Journal
NUTRITION REVIEWS
Volume 74, Issue 1, Pages 48-58Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/nutrit/nuv058
Keywords
carbohydrate malabsorption; disaccharidase deficiency; F-75; lactose intolerance; malnutrition
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Funding
- National Institute for Health Research [CL-2012-18-005, ACF-2008-18-010] Funding Source: researchfish
- MRC [MR/M007367/1] Funding Source: UKRI
- Medical Research Council [MR/M007367/1] Funding Source: Medline
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Context: Severe acute malnutrition (SAM) accounts for approximately 1 million child deaths per year. High mortality is linked with comorbidities, such as diarrhea and pneumonia. Objective: The aim of this systematic review was to determine the extent to which carbohydrate malabsorption occurs in children with SAM. Data Sources: The PubMed and Embase databases were searched. Reference lists of selected articles were checked. Data Extraction: All observational and controlled intervention studies involving children with SAM in which direct or indirect measures of carbohydrate absorption were analyzed were eligible for inclusion. A total of 20 articles were selected for this review. Data Synthesis: Most studies reported carbohydrate malabsorption, particularly lactose malabsorption, and suggested an increase in diarrhea and reduced weight gain in children on a lactose-containing diet. As most studies reviewed were observational, there was no conclusive scientific evidence of a causal relationship between lactose malabsorption and a worse clinical outcome among malnourished children. Conclusion: The combined data indicate that carbohydrate malabsorption is prevalent in children with SAM. Additional well-designed intervention studies are needed to determine whether outcomes of SAM complicated by carbohydrate malabsorption could be improved by altering the carbohydrate/lactose content of therapeutic feeds and to elucidate the precise mechanisms involved.
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