title: Dietary supplementation with aromatic amino acids increases protein synthesis in children with severe acute malnutrition.
abstract: Although 2 earlier studies reported that aromatic amino acid (AAA) supplementation of children with severe acute malnutrition (SAM) improved whole-body protein anabolism during the early postadmission (maintenance) phase of rehabilitation, it is not known whether this positive effect was maintained during the catch-up growth and recovery phases of treatment. This study aimed to determine whether supplementation with an AAA cocktail (330 mg · kg(-1) · d(-1)) vs. isonitrogenous Ala would improve measures of protein kinetics in 22 children, aged 4-31 mo, during the catch-up growth and recovery phases of treatment for SAM. Protein kinetics were assessed by measuring leucine, phenylalanine, and urea kinetics with the use of standard stable isotope tracer methods in the fed state. Supplementation started at the end of the maintenance period when the children were clinically/metabolically stable and continued up to full nutritional recovery. Three experiments were performed: at the end of maintenance (at ∼13 d postadmission), at mid-catch-up growth (at ∼23 d post- admission when the children had replenished 50% of their weight deficit), and at recovery (at ∼48 d postadmission when they had achieved at least 90% weight for length). Children in the AAA group had significantly faster protein synthesis compared with those in the Ala group at mid-catch-up growth (101 ± 10 vs. 72 ± 7 μmol phenylalanine · kg(-1) · h(-1); P < 0.05) and better protein balance at mid-catch-up growth (49 ± 5 vs. 30 ± 2 μmol phenylalanine · kg(-1) · h(-1); P < 0.05) and at recovery (37 ± 8 vs. 11 ± 3 μmol phenylalanine · kg(-1) · h(-1); P < 0.05). We conclude that dietary supplementation with AAA accelerates net protein synthesis in children during nutritional rehabilitation for SAM.
authors.affiliation: USDA/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.
authors.forename: Jean W
authors.initials: JW
authors.lastname: Hsu
authors.forename: Asha
authors.initials: A
authors.lastname: Badaloo
authors.forename: Lorraine
authors.initials: L
authors.lastname: Wilson
authors.forename: Carolyn
authors.initials: C
authors.lastname: Taylor-Bryan
authors.forename: Bentley
authors.initials: B
authors.lastname: Chambers
authors.forename: Marvin
authors.initials: M
authors.lastname: Reid
authors.forename: Terrence
authors.initials: T
authors.lastname: Forrester
authors.forename: Farook
authors.initials: F
authors.lastname: Jahoor
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D024322:Amino Acids, Aromatic / Q000008:administration & dosage*; D001835:Body Weight; D002648:Child; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007554:Isotopes; D007732:Kwashiorkor / Q000178:diet therapy* / Q000534:rehabilitation; D008297:Male; D008954:Models, Biological; D014176:Protein Biosynthesis; D011502:Protein-Energy Malnutrition / Q000178:diet therapy* / Q000534:rehabilitation; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015430:Weight Gain
chemical_list: D024322:Amino Acids, Aromatic; D007554:Isotopes