title: Lysine requirements of moderately undernourished school-aged Indian children are reduced by treatment for intestinal parasites as measured by the indicator amino acid oxidation technique.
abstract: BACKGROUND
  Lysine requirements of well-nourished children from developing regions have been found to be similar to those of children from developed regions (33.5 mg · kg⁻¹ · d⁻¹). However, intestinal parasites have been shown to increase lysine requirements in undernourished adults, and it is not known if a similar phenomenon occurs in undernourished children from poor and unsanitary environments.
  
  
  OBJECTIVE
  Our objective was to measure the lysine requirement of moderately undernourished school-aged Indian children by the indicator amino acid oxidation technique before and after successful treatment for intestinal parasites.
  
  
  METHODS
  Twenty-one undernourished school-aged children (∼8 y of age) with z scores between -2 SD and -3 SD for height-for-age or weight-for-age, who tested positive for intestinal parasites, were studied before and after successful antiparasite treatment. Children were fed any 2 of 7 levels of lysine intakes (5, 15, 25, 35, 50, 65, and 80 mg · kg⁻¹ · d⁻¹) in random order. The lysine requirement was determined by applying a 2-phase linear regression crossover analysis on the fractional oxidation rate of the tracer L-[1-¹³C] phenylalanine in response to the graded lysine intakes.
  
  
  RESULTS
  The lysine requirement of undernourished children with intestinal parasite infestations was determined to be 42.8 mg · kg⁻¹ · d⁻¹ (95% CI: 32.6, 53.1 mg · kg⁻¹ · d⁻¹), and after successful antiparasitic treatment it was determined to be 35.5 mg · kg⁻¹ · d⁻¹ (95% CI: 25.5, 45.5 mg · kg⁻¹ · d⁻¹). The results were significantly different (P < 0.05), although the 95% CIs overlapped.
  
  
  CONCLUSIONS
  The lysine requirement in undernourished children is similar to that of well-nourished children, and intestinal parasitic infestation increased the lysine requirement by ∼20%.
authors.affiliation: Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India;
authors.forename: Raja R
authors.initials: RR
authors.lastname: Pillai
authors.affiliation: The Research Institute, Hospital for Sick Children, Toronto, Canada; relango@cfri.ubc.ca.
authors.forename: Rajavel
authors.initials: R
authors.lastname: Elango
authors.affiliation: Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada; and.
authors.forename: Ronald O
authors.initials: RO
authors.lastname: Ball
authors.affiliation: Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India;
authors.forename: Anura V
authors.initials: AV
authors.lastname: Kurpad
authors.affiliation: The Research Institute, Hospital for Sick Children, Toronto, Canada; Department of Pediatrics and Nutritional Sciences, University of Toronto, Toronto, Canada.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Pencharz
mesh_terms: D000977:Antiparasitic Agents / Q000627:therapeutic use; D001827:Body Height; D001835:Body Weight; D002247:Carbon Isotopes; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena; D003906:Developing Countries; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007201:Indicator Dilution Techniques; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D008239:Lysine / Q000008:administration & dosage* / Q000378:metabolism; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000378:metabolism* / Q000469:parasitology / Q000503:physiopathology; D009751:Nutritional Requirements; D010084:Oxidation-Reduction; D010649:Phenylalanine / Q000008:administration & dosage / Q000378:metabolism*; D011204:Poverty Areas; D015995:Prevalence; D012720:Severity of Illness Index
chemical_list: D000977:Antiparasitic Agents; D002247:Carbon Isotopes; D010649:Phenylalanine; D008239:Lysine
keywords: IAAO; intestinal parasites; lysine; requirement; undernourished children