title: Protein Quality and Growth in Malnourished Children.
abstract: BACKGROUND
  Protein quality refers to the amounts and ratios of essential amino acids in a food. Two methods most commonly used for determining protein quality are the protein digestibility-corrected amino acid score (PDCAAS) and the digestible indispensible amino acid score (DIAAS).
  
  
  OBJECTIVE
  To use existing literature to compare different amino acid profiles and PDCAAS and DIAAS scores in individuals with acute inflammation and to assess their relationship with weight gain in children with severe acute malnourished (SAM).
  
  
  METHODS
  A series stable isotope studies were previously conducted in children with SAM and acute infection, and these data were reviewed with respect to protein synthesis. Eleven published treatment trials for SAM with different therapeutic foods were analyzed to examine the relationship between protein quality scores with weight gain (g/kg/d). Protein scores were calculated with the PDCAAS and DIAAS amino acid reference patterns. A DIAAS score adjusted for the higher weight gain expected in malnourished children was also used. Bivariate correlation analysis was used to examine this relationship.
  
  
  RESULTS
  The protein kinetic data supported the hypothesis that a balance of amino acids that matches the composition of acute-phase proteins maximizes amino acid synthesis. Protein quality scores were highly correlated with the rate of weight gain in recovery from SAM, and the DIAAS scoring system adjusted for the higher expected weight gain had the strongest correlation with the observed weight gain.
  
  
  CONCLUSIONS
  Protein quality scores must account for physiologic status so that they better match with needs and thus better promote health.
authors: Department of Pediatrics, Washington University, St Louis, MO, USA Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA manary@kids.wustl.edu.
authors: Mark
authors: M
authors: Manary
authors: Department of Pediatrics, Washington University, St Louis, MO, USA.
authors: Meghan
authors: M
authors: Callaghan
authors: Department of Pediatrics, Washington University, St Louis, MO, USA.
authors: Lauren
authors: L
authors: Singh
authors: Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark Department for International Health, University of Tampere School of Medicine, Tampere, FD, USA.
authors: André
authors: A
authors: Briend
mesh_terms: D000209:Acute-Phase Proteins / Q000096:biosynthesis; D000596:Amino Acids / Q000008:administration & dosage / Q000032:analysis; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism; D002675:Child, Preschool; D004044:Dietary Proteins / Q000008:administration & dosage*; D004063:Digestion; D005502:Food; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000150:complications / Q000378:metabolism; D007249:Inflammation / Q000378:metabolism; D009751:Nutritional Requirements; D009753:Nutritive Value; D015430:Weight Gain
chemical_list: D000209:Acute-Phase Proteins; D000596:Amino Acids; D004044:Dietary Proteins
keywords: children; growth; malnutrition; protein quality; severe acute malnutrition