Nutritional status of children with undernutrition

2021 
Objective . To assess nutritional status of children with undernutrition without chronic diseases. Patients and methods . Eighty one children without chronic diseases and with undernutrition aged 3 months to 17 years and 2 months, 41 boys (50.6 %), 40 girls (49.4 %), were examined. The anthropometry was assessed by WHO criteria. The complete blood count (n = 69), blood biochemistry (n = 62), insulin level and vitamin status were examined. Bioelectric impedance analysis (n = 58) and indirect respiratory calorimetry (n = 28) were performed. The food intake was assessed in 28 patients. Results . Mild undernutrition was diagnosed in 35 (43.2 %) children, moderate - in 30 (37 %), severe - in 16 (19,8 %) children. The stunting (Z-score height to age < -2) was revealed in 3 (3,7 %) children. Anemia was found in 4 (5.8 %) children, absolute lymphopenia - in 2 (2.9 %), hypoproteinemia in 8 (12.9 %), hypoalbuminemia - in 1 (1.5 %), hypocholesterolemia - in 7 (11.3 %), hypercholesterolemia - in 6 (9.7 %) children. None of children had hypoglycemia. Insulin was decreased in 9 (15.5 %) children. Deficiency of vitamin D was found in 11 (13.6 %) patients. Decrease of fat mass was found in 52 (89,7 %) patients, muscle mass - in 42 (72.4 %), active cell mass - in 18 (31 %), protein - in 37 (63.8 %), minerals - in 41 (70.7 %), total body water - in 36 (62.1 %) patients. Decrease of the phase angle (<4.4) was recorded in 13 (22,4 %) children. Resting energy expenditure was normal in 12 (42,8 %) patients. Carbohydrate oxidation rate was decreased in 20 (71,4 %) children, fat oxidation rate was increased in 15 (53,6 %), protein oxidation rate was normal in 15 (53,6 %) children. The food intake was characterized by low energy intake in 21 (75 %) children. Deficiency of protein, fat and carbohydrate intake were found in 42.9, 60.7 and 82.1 % patients, respectively. Low energy intake due to all macronutrients deficiency was revealed in 35.7 % children. Conclusion . Most children with undernutrition without chronic diseases have a decrease in fat and muscle body components, low energy value of diet and imbalance of macronutrients. Changes in resting metabolism were also revealed.
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