Hoare S, Poppitt S D, Prentice A M, Weaver L T
MRC Dunn Nutrition Group, Keneba, The Gambia.
Br J Nutr. 1996 Oct;76(4):479-90. doi: 10.1079/bjn19960057.
Diarrhoea is a major cause of short-term growth faltering in children of the developing world. If catch-up weight gain is delayed by inadequate dietary intake, or by further bouts of diarrhoea, progressive growth failure occurs. To test the hypothesis that early refeeding is as effective as later feeding after acute diarrhoea with weight loss, we measured the effects of a timed dietary intervention on weight gain after acute diarrhoea in underweight Gambian children. Thirty-four children aged 4-22 months with weight loss following acute diarrhoea were given a high-energy-protein supplement for 14 d beginning either immediately after rehydration or a fortnight later. With a 50% increase in energy intake and a 100% increase in protein intake there was a rapid and highly significant (P < 0.001) gain in weight within a fortnight whether the supplement was given immediately or 2 weeks after presentation. Rates of weight increase were similar whether supplementation was provided early or late, but over the full 28 d (of intervention and non-intervention) children who received late supplementation had greater overall weight gain (P < 0.02) than those supplemented early. Vigorous and early feeding with a high-energy-protein supplement should be central to the management of malnourished children with acute diarrhoea in developing countries, and may be as important as control of diarrhoea in preventing malnutrition and growth failure. This may be achieved in the community using locally available foods, in the face of continuing diarrhoea.
腹泻是发展中国家儿童短期生长发育迟缓的主要原因。如果因饮食摄入不足或再次腹泻导致体重追赶延迟，就会出现渐进性生长发育不良。为了验证急性腹泻伴体重减轻后早期重新喂养与晚期喂养效果相同这一假设，我们测量了限时饮食干预对体重不足的冈比亚儿童急性腹泻后体重增加的影响。34名4 - 22个月因急性腹泻导致体重减轻的儿童，在补液后立即或两周后开始接受为期14天的高能量蛋白质补充剂。无论补充剂是在补液后立即给予还是在出现症状两周后给予，能量摄入量增加50%且蛋白质摄入量增加100%的情况下，两周内体重都迅速且极显著地增加（P < 0.001）。早期或晚期补充时体重增加速度相似，但在整个28天（干预期和非干预期）内，晚期补充的儿童总体体重增加幅度（P < 0.02）大于早期补充的儿童。对于发展中国家患有急性腹泻的营养不良儿童，积极早期给予高能量蛋白质补充剂应是管理的核心，在预防营养不良和生长发育不良方面，这可能与控制腹泻同样重要。面对持续腹泻的情况，在社区中使用当地可得的食物即可实现这一点。
