This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. We tested the hypotheses that the rate of CO2 production is less in marasmic children with acute infection when compared to wellnourished children, but greater when compared to uninfected marasmic children. Fiftyseven children were studied, 28 with marasmus and acute infection, 17 with marasmus, and 12 wellnourished with acute infection. Those with acute infection had malaria, pneumonia or sepsis. The rate of CO2 production was measured using a stable isotope tracer dilution method while the children received feedings. The rate of CO2 production was normalized to the predicted basal metabolic rate, expressed as a ratio. Wellnourished children with acute infection produced more CO2 than marasmic children with or without infection (1.76 0.42 vs 1.46 0.35 and 1.56 0.24, p 0.05). However the rate of CO2 production in marasmic children with acute infection was not greater than in uninfected marasmic children. Regression analyses found that malaria and weightforhe ight Z score were significant predictors of the rate of CO2 production. Energy expenditure was greater than the dietary energy intake (440 kJkg1d1 vs 418 kJkg1d1). The correlation between wasting and the rate of CO2 production provides evidence that there is a metabolic mechanism to conserve energy when nutrients are scarce, and the findings concerning malaria suggest that specific infections effect energy metabolism differently.
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