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OCR for page 31
APPEND IX
ENERGY NEEDS FOR RECOVERY FROM THE EFFECTS OF DIARRHEA
Tables A-1 and A-2 present the subcommittee's
estimates of the amounts of energy that must be consumed
for various periods to petit nutritional recovery after
diarrhea. The figures are based on several assumptions
regarding weight loss during illness (0, 250, or 500 g),
preillness nutritional status (95%, 90Z, or 80% of
expected weight for length), and period of recovery to
preillness weight or to 95% of expected weight for
length (5, 10, or 20 days).
Examination of the tables suggests the following
general conclusions:
The estimates for required energy intake for no
weight loss during illness and for children initially at
95% of expected weight for length are reasonably close
to the FAo/WH014 recommendations for age. The FAD/WHO
are 110, 105, and 100 kcal/day for ages of 6, 12,
values
and 24 months, respectively.
A smaller daily weight gain and hence a lower
daily energy consumption are acceptable if the recovery
period is longer.
.
Younger children must gain more weight daily, and
hence consume more energy, than older children for any
given set of assumptions regarding severity of
illness-induced weight loss, nutritional status, or
duration of recovery.
0 To reach normal weight, children who were already
undernourished must gain more weight daily than
adequately nourished children, if gain is expressed as a
fraction of body weight; thus, they must consume more
energy.
— 31
OCR for page 32
· Younger children, especially if undernourished
before illness, with greater illness-induced weight loss
usually require more than 2 weeks of convalescence to
replace lost weight and substantially more time to
achieve 95% of expected weight for length.
· Even older children require more than 2 weeks to
recover nutritionally if they were already
undernourished, particularly if the goal is to achieve
95% of expected weight for length.
To relate Table 2 to Tables A-1 and A-2, one would
have to correct the densities in Table 2 for the desired
energy intake per day. For example, a 6 month-old child
whose preillness weight for length was 90% of expected
and who lost 250 g during illness would require 166
kcal/kg-day or 1195 kcal/day to recover the lost weight
in 5 days. Such a child would require a minimal energy
intake of 80 kcal/100 ml--1001195 kcal per day/6/250 ml
if receiving six feedings per day. Because the maximal
energy density usually recommended for young children
100 kcal/100 ml, it is obvious that more feedings per
day would be required to achieve some of the higher
growth rates shown in Tables A-1 and A-2.
- 32
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