery was confirmed by anthropometry. Body composition was evaluated by dual-energy X-ray absorptiometry. Both recovered groups had a greater increase in height-for-age Z-scores than in weight-for-age Z-scores after treatment (P < 0.03). Body fat mass (kg) and the percentage of body fat were significantly lower in recovered groups of girls and boys compared with controls. Among boys, lean mass/height (kg/cm), fat-free mass (kg) and the fat-free mass index (kg/m(2)) were significantly lower in the Outpatient and Day-hospital groups than in Controls, but girls did not differ. Bone mineral content (BMC)/height (g/cm) did not differ between the recovered girls and the girls in the Control group (P < 0.15) or between the boys in the Day-hospital group and those in the Control group (P = 0.06). The Outpatient boys group had lower BMC/height than boys in the Control group (P = 0.02). This study demonstrates that when malnourished children receive adequate treatment, linear catch-up growth occurs and is followed by appropriate gain in lean body mass and BMC.
Department of Medicine, Discipline of Nephrology, Federal University of São Paulo, Brazil.
Janaina
J
das Neves
Paula A
PA
Martins
Ricardo
R
Sesso
Ana L
AL
Sawaya
D000273:Adipose Tissue / Q000033:anatomy & histology; D000293:Adolescent; D000375:Aging / Q000502:physiology; D000554:Ambulatory Care Facilities; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D001938:Brazil; D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D005500:Follow-Up Studies; D006761:Hospitals; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000503:physiopathology*; D012016:Reference Values; D012727:Sex Characteristics; D012959:Socioeconomic Factors