Body Composition in Severe Infantile Malnutrition.

In Jamaica infantile malnutrition is most serious among children about 1 year old. The clinical picture may be of the marasmic or the kwashiorkor type, and intermediate forms often occur (1). Waterlow (2) suggested that the essential result of malnutrition was to produce protein depletion in the child, and many attempts have been made to measure the extent of this depletion. Chemical analysis of biopsy samples of liver, muscle, and skin (3-5) and measurement by isotope dilution techniques of total body water (6) and total exchangeable potassium (7) in malnourished children have indicated that there is a decrease in total protein and potassium and an increase in water, particularly extracellular water. The effect on body composition of a low protein diet has been carefully studied in the rat (8-13) and in the pig (14). Waterlow, Cravioto, and Stephen (15) have reviewed the available evidence from human and animal studies and have postulated a body composition for a normal, a malnourished, and a treated child aged 1 year. However, we are not aware of a whole body analysis of any child, normal or malnourished, between birth and 4j years of age. We have been very fortunate in obtaining, through the co-operation of the Department of Anatomy of the University of the West Indies, the bodies of nine children between the ages of 6 and 16 months. Five of these children died from malnutrition, and the other four were relatively well nourished. We have, therefore, been able to examine the changes in body composition produced by malnutrition in human infants.